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Biomedical subjects

G V Stimson

Publications and source records attributed to G V Stimson.

At least 73 records · Page 4Linked to original sources
PubMed1990

National survey of syringe exchange schemes in England.

This report gives information from an England wide survey of syringe exchange carried out in early 1989. A postal questionnaire was sent to 74 agencies, responses received from 65 (88%), of which 55 were agencies operating syringe exchanges. The development of syringe exchanges has been marked by lack of central coordination, supervision and direction, allowing for local autonomy sensitivity to local conditions and a resulting diversity of practices. Four service models were identified: schemes run by drug agencies; pharmacy-based schemes; specialist stand-alone schemes; and schemes based in non-drug agencies. The average number of different clients per week was 21 and it is estimated that they distributed about one million syringes in the year 1988/89. Pharmacy based schemes presented fewer barriers in terms of access but offered limited services on site, while drug agency schemes presented more barriers in terms of access, but offered more services. The significance of these differences is related to the aims of syringe exchange. In a public health orientation, ease of access to sterile injecting equipment would be the priority and the question of individual help in other areas less important. From a drug problems orientation, the ability to offer clients more services to respond to their wider needs would be a priority. It is estimated that by the end of 1989 there were approximately 120 syringe exchange schemes in England.

England↗
PubMed1989

Sexual behaviour of injecting drug users and associated risks of HIV infection for non-injecting sexual partners.

The sexual behaviour of 142 clients of syringe-exchange schemes was measured using a questionnaire interview based survey method. Two to four months later the questionnaire was repeated to provide measures of behavioural change. The majority of these clients were sexually active, 77% having one or more sexual partners in the 3 months prior to the first interview. Many of these clients (46% of those sexually active) had sexual partners who did not inject drugs. There is evidence that this group modified their sexual behaviour towards reducing their own risk of HIV infection, with more having no sexual partners (from 23% to 31%), a reduction in those having multiple partners (from 26% to 21%) and a slight increase in those with regular partners (from 49% to 52%). Not all clients in this group reduced their risk of infection by modifying their sexual behaviour. Some clients continued to engage in high risk sexual behaviour, having multiple partners (21%) and not using condoms (79%). Whilst overall there is evidence of changes in the sexual behaviour of the clients towards a reduced risk of infection, we have identified an associated increase in risk of transmission from them to their sexual partners. Drug injectors who continued to have sexual partners were more likely to have sexual partners who did not inject drugs.

Adult↗
PubMed1989

Changes in HIV risk behaviour in clients of syringe-exchange schemes in England and Scotland.

The impact of syringe-exchange schemes on the behaviour of injecting drug users was investigated through self-reported behaviour change. Fifteen syringe-exchange schemes in England and Scotland participated in a government-sponsored pilot programme from April 1987. Clients were provided with sterile injecting equipment and condoms, and with knowledge of HIV risks. One hundred and forty-two injecting drug users who first attended between April 1987 and March 1988 participated in a prospective interview-based survey with questions at two points in time. Measurements were self-reported attitudinal, knowledge and behavioural changes relevant to HIV infection and transmission. Many clients maintained or adopted low-risk behaviours: 79% sustained or adopted low or lower levels of syringe sharing. Trends identified include decreases in syringe-sharing, from 34 to 27%; using others' syringes (risk of infection) from 25 to 19%; passing on syringes (risk of transmission) from 30 to 25%. Many clients reported changes in sexual behaviour; those with sexual partners decreased from 77 to 69% and those with two or more sexual partners from 26 to 21%. However, non-use of condoms increased from 62 to 79%. Comparison groups of non-attenders showed higher levels of risk behaviour (59-62% sharing syringes, 86-88% with sexual partners). Overall, changes in HIV risk behaviour show small but encouraging trends and support arguments that injectors can be helped to change their behaviour, which could be of cumulative importance in reducing the spread of HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Syringe exchange schemes for drug users in England and Scotland.

In 1987 experimental schemes for distributing injecting equipment to intravenous drug users to help prevent the spread of the human immunodeficiency virus were started by the government. After six months the schemes were found to have been reasonably successful in attracting clients but were less successful in keeping them. It has been shown that equipment can be distributed to drug users on an exchange basis. Many of the clients who were attracted to these schemes had had no treatment or other help for their drug problems.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Recent developments in professional control: the impaired physician movement in the USA.

Many sociological commentators have noted the reluctance of the professions to engage in active self-regulation. However, in the last ten years in the USA a new form of professional control has emerged that encourages active intervention. This focusses on the issue of the "impaired physician' and is concerned with physician ill-health and its effects on medical practice, and is manifested in medical programmes for the identification, treatment and rehabilitation of impaired physicians. This interest in physician behaviour and its consequences for medical practice has developed and is contained mainly within the medical profession and tempers external surveillance and control. The success of the impaired physician movement rests on the ability to take certain areas of conduct such as alcoholism and drug abuse (which are formally disciplinary issues) and handle them as diseases.

Physician Impairment↗
PubMed1982

Seven year follow-up of heroin addicts: life histories summarised.

Data from a seven-year follow-up study of heroin addicts were analysed to show group trends. Time spent in various activities was quantified for each person for each year of the follow-up period and used to provide a composite life history. Time spent by the sample using drugs has decreased over the follow-up period. The most marked decrease appeared in the use of heroin, but the analysis suggests that a hard core of heroin users still used heroin several years after coming to the clinic. There seems to be an overall congruence between abstinence and non-clinic attendance. For this sample the use of illegal opiates without attending a clinic was relatively rare, and total time spent in hospitals and in prisons was rather small. Death occurred randomly during the follow-up period.

Female↗
PubMed1979

Seven-year follow-up of heroin addicts: abstinence and continued use compared.

Data from a seven-year follow-up study of drug addicts were examined to see whether there were any differences between those who had stopped using opiates and those who had continued to use them. Information about the addicts when they first entered the study in 1969 was also reviewed to determine whether any of their characteristics would have predicted whether they would stop using opiates or continue. Those who had stopped using opiates by 1976-7 were more likely than the continuing addicts to have a job and legitimate source of income, to be in good health, and to have a stable address and less likely to have problems with the law or contact with addicts. In 1969, however, there were few differences between those who eventually stopped using drugs and those who continued, though the former group were younger, had a shorter period of heroin use, and had worked less since they became addicted. Over the seven years' follow-up the addicts who stopped taking drugs changed most, while those who stayed on opiates changed their life-style very little.

Adult↗
PubMed1978

Seven-year follow-up of heroin addicts: drug use and outcome.

A representative sample of 128 of the patients who in 1969 attended London drug dependence clinics and received daily prescriptions for heroin was personally followed up seven years later. The mean age of the patients at follow-up was 32.7 years, and a mean of 12.8 years had elapsed since they first admitted to using heroin. Follow-up was successful in 124 cases (97%). Fifty-two people (41%) had stopped attending the clinics, 6 (5%) were in prison, 55 (43%) were still attending the clinics, and 15 (12%) had died. Abstinence from opiates had been achieved by at least 40 people, 33 having abstained for two years or more. Abstinence did not seem to have been replaced by dependence on other drugs, including alcohol. Sixty-two people (48%) were still using opiates; only 7 (5%) did so without attending clinics and obtaining legal prescriptions.

Adult↗
PubMed1977

Do drug advertisements provide therapeutic information?

In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the 'images and stereotypes' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the 'average general practitioner is potentially exposed to 1,300 advertisements every month'. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements.

Advertising↗