BackgroundMaternal psychological health during pregnancy has been associated with offspring psychopathology. However, it is uncertain whether these associations are mediated by the postpartum depression and related child-rearing factors. Therefore, we examined the associations between prenatal and postnatal factors and internalizing and externalizing behavioral problems in childhood, focusing on maternal psychological health in school-aged children in Korea.FindingsThe current study included 1,003 children (580 boys, 423 girls, mean age 9.05 ± 0.70 years, age range 8–11 years) recruited from schools in five Korean cities. Children’s internalizing and externalizing problems were assessed by the Child Behavior Checklist (CBCL). The parents of the children completed structured questionnaires on perinatal factors. Among 1,003 children, 44 had internalizing problems (IP) and 30 had externalizing problems (EP). When comparing children with IP (n = 44) and without IP (n = 959), severe maternal stress during pregnancy (OR3.36, 95% CI 1.80-6.25) and postpartum depression (OR3.19, 95% CI 1.36-7.53) showed a significant association with the IP. When comparing children with EP (n = 30) and without EP (n = 973), low family income (OR2.19, 95% CI 1.05-4.56), unwanted pregnancy (OR2.76, 95% CI 1.28-5.95) and severe maternal stress during pregnancy (OR2.69, 95% CI 1.29-5.61) with the EP. Only maternal stress during pregnancy was significantly associated with the IP after controlling for postpartum depression and with the EP after controlling for family income and unwanted pregnancy.ConclusionThis study suggests the importance of maternal psychological health during perinatal period on children’s mental health. Further prospective studies in a larger sample are required to confirm our findings.

The role of substrate modulus on critical loads to initiate and propagate radial cracks to failure in curved brittle glass shells on compliant polymeric substrates is investigated. Flat glass disks are used to drive the crack system. This configuration is representative of dental crown structures on dentin support in occlusal contact. Specimens are fabricated by truncating glass tubes and filling with epoxy-based substrate materials, with or without alumina filler for modulus control. Moduli ranging from 3 to 15 GPa are produced in this way. Critical loads for both initiation and propagation to failure increase monotonically with substrate modulus, by a factor of two over the data range. Fracture mechanics relations provide a fit to the data, within the scatter bands. Finite element analysis is used to determine stress distributions pertinent to the observed fracture modes. It is suggested that stiffer substrate materials offer potential for improved crown lifetime in dental practice.

Objective: The purpose of this study was to examine the clinical validities and efficiencies of the Child Behavior Checklist (CBCL) and the ADHD Rating Scale-IV (ARS) in identifying children with attention-deficit hyperactivity disorder (ADHD) in Korean community-based samples.Method: A large sample of elementary school students (n = 1668) participated in this study. We used the CBCL and the ARS as the screening instruments. Diagnoses were determined by clinical psychiatric interviews and confirmed by DSM-IV-based structured interviews.Results: Of the 46 subjects who underwent clinical psychiatric interviews, 33 were diagnosed as having ADHD. A T score of 60 with regard to the Attention Problems profile of the CBCL resulted in a reasonable level of sensitivity or positive predictive value in the diagnosis of ADHD. In both the parent and teacher reports of the ARS, 90th percentile cut-off points resulted in a high level of predictive value. The highest levels of specificity and positive predictive value were obtained when we combined the CBCL (T $ 60 in Attention Problems) and the ARS (parent-teacher total $ 90th percentile) reports. Conclusions:These findings suggest that the combined use of the CBCL and the ARS could serve as a rapid and useful clinical method of predicting or even diagnosing children with ADHD in epidemiologic case definitions. Clinical Implications· A combination of the CBCL and the ARS could serve as a rapid and useful instrument for predicting ADHD. · This study provides a clinically useful guideline for identifying ADHD in community-based samples of developing countries. · There seems to be a lack of understanding in child mental health or child psychiatric disorders in Korea, which must be overcome by developing effective mental health services for children. Limitations· We confined the study to selected samples of an urban community. · The sample size of ADHD was relatively small. · The methods used to combine the reports of different informants need further research.

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