The use of phones by elders with disabilities: problems, interventions, costs.

Recognizing the important role the telephone plays in the life of frail elders, this study sought to gain a better understanding of the problems these elders encounter in using their phones to meet their needs. Starting with a sample of 354 frail elders, it was determined that 35, or just under 10%, were having some difficulty in the use of their phones. Twenty-two of these 35 subjects were randomly selected for an assessment of their impairments and phone setups in their homes. Interventions were provided to 19 of the 22 subjects, with two subjects refusing an intervention. At a 6-week follow-up call, all subjects were satisfied with the new phone or phone-related equipment. At a 6-month follow-up, 95% of subjects expressed satisfaction with the intervention. Phone usage increased by 50% for subjects provided a phone intervention. Average cost of equipment was $70.45; cost of personnel time was significantly higher. Recommendations are made for addressing the phone-related problems of frail elders.

Inter-rater agreement and stability of functional assessment in the community-based elderly.

The purpose was to examine the inter-rater agreement and test-retest stability of the Functional Independence Measure (FIM) and the Instrumental Activities of Daily Living Scale (IADL) from the Multidimensional Functional Assessment of Older Adults. These two instruments were administered to 20 older persons living in the community. Two experienced raters administered the assessment instruments over either a short (7-10 days) or long (4 to 6 week) interval. The intraclass correlation (ICC) was used to analyze the data. ICC values were computed for agreement between and within raters and across short and long intervals. ICC values for inter-rater agreement and stability ranged from 0.90 to 0.99. The relation between scores on the FIM and IADL scale was also examined. The analysis produced an r value of 0.85, suggesting a positive statistical relationship among the items assessed. The high ICC values indicate that the Functional Independence Measure Instrument and IADL scale of the Multidimensional Functional Assessment of Older Adults provide consistent information across two experienced raters and over time when used with a sample of elderly persons residing in the community.

Cytokine release by peripheral blood mononuclear cells is affected by 8-methoxypsoralen plus UV-A.

Psoralen plus UV-A (PUVA) is an effective therapy for psoriasis but also for other inflammatory dermatoses. The precise mechanisms of action, however, are not absolutely clear. Therefore, the effect of PUVA on the release of the proinflammatory cytokines interleukin (IL)-1, IL-6, IL-8 and tumor necrosis factor alpha (TNF alpha) was studied. Peripheral blood mononuclear cells (PBMC) obtained from humans were incubated with 8-methoxypsoralen (8-MOP) and exposed to UV-A (20 kJ/m2). This treatment resulted in a significant reduction of IL-6 and IL-8 amounts in the supernatants. In addition, an inhibition of IL-1 beta and TNF alpha production by lipopolysaccharide (LPS)-stimulated PBMC was observed upon PUVA treatment. Accordingly, northern blot analysis showed decreased levels of mRNA encoding for IL-1 beta, IL-6, IL-8 and TNF alpha in PUVA-treated PBMC. Finally PBMC were obtained from psoriatics undergoing oral photochemotherapy before the beginning and after completion of treatment. The PBMC collected after PUVA spontaneously produced significantly less IL-6 and IL-8 in comparison to the respective samples obtained before therapy. A similar suppression of IL-1 beta and TNF alpha by in vivo PUVA was found in LPS-stimulated PBMC. The present data demonstrate that PUVA both in vitro and in vivo suppresses the production of the proinflammatory cytokines IL-1 beta, IL-6, IL-8 and TNF alpha by PBMC. Because these cytokines are important in the mediation of inflammatory reactions, one may speculate that the inhibitory effects could contribute to the antiinflammatory activity of PUVA.

Ostrava--a new endemic focus of Mycobacteria xenopi in the Czech Republic.

From February 1990 until late October 1991, M. xenopi was isolated from the sputa of 30 persons in one of the 4 boroughs of Ostrava. This species could also be identified in water samples and smears taken in 7 out of 14 tested households of both colonized persons and patients with mycobacteriosis xenopi. As established, the optimum conditions for multiplication of M. xenopi exist in exchanger units; control measures for this agent in the exchanger facilities are proposed.

Modulation of intercellular adhesion molecule-1 expression on human melanocytes and melanoma cells: evidence for a regulatory role of IL-6, IL-7, TNF beta, and UVB light.

Intercellular adhesion molecule-1 (ICAM-1) is involved in cell-cell interactions of leukocytes and parenchymal cells and thus plays an important role in immunologic and inflammatory reactions. The expression of ICAM-1 that is found on many different cells such as melanocytes and melanoma cells is induced by various cytokines, including interferon-gamma (IFN gamma), interleukin (IL)-1 and tumor necrosis factor alpha (TNF alpha). Because expression of ICAM-1 in melanoma was found to correlate with increased risk of metastasis, the regulation of ICAM-1 expression on human melanocytes and melanoma cells was investigated. Foreskin-derived melanocytes and melanoma cell lines (A375, G361) were incubated with different cytokines and ICAM-1 expression was evaluated by fluorescence-activated cell sorter. IFN gamma, IL-1, IL-7, TNF alpha, and TNF beta significantly upregulated ICAM-1 expression in a dose-dependent manner. Most interestingly, the cytokine IL-6, which does not influence adhesion-molecule expression on other cells, significantly upregulated melanocyte and melanoma cell ICAM-1 expression. This effect was dose dependent and could be blocked by an IL-6 antibody. Irradiation with ultraviolet (UVB) light did not influence constitutive ICAM-1 expression on melanoma cells and melanocytes, but suppressed cytokine-induced ICAM-1 expression when cells were harvested 16 h after irradiation. These findings were further confirmed by Northern blot analysis, showing a marked accumulation of ICAM-1 mRNA after cytokine treatment, which was reduced by irradiation with UVB light. However, when UVB-exposed melanoma cells were cultured for at least 48 h induction of ICAM-1 expression was observed. These data indicate that, similar to other cells, ICAM-1 expression on melanoma cells and melanocytes is regulated by cytokines and that UVB light affects ICAM-1 expression on melanocytic cells in a biphasic manner.

Genetic analysis of T-DNA insertions into the tobacco genome.

A genetic test was performed on seeds from 283 transgenic tobacco plants obtained by T-DNA transformation. Seeds from self-fertilized transgenic plants were germinated on kanamycin-containing medium, and the percentage of seeds which germinated, as well as the ratio of kanamycin-resistant to kanamycin-sensitive seedlings were scored. Nine categories of transformants could be distinguished according to the number of loci into which T-DNA had inserted, and according to the effects of T-DNA integration on seed or seedling development. In most of the plants, T-DNA was inserted into a single site; others contained multiple independent copies of T-DNA. The number of T-DNA integration sites was found to be independent of whether a binary vector system or a cointegrate Ti plasmid had been used to obtain the transgenic plant. Loss of marker genes or marker gene expression from generation to generation appeared to be a quite frequent event. Plants which appeared to be insertional recessive embryo-lethal mutants did not exhibit this trait in the next generation.