Efficacy of a home-based human immunodeficiency virus prevention video program for teens and parents.

Family-based communication about sexual behavior and sexuality is a predominate theme in the key risk reduction and service objectives for human immunodeficiency virus (HIV) prevention and related issues in Healthy People 2000. These recommendations are particularly poignant for younger adolescents who are not yet sexually active and whose social orientation is primarily to family and parents. A family-centered, home-based, video program to foster parent and teen knowledge and communication regarding issues related to HIV prevention and to increase family and teen communication skills was used in an intensive field test of program efficacy. Sixty-nine families with at least one adolescent age 12 to 14 years were recruited through their primary-care physicians and were randomly assigned to either experimental (video with information and skills training) or control (video with information only) conditions in a pre-posttest with a 4-month follow-up design. Both versions of the video program resulted in substantial increases in HIV-related knowledge for parents and teens, but only the skill-training (experimental) version produced increases in knowledge of communication skills and behavioral demonstrations of family problem solving. Approaches for a broader and more effective parent-training video program and for dissemination through primary-care physicians are discussed.

The overestimation of adherence to pediatric medical regimens.

We evaluated the accuracy of primary health care providers' predictions of parents' adherence to their children's short-term antibiotic regimen and a scheduled follow-up appointment. Adherence predictions were compared with objective measures of the parents' adherence. Providers were poor predictors of nonadherence, greatly overestimating the percentage of parents who would be adherent. Nonadherence is typically addressed by applying adherence improvement strategies to all patients. Recent pediatric research, however, suggests that applying contingency-based interventions for adherent patients can result in later nonadherence if the strategies are withdrawn. Inaccurate predictions of adherence will result in many nonadherent patients not receiving a needed intervention. The results indicate the need for strong behavioral predictors that result in more accurate identification of patient nonadherence to guide further applications of adherence improvement strategies.

Behavior of injured and uninjured children and their parents in a simulated hazardous setting.

Compared the behavior of parents and their previously injured children with parents and their uninjured children in unstructured play and distracted parent conditions. Injured children were more disruptive, more active, and had more contacts with hazards, whereas uninjured children had more appropriate behavior. Parents of injured children had lower rates of play activities. Observable classes of parent and child behaviors amenable to change were associated with a history of child injury. Further study is needed to assess the use of safe and unsafe behavior as proxy measures for injuries and to identify functional classes of safe and unsafe behavior for which active strategies can be developed to prevent children's injuries.

Family/media approach to HIV prevention: results with a home-based, parent-teen video program.

We describe the first study with a home-based HIV prevention video program for parents and young teenagers. The objectives of the program are to inform parents and teenagers about the causes and prevention of HIV infection and other sexually transmitted diseases, to increase family problem-solving skills, and to increase teen problem-solving and assertiveness skills. The objectives pertain to the goals of increasing skills needed to help teenagers avoid or manage high-risk behaviors and situations. Forty-five families with at least one 12- to 14-year-old were randomly assigned to either experimental (receive video program) or control (no video) conditions in a pretest-posttest design. After 6 months (Follow-Up 1), the experimental and control families were reassessed. The control families next received the video program, and the control families were assessed again (Follow-Up 2). The results indicate increases in parent and teen knowledge and skills only with video viewing. Approaches to improving the video program, particularly with teenagers, are discussed.

Synthesis of polyamine-linked bis-daunomycin hydrazones and their interaction with DNA.

A series of bis-anthracycline hydrazones were prepared, compounds 9, containing either two or three secondary amines in the linker chain as well as the corresponding acetyl (10), or benzoyl (11) protected derivatives. Compounds 9 could not be isolated in pure form as they decomposed during semi-preparative h.p.l.c. Compounds 10a-g and 11b were characterized by f.a.b. mass spectrometry. All compounds bis-intercalated into DNA as judged by viscometric lengthening of DNA and by decreased dissociation kinetics from DNA under conditions of SDS sequestration. The secondary amine containing derivatives (9) exhibited dissociation rates less than 10(-5) that of daunomycin. The apparent affinity of these compounds was so great that the dissociation constants could not be quantitated, and they were only liberated from DNA to monomeric species by a slow hydrolysis process of the hydrazone links. Protection of those derivatives containing two amines in the linker by acetyl (10) and benzoyl (11) groups, decreased the dissociation time constant to 490-2900 s (1400-8000 fold slower than daunomycin) with maximal DNA residence time corresponding to a linker length of 14 atoms (approximately 14 A). Addition of a third protected amine in the linker, compound 10g, enhanced the DNA residence time a further three-fold. In vitro inhibition of transcription analysis showed that all of the bis-anthracyclines exhibited a DNA sequence specificity for 5'-CpA-3' sites, with adjacent intercalation sites decreasing in the order CA greater than AC, TC greater than CT greater than GC, CG, CC, TA, and it is apparent that the presence of the basic amino functions in the bridging chain provides for greatly enhanced formation of the drug-DNA complex.

Fast atom bombardment mass spectrometry of some anthracycline and bisanthracycline derivatives.

Fast atom bombardment (FAB) mass spectra of daunomycin, four of its derivatives, seven bisanthracyclines and three mixed-functional daunomycin-acridine derivatives are reported. These anthracyclines all exhibited their expected [MH]+ ions and peaks corresponding to the fragmentations which are characteristic of the anthracycline moiety, and in addition the spectra showed enhanced [MH + n]+ (n = 1-4) ions which were attributed to reductive processes occurring in the liquid matrix under FAB conditions. Daunomycin was also observed to form a dimeric cluster ion [M2H]+ together with associated reduced ions under FAB conditions. We have found that FAB mass spectrometry is an ideal method for the qualitative analysis of large, non-volatile derivatives of anthracyclines.