Statin-associated muscle symptoms (SAMS) in primary prevention for cardiovascular disease in older adults:A protocol for a systematic review and meta-analysis of randomised controlled trials

IntroductionAlthough statins are commonly used for prevention of cardiovascular disease, there is limited evidence about statin-related adverse effects in older people. Statin-related adverse events (AEs), especially the statin-associated muscle symptoms (SAMS), are the most common reasons for their discontinuation. Therefore, it is important to determine the risk of SAMS in the older population. We will undertake a systematic review and meta-analysis primarily focusing on the risk of SAMS and secondarily targeting myopathy, rhabdomyolysis, AEs and serious AEs, dropouts due to SAMS in run-in period, related permanent discontinuation rate of statins and creatine kinase level, among older people who received statins for primary prevention.Methods and analysisThis study has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. We will include randomised controlled trials in which statin was compared with placebo with at least 1 year follow-up among older adults aged ≥65. This review is an update of a Cochrane systematic review that included the articles published before 2012. Cochrane Central Register of Controlled Trials, Medline OvidSP and Embase electronic database searches will be performed to identify relevant articles, limiting the publication date from 1 January 2012 to 13 February 2017. There will be no language limitation. Two independent reviewers will screen titles and abstracts and full text in duplicate. Risk of bias and evidence quality will be assessed using the Cochrane Collaboration’s tool and the Grading of Recommendations Assessment, Development and Evaluation approach, respectively. A meta-analysis using pooled data will be undertaken, if appropriate. We will also perform metaregression and subgroup analyses to identify sources of heterogeneity.Ethics and disseminationThis study is exempt from ethics approval due to the anonymous and aggregated data used. The outcomes will be disseminated by conference presentations and published in a peer-reviewed journal.Trial registration numberCRD42017058436.</jats:sec

Drink wise, age well; reducing alcohol related harm among people over 50: a study protocol

Background: Evidence suggests that the use of alcohol among older adults (defined as those aged 50+) has increased in recent years, with people aged 55-64 now more likely to exceed the recommended weekly guidelines than any other age group. Methods/ design: This is a quasi-experimental study with a before-after design. A postal questionnaire will be sent to 76,000 people aged 50 and over registered with a general practice in five different 'demonstration' (intervention) and control areas in the UK. Multiple interventions will then be delivered in demonstration areas across the UK. At the end of the programme, a postal questionnaire will be sent to the same individuals who completed it pre-programme to establish if there has been a reduction in alcohol use, at-risk drinking and alcohol related problems. Qualitative interviews with clients and staff will explore how the interventions were experienced; how they may work to bring about change and to identify areas for practice improvements. Discussion: This study protocol describes a multi-level, multi-intervention prevention-to-treatment programme which aims to reduce alcohol-related harm in people aged 50 and over

Religion and health : the application of a cognitive-behavioural framework

The empirical examination of the relationship between religion and health has often lacked theoretical direction. The aim of the study was to examine the relationship between dimensions of religiosity and health within the context of James and Wells’ cognitive-behavioural framework of religion. A community sample of 177 UK adults completed measures of religious orientation, religious coping, and prayer activity alongside the SF-36 Health Survey. Consistent with the cognitive-behavioural framework of religion, intrinsic religiosity and meditative prayer scores accounted for unique variance in both physical and mental health scores over a number of religious measures. These findings suggest the potential usefulness and importance of a cognitive-behavioural framework to understand the relationship between religion (as measured by meditative prayer and intrinsic religiosity) and health

East Asia and the global/transatlantic/Western crisis

This paper introduces the special collection on East Asia and the Global Crisis. After justifying why a focus on East Asia is appropriate, it draws out the main themes that run through the individual contributions. These are the extent to which the region is decoupling from the global economy (or the West), the increasing legitimacy of statist alternatives to neoliberal development strategies, and the impact of crises on the definition of ―region‖ and the functioning of regional institutions and governance mechanisms

A framework for design engineering education in a global context

This paper presents a framework for teaching design engineering in a global context using innovative technologies to enable distributed teams to work together effectively across international and cultural boundaries. The DIDET Framework represents the findings of a 5-year project conducted by the University of Strathclyde, Stanford University and Olin College which enhanced student learning opportunities by enabling them to partake in global, team based design engineering projects, directly experiencing different cultural contexts and accessing a variety of digital information sources via a range of innovative technology. The use of innovative technology enabled the formalization of design knowledge within international student teams as did the methods that were developed for students to store, share and reuse information. Coaching methods were used by teaching staff to support distributed teams and evaluation work on relevant classes was carried out regularly to allow ongoing improvement of learning and teaching and show improvements in student learning. Major findings of the 5 year project include the requirement to overcome technological, pedagogical and cultural issues for successful eLearning implementations. The DIDET Framework encapsulates all the conclusions relating to design engineering in a global context. Each of the principles for effective distributed design learning is shown along with relevant findings and suggested metrics. The findings detailed in the paper were reached through a series of interventions in design engineering education at the collaborating institutions. Evaluation was carried out on an ongoing basis and fed back into project development, both on the pedagogical and the technological approaches