The female-male gap in life expectancy in Poland

The difference in life expectancy between the sexes in Poland started to decline only in 1991, equaling 8.4 years in 2009. In addition, with the rapid increase in male excess mortality between 1989 and 1991, the sex gap also increased. With the exception of excess mortality of male infants, the female advantage in mortality grows with age and reaches the maximum at the age of 65–70 years in 2009. The excess mortality of male infants decreased over the studied years from a contribution of over a year to the sex gap in life expectancy at birth in 1959, to less than a month in 2009. Differences in life expectancy at birth between the sexes in Poland are greater in rural than in urban areas and there is a variation between the voivodships: from 7.9 years in 2008 in the Pomorskie voivodship to 10.2 years in Lubelskie. The largest variation in the sex gap in life expectancy was that between different educational groups: and the gap decreased with the level of educational attainment. Diseases of the circulatory system are a major group of causes of death, with the highest contribution to the sex gap in life expectancy, and were the largest factor in the narrowing of the sex gap between 1991 and 2006. External causes of death were the second-largest group contributing to the sex gap in life expectancy at birth in 1991, and to the narrowing of the gap in the studied period. Over the years under study, the importance of malignant neoplasms for the phenomenon in consideration increased, but at the same time life expectancy of both sexes rose due to improvements in mortality from this group of causes. According to our estimates, smoking- and alcohol-related causes of death together explained about 50% of the total difference in life expectancy at birth between the sexes in the years 1989–2006. In this period, the sex gap in life expectancy due to these causes of death increased, which is opposite to what was reported for other developed countries

Umieralność z przyczyn nieznanych i niedokładnie określonych oraz jej trwałe zróżnicowanie terytorialne w Polsce

An effective health policy can be only conducted on the basis of complete and up-to-date statistical data referring to, among others, causes of deaths. The share of deaths due to unknown and ill-defined causes constitutes one of quality indicators of data on mortality. As compared to other European countries, in Poland this share is relatively high, especially in some regions of the country. Presented analysis is devoted to spatial differences of mortality due to unknown and ill-defined causes in 1991–1995 and 2006–2010. Despite the introduction of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, as well as despite the modernization of data collecting system in 1997, spatial differences remained at a constant and moderate level, which probably results from the prevalence of local coding practices. We propose possible solutions that could contribute to decrease in share of death due to unknown and ill-defined causes in Poland, among them standardization of local coding procedures concerning causes of death

Using multiple cause of death information to eliminate garbage codes

Background: International comparisons of mortality largely depend on the quality of data. With more than 20Š of deaths annually assigned to ill-defined cardiovascular conditions, the mortality level due to well-defined causes of death is under-registered in Poland. Objective: We aim to reclassify cardiovascular garbage codes (GCs) into well-defined causes based on multiple causes of death (MCoD) data and to approximate mortality levels due to well-defined causes of death in Poland. We examine the usefulness of the MCoD approach for correcting low-quality data on causes of death. Methods: Based on the unique MCoD dataset for Poland, death counts due to cardiovascular GCs were reassigned to well-defined underlying causes in two steps: (1) manually for death records that included MCoD information constituting a logical chain of conditions leading to death and (2) with coarsened exact matching for the remaining death records. Age-specific and age-standardised death rates for large groups of causes were calculated before and after redistribution and compared to those of other Eastern European countries with relatively good data quality. Results: Of deaths originally assigned to cardiovascular GCs, 86,856 were reclassified, mostly to well-defined cardiovascular diseases, cancers, endocrine, nutritional and metabolic diseases, and respiratory diseases. The age-standardised death rate due to well-defined ischaemic heart diseases increased by 43Š, and the rate due to cerebrovascular diseases by 22Š. Cardiovascular mortality structure by large groups of causes became similar to the structure registered in other Eastern European countries characterised by a low prevalence of GCs. Conclusions: Coarsened exact matching performs relatively well when abundant MCoD information is available and enhances the comparability of cause-of-death data between countries. Contribution: Redistribution of GCs improves the quality of cause-of-death data and enhances their comparability between countries

The concept of the Equivalent Lenght of Life for quantifying differences in age-at-death distributions across countries

Life expectancy, that is the mean age at death in a life table, is the most common measure used to describe and compare mortality distributions. Alternatives to life expectancy that have been proposed so far have also referred to only a single parameter of the mortality distribution. We propose to study mortality distributions by applying Silber’s concept of the Equivalent Length of Life (ELL), which enables comparisons based on up to three parameters of age-at-death distributions: life expectancy, dispersion and skewness. The method, and our decomposition, is used to study convergence/divergence of life-table age-at-death distributions across 35 developed countries of the Human Mortality Database in 1970–2010 and to assess the contribution of the three moments of the distribution to the total differences between countries and trends in the contribution. We observed a divergence of age-at-death distributions across the study countries from 1970 to 2005, followed by a convergence. Differences in life expectancies contributed the most to inequalities between the countries in life-table age-at-death distributions and the observed changes over time for both sexes. An additional important contribution resulted from the growing negative covariance between life expectancy and dispersion of ages at death, indicating that the largest increase in life expectancy occurred in the countries where variation in ages at death was lowest, especially among women. For men, including the skewness parameter resulted in lower differences between countries. The ELL and its decomposition thus have clear added value for studying differences between countries and convergence/divergence of age-at-death distributions

Robotic Grinding Process of Turboprop Engine Compressor Blades with Active Selection of Contact Force

The work presents a robotic system for grinding the blades of a turboprop engine compressor. The proprietary conceptual solution includes a data acquisition system based on a robotic 3D scanner, a neural decision system and a robot performing a grinding process with force control. The contact force of the tool to the blade was assumed as a variable and controlled process parameter. A neural network was used to generate the contact force on the basis of measured machining allowances on the blade. A virtual grid of several dozen regularly spaced points was placed on the surface of the blade. The neural network was learned the allowance-force dependence for the selected points, making it possible to select the proper contact force on the surface to be machined. The developed algorithm for the process of robotic grinding of the blades takes into account the necessity of ongoing quality control of the processing and the introduction of corrections in the process

Identification of epidural space in the sacral spine by means of a thermolesion needle and an radiofrequency (RF) generator - a preliminary report

Caudal epidural injections are one of the commonly used interventions in managing chronic low back pain. The caudal approach to epidural space was first reported by Sicard in 1901. Injection of steroids to treat low back pain was introduced in 1952. Corticosteroids delivered into epidural space demonstrate higher local concentrations over an inflamed nerve root and will be more effective than a steroid administered either orally or by intramuscular injection. The clinical effectiveness evaluations fill the literature with various types of reports including randomised clinical trials, prospective trials, retrospective studies, case reports, and meta-analyses. Evidence from all types of evaluations with regard to clinical outcomes and cost-effectiveness of caudal epidural injections is encouraging. Reports of the effectiveness of all types of epidural steroids vary from 18% to 90%. One of the reasons for this discrepancy is the difficulty in accurate identification of caudal epidural space and inaccurate needle placement when performed without imaging guidance in a substantial number of patients. Caudal epidural injection is a safe, effective technique when performed with due care. In many centres this procedure is performed under fluoroscopic or ultrasound guidance. In our study we used stimulation with a radiofreqency needle to identify caudal epidural space for low back pain treatment (30 patients).Caudal epidural injections are one of the commonly used interventions in managing chronic low back pain. The caudal approach to epidural space was first reported by Sicard in 1901. Injection of steroids to treat low back pain was introduced in 1952. Corticosteroids delivered into epidural space demonstrate higher local concentrations over an inflamed nerve root and will be more effective than a steroid administered either orally or by intramuscular injection. The clinical effectiveness evaluations fill the literature with various types of reports including randomised clinical trials, prospective trials, retrospective studies, case reports, and meta-analyses. Evidence from all types of evaluations with regard to clinical outcomes and cost-effectiveness of caudal epidural injections is encouraging. Reports of the effectiveness of all types of epidural steroids vary from 18% to 90%. One of the reasons for this discrepancy is the difficulty in accurate identification of caudal epidural space and inaccurate needle placement when performed without imaging guidance in a substantial number of patients. Caudal epidural injection is a safe, effective technique when performed with due care. In many centres this procedure is performed under fluoroscopic or ultrasound guidance. In our study we used stimulation with a radiofreqency needle to identify caudal epidural space for low back pain treatment (30 patients)

Decrease in Life Expectancy in Germany in 2020: Men from Eastern Germany Most Affected

The COVID-19 pandemic caused an increase in mortality in 2020 with a resultant decrease in life expectancy in most countries around the world. In Germany, the reduction in life expectancy at birth between 2019 and 2020 was comparatively small, at -0.20 years. The decrease was stronger among men than among women (-0.24 vs. -0.13 years) and in eastern rather than in western Germany (-0.36 vs. -0.16 years). Men in eastern Germany experienced the biggest decline in life expectancy at birth (-0.41 years). For western German men, the decline was less pronounced (-0.19 years). Among women, the decline in life expectancy at birth was also greater in eastern (-0.25 years) than in western Germany (-0.10 years). As a result of these developments, the differences in life expectancy between the two parts of Germany, and between women and men, increased compared with the previous year. Life expectancy at age 65 decreased more strongly than life expectancy at birth for both sexes and in all regions. This reflects the fact that it was mainly older age groups that were affected by the increase in mortality in 2020. This paper provides further insights into mortality changes in 2020, based on age decomposition and an analysis of lifespan inequality. We conclude that the population in eastern Germany was hit harder by the COVID-19 pandemic in 2020 than the population in the western Germany