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Biomedical subjects

W Rakowski

Publications and source records attributed to W Rakowski.

At least 91 records · Page 5Linked to original sources
PubMed1976

Studies on lipolytic system of human placenta, blood lipids and lipid mobilizing activity in pregnant women and newborns.

Lipolytic activity of human placenta and lipid mobilizing activity (LMA), free fatty acids (FFA) as well as esterified fatty acid (EFA) levels in serum of pregnant women in different periods of pregnancy and in newborn's serum were studied. Lipolytic activity of human placenta is low in the first trimester of pregnancy and increases in samples examined after delivery. The levels of FFA and EFA in blood of pregnant women are significantly increased in the second and third trimester of pregnancy. The newborn's blood lipid level is significantly lower than that in the mother's blood. Lipid mobilizing activity in serum of pregnant women increases especially in the third trimester of pregnancy and is also high in newborn's blood. This may indicate that fatty acids released from newborn's adipose tissue are metabolized as a source of energy.

Adipose Tissue↗
PubMedDate not supplied

Training physicians to conduct physical activity counseling.

BACKGROUND: In accordance with the U.S. Preventive Services Task Force recommendations, the current pilot study tests the feasibility and efficacy of a physician-delivered physical activity counseling intervention. METHODS: A sequential comparison group design was used to examine change in self-reported physical activity between experimental (counseling and self-help materials) and control (usual care) patients at base-line and 6 weeks after the initial office visit. Patients in both groups were contacted by telephone 2 weeks after their office visit and asked about the physical activity counseling at their most recent physician visit. Experimental patients also received a follow-up appointment to discuss physical activity with their physician 4 weeks after their initial visit. RESULTS: Counseling was feasible for physicians to do and produced short-term increases in physical activity levels. Both groups increased their physical activity, but the increase in physical activity was greater for patients who reported receiving a greater number of counseling messages. CONCLUSIONS: Physician-delivered physical activity interventions may be an effective way to achieve wide-spread improvements in the physical activity of middle-aged and older adults.

Aged↗
PubMedDate not supplied

Integrating pros and cons for mammography and Pap testing: extending the construct of decisional balance to two behaviors.

BACKGROUND: The ability to study health-related behaviors in combination rather than singly will lead to a more comprehensive approach to health promotion. This investigation focused on mammography and Pap testing. One index was created to reflect the recency of receiving both examinations. A second index integrated opinions about the two procedures into a single measure, guided by the pros, cons, and decisional balance constructs of the Transtheoretical Model of behavior change. METHOD: Data were drawn from the baseline and 1-year follow-up surveys of an HMO sample of women ages 40-74 (N = 1,605). Data collection occurred by telephone. A series of analyses examined whether recency of screening was associated with opinions about screening. RESULTS: The first analysis showed that recency of Pap testing and whether or not a Pap test was obtained between the two surveys were associated with opinions about Pap testing. The next analysis examined the association between the indicator for regularity of both Pap testing and mammography, with the measure of opinions toward the two procedures. The variable measuring receipt of Pap test and mammography was associated with the combined measure of opinions. CONCLUSIONS: The ability to employ combined indicators for recency of testing and test-related opinions is promising for being able to take a more comprehensive approach to women's health. The paper discusses methodological considerations that arise when attempting to integrate two or more behaviors.

Adult↗
PubMedDate not supplied

A population-based survey of physician smoking cessation counseling practices.

BACKGROUND: To be most effective, physicians' smoking cessation interventions must go beyond advice, to include counseling and follow-up. A full profile of physician performance on the recommended activities to promote smoking cessation has not been provided previously. METHODS: We surveyed a representative sample of 246 community-based primary care physicians who had agreed to participate in a 3-year study to evaluate a strategy for disseminating smoking cessation interventions, based on the National Cancer Institute 4-A model and on the Transtheoretical Model of Change. RESULTS: A majority reported they Ask (67%) and Advise (74%) their patients about smoking, while few go beyond to Assist (35%) or Arrange follow-up (8%) with patients who smoke. The criteria for "thorough" counseling was met by only 27% of physicians. More than half were not intending to increase counseling activity in the next 6 months. After controlling for other variables, physicians in private offices were more likely than physicians in HMO or other settings to be active with smoking cessation counseling. General Internal Medicine physicians were most active, and Ob/Gyn physicians were least active, with smoking cessation counseling among primary care specialty groups. CONCLUSIONS: Innovative approaches are needed to motivate, support, and reward physicians to counsel their patients who smoke, especially when considering the movement toward managed health care. PRECIS: A survey of primary care physicians focusing on national guidelines for smoking cessation counseling showed a majority Ask (67%) and Advise (74%) patients about smoking, but few Assist (35%) or Arrange follow-up (8%).

Adult↗
PubMedDate not supplied

Increasing mammography among women aged 40-74 by use of a stage-matched, tailored intervention.

BACKGROUND: Tailoring is a promising technique for encouraging greater performance of health-related behaviors. Tailored interventions are designed to be more individualized to personal characteristics, in contrast to "standard" interventions where all participants receive the same materials. METHODS: A total of N = 1864 women aged 40-74 were recruited from a staff model HMO and randomly assigned to one of three intervention groups: (a) No Educational Materials, (b) Standard Materials, and (c) Stage-Matched Materials. A provider-directed component was common across all three conditions. The Standard and Stage-Matched groups each received two mailed educational packets after baseline and follow-up telephone interviews. The Stage-Matched intervention was based on the Transtheoretical Model of behavior change. RESULTS: Analyses of n = 1397 women (after all attrition) showed that receipt of mammography after the baseline interview was higher for the Stage-Matched group (63.6%) than for the No Materials group (54.9%; OR = 1.43, 95% CI = 1.10, 1.86). The Standard intervention group was intermediate (58. 5%). The Standard group did not differ from the No Materials group, but did differ from the Stage-Matched group in multivariate analysis. CONCLUSIONS: Stage-matched, tailored materials may be a means to encourage screening mammography. Such interventions can be implemented by telephone and mail.

Adult↗
PubMedDate not supplied

Smoking status and mammography in a statewide survey.

The association between smoking status and mammography was examined for women aged 40 to 75 (n = 2902), who were recruited through a statewide random digit dial survey. Controlling for income, education, age, marital status, ethnicity, and self-rated health, logistic regression showed that current smokers were less likely to be screened on each of three indicators of mammography status. Less than a high school education, income less than $20,000, martial status, and age also showed associations with screening. Having a recent medical visit was important for screening specifically among the women who smoked (n = 851). Smoking may pose a challenge to achieving national mammography goals.

Adult↗
PubMedDate not supplied

Comparability and reliability of techniques to assess personal future extension.

The diversity of existing procedures for assessing personal future time perspective requires that we establish whether the techniques used to operationalize even any one dimension are in fact comparable. A sample of 83 older women (mean age = 74.1 years) responded to a questionnaire containing four different techniques commonly employed for determining personal future extension--how far into the future a person is thinking: (a) open-ended thinking and planning; (b) line-marking; (c) line-drawing; and, (d) life-event listing. Results showed a pattern of correlations suggesting only borderline comparability. Same-session retesting of (a), (b), and (c) revealed relatively high correlations, with the exception of open-ended future planning. Based on these data, caution is advised when selecting a procedure to assess future extension.

Aged↗
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Attitude instrument analysis: an examination of factor consistency across two samples.

The factor analytic model of the practitioner-oriented opinions about people (OAP) was tested with a population of gerontological practitioners (N =558). A confirmatory factor analysis was performed to ascertain the degree-of-fit between these data and the published OAP factor model. After results supported the hypothesis that the two samples differed, a second factor analysis was designed to yield estimates of communalities by a least squares multiple regression technique. This analysis eliminated nine items not warranting inclusion in the instrument, redistributed the factors, and brought out a completely new factor. Finally, to test the hypothesis that attitudes toward aging and the aged are uncorrelated, a third analysis was performed in which the six scales of the oblique solution were refactored. The resulting higher order dimensions tended to support this hypothesis.

Aged↗
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Methodological considerations for research on late life future temporal perspective.

Several complications may be encountered by the investigator who wishes simply to "plug a future time perspective measure or two" into highly quantitative analyses. Difficulties in data collection appear to arise both from the complex nature of time perspective and from characteristics sometimes associated with older respondents themselves. Although an accompanying data base for empirically determining the most appropriate procedures is currently absent, it appears that an awareness of certain basic points can enhance the quality and accuracy of data collection. A number of these generic methodological considerations are discussed, and various suggestions are offered. Time perspective should not be considered a universal solution for every researchable issue in gerontology. Its strong face validity and literature to date should, however, encourage our addressing the methodological difficulties that exist.

Aged↗
PubMedDate not supplied

Correlates of expected success at health habit change and its role as a predictor in health behavior research.

Perceived ability to change health habits successfully is undoubtedly an important factor underlying personal health behavior. This report examines expected success in changing future habits, using a sample of community-resident adults 18-65 years of age (n = 1,367). One set of analyses used expected success as a dependent variable, whereas another set used it as an independent variable for health behavior and knowledge indices. In the dependent variable analysis, results showed that reported past success at health habit change was the strongest predictor of success expected in the future. Optimism about future success was also associated with variables that already placed individuals at an advantage to change behavior (e.g., not smoking, regular exercise, lower Body Mass Index, support in the family). When used as a predictor variable, expected future success was not associated with five health-related, self-report indices of behavior, knowledge, and perceived risk. Further examination showed, however, that in three instances the association between expected success and the outcome indices seemed to plateau in the most optimistic group. Extreme optimism (that admits no chance of failure) may be a belief characteristic that deserves further investigation, one that will present a challenge to research and practice. Men tended to report greater expected future success than women, although women had more favorable reports on three of the five health-related behavior/knowledge indices.

Adolescent↗