Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

Background Convalescent plasma therapy for COVID‐19 relies on transfer of anti‐viral antibody from donors to recipients via plasma transfusion. The relationship between clinical characteristics and antibody response to COVID‐19 is not well defined. We investigated predictors of convalescent antibody production and quantified recipient antibody response in a convalescent plasma therapy clinical trial. Methods Multivariable analysis of clinical and serological parameters in 103 confirmed COVID‐19 convalescent plasma donors 28 days or more following symptom resolution was performed. Mixed‐effects regression models with piecewise linear trends were used to characterize serial antibody responses in 10 convalescent plasma recipients with severe COVID‐19. Results Donor antibody titres ranged from 0 to 1 : 3892 (anti‐receptor binding domain (RBD)) and 0 to 1 : 3289 (anti‐spike). Higher anti‐RBD and anti‐spike titres were associated with increased age, hospitalization for COVID‐19, fever and absence of myalgia (all P < 0.05). Fatigue was significantly associated with anti‐RBD ( P = 0.03). In pairwise comparison amongst ABO blood types, AB donors had higher anti‐RBD and anti‐spike than O donors ( P < 0.05). No toxicity was associated with plasma transfusion. Non‐ECMO recipient anti‐RBD antibody titre increased on average 31% per day during the first three days post‐transfusion ( P = 0.01) and anti‐spike antibody titre by 40.3% ( P = 0.02). Conclusion Advanced age, fever, absence of myalgia, fatigue, blood type and hospitalization were associated with higher convalescent antibody titre to COVID‐19. Despite variability in donor titre, 80% of convalescent plasma recipients showed significant increase in antibody levels post‐transfusion. A more complete understanding of the dose‐response effect of plasma transfusion amongst COVID‐19‐infected patients is needed.

We describe the prototype to product development process of a low cost, socio-culturally relevant, easily implemented Internet-based depression prevention intervention for adolescents in primary care. The intervention named "Project CATCH-IT" (Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training) includes an initial motivational interview in primary care to engage the adolescent, fourteen Web-based modules based on behavioral activation, cognitive behavioral and interpersonal psychotherapy which target known risk factors, and a follow-up motivational interview in primary care. This was successfully fielded in a pilot study with 25 adolescents. We know of no other similar interventions developed for the prevention of depression in youth that is potentially universally available at low cost and that utilizes existing systems of healthcare providers.

There are significant disparities in treatment process and symptomatic and functional outcomes in depressive disorders for racial and ethnic minority patients. Using a life-course perspective, the authors conducted a systematic review of the literature to identify modifiable mechanisms and effective interventions for prevention and treatment at specific points -- system, community, provider, and individual patient -- in health care settings. Multicomponent chronic disease management interventions have produced improvements in depression outcomes for ethnic minority populations. Case management appears to be a key component of effective interventions. Socioculturally tailored treatment and prevention interventions may be more efficacious than standard treatment programs. Future research should focus on identifying key components of case management and sociocultural tailoring that are essential for effective interventions and developing new low-cost dissemination mechanisms for treatment and preventive programs that could be tailored to racial and ethnic minorities.

PURPOSE:To compare prevalence, clinical outcomes, and resource utilization between subjects with lower gastrointestinal bleeding (LGIB) and upper gastrointestinal bleeding (UGIB). METHODS:Using administrative data, patient surveys, and chart abstraction, comparisons between subjects admitted withLGIB and UGIB were made by employing bivariate and multivariate statistics. RESULTS:A total of 367 subjects were identified, LGIB ¼ 187 and UGIB ¼ 180. Subjects with UGIB compared to LGIB had greater admission hemodynamic instability including tachycardia and orthostasis but clinical outcomes were similar. In multivariate analyses, no significant differences were observed for in-hospital mortality transfer to the intensive care unit (ICU) or 30-day readmission rate. Resource utilization was similar in UGIB and LGIB, including mean costs, length of stay, and number of endoscopic procedures. CONCLUSIONS:Unlike prior studies, this direct comparison of LGIB to UGIB identified more similarities than differences with similar prevalence rates, clinical outcomes, and resource utilization, suggesting that the epidemiology of gastrointestinal bleeding may be changing.