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      The Generation R Study: design and cohort update 2017

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          Abstract

          The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health from fetal life, childhood and young adulthood. This multidisciplinary study focuses on several health outcomes including behaviour and cognition, body composition, eye development, growth, hearing, heart and vascular development, infectious disease and immunity, oral health and facial growth, respiratory health, allergy and skin disorders of children and their parents. Main exposures of interest include environmental, endocrine, genomic (genetic, epigenetic, microbiome), lifestyle related, nutritional and socio-demographic determinants. In total, 9778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61%, and general follow-up rates until the age of 10 years were around 80%. Data collection in children and their parents includes questionnaires, interviews, detailed physical and ultrasound examinations, behavioural observations, lung function, Magnetic Resonance Imaging and biological sampling. Genome and epigenome wide association screens are available. Eventually, results from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness.

            The Child Feeding Questionnaire (CFQ) is a self-report measure to assess parental beliefs, attitudes, and practices regarding child feeding, with a focus on obesity proneness in children. Confirmatory factor analysis tested a 7-factor model, which included four factors measuring parental beliefs related to child's obesity proneness, and three factors measuring parental control practices and attitudes regarding child feeding. Using a sample of 394 mothers and fathers, three models were tested, and the third model confirmed an acceptable fit, including correlated factors. Internal consistencies for the seven factors were above 0.70. With minor changes, this same 7-factor model was also confirmed in a second sample of 148 mothers and fathers, and a third sample of 126 Hispanic mothers and fathers. As predicted, four of the seven factors were related to an independent measure of children's weight status, providing initial support for the validity of the instrument. The CFQ can be used to assess aspects of child-feeding perceptions, attitudes, and practices and their relationships to children's developing food acceptance patterns, the controls of food intake, and obesity. The CFQ is designed for use with parents of children ranging in age from about 2 to 11 years of age. Copyright 2000 Academic Press.
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              Adolescents' perceptions of social status: development and evaluation of a new indicator.

              Eliminating health disparities, including those that are a result of socioeconomic status (SES), is one of the overarching goals of Healthy People 2010. This article reports on the development of a new, adolescent-specific measure of subjective social status (SSS) and on initial exploratory analyses of the relationship of SSS to adolescents' physical and psychological health. A cross-sectional study of 10 843 adolescents and a subsample of 166 paired adolescent/mother dyads who participated in the Growing Up Today Study was conducted. The newly developed MacArthur Scale of Subjective Social Status (10-point scale) was used to measure SSS. Paternal education was the measure of SES. Indicators of psychological and physical health included depressive symptoms and obesity, respectively. Linear regression analyses determined the association of SSS to depressive symptoms, and logistic regression determined the association of SSS to overweight and obesity, controlling for sociodemographic factors and SES. Mean society ladder ranking, a subjective measure of SES, was 7.2 +/- 1.3. Mean community ladder ranking, a measure of perceived placement in the school community, was 7.6 +/- 1.7. Reliability of the instrument was excellent: the intraclass correlation coefficient was 0.73 for the society ladder and 0.79 for the community ladder. Adolescents had higher society ladder rankings than their mothers (micro(teen) = 7.2 +/- 1.3 vs micro(mom) = 6.8 +/- 1.2; P =.002). Older adolescents' perceptions of familial placement in society were more closely correlated with maternal subjective perceptions of placement than those of younger adolescents (Spearman's rho(teens <15 years) = 0.31 vs Spearman's rho(teens 15 years) = 0.45; P <.001 for both). SSS explained 9.9% of the variance in depressive symptoms and was independently associated with obesity (odds ratio(society) = 0.89, 95% confidence interval = 0.83, 0.95; odds ratio(community) = 0.91, 95% confidence interval = 0.87, 0.97). For both depressive symptoms and obesity, community ladder rankings were more strongly associated with health than were society ladder rankings in models that controlled for both domains of SSS. This new instrument can reliably measure SSS among adolescents. Social stratification as reflected by SSS is associated with adolescents' health. The findings suggest that as adolescents mature, SSS may undergo a developmental shift. Determining how these changes in SSS relate to health and how SSS functions prospectively with regard to health outcomes requires additional research.
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                Author and article information

                Contributors
                +31 (0)10 7043405 , v.jaddoe@erasmusmc.nl
                Journal
                Eur J Epidemiol
                Eur. J. Epidemiol
                European Journal of Epidemiology
                Springer Netherlands (Dordrecht )
                0393-2990
                1573-7284
                9 January 2017
                9 January 2017
                2016
                : 31
                : 12
                : 1243-1264
                Affiliations
                [1 ]The Generation R Study Group (NA-2915), Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [2 ]Department of Epidemiology, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [3 ]Department of Pediatrics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [4 ]Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [5 ]Division of Neonatology, Department of Pediatrics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [6 ]Center for Child and Family Studies, Leiden University, Leiden, The Netherlands
                [7 ]Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
                [8 ]Department of Ophthalmology, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [9 ]Department of Radiology, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [10 ]Department of Public Health, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [11 ]Department of Internal Medicine, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [12 ]Department of Otolaryngology, Head and Neck Surgery, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [13 ]Department of Obstetrics and Gynecology, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [14 ]Department of Child and Adolescent Psychiatry, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [15 ]Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                Article
                224
                10.1007/s10654-016-0224-9
                5233749
                28070760
                9faf5816-3966-4e08-bd5b-c42402ca45b1
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 19 October 2016
                : 30 December 2016
                Categories
                Study Update
                Custom metadata
                © Springer Science+Business Media Dordrecht 2016

                Public health
                cohort study,epidemiology,pregnancy,child,adolescence
                Public health
                cohort study, epidemiology, pregnancy, child, adolescence

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