Continuity and Change in Preschool ADHD Symptoms: Longitudinal Genetic Analysis with Contrast Effects

The genetic and environmental mediation of continuity and change in parent-reported ADHD symptoms were investigated in a cohort of over 6000 twin pairs at 2, 3 and 4 years of age. Genetic analyses of the cross-sectional data yielded heritability estimates of 0.78–0.81 at each age, with contrast effects. A common pathway model provided the best fit to the longitudinal data, indicating that genetic influences underlie 91% of the stable variance in ADHD symptomatology. In other words, what is stable for ADHD symptoms is largely genetic. Contrast effects acting in the same direction at different ages contributed to the observed continuity:longitudinal correlations were greater for dizygotic than monozygotic twins.The Twins Early Development Study is funded by the Medical Research Council.     

Cognitive functioning in substance abuse and dependence: a population-based study of young adults

Aims   To investigate whether substance use disorders (SUDs) are associated with verbal intellectual ability, psychomotor processing speed, verbal and visual working memory, executive function and verbal learning in young adults, and to study the associations of SUD characteristics with cognitive performance.
Participants   A population-based sample ( n  = 466) of young Finnish adults aged 21–35 years.
Measurements   Diagnostic assessment was based on all available information from a structured psychiatric interview (SCID-I) and in- and out-patient medical records. Established neuropsychological tests were used in the cognitive assessment. Confounding factors included in the analyses were comorbid psychiatric disorders and risk factors for SUDs, representing behavioural and affective factors, parental factors, early initiation of substance use and education-related factors.
Findings   Adjusted for age and gender, life-time DSM-IV SUD was associated with poorer verbal intellectual ability, as measured with the Wechsler Adult Intelligence Scale–Revised (WAIS-R) vocabulary subtest, and slower psychomotor processing, as measured with the WAIS-R digit symbol subtest. Poorer verbal intellectual ability was accounted for by parental and own low basic education, whereas the association with slower psychomotor processing remained after adjustment for SUD risk factors. Poorer verbal intellectual ability was related to substance abuse rather than dependence. Other SUD characteristics were not associated with cognition.
Conclusions   Poorer verbal intellectual ability and less efficient psychomotor processing are associated with life-time alcohol and other substance use disorders in young adulthood. Poorer verbal intellectual ability seems to be related to parental and own low basic education, whereas slower psychomotor processing is associated with SUD independently of risk factors.     

Influence of crystallinity on the thermoelectric power factor of P3HT vapour-doped with F4TCNQ

Doping of the conjugated polymer poly(3-hexylthiophene) (P3HT) with the p-dopant 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (F4TCNQ) is a widely used model system for organic thermoelectrics. We here study how the crystalline order influences the Seebeck coefficient of P3HT films doped with F4TCNQ from the vapour phase, which leads to a similar number of F4TCNQ anions and hence (bound + mobile) charge carriers of about 2 × 10⁻⁴ mol cm⁻³. We find that the Seebeck coefficient first slightly increases with the degree of order, but then again decreases for the most crystalline P3HT films. We assign this behaviour to the introduction of new states in the bandgap due to planarisation of polymer chains, and an increase in the number of mobile charge carriers, respectively. Overall, the Seebeck coefficient varies between about 40 to 60 μV K⁻¹. In contrast, the electrical conductivity steadily increases with the degree of order, reaching a value of more than 10 S cm⁻¹, which we explain with the pronounced influence of the semi-crystalline nanostructure on the charge-carrier mobility. Overall, the thermoelectric power factor of F4TCNQ vapour-doped P3HT increases by one order of magnitude, and adopts a value of about 3 μW m⁻¹ K⁻² in the case of the highest degree of crystalline order.

The crystallinity of P3HT strongly benefits the electrical conductivity but not Seebeck coefficient, leading to an increase in power factor by one order of magnitude.     

Association between statin use and cognitive function: A systematic review of randomized clinical trials and observational studies

The US Food and Drug Administration issued a black box warning in 2012 regarding the association of statin use with cognitive impairment. This may deter patients and practitioners from using statins for guideline-directed indications. Large studies have not shown an increase in cognitive impairment with statin use. MEDLINE, EMBASE, and Cochrane databases were searched up to October 2019. We present an up-to-date systematic review of randomized controlled trials (RCTs) and prospective observational studies examining the association between statin use and cognitive status in a population aged ≥60 years. Twenty-four studies with 1,404,459 participants were included in the review. Twenty-one were prospective observational studies, and 3 were RCTs. All 3 RCTs, which ranged from 3.2 to 5.6 years of follow-up, showed no significant association between statin use and adverse cognitive effects (odds ratio [OR] 1.03 [0.82–1.30]) and (OR 1.0 [0.61–1.65]). The mean difference in the Mini-Mental State Examination was insignificant (0.06 [?0.04 to 0.16]) in the third RCT. The follow-up for observational studies ranged from 3 to 15 years. Ten observational studies showed reduced incidence of dementia. Seven showed no association with incident dementia. Three studies showed decline in cognition was similar, whereas one showed slower decline with statin use. There was no evidence of adverse cognitive effects, including incidence of dementia, deterioration in global cognition, or specific cognitive domains associated with statin use in individuals aged ≥60 years. Future studies should examine this association in studies with longer follow-up periods.     

Teaching and assessing the database searching skills of student nurses

Critical appraisal and application of the evidence to practice cannot proceed without first finding the evidence. To teach evidence-based practice database searching skills to students, a nurse educator partnered with a librarian to design, conduct, and assess instruction. The authors describe the creation, administration, and findings from the assessments and the implications for instruction.     

A retrospective study on telephone follow-up of anterior colporrhaphy by a specialized nurse

Introduction and hypothesis

The aim of the study was to evaluate a new follow-up practice after anterior colporrhaphy for central cystocele involving nurse telephone follow-up.

Methods

A retrospective follow-up of all 84 patients with an anterior colporrhaphy operation during 2011 was performed. Standard postoperative procedure in uncomplicated cases of cystocele operation (first-time cystocele operation, no preoperative incontinence or voiding difficulties, and no immediate postoperative complications) was a telephone interview performed by a continence nurse 3 months after patient surgery. A local checklist comprising questions concerning complications, voiding dysfunction, and sexual life, as well as questions from the International Consultation on Incontinence Vaginal Symptoms (ICIQ-VS) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were used. Complex cases were followed by the surgeon with a consultation including gynecological examination after 3 months.

Results

Out of 84 patients with a cystocele operation, 59 were uncomplicated and had a telephone follow-up. Forty-four (75 %) were satisfied and needed no further consultation in the hospital. One patient could not be contacted. Fourteen patients had a consultation, three before the telephone consultation because of bleeding, five because of anxiety, and one each because of voiding dysfunction and prolapse symptoms. Four patients had persisting urinary incontinence and were incorrectly scheduled for a telephone interview.

Conclusions

Selecting uncomplicated cases for a nurse telephone follow-up after cystocele operation is feasible in a majority of cases. This allows doctors to see more new patients and focus on difficult cases, as well as saving time and money.