[Parameters of lipid metabolism in postmenopausal women on oral or transdermal hormone replacement with or without progesterone]. / Lipidstoffwechselparameter postmenopausaler Frauen unter oraler und transdermaler Hormonsubstitution mit oder ohne Gestagenzusatz vom Progesterontyp.

OBJECTIVE: Aim of the study was to show different influences of transdermal and oral hormone replacement therapies (conjugated and micronized estrogens) with or without varying dosages of C21-progestogens on serum lipids and lipoproteins. MATERIAL AND METHODS: We report on serum triglycerides, cholesterol, HDL-, LDL-cholesterol, apolipoprotein A 1 and B levels of 80 postmenopausal women, who received hormone replacement therapies for more than one year. RESULTS: All patients showed increasing (non-significant) serum HDL/LDL-cholesterol-ratios. Transdermal estrogen monotherapy also influenced the lipid parameters in a positive way. Apolipoprotein B, cholesterol and LDL-Cholesterol decreased, apolipoprotein A 1 increased. Transdermal replacement therapy combined with C21-progestagens and all oral therapies resulted in HDL-cholesterol increases. Positive changes in lipid parameters were most remarkably in women receiving oral therapies. The addition of 42 mg medrogestone/cycle caused a more significant decrease of cholesterol serum levels than higher dosages of medrogestone did. During subsequent treatment cycles, serum triglycerides showed increasing levels within the reference limits in women receiving conjugated estrogens and medrogeston. CONCLUSIONS: Transdermal and oral hormone replacement therapies with and without C21-progestogens are ideal for hormone replacement therapy in postmenopausal women with normal or minor pathological lipid parameters. The lowest possible medrogestone dose necessary for endometrium protection should be used.

Cognitive reactions to smoking relapse: the reciprocal relation between dissonance and self-esteem.

Perceptions of health risk associated with smoking, commitment to quitting, and self-concept were assessed among smokers before, during, and after their participation in cessation clinics. Consistent with expectations derived from cognitive dissonance theory, results indicated that relapsers' perception of risk declined after they resumed smoking, although the decline was significant only for relapsers with high self-esteem; high self-esteem relapsers experienced a significantly greater decline in commitment to quitting than did low self-esteem relapsers; and decline in risk perception among relapsers was associated with maintenance of self-esteem. The implications of these results for dissonance theory and the study of smoking relapse and cessation are discussed.

A longitudinal study of the reciprocal nature of risk behaviors and cognitions in adolescents: what you do shapes what you think, and vice versa.

Adolescents' reckless driving, drinking, and smoking, along with their cognitions about these behaviors, were assessed in a 3-year longitudinal design. Consistent with most models of health behavior, the results indicated that health cognitions predict risk behavior. In addition, the current data demonstrate that increases in risk behavior are accompanied by increase in perceptions of vulnerability and prevalence and by decreases in the influence of concerns about health and safety. Furthermore, the changes in prevalence estimates and concern about health and safety predicted subsequent risk behavior. These results demonstrate reciprocity between risk behaviors and related cognitions and suggest that adolescents are aware of the risks associated with their behavior but modify their thinking about these risks in ways that facilitate continued participation in the behaviors.

Adolescent health-threatening and health-enhancing behaviors: a study of word association and imagery.

PURPOSE: To examine the ways in which perceived risks and benefits relate to health-threatening and health-enhancing behaviors by adolescents. METHOD: The study used a word association methodology to explore adolescents' thoughts and affective feelings associated with five health-threatening behaviors (e.g., drinking beer, smoking cigarettes) and three health-enhancing behaviors (e.g., exercising, using a seat belt). RESULTS: Each behavior elicited a mix of positive and negative associations. Health-threatening behaviors had many positive associations in common, such as having fun, social facilitation, and physiological arousal. Health-enhancing behaviors had much less commonality in their positive associations. Patterns of negative associations were not highly similar across behaviors. The content and affective tone of the associations were closely linked to participation in health-threatening behaviors and health-enhancing behaviors. Participants in an activity were far more likely than nonparticipants to associate that activity with positive outcomes, concepts, and affect and less likely to produce outcomes, concepts, and affect and less likely to produce negative associations. CONCLUSIONS: The word association methodology provides a useful technique for exploring adolescents' cognitions and affective reactions with regard to health-related behaviors. The data provided by this method have implications for prevention and intervention programs, as well as for future research.

A psychometric study of adolescent risk perception.

Forty-one high-school students evaluated each of 30 activities (e.g. smoking, drinking, drug use, sex) on each of 14 characteristics of perceived risk and perceived benefit. They also indicated whether they themselves engaged in the activities. Adolescents who participated in an activity perceived the risks to be smaller, better known, and more controllable than did non-participants. Participants also perceived greater benefits relative to risks, greater peer pressure to engage in the activity, and a higher rate of participation by others. Implications for theory, research, and for health education and intervention programs are discussed.

Alcohol problems in later life: evaluation of a model community education program.

Described is the development and evaluation of a three hour multi-media community education program on alcohol problems in later life. Designed for families, older adults and service providers, the program provides information and skills needed to recognize and to take appropriate action with regard to alcohol abuse among the elderly. Compared to a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in response to alcohol problems.

Alcohol problems and depression in later life: development of two knowledge quizzes.

Effective measures of knowledge about mental health in later life are valuable in both needs assessments and educational program evaluations. Described is the development of two short, true/false quizzes, one on alcohol problems and one on depression and suicide in later life. These quizzes can be used to plan and evaluate community education programs on mental health problems in later life. Procedures for developing other knowledge assessments are presented.

A model community education program on depression and suicide in later life.

This paper describes the development and evaluation of a 3-hour multimedia community education program on depression and suicide in later life. Designed for families, older adults, and service providers, the program provides information and teaches skills needed to recognize and respond to depression and suicidal behavior in the elderly. Compared with a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in support of a depressed person.