On World Mental Health Day (10 October), WHO has called for an end to the stigmatisation of depression and other mental disorders and for better access to treatment for all people who need it.
Globally, more than 350 million people have depression, a mental disorder that prevents people from functioning well. But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.
Depression is different from usual mood fluctuations. Depression induces a sustained feeling of sadness for two weeks or more and interferes with the ability to function at work, school or home. Effective treatments include psychosocial treatment and medication. The active involvement of depressed people and those who are close to them in addressing depression is key. The first step is to recognise the depression and reach out for support. The earlier the treatment begins, the more effective it is.
‘We have some highly effective treatments for depression. Unfortunately, fewer than half of the people who have depression receive the care they need. In fact in many countries this is less than 10%,’ says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse. ‘This is why WHO is supporting countries in fighting stigma as a key activity to increasing access to treatment.’
Cultural attitudes and lack of proper understanding of the condition contribute to a reluctance to seek help for depression.
WHO estimates suggest that depression is common in all regions of the world. A recent study supported by WHO revealed that around 5% of people in the community had depression during the last year.
Depression results from a complex interaction of social, psychological and biological factors. There is a relationship between depression and physical health, for example cardiovascular disease can lead to depression and vice versa. Up to one in five women who give birth experience post-partum depression.
In addition, circumstances such as economic pressures, unemployment, disasters, and conflict can also increase the risk of the disorder. At its worst, depression can lead to suicide. Tragically almost one million people commit suicide every year and a large proportion of them had experienced depression.
WHO assists governments in including treatment of depression in their basic health care packages. Through WHO

Five million ‘test tube babies’ have now been born around the world, according to research presented at a conference of fertility experts. Delegates hailed it as a ‘remarkable milestone’ for fertility treatments.
The first test tube baby, Louise Brown, was born in the UK in July 1978. Her mother Leslie Brown died last month.
However, delegates at the conference in Turkey warned couples not to use fertility treatment as an ‘insurance policy’ if they delayed parenthood.
The International Committee for Monitoring Assisted Reproductive Technologies (Icmart) presented its latest data on children born to infertile parents at the European Society of Human Reproduction and Embryology conference.
It said official figures up to 2008, plus three years of estimates, put the total number of test tube babies born at five million.
Icmart chairman Dr David Adamson said: ‘This technology has been highly successful in treating infertile patients. Millions of families with children have been created, thereby reducing the burden of infertility.
IVF success rates (based on figures for 2008)
33.1% for women under 35
27.2% for women aged 35-37
19.3% for women aged 38-39
12.5% for women aged 40-42
‘The technology has improved greatly over the years to increase pregnancy rates.’
About 1.5 million cycles of IVF, and similar techniques, are performed every year, resulting in 350,000 babies, Icmart said.
Stuart Lavery, a consultant gynaecologist and director of IVF at Hammersmith Hospital, said: ‘IVF is now part of the mainstream, it is no longer something couples are ashamed of.’
However, he cautioned that the great success of assisted reproduction techniques should not lull people into thinking they could wait to have children.
‘The subtext is that if people delay childbirth they may view IVF as an insurance policy that they can access at any stage.
‘Unfortunately the facts still suggest that IVF success rates in women as they get older are not fantastic.’
Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: ‘I think it’s significant that we’ve got to five million. It’s far more socially acceptable than it has been over the last 10 or 20 years.
‘One word of warning, we should make sure that couples understand that IVF isn’t a guaranteed solution and if they’re in a position to have their children earlier in life then they should try and do that.
‘IVF really is something that should be preserved for those people who really need it.’ BBC

The Society for Healthcare Epidemiology of America (SHEA) and Centers for Disease Control and Prevention (CDC) have each released new tools and information to help track deadly healthcare-associated infections (HAIs) in nursing homes and other long-term care settings. Potentially deadly HAIs strike volumes of nursing home residents each year, with best estimates suggesting that up to 2.8 million infections can occur in this population annually.
An expert panel published updated infection definitions and guidance that provides uniform criteria for nursing homes and other long-term care facilities to track and monitor HAIs. The updated surveillance definitions, co-ordinated by SHEA’s Long-Term Care Special Interest Group, incorporate evidence published over the past two decades, with definitions for norovirus gastroenteritis and Clostridium difficile infections added and more specific definitions for urinary tract infections included.
In parallel, CDC’s National Healthcare Safety Network (NHSN) released a new tracking component, allowing nursing homes and other long term care facilities to monitor HAIs. The newly published guidance serves as the foundation of the new NHSN component. When facilities track infections, they can identify problems, implement prevention measures, and monitor progress toward stopping infections. State and local health officials can also use the system to monitor the impact of regional prevention efforts. On the national level, data entered into NHSN will gauge progress toward national infection prevention goals.
‘The unsettling truth is that our best estimates of healthcare-associated infections in long-term care facilities, such as nursing homes, most likely understate the true problem,’ said Nimalie Stone, M.D., a lead author of the guidance and a medical epidemiologist at the Centers for Disease Control and Prevention (CDC). ‘Clinicians in nursing homes cannot prevent healthcare-associated infections unless they know where and how they are occurring. Tracking infections within facilities is the first step toward prevention and ultimately saves lives.’
The new NHSN component allows nursing homes and other long term care facilities to track Clostridium difficile (a deadly diarrhoeal infection), drug-resistant infections such as methicillin-resistant Staphylococcus aureus (MRSA), urinary tract infections, and healthcare worker adherence to basic infection control procedures including hand hygiene and glove use.
‘With the rising number of individuals receiving more complex medical care in nursing homes, these new tools provide a needed means for these resource-limited care settings to help track and monitor their facility’s infections using criteria that reflect the care they provide and the patients they see,’ said Suzanne Bradley, MD, a co-author of the paper and editor-in-chief of Infection Control and Hospital Epidemiology. EurekAlert

Genesis Digital Imaging, Inc. (Los Angeles, CA), a privately-held imaging software developer and distributor of diagnostic imaging systems, has been acquired by Carestream Health.

This acquisition enables Carestream to expand its customer base by leveraging the expertise Genesis has in serving U.S. dealers that primarily call on the value tier market and specialty medical practices. Carestream offers a proven portfolio of products and services designed specifically for these types of healthcare customers.

With this acquisition, Carestream is uniquely positioned to serve customers across the U.S. With its direct sales force offering large hospital customers the latest high-end digital radiography systems and healthcare IT solutions, its Quantum Medical Imaging organisation serving customers in the mid-tier hospital, orthopedic and imaging centre segments, and Genesis focusing on customers in the value tier segment, Carestream has innovative products and services and attractive pricing for customers in all areas of the U.S. market.

Mayo Clinic researchers have found a novel way to monitor real-time chemical changes in the brains of patients undergoing deep brain stimulation (DBS). The groundbreaking insight will help physicians more effectively use DBS to treat brain disorders such as Parkinson’s disease, depression and Tourette syndrome.
Researchers hope to use the discovery to create a DBS system that can instantly respond to chemical changes in the brain. Parkinson’s, Tourette syndrome and depression all involve a surplus or deficiency of neurochemicals in the brain. The idea is to monitor those neurochemicals and adjust them to appropriate levels.
　
‘We can learn what neurochemicals can be released by DBS, neurochemical stimulation, or other stimulation. We can basically learn how the brain works,’ says author Su-Youne Chang, Ph.D., of the Mayo Clinic Neurosurgery Department. As researchers better understand how the brain works, they can predict changes, and respond before those changes disrupt brain functioning.
Researchers observed the real-time changes of the neurotransmitter adenosine in the brains of tremor patients undergoing deep brain stimulation. Neurotransmitters such as dopamine and serotonin are chemicals that transmit signals from a neuron to a target cell across a synapse.
The team used fast scan cyclic voltammetry (FSCV) to quantify concentrations of adenosine released in patients during deep brain stimulation. The data was recorded using Wireless Instantaneous Neurotransmitter Concentration Sensing, a small wireless neurochemical sensor implanted in the patient’s brain. The sensor, combined with FSCV, scans for the neurotransmitter and translates that information onto a laptop in the operating room. The sensor has previously identified neurotransmitters serotonin and dopamine in tests in brain tissue. This was the first time researchers used this technique in patients.
Tremors are a visual cue that the technique is working; researchers suspect adenosine plays a role in reducing tremors.
Researchers also hope to learn more about conditions without such external manifestations.
‘We can’t watch pain as we do tremors,’ says Kendall Lee, M.D., Ph.D., a Mayo Clinic neurosurgeon. ‘What is exciting about this electrochemical feedback is that we can monitor the brain without external feedback. So now, we can monitor neurochemicals in the brain and learn about brain processes like pain.’
DBS has been used successfully worldwide to treat patients with tremors. However, physicians do not fully understand why DBS works in patients. They know that when DBS electrodes are inserted before electrical stimulation, there is an immediate tremor reduction. Known as the microthalamotomy effect, it is reported in up to 53 percent of patients and known to last as long as a year.
Researchers hope to use the study findings to create a self-contained ‘smart’ DBS system. Mayo Clinic