An open-source remote heart rate imaging method with practical apparatus and algorithms.

Recent developments in computer science and digital image processing have enabled the extraction of an individual's heart pulsations from pixel changes in recorded video images of human skin surfaces. This method is termed remote photoplethysmography (rPPG) and can be achieved with consumer-level cameras (e.g., a webcam or mobile camera). The goal of the present publication is two-fold. First, we aim to organize future rPPG software developments in a tractable and nontechnical manner, such that the public gains access to a basic open-source rPPG code, comes to understand its utility, and can follow its most recent progressions. The second goal is to investigate rPPG's accuracy in detecting heart rates from the skin surfaces of several body parts after physical exercise and under ambient lighting conditions with a consumer-level camera. We report that rPPG is highly accurate when the camera is aimed at facial skin tissue, but that the heart rate recordings from wrist regions are less reliable, and recordings from the calves are unreliable. Facial rPPG remained accurate despite the high heart rates after exercise. The proposed research procedures and the experimental findings provide guidelines for future studies on rPPG.

Interpersonal psychotherapy for elderly patients in primary care.

OBJECTIVE: Interpersonal psychotherapy (IPT) is recommended in most depression treatment guidelines, but little is known about its effectiveness in real-life practice. This study investigates whether IPT, delivered by mental health workers to elderly patients with major depressive disorder, is more effective than usual general practitioners' care (CAU). METHODS: A pragmatic randomized, controlled trial was conducted in which 143 patients were allocated to IPT (10 sessions) or to CAU. PRIMary care Evaluation of Mental Disorders (PRIME-MD) and Montgomery Asberg Depression Rating Scale (MADRS) assessments were used as primary outcomes. RESULTS: IPT was significantly more effective in reducing the percentage of patients with a diagnosis of depression (PRIME-MD), but not in inducing remission (MADRS <10). Among treatment completers, IPT was superior in improving social and overall mental functioning. A post hoc analysis revealed that IPT was superior to CAU in moderately to severely depressed patients, but not significantly so in mildly depressed patients. CONCLUSIONS: IPT was more effective than CAU for elderly patients with moderate to severe major depressive disorder in general practice. Future research should focus on determinants of treatment outcome.

Prevalence of depression in older patients consulting their general practitioner in The Netherlands.

BACKGROUND: Little is known about the prevalence of depression in older patients consulting their general practitioner. AIM: To estimate the prevalence of major and minor depression in older GP attendees. DESIGN: Cross sectional two-stage screening design. SETTING: Seventeen GPs in urban and 41 GPs in rural settings. METHODS: Data of The West Friesland Study were used. Five thousand, six hundred and eight-six GP attendees of 55 years and older filled in the Geriatric Depression Scale-15 items as a screening instrument for depression (response 62%). Of those screened positive on the GDS-15, 846 (77.5%) were interviewed using the Primary Care Evaluation of Mental Disorders (PRIME-MD). A random sample (n = 102) scoring below the threshold of the GDS-15 was interviewed to estimate the proportion of false negatives. RESULTS: Major depression was prevalent in 13.7% and minor depression in 10.2% of the patients. Depressed patients were older (mean difference 0.7 years; p = 0.037), more often female (OR 1.3; p < 0.001) and lived more often in urban districts (OR 1.5; p < 0.001). Patients with major depression were younger (mean difference 1.9 years; p < 0.001) and more often female (OR 1.4; p = 0.026) than those with a minor depression. Only 22.9% of the patients with a major depression were treated with antidepressants. CONCLUSION: Depression in older GP attendees is a very common health problem. Further research should focus on identifying those groups of patients with high risk of persistence of depression. This could help to focus the limited resources available in general practice to those patients in whom treatment is most urgently needed.