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Reproduction and longevity among the British peerage: the effect of frailty and health selection.

ABSTRACT: Whether a cost of reproduction exists among humans is still questionable. A major study of aristocratic British families finds a significant positive correlation between parity and late-life mortality, which indicates a trade-off between reproduction and longevity. This result is supported by four other studies, while earlier studies have not found a relationship or came to the opposite conclusion. We show that in natural fertility populations the relationship between fertility and late-life mortality cannot be studied correctly without considering the effects of differences in health and of mortality selection during childbearing ages because these two effects lead to a dampening of the true relationship. If these effects are controlled in Hollingsworth's genealogy of the British peerage a significant trade-off between reproduction and longevity exists for females but not for males.

SUBMITTER: Doblhammer G

PROVIDER: S-EPMC1691410 | biostudies-literature | 2003 Aug

REPOSITORIES: biostudies-literature

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Reproduction and longevity among the British peerage: the effect of frailty and health selection.

Doblhammer Gabriele G Oeppen Jim J

Proceedings. Biological sciences 20030801 1524

Whether a cost of reproduction exists among humans is still questionable. A major study of aristocratic British families finds a significant positive correlation between parity and late-life mortality, which indicates a trade-off between reproduction and longevity. This result is supported by four other studies, while earlier studies have not found a relationship or came to the opposite conclusion. We show that in natural fertility populations the relationship between fertility and late-life mor ...[more]

PMID: 12908973

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Project description:BackgroundThe COVID-19 pandemic has highlighted the importance of mental wellbeing. The identification and implementation of quality measures can improve health outcomes and patient experience. The objective was to identify and define a core set of valid and relevant pediatric mental health quality measures that will support health system evaluation and quality improvement in British Columbia, Canada.MethodsThe study consisted of four phases. First, a comprehensive database search identified valid pediatric quality measures focused on mental health and substance use (MH/SU). Second, the identified quality measures were mapped to focus areas, which were then prioritized by two stakeholder groups consisting of 26 members. Third, up to two representative measures for each prioritized focus area were pre-selected by an expert panel (n = 9). And fourth, a three-step modified Delphi approach was employed to (1) assess each quality measure on a 7-point Likert scale against three relevance criteria (representative of a quality problem, value to intended audience and actionable), (2) discuss the results, and (3) select and rank the most relevant measures. Forty-eight stakeholders were invited to participate; of those 24 completed the round 1 survey, 21 participated in the round 2 discussion and 18 voted in the round 3 selection and ranking survey. For round 1, consensus was determined when at least 70% of the response rates were within the range of five to seven. For round 3, Kendall's coefficient of concordance W was used as an estimator of inter-rater reliability.ResultsOne-hundred pediatric mental health quality measures were identified in the database search. Of those, 37 were mapped to ten focus areas. Pre-selection resulted in 19 representative measures moving forward to the Delphi study. Eleven measures met the consensus thresholds and were brought forward to the round 2 discussion. Round 3 ranking showed moderate to strong raters' agreement (Kendall's W = 0.595; p < 0.01) and resulted in the following five highest-ranked measures: level of satisfaction after discharge from inpatient admission due to MH/SU, number of patients experiencing seclusion or restraint, length of time from eating disorder referral to assessment, number of ED visits due to MH/SU, and number of readmissions to ED.ConclusionThe selected core set of valid and relevant pediatric quality measures will support sustainable system change in British Columbia. The five top-ranked measures will be refined and tested for data collection feasibility before being implemented in the province.

Dataset Information

Reproduction and longevity among the British peerage: the effect of frailty and health selection.

Publications

Reproduction and longevity among the British peerage: the effect of frailty and health selection.

Similar Datasets

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