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Biomedical subjects

A F Wessen

Publications and source records attributed to A F Wessen.

18 recordsLinked to original sources
PubMed1989

Blood pressure patterns and migration: a 14-year cohort study of adult Tokelauans.

The longitudinal relation between blood pressure changes and migration experience has been studied in a cohort of 654 adult Tokelauans through three survey periods between 1968 and 1982. Migration from a subsistence life-style on a Pacific atoll to an urbanized Western life-style in New Zealand is associated with increases in body mass in both men and women. Both the systolic and diastolic blood pressures of migrant men are significantly higher than would be expected in this cohort on the basis of age when compared with the nonmigrants. This is consistent with a rise around the time of migration to a level which is then maintained, with the diastolic pressures taking longer than the systolic pressures to respond to the migration stimuli. Most of this rise in blood pressure may be attributed to weight gain, but a significant part of the diastolic pressure excess remains unexplained. This pattern is not exhibited by the women, which may be a reflection of the sex roles in this Polynesian society. These findings indicate a need for new immigrants to be encouraged not to gain weight when confronted with new dietary choices.

Acculturation↗
PubMed1988

Medical student's access to information and resources for the residency selection process.

In the study reported here, the authors analyzed senior medical students' attitudes regarding the availability of information and resources pertaining to the residency selection process. Results of a nationwide survey of students showed that when the students had access to information from medical professionals (that is, faculty members, deans, house staff physicians), they felt they had greater access to information than did students who made greater use of other sources (official directories, classmates and the "grapevine"). Furthermore, the findings suggest that greater availability of information from medical professionals was related to higher levels of overall satisfaction with the residency match. While no evidence is presented that demonstrates that medical school faculty members and administrators were unwilling to devote attention to any particular group of students, the data suggest that these professionals provided information regarding the residency selection process more often to medical students at high-prestige schools, students who chose high-prestige specialties, and students who perceived themselves as having high class rank than to other students. Also, students in publicly supported schools felt the cost of travel for interviews to be more burdensome than did the students in private schools.

Attitude↗
PubMed1987

An analysis of medical students' residency and specialty choices.

The contemporary geographic maldistribution of physicians and shortages in some specialty areas is a persistent problem facing United States federal and state wide health planners. This paper attempts to illustrate some of the formal and informal processes of the selection of specialties and residency programs based on a survey of senior students of 37 selected American medical schools at the time of the National Residency Matching Program in 1982. Results of a factor analysis on influences on specialty choice produced two major clusters of medical students; those predominantly influenced in specialty choice by the faculty and other senior physicians (sponsorship), and those predominantly influenced by the social dimension of the physicians' role (social responsibility). These medical specialty choice orientations were also systematically related to either choice of specialty vs primary care medicine, to a life-style or status related choice of residency program, and to students' perceptions regarding a program's evaluation of a candidate. The results of the survey suggested that students who chose primary care were more apt to be influenced by sources outside of the medical school. These findings raise questions regarding the efficacy of medical school curriculum in motivating career choices in primary care. This is particularly important in view of the stated need to increase the proportion of medical school graduates choosing primary care careers.

Career Choice↗
PubMed1985

Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island Migrant Study.

The Pacific atoll population of Tokelau has been followed since 1968 to assess the health consequences of migration to a western society. The blood pressure of a cohort of 532 adults who were still living in Tokelau in 1976 (nonmigrants) are compared with those of a cohort of 280 adults who had migrated to New Zealand (migrants). Significant differences between migrants and nonmigrants were detected in the rates of change of both systolic and diastolic pressures in men, and in the rates of change of diastolic pressures in women. The age-, body mass, and blood pressure-corrected rates of change were greater in migrants than in nonmigrants, and greater in men than in women. Blood pressures tend to rise 1 mmHg/year faster among male migrants than among male nonmigrants, and about 0.4 mmHg/year faster among female migrants than among female nonmigrants. These findings have clear implications for the health of migrants.

Adolescent↗
PubMed1979

Correlations between appointment keeping and reorganization of hospital ambulatory pediatric services.

Over a period of 13 months before and after a university-affiliated hospital's daytime ambulatory pediatric facility was upgraded from an episodic care clinic to a primary care unit, 260 subjects were interviewed in an attempt to predict compliance with return appointment scheduling. The parents of patients more than 10 years of age were the least compliant, but most of the differences in compliance appeared due to the subject's evaluation of the diagnostic ability, thoroughness, and sympathy of the physician at the initial visit. Although no changes were noted in the subjects' demographic characteristics or in their general opinions of ambulatory health care delivery or of attitudes desired of physicians, their evaluations of recent visits improved and the missed appointment rate declined by 46% in the course of the study. Moreover, the pediatric house officers, who evaluated the patients, demonstrated an increased ability to assess the characteristics the subjects found important in physicians. Improvements are still needed, especially in the amount of communication between house officers, patients, and parents, but heeding clients' opinions about the provision of primary health care may help to make missed appointment rates negligible.

Adolescent↗