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J S Lawrence

Publications and source records attributed to J S Lawrence.

At least 19 recordsLinked to original sources
PubMed1996

Examination of the relationship between African American adolescents' condom use at sexual onset and later sexual behavior: implications for condom distribution programs.

School-based condom distribution programs have generated considerable controversy across the country. In the present study 249 sexually active African American adolescents who did (n = 119) and did not (n = 130) use a condom during their initial sexual experience were compared to assess whether condom use at the onset of sexual activity was associated with later differences in sexual behavior. The results indicated that youths who used a condom from the onset of sexual activity were more likely to have used a condom in the most recent intercourse occasion, less likely to be diagnosed with a sexually transmitted disease (STD) or to combine substance use with sexual activity, endorsed more positive attitudes toward condoms, and were older when they initiated sexual activity. The findings have implications for condom availability programs and indicate that initial condom use was not associated with earlier onset of sexual activity and was associated with higher rates of precautionary behavior among sexually active minority adolescents.

Adolescent↗
PubMed1991

Investigating stress levels of residents: a pilot study.

A pilot study of the levels of stress among residents was conducted in three departments in a university hospital prior to initiating a programme in stress management for residents. The Beck Depression Inventory, which is a brief, standardized self-report measure of depression, was given to residents in anaesthesiology, paediatrics and psychiatry. Six additional questions were asked about the functioning of peers and services residents would like to have available. Of the 113 residents surveyed, 16% were experiencing a mild mood disturbance. The researchers feel this is probably under-reported. Residents felt that about 15% of their colleagues were emotionally impaired; 10% may have a drug and/or alcohol problem; 12% were having marital problems. Eighty per cent of all residents studied said that they would attend support groups if they existed. Approximately 60% thought coping skills/stress management seminars would be useful, and 30% of the paediatric and anaesthesiology residents (60% of the psychiatry residents) said they would use confidential individual psychotherapy if it were available.

Anesthesiology↗
PubMed1990

Confidence weighted answer technique in a group of pediatric residents.

Physicians who are excessively underconfident or overconfident about their knowledge may have impaired clinical judgement. Confidence weighting of multiple choice examinations asks test-takers to state how confident they are that the answers they selected are correct. This previously described method allows the examinee to receive 'overconfidence' and 'underconfidence' scores. This study was designed to test the hypothesis that these scores would correlate with faculty assessment of pediatric residents' confidence level as observed in the clinical setting. Thirty-three pediatric residents took an examination of general pediatric knowledge using confidence weighting method. Percentage of questions answered correctly ranged from 40 to 81%. There was an association between increasing overconfidence and lower examination scores (r = 0.58; p = 0.001). Increasing overconfidence was also associated with decreasing underconfidence (r = 0.38; p = 0.04). Five faculty members, the program director and the chief resident were asked to rate their perceptions of the residents' confidence on a Likert-type scale. The period of observation ranged from 9 months to 3 years. Linear regression demonstrated an association between underconfidence indices and observed confidence in the clinical setting (r = 0.39; p = 0.03). In addition, three of four residents who left the program had either over- or underconfidence indices greater than one standard deviation from the mean. These results indicate that the multiple choice examination with confidence weighting can predict residents who will be judged as underconfident by clinical preceptors. This finding is important in light of our impression that such house officers often have difficulties later during their residencies.

Humans↗
PubMed1988

The predictive validity of a resident selection system.

This paper describes a new system for resident selection that uses a descriptive rating scale and a microcomputer to create a rank order list for the National Resident Matching Program. The methods utilized to analyze the time efficiency, interrater reliability, and predictive validity of the system are reported. Interrater reliability was found to be high. The rank list was shown to correlate with both clinical performance of Pl-1 and Pl-2 pediatric residents and the American Board of Pediatrics In-training Examination. Correlations for the Pl-2 year were stronger than for the Pl-1 year.

Humans↗
PubMed1987

A family survey of lupus erythematosus. 1. Heritability.

First degree relatives and spouses of 36 patients with systemic lupus erythematosus (SLE) and 37 with discoid lupus erythematosus (LE) were assessed using the ARA criteria. They were compared with relatives and spouses of patients with other rheumatic and related complaints. Definite SLE was present in 3.9% of relatives of SLE probands, 2.6% of discoid relatives and 0.3% of controls. Discoid LE was diagnosed in 0.6% of SLE and 3.5% of discoid families compared with 0.5% of controls. None of the spouses of LE probands had SLE or discoid LE. The data gave the best fit for a polygenic inheritance with a heritability of 66 +/- 11% for SLE and 44 +/- 10% for discoid LE. Genetic factors are thus less important in SLE and discoid LE than in generalized osteoarthritis, spondylitis or gout with heritabilities of 90, 72 and 90%, respectively.

Arthritis, Rheumatoid↗
PubMed1976

Comparative toxicity of gold preparations in treatment of rheumatoid arthritis.

Patients with rheumatoid arthritis have been treated alternately with aurothioglucose and aurothiomalate. In the earlier part of the study an oily suspension of aurothioglucose and an aqueous solution of aurothiomalate were used, but later an aqueous solution of aurothioglucose was alternated with the oily suspension and an oily suspension of aurothiomalate with the aqueous solution. Skin eruptions, stomatitis, and albuminuria were significantly more common in patients treated with the aqueous solution than with the oily suspension.

Albuminuria↗
PubMed1976

Osteoarthrosis in a rural South African Negro population.

The prevalence and distribution of osteoarthrosis has been studied in a South African Negro population. One or more joints were affected in 60% of the males and 48% of the females, compared with a prevalence of 55% in males and 63% in females in a comparable English population. Multiple osteoarthrosis was significantly less common in the African than in the English population, the difference here being greatest in females. Clinical Heberden's nodes were also very infrequent in the African population. However, the Tswana males had significantly more osteoarthrosis of the metacarpophalangeal and proximal interphalangeal joints than was encountered in English males. This is attributed to the traumatic effect of hard manual work which is carried on into old age among most African populations.

Adult↗
PubMed1976

Radiological cervical arthritis in populations.

The prevalence of cervical rheumatoid arthritis and its relationship to rheumatoid serum factors and erosive arthritis in peripheral joints has been studied in radiographs of the cervical spine and of the hands and feet drawn from 12 population samples. The changes were graded in accordance with the Atlas of Standard Radiographs of Arthritis. Rheumatoid arthritis of the cervical spine (grades 2-4) was observed in 4.1% of males and 4.7% of females aged 15 and over. Prevalence was greatest in those born before 1900, 15% of whom were affected. There was a significant association with the sheep cell agglutination test but not with the bentonite flocculation test, though the latter correlated well with erosive arthritis in the joints of the hands and feet. Arthritis of the cervical spine showed a significant correlation with both seropositive and seronegative erosive arthritis in the peripheral joints. A significantly higher prevalence of cervical arthritis than expected was noted in two population samples, one in Germany and the other in West Africa, though in neither was there a high prevalence of peripheral arthritis. The German population had relatively high antistreptolysin titres. A low prevalence of cervical arthritis was noted in populations in Czechoslovakia and in Arizona. 'Congenital' block vertebra had a prevalence of 0.9% in persons born before 1935, but none was observed in those born since. The figures suggest that environmental influences predisposing to cervical arthritis and block vertebra have changed in the last 40 years.

Adolescent↗
PubMed1976

Arthritis and hypogammaglobulinaemia. A. Family survey.

1. Hypogammaglobulinaemic patients admitted to the Medical Research Council's immunoglobulin therapy trials up to 1963 were examined for evidence of arthritis and were compared with population samples from Leigh, Wensleydale and Watford which were used as controls. 2. Four out of 60 males had inflammatory polyarthritis compared with an expected 0.4. In addition, 3 had synovitis limited to the knees and 4 had had polyarthritis in the past, the expected figures being 0.12 and 2.4 respectively. None of the patients had definite rheumatoid arthritis as defined by the American Rheumatism Association Criteria, though one satisfied the New York Criteria for Still's disease. All were seronegative and none of the patients with polyarthritis had radiological evidence of arthritis. None of the 18 female patients had arthritis. The prevalence of arthritis of synovitis in males was 29% in 1964, but in the following 3 years varied between 8 and 11%, suggesting a strong environmental influence. 3. All of the 7 males with inflammatory polyarthritis had levels of IgG, IgA, IgM and IgD, which were less than 30% of the standard normals and steatorrhoea was present in three. Steatorrhoea was also noted in 2 of 5 patients wih arthritis who died before the start of the survey, compared with 7% of all the males. 4. Clinical inflammatory polyarthritis was no more common in the first-degree relatives of patients with hypogammaglobulinaemia than in the population as a whole and they had no excess of erosive arthritis visible in X-rays of the hands or feet nor was sacro-iliitis excessively frequent. 5. Positive tests for rheumatoid factor were found in only 2 of the patients with hypogammaglobulinaemia and the first-degree relatives had no more positive sheep cell agglutination or latex fixation tests than expected in random population samples. 6. It is concluded that the seronegative polyarthritis which occurs in patients with hypogammaglobulinaemia is unrelated genetically to rheumatoid arthritis or Still's disease.

Adolescent↗
PubMed1975

Rheumatic disorders in the South African Negro. Part II. Osteo-arthrosis.

The prevalence of osteo-arthrosis of the hip, the knee, the small joints of the hand and the metatarsophalangeal joint of the big toe, has been studied in a South African Negro population. The pattern of joint involvement differed considerably from that expected in a White population. Interphalangeal osteo-arthrosis was much less common in Black women than in White, and Heberden's nodes were seen in only 3 of 93 respondents who were over 65 years of age. Osteo-arthrosis of the metacarpophalangeal joints also, was less common in Black women than in White, but the Black men showed a much greater involvement than that seen in White men. As in White peoples, osteo-arthrosis of the metatarsophalangeal joint of the big toe was commoner in women than in men, but the over-all prevalence did not reach the high levels in Whites. Osteo-arthrosis of the knee was much commoner in the women than in the men; this was associated with a marked tendency to obesity in the older women. The hip joint which is a common site for osteo-arthrosis in Whites, was seldom affected in this Black population. It is clear from this study that the apparent rarity of certain forms of degenerative arthritis in the South African Negro is not owing to any inherent resistance to the disease, because osteo-arthrosis of certain joints, such as the knee in women and the metacarpophalangeal joints in men, is even more common in Blacks than in Whites. The differences encountered can, in many instances, be attributed to differences in occupation and life style in the two populations; but genetic factors, may also play a part in the sense that certain predisposing disorders, such as congenital subluxation of the hip, appear to be far less common in Blacks than in Whites.

Adult↗
PubMed1975

Hypertension in relation to musculoskeletal disorders.

Generalized osteoarthrosis was found to be significantly more common in older males with high than with low diastolic blood pressure. The excess of osteoarthrosis in those with hypertension was mainly in the hips, knees, carpometacarpal and metacarpophalangeal joints, and was independent of obesity in the hypertensive group. It was not associated with a higher cholesterol or uric acid level in the serum. Radiological evidence of avascular necrosis was present in 36% of males with osteoarthrosis of the hips and diastolic blood pressure above 100 mmHg, in 20% with a diastolic pressure of 81-100 mmHg, but was found in none of those with osteoarthrosis and blood pressure of 80 mmHg or below. Only those with osteoarthrosis and a diastolic pressure above 100 mmHg had significantly more avascular necrosis that expected. Osteoarthrosis of the knee in female was more frequent in the hypertensive groups independent of obesity. It is concluded that vascular disorders are involved in this form of generalized osteoarthrosis.

Blood Pressure↗