Cognitive-behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial - the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study.

Background: Falls cause fear, anxiety and loss of confidence, resulting in activity avoidance, social isolation and increasing frailty. The umbrella term for these problems is 'fear of falling', seen in up to 85% of older adults who fall. Evidence of effectiveness of physical and psychological interventions is limited, with no previous studies examining the role of an individually delivered cognitive-behavioural therapy (CBT) approach.

Development of a decision analytic model to support decision making and risk communication about thrombolytic treatment.

Background: Individualised prediction of outcomes can support clinical and shared decision making. This paper describes the building of such a model to predict outcomes with and without intravenous thrombolysis treatment following ischaemic stroke.

Methods: A decision analytic model (DAM) was constructed to establish the likely balance of benefits and risks of treating acute ischaemic stroke with thrombolysis.

Modelling the efficiency of local versus central provision of intravenous thrombolysis after acute ischemic stroke.

Background And Purpose: Prehospital redirection of stroke patients to a regional center is used as a strategy to maximize the provision of intravenous thrombolysis. We developed a model to quantify the benefit of redirection away from local services that were already providing thrombolysis.

Methods: A microsimulation using hospital and ambulance data from consecutive emergency admissions to 10 local acute stroke units estimated the effect of redirection to 2 regional neuroscience centers.

A comparison of actual versus predicted emergency ambulance journey times using generic Geographic Information System software.

Study Objective: The planning of regional emergency medical services is aided by accurate prediction of urgent ambulance journey times, but it is unclear whether it is appropriate to use Geographical Information System (GIS) products designed for general traffic. We examined the accuracy of a commercially available generic GIS package when predicting emergency ambulance journey times under different population and temporal conditions.

Methods: We undertook a retrospective cohort study of emergency ambulance admissions to three emergency departments (ED) serving differing population distributions in northeast England (urban/suburban/rural).

CYP2C19 genotype predicts steady state escitalopram concentration in GENDEP.

In vitro work shows CYP2C19 and CYP2D6 contribute to the metabolism of escitalopram to its primary metabolite, N-desmethylescitalopram. We report the effect of CYP2C19 and CYP2D6 genotypes on steady state morning concentrations of escitalopram and N-desmethylescitalopram and the ratio of this metabolite to the parent drug in 196 adult patients with depression in GENDEP, a clinical pharmacogenomic trial. Subjects who had one CYP2D6 allele associated with intermediate metabolizer phenotype and one associated with poor metabolizer (i.

Medical disorders in people with recurrent depression.

Background: Few studies have examined the rates of physical disorders in those with recurrent depression.

Aims: To examine self-reported physical disorders in people with recurrent depression compared with a psychiatrically healthy control group.

Method: As part of a genetic case-control association study, 1546 participants with recurrent depression and 884 controls were interviewed about lifetime ever treatment for 16 different physical health disorders.

The rising share of nonmarital births: fertility choice or marriage behavior?

Much of the sharp rise in the share of nonmarital births in the United States has been attributed to changes in the fertility choices of unmarried and married women-in response, it is often argued, to public policy. In contrast, we develop and test a model that attributes the rise to changes in marriage behavior, with no necessary changes infertility. A variety of empirical tests strongly support this conclusion and invites focused attention to issues related to marriage behavior as well as to the interactions between marriage and fertility.