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Objective@#To examine the longitudinal relationship between the prosocial behaviors and depressive symptoms in rural adolescents using a cross-lagged model,and to provide a reference for improving mental health of adolescents.@*Methods@#Participants were junior school 372 students in grade seven recruited from a rural school in Anhui province, who filled the Strengths and Difficulties Questionnaire (SDQ) and a short version of Center for Epidemiological Survey Depression Scale (CESD-10) three times (once a year for 2 years),and the cross lag model is established.@*Results@#Depressive symptoms(r=0.39-0.45) and prosocial behavior(r=0.43-0.46) of rural adolescents are relatively stable in junior middle school(P<0.01)；The depression score of adolescents in grade 9 was higher than that in grade 7 and 8(P<0.05) and girls’ depression score was higher than boys’ (F=7.94,P<0.01).The relationships between prosocial behaviors(T1, T2, T3) and depressive symptoms(T1, T2, T3) were all negatively correlated in rural adolescents(r=-0.23~-0.13, P<0.05). Depressive symptoms in T1 and T2 could negatively predict prosocial behaviors in T2 and T3, respectively (β T1-T2=-0.10, β T2-T3=-0.11, P<0.05), while prosocial behaviors in T2 could negatively predicted depressive symptoms in T3 (β=-0.14, P<0.05).@*Conclusion@#During the three years of junior high school, the depressive symptoms of rural adolescents negatively predicted prosocial behavior, and from the second to the third year of junior high school, prosocial behavior negatively predicted depressive symptoms.Community health workers should pay more attention on depressive symptoms of rural adolescents, which could be prevented and improved through prosocial behavioral intervention, including helping and sharing.
RESUMO
OBJECTIVE: to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. METHODS: this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. RESULTS: in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75th percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875. CONCLUSIONS: this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination. .
OBJETIVO: validar de forma prospectiva um nomograma de bilirrubina transcutânea (BTc) para identificar hiperbilirrubinemia grave em neonatos a termo e pré-termo tardios saudáveis na China. MÉTODOS: foi realizado um estudo multicêntrico que incluiu 9174 neonatos a termo e pré-termo tardios saudáveis em oito unidades da China. Foram realizadas dosagens de BTc utilizando um bilirrubinômetro. Os valores de BTc foram traçados em um nomograma de BTc para identificara capacidade de predição de hiperbilirrubinemia significativa. RESULTADOS: 972 recém-nascidos (10,6%) desenvolveram hiperbilirrubinemia significativa. O percentil 40 de nosso nomograma pode identificar todos os recém-nascidos com risco de hiper-bilirrubinemia significativa, porém com baixo valor preditivo positivo (VPP) (18,9%). De 453 recém-nascidos acima do percentil 95, 275 recém-nascidos desenvolveram posteriormente hiperbilirrubinemia significativa, com VPP elevado (60,7%), porém com baixa sensibilidade (28,3%). O percentil de 75 foi altamente específico (81,9%) e moderadamente sensível (79,8%). A área sob a curva (ASC) de nosso nomograma de BTc foi de 0,875. CONCLUSÕES: este estudo validou o nomograma de BTc, que pode ser utilizado para prever hiperbilirrubinemia significativa em neonatos a termo e pré-termo tardios saudáveis na China. Contudo, combinar o nomograma de BTc e fatores de risco clínicos pode melhorar a precisãode predição da hiperbilirrubinemia grave, o que não foi avaliado neste estudo. São necessários estudos adicionais para confirmar essa combinação. .