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J Warren

Publications and source records attributed to J Warren.

At least 55 records · Page 3Linked to original sources

The organizational context of non-lethal workplace violence: its interpersonal, temporal, and spatial correlates.

This article examines 993 violent incidents involving faculty, students, and staff that occurred at a highly ranked teaching and research university and its affiliated medical center. Violent incidents were included in the sample if they involved faculty, students, or staff, regardless of their specific location or context (i.e., whether they occurred on campus and/or off-campus and whether they occurred within the context of work or some other activity). The theoretical goal of the project was to compare work-related incidents with non-work-related incidents of interpersonal violence occurring in a single, multifunctioning, and professionally hierarchical organization. Data were collected over a 7-year period from three police departments (city, county, and university), university records, and criminal history records obtained from the state police. The coding protocol was developed to capture crime-scene information pertinent to each of the incidents. This included information about the victim, the perpetrator, the relationship between the victim and perpetrator, and the violent incident. The data were examined using nonparametric statistics and logistic regression to model predictive differences between the workplace and non-workplace incidents. The results suggest that the workplace incidents of violence differ from the non-workplace incidents according to their time, victim age, degree of victim injury, and whether the workplace is a medical location. The authors conclude that these differences are better explained by the movement of people in and out of the workplace who bring societal violence with them, rather than by a category or type of workplace violence.

Adult↗

Risk communication: clinicians' reported approaches and perceived values.

Despite significant conceptual and empirical advances in research on the risk assessment of violence during the last decade, there has apparently been no empirical research in the related area of risk communication. After summarizing the major theoretical and practical justifications for studying risk communication, this article describes the results of two studies of clinicians' risk communication practices. In Study 1, practicing clinicians (psychiatrists and psychologists; n = 55) were surveyed. Only one clinician indicated that he employed numerical probability figures in communicating risk; a total of nine reasons for not using numerical probabilities were cited, in varying combinations, by participants. Risk communication practices that were reportedly employed included a total of 11 approaches, endorsed in varying combinations. In Study 2, a separate sample of clinicians (n = 59) rated (1) the importance of the Study 1 reasons against using numerical probability figures in risk communication and (2) the value of the different forms of risk communication derived in Study 1. These data apparently offer the first empirical description of how clinicians communicate the results of risk assessments of violence and their reasons for communicating in such ways.

Communication↗

Crystal structures of HIV-1 reverse transcriptase in complex with carboxanilide derivatives.

The carboxanilides are nonnucleoside inhibitors (NNIs) of HIV-1 reverse transcriptase (RT), of potential clinical importance. The compounds differ in potency and in their retention of potency in the face of drug resistance mutations. Whereas UC-84, the prototype compound, only weakly inhibits many RTs bearing single point resistance mutations, inhibition by UC-781 is little affected. It has been proposed that UC-38 and UC-781 may form quaternary complexes with RT at a site other than the known binding pocket of other NNIs. X-ray crystal structures of four HIV-1 RT-carboxanilide complexes (UC-10, UC-38, UC-84, and UC-781) reported here reveal that all four inhibitors bind in the usual NNI site, forming binary 1:1 complexes with RT in the absence of substrates with the amide/thioamide bond in cis conformations. For all four complexes the anilide rings of the inhibitors overlap aromatic rings of many other NNIs bound to RT. In contrast, the second rings of UC-10, UC-84, and UC-781 do not bind in equivalent positions to those of other "two-ring" NNIs such as alpha-APA or HEPT derivatives. The binding modes most closely resemble that of the structurally dissimilar NNI, Cl-TIBO, with a common hydrogen bond between each carboxanilide NH- group and the main-chain carbonyl oxygen of Lys101. The binding modes differ slightly between the UC-10/UC-781 and UC-38/UC-84 pairs of compounds, apparently related to the shorter isopropylmethanoyl substituents of the anilide rings of UC-38/UC-84, which draws these rings closer to residues Tyr181 and Tyr188. This in turn explains the differences in the effect of mutated residues on the binding of these compounds.

Anilides↗

Time in hospital.

This article is based on research into patients' perceptions of being in hospital. Time, ordinarily taken for granted, becomes a significant problem for people in hospital. Patients seek control over time that they do not seem to have during their stay in hospital. They try to keep track of time and find ways of passing it, while believing that precious personal time is lost to them. The insight gained into differing perceptions of time and how patients coped with these can be used to reduce some of the tensions and negative aspects of the way time is experienced in hospital.

Adaptation, Psychological↗

Guidelines on admission and discharge for adult intermediate care units. American College of Critical Care Medicine of the Society of Critical Care Medicine.

OBJECTIVE: To present guidelines for writing admission and discharge policies for adult intermediate care units. DATA SOURCES: Opinion of practitioners with experience and expertise in managing critical and intermediate care units. DATA SYNTHESIS: Consensus was reached regarding the characteristics of patients best suited for management in an intermediate care unit, as supported by a literature review. CONCLUSION: Criteria were developed that define patients who are optimal candidates for management in an intermediate care unit.

Adult↗

Information overload: opportunities and challenges for the GP's desktop.

Recent developments in health data networks, the health sector and information systems, have created an overload of information available to the General Practitioner. The implementation of viable Health Data Networks within hospitals and subsequent connection to the GP's desktop PC enables increased access to patient records, decision-support and communication with experts around the world To address the high usage of expensive health services and lengthy waiting lists health services around the world are embracing programs such as Community, Coordinated, Shared and Managed care. This focus on coordination of care and increased emphasis on evidenced-based medicine is greatly enhanced through the advent of viable health data networks. Other resources such as databases, best-practice guidelines, the web, email, telemedicine and a range of commercial programs that provide further services has created an overload of resources available to the GP. Current human-computer interface guidelines are not adequate for prescribing design solutions to deal with the information overload facing GPs. The challenge for the near future is to present the vast array of information sources to the GP in an acceptable and useable information system interface. Part of the solution may revolve around the development of standards for Electronic Health Record systems for GPs, as is being done currently in Australia; but we suspect that less mainstream interface technologies will be required to exploit the wealth of available healthcare information.

Australia↗

Molecular characterization of a protozoan parasite target antigen recognized by nonspecific cytotoxic cells.

The target cell antigen(s) on tumor cells and on protozoan parasites recognized by NK and nonspecific cytotoxic cells (NCC) has not yet been specifically identified. NCC may be the teleost equivalent of NK cells and IL-2-activated NK cells. A ligand recognized by NCC has been identified. It is expressed on both protozoan parasites and mammalian tumor target cells. In the present study, a protozoan parasite antigen (NK target antigen/NKTag/p46) was purified from Tetrahymena pyriformis and the entire amino acid sequence was deduced from cDNA. Soluble and purified NKTag inhibited NCC lysis of human and mouse transformed target cells. Homology comparisons using Swissprot database revealed that NKTag is a novel protein. Molecular weight computation of the deduced sequence demonstrated that NKTag is a 48.17-kDa protein containing 422 amino acids with relatively high percentages of tyrosine and serine residues. Expression of NKTag on various mammalian tumor target cells, normal tissue, and T. pyriformis was determined using anti-multiple antigenic peptide (MAP) monoclonal antibody (mab) 22A12 [generated against an N-terminal 20-mer (aa 61-80) of p46]. This mab bound to tissue-cultured and tumor cells (YAC-1, IM-9, NC-37, MOLT-4, and U937) with low levels of binding to fish, mouse, and equine cells. Studies were also done to determine if purified and iodinated NKTag bound specifically to NCC. Binding was saturable and specific. These data provide evidence that NCC recognize a target cell ligand which is found on both protozoan and tumor cells. This may provide an explanation as to how NCC (including activated NK cells) recognize a vast array of targets in the absence of haplotype recognition and in spite of a diverse species of origin.

Amino Acid Sequence↗

Detection of behavioural and emotional problems in deaf children and adolescents: comparison of two rating scales.

The aim of this study was to establish rates of behavioural and emotional problems, and of social maladjustment, in a population of deaf children, particularly in relation to different methods of communication. The parents of 84 children who attended two schools for the deaf took part. They completed the parents' checklist (PCL), a behaviour rating scale for deaf children, and the Child Behaviour Checklist (CBCL), a measure widely used in the general population. The two instruments were significantly correlated on the severity of behavioural and emotional problems, but their previously established cut-off scores detected different rates of possible clinical cases, i.e. children with mental health disorders. According to the CBCL, 40% of children were within the clinical range, and 82% were socially dysfunctional compared with the general population. The PCL identified a much higher percentage (77%) of caseness. Behavioural and emotional problems were significantly higher in Asian children. Although all subjects used sign language, the additional use of speech, which may indicate increased hearing ability, had a protective effect for adolescents. The findings are discussed in relation to the validation of the instruments and the development of intervention programmes for deaf children.

Adolescent↗

Localization of monocyte chemoattractant peptide-1 expression in the central nervous system in experimental autoimmune encephalomyelitis and trauma in the rat.

Monocyte chemoattractant protein-1 (MCP-1) is a member of the chemokine beta family of chemoattractants that has been shown to play a major role in the initiation of monocyte and T cell inflammation to sites of tissue injury. In this study, we have examined the distribution of MCP-1 expression in inflammation in the central nervous system (CNS) associated with the autoimmune disease experimental autoimmune encephalomyelitis (EAE) and compared the results with those detected in inflammation associated with trauma. In EAE, MCP-1 expression was detected at the onset of inflammation, prior to clinical expression of disease, in lymphocytes and endothelial cells in subarachnoid locations. Monocyte infiltration into these areas appeared 24 h later. After the onset of clinical signs, MCP-1 expression was widely distributed in the spinal cord with levels increasing and decreasing in association with disease activity. Lymphocytes, macrophages, astrocytes, and endothelial cells could be identified as sources of MCP-1 by immunoreactivity and in situ hybridization. A similar close correlation between macrophage infiltration and the levels of mRNA for MCP-1 was found in the CNS of rats subjected to trauma, and in these animals MCP-1 was detected by immunohistochemistry in macrophages and endothelial cells. The results support the conclusion that MCP-1 is an important mediator of inflammation in the CNS.

Animals↗

Evaluation of immune dependence of anthelmintic treatment of Heligmosomoides polygyrus in CBA/Ca mice.

The efficacy of anthelmintic treatment of adult Heligmosomoides polygyrus was evaluated in immunologically intact and immune-incompetent (T-cell-deprived) CBA/Ca mice. There was no statistically significant difference in the cure rate, in terms of percentage reduction in worm burden, following treatment with pyrantel pamoate and levamisole between normal (57-71% reduction) and immune-incompetent mice (69-78% reduction). The rate of expulsion, and the total number, of worms expelled from infected mice following drug treatment were comparable in normal and deprived mice. The activity of 2 drugs against adult H. polygyrus has been shown to be independent of the immune status of the host. The significance of the mode of actions of drugs and the site of residence of a parasite within the host are discussed.

Animals↗

Characteristics of troubled youths in a shelter.

The purposes of this descriptive study were to: (a) describe the identifiable characteristics of a population of runaway youths; (b) describe certain aspects of the youths' current and past situations, such as alcohol and drug use/abuse and a history of physical or sexual abuse; (c) identify significant life events by means of the Coddington Life Events Scale (LES); and (d) examine possible ways in which health and mental health practitioners can best assist these youths and their families through times of crisis. A convenience sample of 78 runaway youths was drawn from an available population of 780 youths who were admitted to a runaway shelter, during the 7-month period of the study. The shelter is located in a semiurban community in north central Florida. Data collection instruments included the Structured Clinical Interview Instrument and the LES. These were administered to volunteer youth participants during the face-to-face interviews. Data from the current study support the assertion that many runaway youths live in abusive situations and are exposed to drugs and alcohol from a variety of sources. Furthermore, the high scores on the LES show insurmountable levels of stressful life events that occur at any given time. Researchers recommend that prevention programs focusing on the antecedents of runaway behavior be developed to prevent future runaway episodes.

Adolescent↗

Psychopathy in instrumental and reactive violent offenders.

Can violent offenders who commit acts of instrumental aggression for goal-oriented purposes such as robbery be distinguished from those who commit acts of reactive (or hostile) aggression in response to provocation? Because violent offenders often have a history of both instrumental and reactive aggression, this study distinguished between offenders with a history of at least 1 instrumental violent offense and offenders with a history of reactive violent offenses. Two studies tested the hypothesis that instrumental offenders would score higher than reactive offenders and nonviolent offenders on R. D. Hare's (1991) Psychopathy Checklist. The first study sample consisted of 106 violent and nonviolent offenders recruited from a medium-security correctional facility. The second study sample consisted of 50 violent offenders referred for pretrial forensic evaluation. In both samples, instrumental offenders could be reliably distinguished from reactive offenders on the basis of violent crime behavior and level of psychopathy. Group differences could not be attributed to participant age, race, length of incarceration, or extent of prior criminal record.

Adult↗