Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries.

With advances in the effectiveness of treatment and disease management, the contribution of chronic comorbid diseases (comorbidities) found within the Charlson comorbidity index to mortality is likely to have changed since development of the index in 1984. The authors reevaluated the Charlson index and reassigned weights to each condition by identifying and following patients to observe mortality within 1 year after hospital discharge. They applied the updated index and weights to hospital discharge data from 6 countries and tested for their ability to predict in-hospital mortality. Compared with the original Charlson weights, weights generated from the Calgary, Alberta, Canada, data (2004) were 0 for 5 comorbidities, decreased for 3 comorbidities, increased for 4 comorbidities, and did not change for 5 comorbidities. The C statistics for discriminating in-hospital mortality between the new score generated from the 12 comorbidities and the Charlson score were 0.825 (new) and 0.808 (old), respectively, in Australian data (2008), 0.828 and 0.825 in Canadian data (2008), 0.878 and 0.882 in French data (2004), 0.727 and 0.723 in Japanese data (2008), 0.831 and 0.836 in New Zealand data (2008), and 0.869 and 0.876 in Swiss data (2008). The updated index of 12 comorbidities showed good-to-excellent discrimination in predicting in-hospital mortality in data from 6 countries and may be more appropriate for use with more recent administrative data.

Prevalence, treatment and control of dyslipidaemia in Switzerland: still a long way to go.

BACKGROUND: There is little information regarding the prevalence and management of dyslipidaemia in Switzerland. DESIGN: Cross-sectional population-based study of 3238 women and 2846 men aged 35-75. METHODS: Dyslipidaemia prevalence, treatment and control were defined according to PROCAM guidelines adapted to Switzerland. RESULTS: About 29% of the overall sample presented with dyslipidaemia, of which 39% were treated and 58% of those treated were controlled. Among the 710 patients with personal history of cardiovascular disease (CVD) and/or diabetes, 632 (89%) presented with dyslipidaemia, of which 278 (44%) and 134 (21%) patients were treated and adequately controlled, respectively. On multivariate analysis, hypolipidaemic drug treatment was positively related with age and body mass index (P for trend <0.001), and negatively related with smoking status (P for trend <0.002), whereas personal history of CVD and/or diabetes had no effect [odds ratio (OR)=1.12, 95% confidence interval (CI): 0.90-1.38]. Adequate control of lipid levels was negatively related with female sex (OR=0.65, 95% CI: 0.45-0.94) and personal history of CVD and/or diabetes (OR=0.42, 95% CI: 0.30-0.59). When personal history of CVD and/or diabetes was replaced by PROCAM risk categories, patients in the highest risk were also less well controlled. CONCLUSION: In this population-based study, one-third of the participants was dyslipidaemic, but less than half was treated and only one-fifth was adequately controlled. The low treatment and control levels among individuals at high risk for CVD calls for a better application of recommendations regarding personal preventive measures.

Automatització d’una piscina de natació contínua contracorrent de 6 carrils

L’objecte d’aquest projecte és fer l’automatitazció d’una piscina de natació contínua contracorrent de 6 carrils. L’automatització haurà de controlar en tot moment l’estat de l’aigua de la piscina per mantenir-la en bones condicions. Això es durà a terme mitjançant el citcuit de recircuació i el circuit de dosificació. A part de tasques de mantenimen, l’automatització hautà de permètre que mitjançant unes pantalles tàctils els usuaris puguin controlar el corrent que surt per la bomba contracorrent i puguin crear els seus propis programes d’entrenamnent. La piscina serà d’obra, d’unes dimensions 15,4x4x2 que emplenarem d’aigua dolça calenta i la tractarem amb clor. Per poder mantenir la piscina i la seva aigua en bones condicions haurem de controlar certs paràmetres com el clor, el pH i la temperatura

Footnotes June 2002, Vol.26, no.6

Monthly newsleter of the State Library

Les Mille et une nuits. Tome 6 / , contes arabes traduits en français par Galland

[Mille et une nuits (français). 1825]

Footnotes, June/July 2001, Vol.25, no.6/7

Monthly newsletter for the State Libary of Iowa

Footnotes May/June 2000, Vol.24, No.5/6

Monthly newsletter of the State Library of Iowa

Smart News, Issues 6, Summer 2001

Newsletter for Economic Development