Introduction: This systematic review and meta-analysis evaluates the overall effects of lifestyle interventions upon hepatic fat content and metabolism-related indicators among adults with metabolic associated fatty liver disease.Methods: It was registered under PROSPERO (CRD42021251527). We searched PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, Scopus, CNKI, Wan-fang, VIP, and CBM from the inception of each database to May 2021 for RCT studies of lifestyle interventions on hepatic fat content and metabolism-related indicators. We used Review Manager 5.3 for meta-analysis and used text and detailed tabular summaries when heterogeneity existed.Results: Thirty-four RCT studies with 2652 participants were included. All participants were obesity, 8% of whom also had diabetes, and none was lean or normal weight. Through subgroup analysis, we found low carbohydrate diet, aerobic training and resistance training significantly improved the level of HFC, TG, HDL, HbA1c, and HOMA-IR. Moreover, low carbohydrate diet is more effective in improving HFC than low fat diet and resistance training is better than aerobic training in reduction in HFC and TG (SMD, -0.25, 95% CI, -0.45 to -0.06; SMD, 0.24, 95% CI, 0.03 to 0.44, respectively).Discussion: Overall, this is the first review that systematically synthesizes studies focused on the effects of various lifestyle on adults with MAFLD. The data generated in this systematic review were more applicable to obesity MAFLD rather than lean or normal weight MAFLD.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier (CRD42021251527).

Background: Perinatal depression (PND) in low‐resource areas is a significant concern that imposes a substantial burden on both families and societies. Although many studies have explored rural PND, there is a lack of systematic synthesis of the existing research. This study aimed to estimate the global prevalence of PND among rural women and to summarize its determinants.Methods: Comprehensively electronic searches were performed across eight English databases. Two reviewers independently assessed the eligibility of the study and extracted the relevant data. Any inconsistencies were resolved through discussion with a third reviewer. Prevalence estimates were calculated using a random‐effects meta‐analysis model. Subgroup analysis, sensitivity analysis, and meta‐regression were employed to examine the source of heterogeneity. In addition, a narrative synthesis of the influence factors reported in the included studies was provided.Results: The search identified 17,810 studies, of which 86 were included in the analyses. The pooled prevalence of PND in rural areas was 22.1% (95% CI 19.0%–25.3%, p < 0.001, I² = 99.2%). Subgroup analyses indicated higher PND prevalence in low‐income (24.5%) and lower middle‐income countries (22.8%). Additionally, PND prevalence was greater when assessed using self‐reported screening instruments (22.8%) compared to diagnostic interviews (17.6%). Major risk factors included violence, antenatal psychiatric disorder, low family income, male‐child preference, and food insecurity, while positive social support and higher levels of education were protective factors.Conclusions: Our findings suggest that the prevalence of PND is higher in rural areas compared to global data, particularly in low‐income and lower middle‐income countries. To improve rural maternal mental health, it is essential to develop measures targeting modifiable risk factors for PND, including promoting gender equality, implementing antiviolence initiatives, and strengthening economic support systems. Addressing these factors can help reduce the burden of PND and enhance the well‐being of mothers in rural communities.

China’s three-child policy was implemented in May 2021 to stimulate a rise in fertility levels. However, few previous studies have explored fertility intentions to have a third child and have only focused on childless or one-child populations, resulting in a gap in findings between fertility intention and fertility behavior. Thus, we conducted a nationwide cross-sectional study on 1308 participants with two children. Results showed that only 9.6% of participants reported planning to have a third child and 80.2% of the population had heard of the policy but had no idea of the detailed contents. Participants with two daughters (OR = 3.722, 95% CI = 2.304–6.013) were willing to have one more child. Instrumental values (OR = 1.184, 95% CI = 1.108–1.265) and policy support (OR = 1.190, 95% CI = 1.124–1.259) were the facilitators. Perceived risk (OR = 0.883, 95% CI = 0.839–0.930) and higher educational level (OR = 0.693, 95% CI = 0.533–0.900) were the leading barriers to having one more child. Therefore, the government should deepen parents’ understanding of the “three-child policy” and devise ways of reducing the negative impacts of having a third child to boost the intention to have more children. Our proposed approach can also be used to better understand the reasons for low fertility rates in other countries.

The changes in China’s family planning policy in recent years have led to changes in the age structure of pregnant women, and the prevalence of postpartum depression (PPD) is also on the rise. Cognitive Behaviour Training (CBT) as an effective intervention is widely used for postpartum depression. However, the shortage and health disparities of mental health resources, the stigma of postpartum depression in postpartum women and the need for postpartum recovery and child care prevent postpartum women from seeking traditional face-to-face CBT. Therefore, the purpose of this proposed study is to examine the effect of mobile phone applications (App) based CBT on postpartum depression, anxiety, pressure and parenting sense of competence. A double blind, randomized controlled trial will be used in this study to examine the effectiveness of App-based CBT in reducing the prevalence of postpartum depression compared with usual postpartum care in China. A total of 120 participants will be recruited in this study. The intervention consists of a weekly theme module app for continuous six weeks, each module including learning content and assignments. The control group received usual postpartum care content through the App. Outcome measures include postpartum depression, anxiety, pressure and parenting sense of competence at 0-, 3- and 6-month after the intervention. If our intervention is effective, it will provide a time-friendly and unrestricted intervention for the psychological care of perinatal women, which can effectively solve the shortage and unevenness of mental health resources. Chinese Clinical Trial Registry, ChiCTR1900020735 . Registered 15 January 2019.

Developing countries face a shortage of nurses with higher education, such as those with a master’s degree. However, few studies have investigated the interaction between career decision and professional commitment (PC) of nursing students, especially for postgraduates. This study performed correlation analysis for career decision-making self-efficacy (CDMSE) and PC of 545 nursing postgraduate students from nursing schools at 19 universities or colleges throughout mainland China, who came from different regions, and possessed different years of study and different types of degrees as well as part-time job experiences. Data reliability and validity were confirmed for both Career Decision-Making Self-Efficacy Scale for university students (CDMSE-R) and Professional Commitment Questionnaire (PCQ). We found positive correlations between factors of PC and CDMSE. The score of CDMSE was different between regions, degree types, grades, and part-time job experiences. According to our results, we suggest nursing education or career advisory services should promote the PC of nursing students according to factors of their CDMSE scores.