"Missed, dissed, and pissed": making meaning of neighborhood risk, fear and anger management in urban black youth.

The risk factor, stress engagement, and coping experiences of African American youth are not well understood. Given the stressors of racism, hopeless perceptions of urban youth, and violence experience and exposure, anger experience and expression are reasonable resilient and risky reactions to this atmosphere of hostility. This study analyzed the impact upon the anger management of adolescents when calamity fears, neighborhood social capital, and kinship social support are known. The findings suggest that when the calamity fears of youth are high, their anger experience and expression is minimized. This finding was prominent for adolescents living in high-risk neighborhoods. Kinship social support showed a positive relationship to anger suppression for youth in high-risk environments. Implications for understanding the phenomenological stress and coping experiences of African American youth are discussed.

HIV prevention beliefs among urban African-American youth.

PURPOSE: This study investigates specific beliefs related to prevention of AIDS and HIV infection among African-American teenagers. METHODS: This study administered valid and reliable measures of HIV/AIDS risk knowledge and prevention beliefs to 150 African-American teenagers. Demographic and psychosocial data were gathered. RESULTS: Black teenagers respond in socially acceptable and undesirable ways and this ambivalence can be explained within the theory of reasoned action. These teens simultaneously believed in the importance of safe sex behaviors while expressing doubt about the viability of some safe sex behaviors. Females demonstrated higher self-efficacy and self-control beliefs while males were more likely to endorse culturally loaded suspicious beliefs about AIDS contraction and transmission. CONCLUSIONS: Those teenagers who perceived themselves as highly knowledgeable scored lower on reliable AIDS Knowledge and Prevention Beliefs measures than those who claimed moderate AIDS knowledge. Some of these "Know It All" teenagers may reflect a subculture of pseudo-confidence that requires special interventions.

Culturally sensitive AIDS education and perceived AIDS risk knowledge: reaching the "know-it-all" teenager.

Video education is the most popular and effective medium for informing the adolescent population. This study investigated the impact of a culturally relevant HIV/AIDS video education. One hundred and ninety-four African-American teenagers were assigned to either a culturally sensitive or culturally dissimilar video education intervention. Results indicate that both interventions were effective in increasing AIDS knowledge scores. An interaction effect was found between levels of perceived AIDS risk knowledge and participation in the culturally sensitive intervention (CSV). Only the CSV intervention was effective with adolescents who claimed to "know a lot" about AIDS (e.g., "Know-It-All" subgroup). Students in both conditions who were worried about getting AIDS demonstrated higher AIDS risk knowledge at post-assessment. This study provides further evidence of within-ethnicity diversity among African-American youth and for developing culture- and subgroup-specific HIV/AIDS education.

AIDS prevention struggles in ethnocultural neighborhoods: why research partnerships with community based organizations can't wait.

Community based AIDS prevention programming and research in minority neighborhoods are growing. The AIDS epidemic has demoralized many minority communities and has added to enormously stressing social conditions. Obstacles to effective AIDS prevention programming must be removed before stable, accessible, and culturally relevant services can be provided. A pilot study was conducted to identify the obstacles to AIDS research or intervention in ethnic minority neighborhoods. Twenty-nine administrators and counselors from Community Based Organizations completed questionnaires concerning reasons for entering the field of AIDS prevention, enjoyment of work, hopefulness towards AIDS efforts, priority of AIDS funding, and opinions about most and least helpful prevention efforts in minority communities. Barriers identified as most problematic include insufficient funds, lack of culturally relevant materials, denial of the epidemic in minority communities, distrust of majority culture institutions, and myths/beliefs regarding AIDS contraction, transmission, and origin. Future research ideas are identified to improve culturally relevant AIDS prevention interventions in ethnocultural neighborhoods.

Impact of culturally sensitive AIDS video education on the AIDS risk knowledge of African-American adolescents.

AIDS video education is a major mode of providing information about the spread and prevention of the human immunodeficiency virus (HIV). Very little has been written about the need for culturally salient messages in increasing the acquisition and retention of HIV/AIDS prevention information, even though there is considerable agreement that limited culturally sensitive information is reaching African-American youth. This investigation sought to ascertain the impact of a culturally similar AIDS video on the acquisition of AIDS knowledge and endorsement of HIV/AIDS prevention beliefs. This study randomly assigned classes of African-American teenagers to one of two treatment groups: culturally similar video (CSV) AIDS education and culturally dissimilar video (CDV) AIDS education. Results suggest that the CSV group demonstrated significant improvement in pre- to post- AIDS knowledge scores compared to the CDV group (using ANCOVA procedures). The intervention was not significant in demonstrating change in beliefs about prevention. Implications for the development of HIV/AIDS prevention programs for inner-city African-American youth are discussed.

PIP: Psychologists from the University of Pennsylvania in Philadelphia randomly assigned 121 inner-city, African American adolescents into 2 AIDS Education groups. The Culturally Similar Video (CSV) group (experimental group) watched the video Don't Forget Sherrie, which had elements of similarity in terms of language (slang and black English), environment (urban setting), race (African American), fashion, life dilemmas (struggle between choosing mainstream and counterculture lifestyle), and modern background music. The control group watched a culturally dissimilar video (CDV). Before viewing, the 2 groups were similar in variables related to previous AIDS education. 17% of the CSV group and 14% of the CDV group received no formal AIDS education. In fact, the median hours of AIDS education for both groups was just 2 hours. These 2 figures indicate that urban youth receive limited or no formal AIDS education. The youth in the CSV group perceived the video more favorably than did those in the CDV group (score, 3.84 vs. 2.99; p = .04). Their pre- and post-AIDS knowledge scores improved significantly compared to those of the CDV group (score increase, 2.68 vs. 1.27; p .05). Both groups had similar levels of distress concerning HIV/AIDS presented via the video (score, 3.99 vs. 3.96). Their attitudes towards AIDS prevention practices, choice of safer options, and endorsement of culturally-based AIDS beliefs were also similar. These findings show that a CSV similar video intervention is more effective in improving AIDS knowledge for inner-city African American adolescents between pre- and postviewing than is a CDV. Even though the CSV did not have an effect on prevention or cultural beliefs or safer alternative options, the CSV youth did not perceive it to be any less threatening than the CDV. CSV youth believed the video would have been more effective had it shown someone living, struggling, and dying from AIDS and more people injecting drugs. Role playing, rehearsal, and drama may increase knowledge and motivation among these youth.

Trans-retinoic acid and related differentiation agents.

Interest in retinoids as therapeutic agents has developed as a result of the observations of remission induction with all-trans retinoic acid (tRA) in patients with acute promyelocytic leukemia (APL), and of high objective response rates noted with the combination of cis-retinoic acid (cRA) with interferon-alpha in squamous cell carcinomas of skin and cervix. The therapeutic experience with RA in APL is discussed in this article from the perspectives of new information concerning retinoid biology, observations related to the development of the retinoid syndrome, complex pharmacology of this agent, and possible explanations for development of retinoid resistance. The current National Cancer Institute-supported drug development strategy for RA used alone or in combination with other differentiating agents, and the potential therapeutic uses in cancer for other retinoids are also discussed.

Levamisole: known effects on the immune system, clinical results, and future applications to the treatment of cancer.

Levamisole has been used in a wide array of clinical research and treatment settings over the past two decades, ranging from such diseases as helminthic infestations to various autoimmune diseases. Numerous preclinical evaluations and clinical trials with levamisole in the cancer arena have been sponsored by the National Cancer Institute and other agencies worldwide with the hopes of demonstrating anticancer activity. Trials in advanced breast cancer, lung cancer, colorectal cancer, melanoma, and lymphoproliferative diseases have generally been negative or inconclusive. However, there is some indication that levamisole may be useful by itself as an adjuvant therapy for resected melanoma; recently it has been shown to be effective in combination with fluorouracil (5-FU) as adjuvant therapy for tumor-node-metastasis (TNM) stage III (Dukes' C) colon carcinoma. In the aggregate, the past 20 years of clinical experience with levamisole has resulted in as many questions as answers. However, further testing of the anticancer activity of levamisole can be expected in clinical research trials over the next few years. Hopefully, these future trials will include studies of the mechanisms of action of this agent.

Halothane potentiates the antitumor activity of gamma-interferon and mimics calmodulin-blocking agents.

This study reports effects of halothane on tumor cells in vitro. Cells from the human colon cancer cell line HT-29 were exposed to various concentrations of halothane for 8-72 h. The effect of this exposure on this colon cancer cell line, with and without coincubation with the biologic response modifier gamma-interferon (IFN-gamma), was studied. Using the tumor target cell survival (TTCS) assay, concentrations of halothane from 0.5 to 2% markedly augmented the antitumor activities of IFN-gamma against HT-29. The tumor cell cytostatic effects of IFN-gamma in the 0.75-6-unit/ml range were increased nearly 400% by concentrations of halothane as low as 1%. These results were confirmed in a separate cytolytic assay (Indium-111 release assay), which revealed that halothane concentrations in the 2-4% range markedly increased the cytolytic capacity of IFN-gamma at doses of IFN-gamma between 75 and 1,250 units/ml. The cytolytic activity of IFN-gamma was increased nearly 300% by doses of halothane as low as 1%. A nearly identical pattern of augmentation of IFN-gamma-induced antitumor activity was observed when the known calmodulin inhibitor trifluoperazine (TFP) was coincubated with IFN-gamma. At concentrations of 4-10 microM, the antitumor activity of IFN-gamma was increased nearly 400%. These observations suggest that the pattern of halothane potentiation of the antitumor activity of IFN-gamma is similar to that exhibited by known calmodulin inhibitors.

Interleukin 2 and lymphokine-activated killer cell therapy: analysis of a bolus interleukin 2 and a continuous infusion interleukin 2 regimen.

Several groups have described the efficacy of interleukin 2 (IL-2) plus lymphokine-activated killer (LAK) cells in the treatment of cancer patients with significant response rates noted in patients with renal cell cancer and malignant melanoma; however, the optimum regimen remains undefined. The Biological Response Modifiers Program of the National Cancer Institute conducted two consecutive Phase I/II studies evaluating the toxicity and clinical efficacy of different methods of IL-2 and LAK cell therapy. In the first trial, we modified the standard Rosenberg regimen by decreasing the duration of priming in an attempt to reduce the toxicity related to this phase of the therapy and thereby administer more IL-2 doses with the LAK cells. In the second trial, we used a continuous i.v. infusion IL-2 regimen and altered both the leukapheresis procedure and the LAK cell culture techniques based on our in vitro and preclinical studies suggesting that 2-day LAK cells were superior. Thirty cancer patients received i.v. bolus IL-2 at 100,000 units/kg every 8 h for 3 days during priming and for 5 days during LAK cell administration. A second group of 22 cancer patients received IL-2 by continuous i.v. infusion at 3 x 10(6) units/m2 for 5 days during priming and an additional 5 days of IL-2 with the LAK cell phase of the treatment. The timing of the start of the leukapheresis procedures, their duration and number, and the LAK cell culture techniques differed in the two trials. Overall, 52 patients with various cancers were treated. The toxicities associated with each regimen were similar to those seen in other IL-2 plus LAK cell trials. Four patients (one each with melanoma and diffuse large cell lymphoma and two with renal cell cancer) exhibited partial responses lasting 2, 4, 10, and 15+ mo. Serial tumor biopsies from treated patients demonstrated that therapy can produce a marked mononuclear cell infiltrate and an increase in HLA-DR expression on tumor cells. There was no difference in the overall response rate between the two regimens, but toxicity was less with continuous i.v. infusion IL-2. The 5-day continuous i.v. infusion regimen resulted in significantly higher rebound lymphocytosis, cell yield from leukapheresis, and number of LAK cells harvested from culture.

Immunomodulatory properties and toxicity of interleukin 2 in patients with cancer.

We performed a phase Ia/Ib study of interleukin 2 (IL2) in patients with cancer. Single doses of IL2 from 10(3) units/m2 to 10(7) units/m2 were well tolerated but failed to induce significant immunological changes. Chronic IL2 treatment for 5 days out of 7 for 3 weeks was well tolerated at doses below 10(7) units/m2 and was accompanied by significant immunological changes. Following chronic treatment with intramuscular injections of IL2 at 1 x 10(6) units/m2, we observed augmentation of peripheral blood natural killer activity and induction of peripheral blood LAK activity. Induction of LAK activity was most evident when IL2 was included in the cytotoxicity assay. There was a marked increase in the number of peripheral blood mononuclear cells bearing the Leu-19 marker in association with the observed increases in natural killer and LAK activity. A small percentage of Leu-19+ cells coexpressed CD3. There was heterogeneous expression of the low affinity Fc receptor (CD16). In vivo induced Leu-19+ cells could be divided into two populations, dim and bright, based on the intensity of fluorescent staining with antibodies to Leu-19. The majority of Leu-19 bright cells were CD16- while the majority of Leu-19 dim cells were CD16+. In addition, the intensity of CD16 staining was higher for Leu-19 dim cells than for Leu-19 bright cells. Increases in the amounts of CD38 and CD8 antigens were also observed. Significant increases in serum levels of the soluble IL2 receptor were observed during treatment. One partial remission was noted in a woman with non-Hodgkin's lymphoma.

Lack of relationship between in vitro tumor cell growth and prognosis in extensive-stage small-cell lung cancer.

The ability to establish a continuously growing tumor cell line from fresh tumor specimens has been associated with shortened survival in some human malignancies. Therefore, we assessed the relationship between survival and in vitro tumor cell growth from specimens obtained during routine staging procedures in 68 consecutive patients with untreated, extensive-stage small-cell lung cancer (SCLC) who received etoposide/cisplatin chemotherapy. Three groups of SCLC patients could be distinguished: (1) 23 patients in whom a tumor cell line was established in vitro; (2) 28 patients in whom tumor-containing specimens were cultured but in vitro growth did not occur; and (3) 17 patients in whom no tumor-containing specimen could be procured. No significant difference in response rates to chemotherapy of the three groups was noted. Poor performance status (P2 = .001), male gender (P2 = .0008), liver metastases (P2 = .0033), brain metastases (P2 = .0152), and the ability to obtain a tumor-containing specimen from the patient for laboratory culture (P2 = .0005) were all significant independent predictors of decreased survival in this patient population. While the ability to obtain a tumor cell specimen for cell culture using routine staging and diagnostic procedures identified patients with shortened survival, we found no significant survival differences between patients whose tumor cell specimens grew in cell culture v those that did not (median survival of 7 months v 11 months, P2 = .72). Our study indicates that the clinical outcome of extensive-stage SCLC patients from whom tumor cell lines can be established is not significantly different than in those cases from whom tumor-containing specimens could not be grown in vitro.

Differential release of mediators from human basophils: differences in arachidonic acid metabolism following activation by unrelated stimuli.

We have examined the release of histamine and LTC4 from purified human basophils challenged with several different stimuli, both physiological and nonphysiological. Basophils (n = 16) challenged with 0.1 micrograms/ml anti-IgE released 38 +/- 4% of their available histamine and 39 +/- 12 ng LTC4/10(6) basophils within 15-30 min. F-Met peptide (n = 8) caused the release of 54 +/- 8% histamine and 42 +/- 25 ng LTC4/10(6) basophils within a period of 2-5 min. C5a caused the release of 22 +/- 3% histamine from selected donors but failed to initiate any LTC4 release unless combined with D2O or 5 mM extracellular calcium. The two nonphysiological stimuli A23187 and TPA caused extensive histamine release, 67 +/- 8 and 82 +/- 11%, respectively, and while A23187 initiated a large and rapid release of leukotriene, TPA failed to release any LTC4 even when combined with D2O or 2-5 mM extracellular calcium. Increased concentrations of extracellular calcium enhanced anti-IgE and f-Met peptide induced release of LTC4 but inhibited the A23187 induced release of leukotriene. A single peak of immunoreactive leukotriene C4 that comigrated with the authentic standard was identified using HPLC followed by radioimmunoassay. No LTD4 or LTE4 could be detected. Purified human basophils incubated with 0.2 microM [3H]AA incorporated 290 pmol/10(6) cells, or 32 +/- 5% of the available label within 60 min. The [3H]AA was taken principally into the phospholipids (73 +/- 5%), with 20 +/- 3% as neutral lipid, and only 5 +/- 2% remaining as the free acid. Three phospholipid subclasses, phosphatidylcholine, PC (24 +/- 2%), phosphatidylinositol, PI (22 +/- 1%), and phosphatidylethanolamine, PE (15 +/- 3%), accounted for the majority of the incorporated [3H]AA while the remainder of the phospholipids accounted for less than 5% of the total cpm. HPLC analysis of the lipid mediators released during stimulation with 0.1 micrograms/ml anti-IgE revealed [3H]LTC4 (2.4 +/- 1.0%), [3H]5HETE (1.0 +/- 0.1%), unmetabolized [3H]AA (91 +/- 2%), and an unidentified peak (3.4 +/- 1.4%). The unknown metabolite eluted with the prostaglandins, was inhibited by indomethacin, and appeared to have a relatively high specific activity. It may thus represent an artifact of the labeling procedure rather than a novel basophil-derived prostaglandin.