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Biomedical subjects

J M Robine

Publications and source records attributed to J M Robine.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Past and present asthma mortality: towards a shift in the secular trend?].

In recent years disconcerting observations have been published concerning changes in mortality from asthma in France and other countries. These conclusions are difficult to assess due to uncertainty regarding the underlying asthma mortality trends. We have attempted to address this question by constituting a statistical series of asthma deaths from 1925 to 1989. The 1925 to 1989 mortality trend is clearly decreasing. This decrease follows the same rhythm as the general mortality decline, since the proportion of asthma in total deaths remained between 3 to 4/1000. Three periods are emphasized: from 1925 to 1965 where the decreasing trend is interrupted by an important crisis in mortality, from 1965 to 1980 where the decrease is regular, and the last period since 1980 with an important crisis in 1985 and 1986; crisis applying to all genders and ages. The latest trend is uncertain. Careful epidemiologic surveillance will decide between a change in the secular trend or a transitory crisis and thus determine the cause(s). An effect due to the reinclusion by ICD 9 of a fluctuating component in asthma mortality cannot be excluded.

Abstracting and Indexing↗
PubMed1992

The relationship between age and the prevalence of senile dementia: a meta-analysis of recent data.

A linear regression model derived from a meta-analysis of 13 epidemiological studies of senile dementia conducted since 1980, and employing internationally-known case-finding procedures, suggests a much lower general rate of dementia prevalence than has been previously estimated. An exponential increase with age is observed, with senile dementia prevalence diagnosed by Diagnostic and Statistical Manual (DSM-III) criteria doubling every 6 years and senile dementia of the Alzheimer's type (SDAT) every 4.2 years. Studies providing data for the oldest ages indicating a drop in the rate of increase after the age of 80 suggest that senile dementia may be age-related rather than ageing-related. Estimates derived from this model may provide a reasonably accurate means of estimating dementia prevalence in the general population. The limitations of this method for the purposes of prediction and studies of risk factors are discussed in relation to the hypothesized heterogeneity of senile dementia and possible cohort effects.

Age Factors↗
PubMed1992

Measurement and utilization of healthy life expectancy: conceptual issues.

The periodic calculation of healthy life expectancies permits the evaluation of the impact of new health policies at a given moment, as well as the assessment of trends under changing health conditions. In spite of their apparent simplicity, the results obtained will have to be interpreted by experts. Useful reference values can be provided by international comparisons. However, several choices remain to be made, such as (i) the types of morbidity and disability data to be associated with mortality data; (ii) the multiple indicators available; (iii) the type of observations to be recorded, i.e., "abilities" or "performances"; (iv) whether or not the recovery of lost functions should be considered; (v) the mode of computation, i.e., life expectancy before the first morbid event or global healthy life expectancy; and (vi) the determination of thresholds based on either relative or absolute criteria.

Activities of Daily Living↗
PubMed1991

Healthy life expectancy: evaluation of global indicator of change in population health.

OBJECTIVE: To review and evaluate the usefulness of healthy life expectancy as a global indicator of changes in a population's health. DESIGN: Review of all known studies to date from the United States, mainland Europe, Canada, and the United Kingdom that have used Sullivan's method of calculating disability free life expectancy. MAIN OUTCOME MEASURES: Life expectancy and disability free life expectancy. RESULTS: Over the past decade the average healthy life expectancy was 60 years for men and 64 for women, with the proportion of years of disability ranging from 11% to 21% in men and from 14% to 24% in women. At the age of 65 men could expect eight years of disability free life and women 10, with the life expectancy being respectively 14 and 19 years. The difference between the wealthiest and poorest income quintiles was 6.3 years in life expectancy and 14.3 in disability free life expectancy for men and 2.8 and 7.6 respectively for women. These results suggest that disparities in health are greater between social groups than between the sexes. Diseases affect mortality and morbidity differently. The order of importance for affecting life expectancy was circulatory disease, cancer, and accidents and for disability free life expectancy, circulatory disease, locomotor disorders, and respiratory disorders. CONCLUSIONS: Healthy life expectancy is a valuable index for the appreciation of changes in both the physical and the mental health states of the general population, for allocating resources, and for measuring the success of political programmes. Future calculations should also take into account the probability of recovery and thus extend the applicability of the indicator to populations in poor health rather than focusing on the well population.

Age Factors↗
PubMed1989

[Longitudinal study of the functional capacity of aged persons in Upper Normandy, 1978-1985].

A longitudinal study of 1,082 elderly persons was conducted by INSERM over a six-year period in order to identify risk factor in pathological ageing. Several functional capacities were selected for study on the basis of their relevance to independent daily living. This article describes the methodology and the extent to which research objectives were able to be fulfilled. The initial survey took place in 1978-79. A follow-up study targeted two distinct areas of interest: the monitoring of mortality rates and the re-evaluation of the performance of survivors at three and six year intervals. Re-evaluation of performance involved the exploration of the individual's mobility, capacity to carry out activities of daily living etc. The consistency of the entire data set assembled over the six-year period was assessed in various ways. At six year follow-up survival rate could be determined for 98.8% of the initial cohort, and 87.1% of the survivors were able to be reinterviewed. The different probabilities of healthy survival, by sex and age, are tabulated in the appendices.

Activities of Daily Living↗
PubMed1989

[Estimating the value of disability-free life expectancy for western countries in the last decade. How can this new health status indicator be used?].

Disability-free life expectancy (DFLE) is an indicator of the mean duration of life in good health, based on the measurement of mortality combined with the measurement of disability. To date, some experimental calculations have been carried out mainly in Canada, England, France, the Netherlands and the United States of America. Taking these studies as a whole, disability-free life expectancy in the last decade can be estimated at about 59 years for men and about 63 years for women. The share of years of disability within life expectancy ranges from 11% to 27%. The calculations show that women suffer disability for a greater part of their life expectancy than men. The calculations also reveal social inequalities in health. Health authorities in Western countries are showing increasing interest in this indicator today. The main points in its favour are its simplicity in practice, its usefulness for determining objectives, allocating resources, measuring the success or failure of health policies, assessing current needs and defining future scenarios.

Aged↗
PubMed1987

[Risk and risk factors of disability in the aged].

Since 1978 the INSERM's Research (Unit-164) has been conducting a research programme on risk factors of mortality and disability. This study is based on a 5-year follow up of 4,200 elderly persons 60 and over in three regions of France. The aim is to provide the first results on 1082 people 65 and over living in upper Normandy. Initial level of disability appears the best predictive factor of 3-year mortality. Other predictive variables are age, sex, dyspnea during exertion and recent hospitalization. Pathologies reported by general practitioners are less informative on 3-year survival probability than variables related to frailty of subjects. The 5-year mortality is predicted by such pathologies as mental deterioration or cardio-respiratory diseases and age, sex, institutionalization and early smoking habits. The incidence of disability within 3 years is essentially predicted by pathologies: osteo-articular diseases (osteo-arthritis), mental deterioration and respiratory track diseases. These results favour a model of slow sequential decrease of health status, with mortality occurring after a long period of disability.

Aged↗
PubMed1987

[Indicators of disability-free life expectancy. Global indicators of the health status of populations].

Disability free life expectancy (DFLE) is an index of mean length of healthy life. It aims at measuring the evolution in the populations state of health. The first calculations were achieved at the end of the 60s and about ten experimental calculations have been made until now, mostly in the United States, Canada, Japan and France. Nowadays this index is very well accepted. Its major qualities are its usefulness for setting health targets and determining the present and future needs. Is DFLE destined for becoming a conjonctural index of health state? The circumstances are undoubtedly propitious. Nevertheless, in order to be used in routine the DFLE index must answer three conditions, which the current approach does not fulfil i.e. the viability of disability measurement for comparisons in time; a registration of period data which is based on the incidence of entrance in disability; a calculation which is adapted to the disability whether it is reversible or not.

Aged↗
PubMed1987

[The role of a cultural factor in the educational practices of mothers of young children].

Through 3 groups of mothers, defined as belonging to 3 different geographical areas which are considered to represent cultural heritage, a series of educational practices towards infant under one year of age was studied. Among factors acting on practices which further the infants' contacts with others and exploration of environment, the usual sociodemographic characteristics play a part which is not greater than the one of the personal mother's dynamic and mostly of the cultural context (geographical area), which occurs as the first variable in a stepwise regression. When the child is 3 years old, durability of the maternal behavior is brought to the fore. The authors discuss the repercussion of these differences on the future of the children belonging to each of these groups.

Child Rearing↗
PubMed1987

[Study of the factors associated with the inability to perform household tasks among aged persons on the Ile-de-France. Application to the sub-regional planning of home-help services].

The aim of this paper is to present the preliminary results of a planning project in the area of health and social services for the elderly, which makes it possible to estimate the number of persons likely to seek help from such services at the administrative area levels with decisional powers. This involves identifying predictors of disability from raw data routinely available in the census and at various administrative area levels, the municipality being the preferred level. From the epidemiological data collected at the regional level, an indicator of disability has been constructed. Initially, those factors possibly associated with disabilities were identified by regrouping the variables in four dimensions (discriminant analysis): socio-economic, physical environment, human environment, local administrative area environment (district data from census, medical-social services offered in the area, ect.). Subsequently, a logistic regression made it feasible to calculate the coefficients attached to these predictors of disability. In our sample, sex, age and level of housing amenities in the dwelling place appear to be predictors of disability. The application of the coefficients obtained at the region level--by means of an epidemiological approach to distributions by sex, age and dwelling amenities characterizing a municipality or group of municipalities (territorial approach)--enabled us to estimate the number of persons 65 and over likely to seek help from home-assistance services at whatever administrative area level chosen. In certain of its quantitative aspects, this mixed approach (individual and area) helps in determining need, the first step in the planning process.

Activities of Daily Living↗
PubMed1986

Problems encountered in using the concepts of impairment, disability, and handicap in a health assessment survey of the elderly in Upper Normandy.

Three types of difficulty in applying the ICIDH concepts in survey assessments of the health status of the elderly are described. There are conceptual problems related to the relationship and equivalence between handicap, performance, and functional ability. There are technical difficulties in operationalizing the concepts for development of a questionnaire for use in home surveys. Finally, there are problems when attempts are made to discern the role of environment in the development of handicap.

Activities of Daily Living↗
PubMed1985

[Breast feeding. Nature of the choice].

The choice of breast feeding was studied in a sample of 1,954 mothers of urban and rural areas investigated in 1978 during the first year of life of their child. Women who chose breast feeding were more often urban, highly educated, mothers of one child, well medically supervised and happy during pregnancy. They were more concerned by the way their child fed and about his general status. The group of women who stated that they could not breast-feed showed a high percentage of health problems. On the contrary, those who refused were in a good state of health.

Breast Feeding↗
PubMed1985

[Factors determining health practices: prenatal care in rural and urban environment].

A 1978 study of prenatal care patterns in one area of France showed that frequent visits to specialists was the dominant pattern in urban areas, whatever the socioeconomic characteristics, or conditions of health, of the women. In rural areas, however, the patterns adopted varied markedly according to health problems encountered during pregnancy. In the absence of illness, 64% of rural women went to their general practitioner for a reduced number of prenatal visits; when health problems were perceived, however, their practices became more similar to those of city women. These variations remained after allowing for socioeconomic and cultural differences. Overall, patterns adopted varied significantly according to area of residence.

Adult↗
PubMed1984

[Professional housekeeping aide for elderly persons. Needs, demand and beneficiaries].

Professional home help services (aide- menag ère) in France is one of the principal means to permit the disabled elderly to remain at home. For this reason, an evaluative study was conducted on existent needs of the inhabitants of one region: Upper-Normandy. The authors considered both demand and effective need among people concerned. At the time of the study (1979), 4.2% of the population 65 and older were beneficiaries of the service. The proportion of those who would have desired the service was then 14.7%--or 3.5 times higher. But the study of effective need provided a very different perspective: it concerned those unable to perform household tasks and also having no possibilities of help from the immediate family. If home assistance were limited to those not bedridden, having restricted ability to perform household tasks, and living alone, it would affect 17% of the elderly and would require 64,000 hours weekly, against 43,000 provided at the time of the survey. If other tasks were included (personal hygiene care, or care of the bedridden or of those unable to go out), the service would affect 24% of the population and would require 153,000 hours weekly. Based on the criteria applied, it appears that 20% of the service goes to those without effective need. Also, almost two-thirds of those needing the service state that they do not want it. The development of home help services in France must be considered in the framework of a global planning process of all services designed to enable the dependent elderly to remain at home.

Aged↗