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M Adrian

Publications and source records attributed to M Adrian.

80 records · Page 5Linked to original sources

Can life expectancies be used to determine if health promotion works?

PURPOSE: The goal of this study was to develop a method to measure the impact and cost-effectiveness of health promotion. DESIGN: Age- and sex-specific changes in life expectancy in Canada between 1970 to 1972 and 1985 to 1987, after the introduction of national health insurance (1970) and health promotion (1975), are used to assess the impact due to biological hardiness, improvements in the health care field, and the effects of health promotion. SUBJECTS: The subjects were the total male and female population of Canada between the years 1970 to 1972 and 1985 to 1987. MEASURES: Life expectancy by years of age by sex was the measurement used. RESULTS: A method is presented that allows the calculation of the differential effects of health promotion, health care, and biological hardiness on changes in life expectancy based on sequential subtraction of life expectancies for one-year age cohorts over a 15-year period. Results were obtained for each year of age for men and women, showing gender and age differences in the relative impact of the three factors. In this illustrative example using Canadian data, health promotion was found to have less impact on longevity than health care or biological hardiness. However, of the three, health promotion was the most cost-effective. CONCLUSION: This method can be used to quantify changes in life span due to health promotion, health care, and biological hardiness for men and women at each year of age and to relate this to health expenditures for the whole population. The method is limited in that it cannot determine the relative impact of other factors that can affect life expectancy such as environmental changes or social trends.

Age Factors↗

[A biochemical and cytological explanation of cochlear otospongiosis].

Carrying on their study about the enzymatic activity of the otospongiotic micro-foci and the hydrolytic activity of the perilymph, the authors present their work concerning the value of trypsin and alpha-1-anti-trypsin in the perilymph of otospongiotic patients operated on by stapedectomy. They describe the method used and give the obtained results which permit to believe that the values of trypsin, and a contrario of anti-trypsin, appear to constitute an index of the severity of the progression. Moreover, the authors have investigated the eventual toxic action of various trypsin concentrations on the hair cells of the Corti organ in the guinea-pig. This study has been carried through successfully by means of the electron microscopic scanning method which allows to obtain an "electron cochleogramme in situ". They explain the method and come to the conclusion that the intensity and extension of the Corti hair cells alterations in a cochlea receiving a perfusion with trypsin solutions, are tightly related to the trypsin concentration. However, they do not pretend so far that these results reflect exactly the anatomo-pathologic reality during the slow progression of otospongiosis towards cochlear deterioration. These two series of experimentation appear to confirm their enzymatic concept of otospongiosis: the long, slow and extremely capricious progression of the disease is the duplicate of its cytologic progression, the contact between hydroltic enzymes and Corti cells having the same capricious character. These findings perfectly corroborate the previus ones they made in this field, as well as the correlations they have established between hydrolytic activity of the perilymph and audiometric progression. Consequently, they believe that the mechanism of the otospongiotic disease is provoked by the rupture of the balance trypsin/anti-trypsin in the otospongiotic micro-foci and thus in the inner ear fluids.

Animals↗