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Biomedical subjects

C Levine

Publications and source records attributed to C Levine.

At least 19 recordsLinked to original sources
PubMed2001

The experiences and challenges of informal caregivers: common themes and differences among whites, blacks, and hispanics.

PURPOSE: This study examined commonalities and differences in the experiences and challenges of White, Black, and Hispanic informal caregivers in New York, NY. DESIGN AND METHODS: A randomly selected representative cross-section of 2,241 households was contacted through telephone interviews. Complete data were available for 380 eligible participants, who were classified as White (n = 164), Black (n = 129) and Hispanic (n = 87). Descriptive, bivariate, and multivariate analyses were conducted to examine differences in caregiving intensity, reported difficulty with providing care, and having unmet needs with care provision. RESULTS: Over 70% of caregivers had no help from formal caregivers, even though over 80% had been providing care for at least 1 year, and 40% had been providing this care for 20 or more hr per week. Compared with White caregivers, Black caregivers were more likely to provide higher intensity care, to report having unmet needs with care provision, and to experience increased religiosity since becoming caregivers, but were less likely to report difficulty with providing care. Hispanic caregivers were more likely than White caregivers to have help from formal caregivers and to experience increased religiosity since becoming caregivers. IMPLICATIONS: Although many similarities exist in the experiences and challenges of informal caregivers, gaining insight from different populations of family caregivers would help program planners, policy makers, and formal caregivers to develop and implement culturally sensitive programs and policies that are supportive of the needs of these caregivers in their ever-expanding roles. Future efforts also should focus on exploring the potentially significant role that community resources, in particular, religious institutions, could play in providing outreach and support to racial/ethnic minority caregivers.

Adolescent↗
PubMed2000

Mutational analysis of Escherichia coli topoisomerase IV. I. Selection of dominant-negative parE alleles.

In order to define regions of ParE, one of the two subunits of topoisomerase IV, that are involved in catalysis during topoisomerization, we developed a selection procedure to isolate dominant-negative parE alleles. Both wild-type parC and mutagenized parE were expressed from a tightly-regulated lac promoter on a moderate-copy plasmid. Mutated parE alleles were rescued from those plasmids that caused IPTG-dependent cell death. The mutant ParE proteins could be divided into two groups when reconstituted with ParC to form topoisomerase IV, those that elicited hyper-DNA cleavage and those that affected covalent complex formation.

Alleles↗
PubMed2000

Interaction of temperature, humidity, driver preferences, and refrigerant type on air conditioning compressor usage.

Recent studies have shown large increases in vehicle emissions when the air conditioner (AC) compressor is engaged. Factors that affect the compressor-on percentage can have a significant impact on vehicle emissions and can also lead to prediction errors in current emissions models if not accounted for properly. During 1996 and 1997, the University of California, Riverside, College of Engineering-Center for Environmental Research and Technology (CE-CERT) conducted a vehicle activity study for the California Air Resources Board (CARB) in the Sacramento, CA, region. The vehicles were randomly selected from all registered vehicles in the region. As part of this study, ten vehicles were instrumented to collect AC compressor on/off data on a second-by-second basis in the summer of 1997. Temperature and humidity data were obtained and averaged on an hourly basis. The ten drivers were asked to complete a short survey about AC operational preferences. This paper examines the effects of temperature, humidity, refrigerant type, and driver preferences on air conditioning compressor activity. Overall, AC was in use in 69.1% of the trips monitored. The compressor was on an average of 64% of the time during the trips. The personal preference settings had a significant effect on the AC compressor-on percentage but did not interact with temperature. The refrigerant types, however, exhibited a differential response across temperature, which may necessitate separate modeling of the R12 refrigerant-equipped vehicles from the R134A-equipped vehicles. It should be noted that some older vehicles do get retrofitted with new compressors that use R134A; however, none of the vehicles in this study had been retrofitted.

Air Conditioning↗
PubMed1999

The trouble with families: toward an ethic of accommodation.

Although some clinicians are extraordinarily sensitive to the legitimate roles of patients' families in medical crises, a persistent tendency to equate families with trouble is evident in both the literature and the practice of medicine. Some negative presumptions about families derive from western medicine's almost exclusive focus on the individual patient in codes of ethics, training, and practice. Modern bioethics has reinforced this individualistic approach. Physicians' primary responsibilities are unequivocally to their patients, but a complete understanding of the patient's personhood must include consideration of the significant persons who help define the patient's core identity. One source of tension between professionals and families lies in differing perceptions of the roles that family members should play and how they should play them. Members of a family may act as advocates, provide or manage care, serve as trusted companions on the journey through illness and death, and make decisions on behalf of an incompetent patient. Each role presents potential conflicts. Other sources of conflict include disagreement within a family; challenges to physician authority; fear of litigation; and differing religious, ethnic, or cultural traditions. An ethic of accommodation emphasizes the need to negotiate care plans that do not compromise patients' basic interests but that recognize the capacities and limitations of family members. Family caregivers want understandable and timely information, better training, compassionate recognition of their anxiety, guidance in defining their roles and responsibilities, and support for the setting of fair limits on their sacrifices. Health care professionals can better meet these needs through education and skills acquisition, the establishment of partnerships with families, and regular dialogue and communication.

Caregivers↗
PubMed1999

Home sweet hospital: the nature and limits of private responsibilities for home health care.

Family caregivers, often called "informal" caregivers, are the unpaid relatives, partners, or close friends who provide directly or manage the health care for individuals who are seriously ill or disabled. As a result of changes in the American health care system, family caregivers confront increasing responsibilities, burdens, and challenges. However, there are limits to family responsibility for caregiving, and whereas families may take the first step toward accepting responsibility for home care, professionals and institutions bear continuing responsibility. Public policies and programs have an enormous impact on the availability of home care assistance and services, the family's ability to afford and provide home care, and a caregiver's continued participation in the workforce. One of the major goals for the future of home care should be to recognize and respond appropriately to diverse family structures, strengths and limitations, and needs.

Caregivers↗
PubMed1999

Needs survey of Canadian rosacea patients.

BACKGROUND: In 1995, a Rosacea Awareness Program (RAP) was initiated in Canada to make available educational resources for physicians and rosacea patients. Material is in French or English, and is accessible though physician offices and by toll-free telephone. Information was communicated to the public via noncommercial, editorial media. The RAP created a database of rosacea patients in Canada. OBJECTIVE: We investigated if individuals in the database had a confirmed diagnosis of rosacea, how they perceived their treatment by the medical system, and identified their needs. METHODS: A two-page questionnaire was mailed to 7874 individuals registered with the RAP. Thirty percent of these individuals responded. Where comparisons were made a chi-squared statistic was used. RESULTS: Over 70% learned of the RAP via public media. It took patients an average of 5 years to have a diagnosis made after the first symptoms appeared. In the majority of patients (53%) the diagnosis was ultimately made by a specialist. Fifty-eight individuals said they had not discussed their condition with their doctor. Patients were likely to continue on medication that was prescribed (60%) and topical metronidazole was the most common medication used, mostly the gel formulation. Most patients used these twice daily. Patients were very satisfied with treatments and almost 90% had reduced symptoms. Despite receiving explanations and written material, patients expressed a strong interest in more information being available on skin care, make-up, and psychological aspects of rosacea. CONCLUSIONS: The RAP provides a needed educational service and is a useful database. Patients are very knowledgeable about their disease, but despite this and excellent therapeutic responses, the patients demand more information.

Administration, Cutaneous↗
PubMed1998

DNA gyrase and topoisomerase IV: biochemical activities, physiological roles during chromosome replication, and drug sensitivities.

DNA gyrase and topoisomerase IV are the two type II topoisomerases present in bacteria. Though clearly related, based on amino acid sequence similarity, they each play crucial, but distinct, roles in the cell. Gyrase is involved primarily in supporting nascent chain elongation during replication of the chromosome, whereas topoisomerase IV separates the topologically linked daughter chromosomes during the terminal stage of DNA replication. These different roles can be attributed to differences in the biochemical properties of the two enzymes. The biochemical activities, physiological roles, and drug sensitivities of the enzymes are reviewed.

Bacterial Proteins↗
PubMed1998

Identification of dnaX as a high-copy suppressor of the conditional lethal and partition phenotypes of the parE10 allele.

Termination of DNA replication, complete topological unlinking of the parental template DNA strands, partition of the daughter chromosomes, and cell division follow in an ordered and interdependent sequence during normal bacterial growth. In Escherichia coli, topoisomerase IV (Topo IV), encoded by parE and parC, is responsible for decatenation of the two newly formed chromosomes. In an effort to uncover the pathway of information flow between the macromolecular processes that describe these events, we identified dnaX, encoding the tau and gamma subunits of the DNA polymerase III holoenzyme, as a high-copy suppressor of the temperature-sensitive phenotype of the parE10 allele. We show that suppression derives from overexpression of the gamma, but not the tau, subunit of the holoenzyme and that the partition defect of parE10 cells is nearly completely reverted at the nonpermissive temperature as well. These observations suggest a possible association between Topo IV and the replication machinery.

Alleles↗
PubMed1995

Stomal seeding of head and neck cancer by percutaneous endoscopic gastrostomy tube placement.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes have replaced nasogastric tubes and Stamm gastrostomy tubes as a preferred means of feeding for patients with head and neck cancers, as recommended by the results of large series. A patient with stomal seeding of squamous cell carcinoma of the upper aerodigestive tract by PEG placement was reported. A review of literature was performed. METHODS: A Medline search of implantation of squamous cell carcinoma from the upper aerodigestive tract to PEG exit site since the introduction of PEG was performed. RESULTS: Two reports of implantation of squamous cell carcinoma of the upper aerodigestive tract to PEG exit site were found. Both patients and our patient were staged T4. CONCLUSIONS: Implantation of squamous cell carcinoma from the upper aerodigestive tract to the PEG exit site is a rare and late complication. Its prevalence is not known. For patients with a significant amount of squamous cell carcinoma in the upper aerodigestive tract, we recommend Stamm gastrostomy over PEG insertion by the pull technique. There is no report of such late complication by the push technique.

Abdominal Muscles↗