Adaptation of the Clinical Global Impression for Use in Correctional Settings: The CGI-C.

Background: Provision of mental health care in correctional settings presents unique challenges. There is a need for a simple-to-use tool to measure severity of mental illness in correctional settings that can be used by mental health staff from different disciplines. We adapted the severity scale of the Clinical Global Impression for use in correctional settings, which we have called CGI-C, and carried out a reliability study. Method: Clinical descriptions of typical inmate presentations were developed to benchmark each of the seven possible ratings of the CGI. Twenty-one case vignettes were then developed for study of inter-rater reliability, which were then rated using the CGI-C by five forensic psychiatrists (on three occasions) and 11 multidisciplinary health care clinicians (twice). The tool was introduced into clinical practice, and the first 57 joint assessments carried out by both a psychiatrist and a clinician in which a CGI-C was rated were compared to measure inter-rater reliability. Results: We found very good inter-rater and test-retest reliability in all analyses. Gwet's AC, calculated on initial ratings of the vignettes by the psychiatrists, was 0.85 (95% CI 0.81-0.90, p < 0.001) and 0.87 (95% CI 0.83-0.91, p < 0.001) for clinician ratings. Inter-rater reliability based on 57 joint face-to-face assessments of inmates showed Gwet's AC coefficient of 0.93 (95% CI 0.88-0.97). Conclusion: The CGI-C is simple to use, can be used by members of the multidisciplinary team, and shows high reliability. The advantage in correctional settings is that it can be used even with the most severely ill and behaviorally disturbed, based on observation and collateral information.

Psychosocial Predictors of Cognition in Bariatric Surgery.

BACKGROUND: Obesity affects individuals worldwide and is currently the 5th leading cause of death according to the WHO. Bariatric surgery is an effective strategy that produces durable long-term weight loss. There is a bidirectional interplay between mental health and obesity; with higher depression and anxiety in the obese population as well as significant effects on weight loss for people with mental health disorders. OBJECTIVE: Our cross-sectional study aimed to examine psychosocial predictors of cognition for the pre-operative bariatric surgery population and its effect on work productivity. METHODS: Demographic data, perceived cognitive deficits (PDQ-5), depression scale (PHQ-9), anxiety (GAD-7), Quality of life (SF36) and work impairment (LEAPS) was collected from 302 pre-operative bariatric surgery candidates at their initial assessment. Multiple regression was conducted with perceived cognitive deficits as the dependent variable. A secondary analysis was done controlling for anxiety and depression. RESULTS: Variables that were significantly associated with perceived cognition were anxiety, depression, work productivity and overall mental health quality of life. Perceived cognition was also significantly associated with work impairment independent of mood symptoms. DISCUSSION: Anxiety and depression are prevalent in the pre-operative bariatric surgery population, significantly affecting cognition, and should be routinely screened. Work performance was also affected by cognition in our population but the link between obesity and cognition needs to be further explored. CONCLUSIONS: We identified a significant association between perceived cognition and psychosocial factors in pre-operative bariatric surgery candidates. Further studies will be needed to better explore obesity and its impact on cognition.

The Relationship between Psychosocial Factors and Cognition in Multiple Sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a common disorder in some regions of the world, with over 2.3 million people diagnosed worldwide. Cognitive impairment is one of the earliest symptoms to present in the course of the disease and can cause significant morbidity. We proposed a study to explore the psychosocial predictors of cognitive impairment in MS patients in Saudi Arabia, a previously unexplored patient population. METHODS: Demographic data, depression scale (PHQ9), symptom burden (PHQ15), anxiety (GAD7), disease duration, and Montreal Cognitive Assessment (MOCA) scores were collected from 195 patients in a neurology clinic in Ryiadh, Saudi Arabia. Univariate and multiple regression analyses were conducted to identify variables that are significantly associated with cognitive impairment. RESULTS: Variables that were identified to be significantly associated with cognition, p < 0.05, were education level, disease duration, and family history. DISCUSSION: Both education level and disease duration were variables identified in previous studies. We showed family history to be a significant variable, and no association was found with depression or anxiety, which is unique to our study population. CONCLUSIONS: We identified several psychosocial predictors that are associated with cognition in our patient population. It was also noted that a difference exists between patient populations, highlighting the need for further studies in specific geographical regions.

Rapid and specific electrochemical detection of prostate cancer cells using an aperture sensor array.

A rapid, simple and specific cancer cell counting sensor would allow for early detection and better disease management. We have developed a novel cell counting device that can specifically count 125 prostate cancer cells in both complex media with serum and a mixed cell population containing non-target cells within 15 min. The microfabricated glass chip with exposed gold apertures utilizes the anti-EpCAM antibody to selectively count prostate cancer cells via differential pulse voltammetry. The newly developed sensor exhibits excellent sensitivity and selectivity. The cells remain viable throughout the counting process and can be used for further analysis. This device could have utility for future applications in early stage cancer diagnosis.

Electrical power free, low dead volume, pressure-driven pumping for microfluidic applications.

This paper presents a simple-to-construct, low dead volume pump capable of generating a wide range of positive and negative pressures for microfluidic applications. The pump generates pressure or vacuum by changing the volume of air confined inside a syringe and is able to generate pressures between -95 and +300 kPa with a resolution as high as 1 Pa. Different from syringe pumps and electrokinetic pumping, which are capable of controlling flow rates only, our pump can be used to generate constant flow rates or constant pressures, which are required for certain applications such as the aspiration of biological cells for biophysical characterization. Compared to syringe pumps, the new pump has almost zero dead volume and does not exhibit pulsatile flows. Additionally, the system does not require electrical power and is cost effective (∼$100). To demonstrate the capabilities of the pump, we used it to aspirate osteoblasts (MC3T3-E1 cells) and to determine Young's modulus of the cells, to generate a concentration gradient, and to produce variable-sized droplets in microchannels using hydrodynamic focusing.