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Biomedical subjects

R S Broadhead

Publications and source records attributed to R S Broadhead.

9 recordsLinked to original sources

Harnessing peer networks as an instrument for AIDS prevention: results from a peer-driven intervention.

OBJECTIVE: Since 1985, community outreach efforts to combat acquired immunodeficiency syndrome (AIDS) among injecting drug users (IDUs) in the United States have overwhelmingly depended on a provider-client model that relies on staffs of professional outreach workers. We report on a comparison of this traditional outreach model with an innovative social network model, termed "a peer-driven intervention" (PDI). The latter provides IDUs with guidance and structured incentives that permit them to play a much more active role in the outreach process, thereby harnessing peer pressure on behalf of human immunodeficiency virus (HIV) prevention efforts. METHODS: We compare the performance of a traditional outreach intervention (TOI) and a PDI that were implemented in medium-sized towns in eastern and central Connecticut. Comparisons are based on the number and representativeness of IDUs recruited at each site, the effectiveness of HIV prevention education, compliance rates with AIDS risk reduction recommendations, and relative cost. The analyses are based on 522 initial interviews and 190 six-month follow-up interviews conducted during the first two years of each intervention's operation. RESULTS: Both interventions produced significant reductions in HIV risk behaviors, as measured using self-reports. The PDI outperformed the traditional intervention with respect to the number of IDUs recruited, the ethnic and geographic representativeness of the recruits, and the effectiveness of HIV prevention education. In addition, the costs of recruiting IDUs into the intervention and educating them about HIV in the community was only one-thirtieth as much in the PDI as in the traditional intervention. CONCLUSIONS: The findings suggest that given guidance and nominal incentives, IDUs can play a more extensive role in community outreach efforts than the traditional model allows. The findings also suggest that both interventions reduce HIV-associated risk behaviors, but the PDI reaches a larger and more diverse set of IDUs, and does so at much less expense.

Adult↗

Clinical clerkships in professional education: a study in pharmacy and other ancillary professions.

An empirical study of the dynamics of clinical clerkships in professional education is offered, with particular attention to ancillary professions. For students to eventually establish innovative practices within professional organizations, they need skills in the technical aspects of their fields, as well as in role-making and interprofessional negotiation. In examining a clinical clerkship in pharmacy, it was found that faculty overwhelmingly focus on technical matters, and assume that technical competence alone is enough to attain role expansion. The experiences of students, simulating participation in a complex organization as members of clinical teams, give good reason to question this and other assumptions constituting the structure of clerkships. Several recommendations issue from the analysis for strengthening the objectives of professional training.

Clinical Clerkship↗

Observational study of job satisfaction in hospital pharmacy technicians.

Intrinsic and extrinsic factors contributing to job satisfaction of pharmacy technicians in two community hospitals were studied. A pharmacy student employed part-time as a pharmacy technician by one of the hospitals observed fellow technicians in a wide range of job activities for 22 months. In a second hospital, the same student conducted similar observations during one summer while posing as a social researcher. Both hospitals had technician training programs providing classroom instruction and on-the-job training. Data were gathered primarily from informal conversations with technicians and pharmacists and by recording activities through notetaking. Formal training programs, praise from pharmacists, opportunities to train other technicians, diversity of job activities, and autonomy in coordinating work with time demands were identified as factors contributing to job satisfaction of technicians. Negative aspects of the job that employers attempted to circumvent or clarify were the unchallenging nature of the work and the limited opportunities for advancement. Technicians' and pharmacists' attitudes toward job enrichment for technicians are discussed, and suggestions for improving technicians' intrinsic and extrinsic job satisfaction are provided. A reliable cadre of pharmacy technicians is necessary for further expansion of clinical pharmacy services under current hospital budgetary restraints. In addition to modifying job activities to promote technicians' intrinsic job satisfaction, pharmacy managers can improve extrinsic satisfaction by providing adequate salaries, job security, and flexible work schedules.

Humans↗

Variation of the recombination fraction in Drosophila melanogaster females.

The distribution of the recombination fraction between two distal, autosomal loci, plexus and orange, was investigated in reciprocal crosses between the marker stock and each of two wild-type strains, Harwich and Ottawa. The dysgenic cross between Harwich males and marker females exhibited high sterility, low fecundity, and a non-normal distribution of the recombination fraction. Neither the distribution of the reciprocal Harwich cross nor those of the two Ottawa crosses deviated from normal. In general, the results support the view that the recombination fraction is a variable.

Animals↗

The impact of a needle exchange's closure.

OBJECTIVE: The Windham, Connecticut, needle exchange closed in May 1997 after becoming embroiled in a public controversy in which it was blamed for the city's drug problem, discarded syringes, and even the economic decline of the city itself. The authors interviewed injection drug users and conducted a community survey of discarded drug paraphernalia to explore the effects of the needle exchange's closure. METHODS: After the needle exchange was closed in March 1997, the authors re-recruited former participants in an AIDS prevention research project, the majority of whom were clients of the needle exchange. The authors analyzed responses from these respondents' pre-closure interviews and from III post-closure initial interviews and 78 post-closure follow-up interviews as well as data on discarded syringes and "dope bags". RESULTS: Following the closure of the needle exchange, significant increases were found in the percentage of respondents who reported an unreliable source as their primary source of syringes, in respondents' reports of the frequency of reusing syringes, and in the percentage of respondents who reported sharing of syringes. Surveys of outdoor drug-use areas found that the closure of the needle exchange did not reduce the volume of discarded syringes and other drug-injection debris. CONCLUSIONS: The problems in Windham that led to the closure of the exchange still remain, and the city's drug injectors are engaging in higher levels of HIV risk behavior.

Adult↗