2,336 research outputs found

    High dose atorvastatin associated with increased risk of significant hepatotoxicity in comparison to simvastatin in UK GPRD cohort

    Get PDF
    Background and Aims: Occasional risk of serious liver dysfunction and autoimmune hepatitis during atorvastatin therapy has been reported. We compared the risk of hepatotoxicity in atorvastatin relative to simvastatin treatment. Methods: The UK GPRD identified patients with a first prescription for simvastatin [164,407] or atorvastatin [76,411] between 1997 and 2006, but with no prior record of liver disease, alcohol-related diagnosis, or liver dysfunction. Incident liver dysfunction in the following six months was identified by biochemical value and compared between statin groups by Cox regression model adjusting for age, sex, year treatment started, dose, alcohol consumption, smoking, body mass index and comorbid conditions. Results: Moderate to severe hepatotoxicity [bilirubin >60μmol/L, AST or ALT >200U/L or alkaline phosphatase >1200U/L] developed in 71 patients on atorvastatin versus 101 on simvastatin. Adjusted hazard ratio [AHR] for all atorvastatin relative to simvastatin was 1.9 [95% confidence interval 1.4–2.6]. High dose was classified as 40–80mg daily and low dose 10–20mg daily. Hepatotoxicity occurred in 0.44% of 4075 patients on high dose atorvastatin [HDA], 0.07% of 72,336 on low dose atorvastatin [LDA], 0.09% of 44,675 on high dose simvastatin [HDS] and 0.05% of 119,732 on low dose simvastatin [LDS]. AHRs compared to LDS were 7.3 [4.2–12.7] for HDA, 1.4 [0.9–2.0] for LDA and 1.5 [1.0–2.2] for HDS. Conclusions: The risk of hepatotoxicity was increased in the first six months of atorvastatin compared to simvastatin treatment, with the greatest difference between high dose atorvastatin and low dose simvastatin. The numbers of events in the analyses were small

    Advancing leadership in sport: Time to 'actually' take the blinkers off?

    Get PDF
    In a recent article entitled Advancing Leadership in Sport: Time to Take off the Blinkers?’ Cruickshank and Collins presented what they deemed to be a critical analysis of extant leadership research in sport, attempting to establish a rationale for a greater emphasis on both the cognitive and ‘darker’ (i.e., socially undesirable) sides of leadership. The purpose of the present article is to challenge and clarify a number of misrepresentations in the arguments made in the foundation article, and to question some of the resultant recommendations made. Specifically, the present response will focus on Cruickshank and Collins’ (a) lack of specificity regarding the actual ‘dark’ traits they are apparently purporting to be effective leadership traits, (b) the dearth of theoretical and empirical support for their claims relating to the benefits of ‘dark’ leadership (c) misrepresentation of transformational leadership theory, (d) decision to ignore other relevant theoretical frameworks when presenting their arguments, and (e) apparent confirmation bias in the selective use of literature to support their arguments. Leadership research in sport may well benefit from new directions and methodological advancements and on this level we concur with the aims of Cruickshank and Collins’ article. However, we believe their misrepresentations and inappropriate recommendations do little to advance this area of research, and potentially serve to take it backwards not forwards

    Development and initial validation of an indirect measure of transformational leadership integrity

    Get PDF
    An indirect measure of transformational leadership integrity was developed across three studies. In Study 1, the transformational leadership integrity implicit association test (TLI-IAT) was developed and tested with 65 leaders across heterogeneous organizational contexts. Study 2 involved 51 coaches from 18 sports. Results from Studies 1 and 2 supported the construct validity of the instrument, providing evidence of the instrument's convergent and discriminant validity. Study 3 involved 32 coaches and 133 players from six sports. Findings supported the criterion validity of the measure, providing evidence for the instrument's predictive validity. In sum, evidence is presented that supports the TLI-IATs construct and criterion validity. As such, the present research has made significant advancements to the transformational leadership integrity literature and provides researchers with an indirect measure of automatic transformational leadership integrity self-attitudes
    • …
    corecore