Predicting 10-year risk of fatal cardiovascular disease in Germany: an update based on the SCORE-Deutschland Risk Charts

Estimation of absolute risk of cardiovascular disease (CVD), preferably with population-specific risk charts, has become a cornerstone of CVD primary prevention. Regular recalibration of risk charts may be necessary due to decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for fatal CVD risk assessment were first calibrated for Germany with 1998 risk factor level data and 1999 mortality statistics. We present an update of these risk charts based on the SCORE methodology including estimates of relative risks from SCORE, risk factor levels from the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) and official mortality statistics from 2012. Competing risks methods were applied and estimates were independently validated. Updated risk charts were calculated based on cholesterol, smoking, systolic blood pressure risk factor levels, sex and 5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower according to the updated risk charts compared to the first calibration for Germany. In a nationwide sample of 3062 adults aged 40-65 years free of major CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated charts was lower by 29% and the estimated proportion of high risk people (10-year risk > = 5%) by 50% compared to the older risk charts. This recalibration shows a need for regular updates of risk charts according to changes in mortality and risk factor levels in order to sustain the identification of people with a high CVD risk.

The demise of the Beothuk as a past still present

This article aims to investigate contemporary cultural representations of the Beothuk Indians in art, literature and museum displays in Newfoundland, Canada, focussing on ways these reimagine the past for the present, offering perspectives on contested histories, such as the circumstances leading to the demise of the Beothuk. Wiped out through the impact of colonialism, the Beothuk are the ‘absent other’ who continue to be remembered and made present through the creative arts, largely at the expense of other indigenous groups on the island. Rather than focussing on the ‘non-absent past, according to Polish scholar Ewa Domańska, ‘instead we turn to a past that is somehow still present, that will not go away or, rather, that of which we cannot rid ourselves’ (2006, 346). Depictions of the last Beothuk are part of a cultural remembering where guilt and reconciliation are played out through media of the imagination