WIEK EMERYTALNY LUDNOŚCI W PAŃSTWACH UNII EUROPEJSKIEJ W KONTEKŚCIE OBCIĄŻENIA EKONOMICZNEGO I PRZECIĘTNEGO TRWANIA ŻYCIA

The author proposes a technique of calculating the postulated minimum upper limit of the productive age, which uses potential demography methods. The technique is based on the postulate that the total number of years to live after the productive age for the whole population should not be higher than the total years to live in the productive age. This method accounts for both the length of the life expectancy and the population age structure. The minimum upper limit of the productive age is the highest for the population with a long life expectancy and high age dependency ratio. The results obtained using this technique for calculations in all European Union member states were compared and related to the statutory pension ages.The author proposes a technique of calculating the postulated minimum upper limit of the productive age, which uses potential demography methods. The technique is based on the postulate that the total number of years to live after the productive age for the whole population should not be higher than the total years to live in the productive age. This method accounts for both the length of the life expectancy and the population age structure. The minimum upper limit of the productive age is the highest for the population with a long life expectancy and high age dependency ratio. The results obtained using this technique for calculations in all European Union member states were compared and related to the statutory pension ages

Providers' assessment of a novel interactive health information technology in a pediatric intensive care unit

Objective: To explore perceptions of critical care providers about a novel collaborative inpatient health information technology (HIT) in a pediatric intensive care unit (PICU) setting. Methods: This cross-sectional, concurrent mixed methods study was conducted in the PICU of a large midwestern children's hospital. The technology, the Large Customizable Interactive Monitor (LCIM), is a flat panel touch screen monitor that displays validated patient information from the electronic health record. It does not require a password to login and is available in each patient's room for viewing and interactive use by physicians, nurses, and families. Quantitative data were collected via self-administered, standardized surveys, and qualitative data via in-person, semistructured interviews between January and April 2015. Data were analyzed using descriptive statistics and inductive thematic analysis. Results: The qualitative analysis showed positive impacts of the LCIM on providers' workflow, team interactions, and interactions with families. Providers reported concerns regarding perceived patient information overload and associated anxiety and burden for families. Sixty percent of providers thought that LCIM was useful for their jobs at different levels, and almost 70% of providers reported that LCIM improved information sharing and communication with families. The average overall satisfaction score was 3.4 on a 0 to 6 scale, between "a moderate amount" and "pretty much." Discussion and Conclusion: This study provides new insight into collaborative HIT in the inpatient pediatric setting and demonstrates that using such technology has the potential to improve providers' experiences with families and just-in-time access to EHR information in a format more easily shared with families

The Natural Resource Law Center Conference on “Challenging Federal Ownership and Management Public Lands and Public Benefits”

8 pages

Excess death rate in Eastern European countries and countries of the former USSR during the Covid-19 pandemic in the years 2020 and 2021

Measuring the impact of the COVID-19 epidemic on mortality on the basis of deaths reported by statistical offices by cause may be challenging due to the often poor quality of data. Therefore, this study analysed the level of excess mortality, regardless of the cause, to measure the true impact of the epidemic on the number of deaths. The analysis focused on selected countries from Eastern Europe, the Caucasus and Central Asia as well as the Russian Federation, and was limited to the period 2020–2021. Time series analysis methods were used in order to account for seasonal fluctuations in mortality throughout the year. It was determined that some of the studied countries were “blind” to the development of the coronavirus epidemic in selected periods. The findings from this study allow the true scale and extent of the COVID-19 epidemic to be assessed correctly. Taking into account excess deaths would lead to substantial increase in the number of deaths attributed to the COVID-19. In the case of the 19 countries surveyed this number should be increased from the level of nearly 800,000 officially reported deaths to over 2 million excess deaths. The actual scale of deaths experienced during the COVID-19 pandemic has had grave ramifications both for society and various sectors of the econom

Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients <18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's ?. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (? ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients <18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's κ. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (κ ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

The rate of vaccination against COVID-19 and the number of excess deaths by region in Poland

Badania naukowe dowodzą skuteczności powszechnych szczepień w zwalczaniu chorób wirusowych lub łagodzeniu ich skutków. Celem badania omawianego w artykule jest ocena zależności między poziomem wyszczepienia populacji Polski przeciw COVID-19 a liczbą nadmiarowych zgonów w ujęciu regionalnym. Kluczowymi predyktorami użytymi w badaniu były: wskaźnik pełnego zaszczepienia przeciw COVID-19 dla regionów (NUTS 2), podregionów (NUTS 3) i powiatów na koniec 2021 r. oraz liczba nadmiarowych zgonów w przeliczeniu na 100 tys. osób w drugim półroczu 2021 r. i pierwszym półroczu 2022 r., czyli podczas czwartej i piątej fali pandemii. Badanie oparto na danych GUS i Centrum e-Zdrowia. Nadmiarowe zgony oszacowano za pomocą analizy szeregów czasowych. Do obliczeń wykorzystano liczbę zgonów według wieku i płci zmarłych w ujęciu tygodniowym dla NUTS 2 i NUTS 3 oraz liczbę zgonów według okresów półrocznych dla powiatów. Wyniki przeprowadzonych analiz wskazują na występowanie umiar-kowanie silnego związku między poziomem wyszczepienia populacji przeciw COVID-19 na koniec 2021 r. a liczbą nadmiarowych zgonów w okresie od początku lipca 2021 r. do końca czerwca 2022 r. Ustalono również silne zróżnicowanie terytorialne zarówno poziomu nadmiernej umieralności w okresie od początku lipca 2021 r. do końca czerwca 2022 r., jak i poziomu wyszczepienia przeciw COVID-19 na koniec 2021 r.Scientific studies prove the effectiveness of universal vaccination in fighting viral diseases or mitigating their effects. The aim of the study discussed in this article is to assess the relationship between the rate of vaccination of the Polish population against COVID-19 and the number of excess deaths by region. The key predictors used in the study were the rate of full vaccination against COVID-19 for regions (NUTS 2), sub-regions (NUTS 3) and powiats at the end of 2021, and the number of excess deaths per 100,000 people in the second half of 2021 and the first half of 2022, i.e. during the fourth and fifth waves of the pandemic. The research was based on Statistics Poland and e-Health Centre data. Excess deaths were estimated using the analysis of time series. The calculations were performed using the number of deaths by age and sex of the deceased on a weekly basis for NUTS 2 and NUTS 3, and on a half-year basis for powiats. The results of the performed analyses indicate that there is a moderately strong association between the anti-COVID-19 vaccination rate at the end of 2021 and the number of excess deaths in the period between the beginning of July 2021 and the end of June 2022. We also observed significant differences between regions as far as their excess death rates between the beginning of July 2021 and the end of June 2022, and their anti-COVID-19 vaccination rates at the end of 2021 are considered