An aetiological model of depression outlined in earlier research was confined with a new factor of teenage depression shown to increase risk of onset.

OBJECTIVE To determine the ability of pathologists to reproducibly diagnose a newly defined lesion, i.e. the papillary urothelial neoplasm of low malignant potential (PUNLMP) using the published criteria, defined by the 1998 World Health Organisation/International Society of Urological Pathology (WHO/ISUP) classification system; in addition, debate remains about the clinical behaviour of these lesions, thus the rates of recurrence and progression of PUNLMP lesions were assessed and compared with low‐grade papillary urothelial carcinomas (LG‐PUC) and high‐grade (HG‐PUC) over a 10‐year follow‐up. PATIENTS AND METHODS Forty‐nine cases of superficial bladder cancer (G1–3 pTa) representing an initial diagnosis of transitional cell carcinoma made in 1990 were identified and re‐graded using the 1998 WHO/ISUP classification by two pathologists. Inter‐observer agreement was assessed using Cohen weighted κ statistics. After re‐classification the clinical follow‐up was reviewed retrospectively, and episodes of recurrence and progression recorded. RESULTS The inter‐observer agreement was moderate, regardless of whether one (κ 0.45) or two (κ 0.60) pathologists were used to grade these lesions. Re‐classification identified 12 PUNLMP, 28 LG‐PUC and nine HG‐PUC. PUNLMP lesions recurred in 25% (3/12) of cases; no progression was documented. Recurrence rates were 75% (21/28) and 67% (6/9) for LG‐ and HG‐PUC, respectively, and progression rates were 4% (1/28) and 22% (2/9). CONCLUSION The 1998 WHO/ISUP classification of urothelial neoplasms can be reproducibly applied by pathologists, with a moderate level of agreement. There is evidence that PUNLMP lesions have a more indolent clinical behaviour than urothelial carcinomas. However, the risk of recurrence and progression remains, and clinical monitoring of these patients is important.

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Impulsivity-related falls (IRFs) sustained by hospitalized, older adults can lead to critical adverse events. The purpose of this study was to determine whether 7 common fall risk factors contributed to the occurrence of IRF in hospitalized, older adults. This study found that 31% of falls were classified as IRF. Logistic regression indicated that inattention and mobility were contributors to IRF. Early identification of these 2 risk factors could improve identification of potential IRFs and reduce fall rates.