Search

This study extends the limited research on predictors of completion of adolescent residential drug and alcohol program. A Queensland, Australia, five-bed state-wide voluntary adolescent drug and alcohol withdrawal service collected routine clinical pre-entry data over a period of 9 years (2000–2009) on 524 subjects. Potential predictors of program completion included socio-demographic, family functioning, past mental health history, mental health problems on admission, and patterns of drug use variables. The chi-square analysis identified significant predictors with subsequent multivariate logistic regression modeling. Given the loss of data, additional multiple imputation logistic regression analysis was utilized. Initial predictors were aged 17 and over; a past history of psychiatric treatment or violence or assault; mental health problems identified on entry; absence of current alcohol use or ecstasy use. After regression and multiple imputation modeling, predictors were a history of psychiatric treatment and of violence/assault. A history of co-morbidity rather than traditional markers of good outcomes such as sex, ethnic background, income support, and housing support predicted program retention. The study reinforces the important role of non-substance psychiatry co-morbidity in the treatment of substance use disorder. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is a group of health conditions affecting the heart and vascular system with very high prevalence and mortality rates. The presence of CVD is characterised by high levels of inflammation which have previously been associated with increased plasma concentrations of N-acetyl neuraminic acid (Neu5Ac). While Neu5Ac has been studied in the context of CVD, Neu5,9Ac2 has not, despite being the second most abundant sialic acid in human plasma. A small-scale pilot study of thirty plasma samples from patients with diagnosed CVD, and thirty age and sex-matched healthy controls, was designed to gain insight into sialic acids as biomarkers for CVD and potential future areas of study. Each sample was assayed for Neu5Ac and Neu5,9Ac2 concentrations. Mean Neu5Ac and Neu5,9Ac2 concentrations were significantly elevated in patients with CVD compared to healthy controls (Neu5Ac: P < 0.001; Neu5,9Ac2: P < 0.04). Receiver operator curve (ROC) analysis indicated that both Neu5Ac and Neu5,9Ac2 have reasonable predictive power for the presence of CVD (Neu5Ac AUC: 0.86; Neu5,9Ac2 AUC: 0.71). However, while Neu5Ac had both good sensitivity (0.82) and specificity (0.81), Neu5,9Ac2 had equivalent specificity (0.81) but very poor sensitivity (0.44). A combination marker of Neu5Ac + Neu5,9Ac2 showed improvement over Neu5Ac alone in terms of predictive power (AUC: 0.93), sensitivity (0.87), and specificity (0.90). Comparison to a known inflammatory marker, high sensitivity c-reactive protein (hs-CRP: P-value: NS, ROC:0.50) was carried out, showing that both Neu5Ac and Neu5,9Ac2 outperformed this marker. Further to this, hs-CRP values were combined with the three different sialic acid markers to determine any effect on the AUC values. A slight improvement in AUC was noted for each of the combinations, with Neu5Ac + Neu5,9Ac2 + hs-CRP giving the best AUC of 0.97 overall. Thus, Neu5Ac would appear to offer good potential as a predictive marker for the presence of CVD, which the addition of Neu5,9Ac2 predictive power improves, with further improvement seen by the addition of hs-CRP. [ABSTRACT FROM AUTHOR]