Development of the place-based Adelante social marketing campaign for prevention of substance use, sexual risk and violence among Latino immigrant youth.

Immigrant Latino youth represent a high-risk subgroup that should be targeted with health promotion efforts. However, there are considerable barriers to engagement in health-related programming. Little is known about the engagement possibilities of social marketing campaigns and digital strategies for traditionally 'hard-to-reach' immigrants, underscoring the importance of testing these techniques with immigrant Latino adolescents. We developed and piloted a place-based social marketing campaign in coordination with the branded, Positive Youth Development-based (PYD) Adelante intervention targeting risk factors for co-occurring youth substance abuse, sexual risk and violence. Building on prior research, we conducted a four-phase formative research process, and planned the Adelante social marketing campaign based on findings from one group interview and ongoing consultation with Adelante staff (n=8) and four focus groups with youth (n=35). Participants identified four overarching campaign themes, and suggested portrayal of resilient, proud youth who achieved goals despite adversity. Youth guided selection of campaign features and engagement strategies, including message/visual content, stylistic elements, and a mixed language approach. We developed a 12-month campaign to be delivered via print ads, multi-platform social media promotion, contests, youth-generated videos, blog posts, and text messaging. We describe the process and outcome of campaign development and make recommendations for future campaigns.

Neurointensive care of patients with severe community-acquired meningitis.

BACKGROUND: Reports about neurointensive care of severe community-acquired meningitis are few. The aims of this retrospective study were to review the acute clinical course, management and outcome in a series of bacterial meningitis patients receiving neurointensive care. METHODS: Thirty patients (median age 51, range 1-81) admitted from a population of 2 million people during 7 years were studied. The neurointensive care protocol included escalated stepwise treatment with mild hyperventilation, cerebrospinal fluid (CSF) drainage, continuous thiopentotal infusion and decompressive craniectomy. Clinical outcome was assessed using the Glasgow outcome scale. RESULTS: Twenty-eight patients did not respond to commands on arrival, five were non-reacting and five had dilated pupils. Twenty-two patients had positive CSF cultures: Streptococcus pneumoniae (n=18), Neisseria meningitidis (n=2), ß-streptococcus group A (n=1) and Staphylococcus aureus (n=1). Thirty-five patients were mechanically ventilated. Intracranial pressure (ICP) was monitored in 28 patients (intraventricular catheter=26, intracerebral transducers=2). CSF was drained in 15 patients. Three patients received thiopentothal. Increased ICP (>20 mmHg) was observed in 7/26 patients with available ICP data. Six patients died during neurointensive care: total brain infarction (n=4), cardiac arrest (n=1) and treatment withdrawal (n=1). Seven patients died after discharge, three due to meningitis complications. At follow-up, 14 patients showed good recovery, six moderate disability, two severe disability and 13 were dead. CONCLUSION: Patients judged to have severe meningitis should be admitted to neurointensive care units without delay for ICP monitoring and management according to modern neurointensive care principles.

A defined substrate technology for the enumeration of microbial indicators of environmental pollution.

The examination of water and other environmental sources for microbial pollution is a major public health undertaking. Currently, there are two accepted methods in use: the multiple-tube fermentation (MTF) and the membrane filtration (MF) tests. Both methods are designed to enumerate the secondary indicator group, total coliforms. Both tests suffer several inherent limitations, including a time delay of three to seven days to obtain a definitive result, the subjective nature of the test interpretation, and the inability to provide directly useful public health information. A defined substrate technology, originally used to enumerate specific bacterial species from mixtures in clinical urine specimens, was applied to water testing; the technology was constituted to enumerate simultaneously both total coliforms and the primary indicator bacterium E. coli. Examination of environmental isolates of these two classes of target microbes showed sensitivity equal to available methods, with potentially greater specificity. It was not subject to inhibition by bacteria other than the targets, grew injured coliforms, did not require confirmatory tests, and the maximum time to a positive was 24 hours. The defined substrate technology provides both regulatory and directly useful public health information.

Assay of extracellular proteinases using a colorimetric collagen substrate for the differentiation of Serratia in the tribe Klebsielleae.

The gelatin test has been utilized for many years as a characteristic to separate the genus Serratia from other members of the tribe Klebsielleae. Gelatin is a large protein matrix that cannot diffuse into bacterial cells. Microbes that attack gelatin do so by producing extracellular proteinases. The measurement of gelatinase has suffered from the lack of a definable endpoint and the inability to quantitate the enzyme. A method was developed utilizing an azo-dye-labelled collagen substrate that could measure the extracellular proteinase of serratia. The test was easy to perform, inexpensive, and potentially quantifiable. The azo-dye test corresponded completely with the gelatinase tests.

Inactivation of the polyanionic detergent sodium polyanetholsulfonate by hemoglobin.

Sodium polyanetholsulfonate (SPS) has been added to blood culture media for many years. Its incorporation results in a higher yield of positive blood cultures due to its inactivation of antimicrobial cationic compounds. The most active of these cations include complement components, aminoglycoside-aminocyclitol antibiotics, and receptors on polymorphonuclear leukocytes. There have been reports from studies conducted outside patient blood culture bottles that SPS itself may possess antibacterial activity against some isolates of Neisseria meningitidis, Neisseria gonorrhoeae, and Peptostreptococcus anaerobius. Conversely, in patient clinical trials there has been no significant difference in pathogen isolation rates in the presence or absence of SPS. In an attempt to explain this in vitro/in vivo disparity, a search was undertaken to elucidate which variable constituent in blood, heretofore not studied quantitatively, might have a major effect on modulating the activity of SPS. It was found that hemoglobin combined stoichiometrically with SPS with a Kd of approximately 10(-7) mol/liter. Optimum SPS inactivation occurred at an SPS/hemoglobin ratio of 1:6 (wt/wt). SPS-sensitive isolates of N. gonorrhoeae and N. meningitidis were protected by the addition of hemoglobin from the antimicrobial effects of this polyanion in time-kill studies. This protection was directly related to the amount of SPS combined in solution. Therefore, the amount of free hemoglobin in solution must be measured when studying the antimicrobial activity of polyanions or when evaluating the effect of different polyanions on the recovery rates of pathogens in patient blood culture clinical trials.