Search

The amusing drawing of Leslie Johnston's bookshop offering 'Rare, Out-of-print and Nonexistent Books' (NB, September 27) may remind bookish TLS readers are there any other sort?--of the once-celebrated Fortsas Hoax. [...]

This study aims to understand the spatiotemporal changes in patterns of tropical crop cultivation in Eastern Thailand, encompassing the periods before, during, and after the COVID-19 pandemic. Our approach involved assessing the efficacy of high-resolution (10 m) Sentinel-2 dense image time series for mapping smallholder farmlands. We integrated harmonic regression and random forest to map a diverse array of tropical crop types between summer 2017 and summer 2023, including durian, rice, rubber, eucalyptus, oil palm, pineapple, sugarcane, cassava, mangosteen, coconut, and other crops. The results revealed an overall mapping accuracy of 85.6%, with several crop types exceeding 90%. High-resolution imagery demonstrated particular effectiveness in situations involving intercropping, a popular practice of simultaneously growing two or more plant species in the same patch of land. However, we observed overestimation in the majority of the studied cash crops, primarily those located in young plantations with open tree canopies and grass-covered ground surfaces. The adverse effects of the COVID-19 pandemic were observed in specific labor-intensive crops, including rubber and durian, but were limited to the short term. No discernible impact was noted across the entirety of the study timeframe. In comparison, financial gain and climate change appeared to be more pivotal in influencing farmers’ decisions regarding crop cultivation. Traditionally dominant crops such as rice and oil palm have witnessed a discernible decline in cultivation, reflecting a decade-long trend of price drops preceding the pandemic. Conversely, Thai durian has seen a significant upswing even over the pandemic, which ironically served as a catalyst prompting Thai farmers to adopt e-commerce to meet the surging demand, particularly from China.

Vagus nerve stimulation (VNS) has been used to address thesymptoms of treatment-resistant depression (Rush et al., 2000)and is proposed to also alleviate anxiety effects (George et al.,2008). Transcutaneous VNS (tVNS) offers a less invasivetreatment mechanism for clinical populations; however, little isknown about tVNS effects on mood and anxiety in a non-clinical adult population. Using auricular tVNS, the presentstudy showed that 10 minutes of tVNS immediately precedingsecond-language learning across three consecutive daysreduced state negative affect, somatic anxiety, and cognitiveanxiety, dependent on task performance and/or traitmood/anxiety.

ObjectiveTo use cognitive interviewing and pilot testing to develop a survey instrument feasible for administering in the food pantry setting to assess daily intake frequency from several major food groups and dietary correlates (e.g. fruit and vegetable barriers) - the FRESH Foods Survey.DesignNew and existing survey items were adapted and refined following cognitive interviews. After piloting the survey with food pantry users in the USA, preliminary psychometric and construct validity analyses were performed.SettingThree US food banks and accompanying food pantries in Atlanta, GA, San Diego, CA, and Buffalo, NY.ParticipantsFood pantry clients (n 246), mostly female (68 %), mean age 54·5 (sd 14·7) years.ResultsMeasures of dietary correlates performed well psychometrically: Cronbach's α range 0·71-0·90, slope (α) parameter range 1·26-6·36, and threshold parameters (β) indicated variability in the 'difficulty' of the items. Additionally, all scales had only one eigenvalue above 1·0 (range 2·07-4·71), indicating unidimensionality. Average (median, Q1-Q3) daily intakes (times/d) across six dietary groups were: fruits and vegetables (2·87, 1·87-4·58); junk foods (1·16, 0·58-2·16); fast foods and similar entrées (1·45, 0·58-2·03); whole-grain foods (0·87, 0·58-1·71); sugar-sweetened beverages (0·58, 0·29-1·29); milk and milk alternatives (0·71, 0·29-1·29). Significant correlations between dietary groups and dietary correlates were largely in the directions expected based on the literature, giving initial indication of convergent and discriminant validity.ConclusionsThe FRESH Foods Survey is efficient, tailored to food pantry populations, can be used to monitor dietary behaviours and may be useful to measure intervention impact.

OBJECTIVES/HYPOTHESIS: We developed and validated a septal deformity grading (SDG) system that accounts for anatomic location and grading of deformity severity. STUDY DESIGN: Retrospective cohort study. METHODS: Subjects were patients with nasal obstruction presenting to University of California, Irvine Medical Center. Subjects were given pre- and postoperative Nasal Obstruction Symptom Evaluation (NOSE) questionnaires and were evaluated by a facial plastic surgeon using our septal deformity grading (SDG) system. Validity and reliability analyses were conducted on the SDG results. Statistical analyses were conducted on SDG and NOSE data to assess and compare instruments, and to validate the SDG instrument using the NOSE instrument. RESULTS: One hundred thirty-five patients met inclusion criteria. Cronbachs α was ≥ 0.7 for SDG and pre- and postoperative NOSE scores. There was a significant difference in pre- and postoperative NOSE scores (Z score = -7.21, P

This essay calls for a pedagogy of consilience and renewal as a dynamic fusion of research and practices in order to provide a more coherent way of examining some of the keen, interlaced variables that trouble the academy and society. The project challenges scholars to study five key scholarship of learning variables that should help transform the way we look at pedagogy for the betterment of North American society and beyond. The variables—a quintile—are knowledge, geography, critical thinking, civic engagement, and empathy.

Abstract Background To evaluate the impact of home-delivered, medically tailored meals and medical nutrition therapy among food-insecure patients following hospitalization for congestive heart failure by comparing clinical outcomes to a retrospectively matched cohort. Methods Patients at high risk for readmission and food insecurity received up to three months of medically tailored meals and medical nutrition therapy after discharge. Pre-intervention and post-intervention weight, body mass index, blood pressure, and dietary intake were assessed. A combination of difference-in-difference and logistic regression models were used to compare changes between cohorts and evaluate impact attributable to the program. Results Thirty-nine program participants were compared to a matched cohort of 117 unexposed patients. Participants experienced a marginal reduction in body mass index and an increase in systolic and diastolic blood pressure; however, these results were not statistically significant. To determine relevance to clinical cut-offs, logistic regressions were used, demonstrating that exposure to the intervention resulted in higher odds of a categorical reduction in blood pressure (OR: 1.85), though this did not reach statistical significance (95% CI: 0.67–5.32). Pre vs. post trends indicated that more-healthful foods and drinks increased numerically or remained similar to baseline, while less-healthful foods decreased numerically or remained similar to baseline. Conclusions and implications These findings highlight the need for more longitudinal research on medically tailored meals and medical nutrition therapy interventions using clinical outcomes while setting realistic suggestions for program implementation. This study additionally illustrates the promise of integrating electronic medical record data and matched cohorts into medical nutrition program evaluation within the health sector.

Objectives: To examine the relationships between food security, nutrition security, Supplemental Nutrition Assistance Program (SNAP) participation, and cardiometabolic outcomes, including hypertension, hyperlipidemia, or diabetes, among low-income U.S. individuals. Methods: A cross-sectional survey of 486 participants (April–June 2021) assessed food and nutrition security and cardiometabolic outcomes. Mixed-effects logistic regression models adjusted for covariates and included a random effect for state of residence. Moderation analyses evaluated SNAP participation's impact. Results: Very low food security was associated with higher odds of having at least one cardiometabolic condition, such as hypertension, hyperlipidemia, or diabetes (AOR = 1.96; 95% CI: 1.04–3.69; p = 0.04). SNAP moderated this relationship (p-interaction = 0.007), with non-participants experiencing significantly higher risk. Non-SNAP participants with very low food security had 3.17 (95% CI = 1.17–8.61) times higher odds of having a cardiometabolic condition. Among SNAP participants, very low food security was not significantly associated with having a cardiometabolic condition (OR = 1.62; 95% CI = 0.64–4.13). Higher nutrition security was associated with lower odds of having at least one cardiometabolic condition (AOR = 0.59; 95% CI: 0.41–0.83; p = 0.002). Conclusions: Nutrition security and SNAP participation mitigate cardiometabolic risks, underscoring their importance in public health interventions. [ABSTRACT FROM AUTHOR]

Accurately documenting where and when firearms are discharged is a critical first step in gun violence prevention. Many cities rely on police calls for service as their primary source for this information. Recent studies find, however, that citizens underreport gunshots. This has led some communities to invest in gunshot detection technology (GDT) as an alternative data source. GDT remains an expensive and often controversial solution with limited evidence for long-term benefits. This underscores the need for additional research on third-party reporting of gunshots. The current study, conducted in Portland Oregon, surveyed 1,240 residents in 23 neighborhoods with above-average firearm discharges. Analyses confirm that gunshots are vastly underreported. Multivariate logistic regressions found that respondents with higher trust in the police and those worried about gun violence were more likely to call 911 when they heard gunfire. Obstacles to reporting include ambiguity regarding the nature of the sound, diffusion of responsibility, and the perceived hassle of dealing with the local emergency dispatch system. Implications for surveilling gun violence are discussed. [ABSTRACT FROM AUTHOR]

Background: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study was designed to determine the effects of a best‐practice hearing intervention on cognitive decline among community‐dwelling older adults. Here, we conducted a secondary analysis of the ACHIEVE Study to investigate the effect of hearing intervention on self‐reported communicative function. Methods: The ACHIEVE Study is a parallel‐group, unmasked, randomized controlled trial of adults aged 70–84 years with untreated mild‐to‐moderate hearing loss and without substantial cognitive impairment. Participants were randomly assigned (1:1) to a hearing intervention (audiological counseling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed semiannually for 3 years. Self‐reported communicative function was measured with the Hearing Handicap Inventory—Elderly Screening version (HHIE‐S, range 0–40, higher scores indicate greater impairment). Effect of hearing intervention versus control on HHIE‐S was analyzed through an intention‐to‐treat model controlling for known covariates. Results: HHIE‐S improved after 6‐months with hearing intervention compared to control, and continued to be better through 3‐year follow‐up. We estimated a difference of −8.9 (95% CI: −10.4, −7.5) points between intervention and control groups in change in HHIE‐S score from baseline to 6 months, −9.3 (95% CI: −10.8, −7.9) to Year 1, −8.4 (95% CI: −9.8, −6.9) to Year 2, and − 9.5 (95% CI: −11.0, −8.0) to Year 3. Other prespecified sensitivity analyses that varied analytical parameters did not change the observed results. Conclusions: Hearing intervention improved self‐reported communicative function compared to a control intervention within 6 months and with effects sustained through 3 years. These findings suggest that clinical recommendations for older adults with hearing loss should encourage hearing intervention that could benefit communicative function and potentially have positive downstream effects on other aspects of health. [ABSTRACT FROM AUTHOR]

We provide new evidence concerning two views of episodic associations: The independent associations hypothesis (IAH)posits that associations are unidirectional and separately modifiable links (AB; AB); the associative symmetry hypothesis(ASH) considers the association to be a holistic conjunction of A and B representations. While existing literature focuseson tests that compare the correlation of forward and backward associations and favors ASH over IAH, we provide thefirst direct evidence of IAH by showing that forward and backward associations are separately modifiable for semanti-cally related pairs. In two experiments, participants studied 30 semantically unrelated and 30 semantically related pairsintermixed in a single list, and then performed a series of up to eight cued-recall test cycles. All pairs were tested in eachcycle, and the testing direction (A-? or B-?) alternated between cycles. Consistent with prior research, unrelated pairsexhibited associative symmetry accuracy and response times improved gradually on each test, suggesting that testing inboth directions strengthened the same association. In contrast, semantically related pairs exhibited a stair-like pattern,where performance did not change from odd to even tests when the test direction changed; it only improved between testsof the same direction. We conclude that episodic associations can have either a holistic representation (ASH) or separatedirectional representations (IAH), depending on the semantic relatedness of their constituent items.

IntroductionThis study aimed to develop and test novel self-administered measures (Absorptive capacity, Adaptive capacity, and Transformative capacity) of three aspects of a household's resilience to financial shocks (e.g., job loss) that can increase food insecurity risk.MethodsMeasures were piloted in a convenience sample of households at risk for food insecurity in the United States. The survey included the new measures, validation variables (financial shock, household food security, general health, personal resilience to challenges, and financial wellbeing), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed [Cronbach's alpha (CA)], and construct validity was assessed (Spearman's correlation). Also, brief screener versions of the full measures were created.ResultsParticipants in the analytic samples (n = 220-394) averaged 44 years old, 67% experienced food insecurity, 47% had a high school diploma or less, 72% were women, and the sample was racially/ethnically diverse. Scores for Absorptive capacity [one factor; CA = 0.70; Mean = 1.32 (SD = 0.54)], Adaptive capacity [three factors; CAs 0.83-0.90; Mean = 2.63 (SD = 0.85)], and Transformative capacity [three factors; CAs 0.87-0.95; Mean = 2.70 (SD = 1.10)] were negatively associated with financial shocks (−0.221 to −0.307) and positively associated with food insecurity (0.310-0.550) general health (0.255-0.320), personal resilience (0.231-0.384), and financial wellbeing (0.401-0.474).DiscussionThese findings are encouraging and support reliability and validity of these new measures within this sample. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may prove useful for needs assessments, program evaluation, intake screening, and research/surveillance. Widespread adoption in the future may promote a more comprehensive understanding of the food insecurity experience and facilitate development of tailored interventions on upstream causes of food insecurity.

Many everyday decisions are based not only on memories ofdirect experiences, but on memories that are integrated acrossmultiple distinct experiences. Sometimes memory integrationbetween existing memories and newly learnt informationoccurs rapidly, without requiring inference during thedecision. It is known that prior knowledge (i.e. schema)affects the initial acquisition, and consolidation, of memories.In this study, we explore the effect of schema on theintegration of acquired memories between paired associates(e.g. integrating A-B and B-C into A-B-C) that were schemaconsistent or inconsistent, as confirmed with a latent semanticanalysis of text corpora. We find that enabling fast learning,by using material that is consistent with a schema, allows forfast memory integration. These behavioral results areconsistent with predictions generated from neuroscientifichypotheses suggesting that an existing schema might enableneocortical learning that is distinct from a more explicithippocampus-mediated integration of new information.

Abstract Background Post-traumatic stress disorder (PTSD) is a significant public health problem, affecting approximately 7% of the general population and 13–18% of the combat Veteran population. The first study using acupuncture for PTSD in a civilian population showed large pre- to post-treatment effects for an empirically developed verum protocol, which was equivalent to group cognitive behavior therapy and superior to a wait-list control. The primary objective of this study is to determine both clinical and biological effects of verum acupuncture for combat-related PTSD in treatment-seeking US Veterans. Methods This is a two-arm, parallel-group, prospective randomized placebo-controlled clinical trial. The experimental condition is verum acupuncture and the placebo control is sham (minimal) acupuncture in 1-h sessions, twice a week for 12 weeks. Ninety subjects will provide adequate power and will be allocated to group by an adaptive randomization procedure. The primary outcome is change in PTSD symptom severity from pre- to post-treatment. The secondary biological outcome is change from pre- to post-treatment in psychophysiological response, startle by electromyographic (EMG) eyeblink. Assessments will be conducted at pre-, mid-, post-, and 1-month post-treatment, blind to group allocation. Intent-to-treat analyses will be conducted. Discussion The study results will be definitive because both clinical and biological outcomes will be assessed and correlated. Issues such as the number needed for recruitment and improvement, use of sham acupuncture, choice of biological measure, and future research need will be discussed. Trial registration ClinicalTrials.gov NCT02869646 . Registered on 17 August 2016.

Purpose To examine daily fruit and vegetable (FV) intake frequency by household food security status (high food security, marginal food security, low food security, and very low food security), and scores on three hunger-coping behavior scales (i.e., "rationing food supplies," "financial strategies," and "trade-off strategies"), and one physiological hunger symptoms scale among a very low-income population in the Midwestern United States. Methods Adult participants (aged 19 and older and caregivers to at least one child aged 0-18) were recruited from public libraries, food pantries, and other community locations to participate in a cross-sectional self-administered survey (n = 306). The primary outcome variable was daily FV intake frequency, measured from five items from the 16-item NYPANS dietary screener (fruit, green salad, carrots, other vegetables, and non-fried potatoes). These items were converted into daily frequencies and then summed. Daily FV intake frequency was also log transformed to meet statistical model assumptions. The main independent variables in this study were household food security (measured using the 6-item USDA Household Food Security Survey Module), scores on three 5-item hunger-coping behavior scales (max scores = 5), and one 5-item physiological hunger symptoms scale (max scores = 5). Potential sociodemographic and household characteristics (e.g., sex, age, race/ethnicity, education, income, marital status, food assistance, income assistance, food pantry use, household child to adult ratio, and automobile access) were assessed as potential covariates. Generalized linear models were used to assess the relationship between independent variables and daily FV intake frequency. Results 278 participants provided complete data for the outcome variable and were included in the sample. The sample was 73% female, 45% African American, 14% Hispanic, and 28% Caucasian. A majority of participants (60%) reported annual household incomes under $15,000. A high proportion of participants (42%) had very lowfood security, as compared to the national average of 6%. Participants reported consuming FV 2.40 times per day (SD=1.76) on average. Compared the high food secure group (In adjusted models), being in the "very low" food security group was associated with a 26% decrease, on average, in daily FV intake frequency (exp(ß)=0.74, 95%CI=0.61-0.88, p Conclusions Compared to the high food secure group, those in the "very low" food secure group reported a significantly lower mean daily FV intake frequency, but not those in the "low" food secure group. This emphasizes the need to examine the "low" and "very low" food secure groups separately when studying factors associated with diet. Engaging in hunger-coping behaviors and experiencing physiological hunger symptoms was associated with decreased daily FV intake frequency. It is not clear if the hunger coping-behaviors themselves directly lead to decreased daily FV intake frequency, or if they were a marker for food insecurity and associated economic distress. These constructs and relationships should be examined in future studies. Programs and policies, which seek to promote fruit and vegetable intake among low-income populations, should target the "very low" food secure as the most at-risk for low intake. Also, researchers and community organizations working with food insecure groups could potentially measure hunger-coping behaviors and hunger symptoms in a complementary fashion to traditional measures of food insecurity to gain more contextual information about the experiences of this population.

Depression has been linked to food security, particularly among low-income mothers. However, less is known about the relationship between CHAOS (Confusion, Hubbub, and Order Scale), a measure of family functioning such as timeliness and order, and varying levels food security. The purpose of this paper was to evaluate the relationship between depression, CHAOS, and sociodemographics on the level of food insecurity in a cross-sectional sample of low-income households with children, ages 0-18 years. Participants were recruited from low-income communities in a medium sized Midwestern city in the United States. Eligible participants were =19 years of age, a parent or primary caregiver to at least one child, and English- or Spanish- speaking. Survey items included participation in the Supplemental Nutrition Assistance Program (SNAP), food security, depression, CHAOS, and sociodemographics/family characteristics. Descriptives and Chi-square tests were conducted for all variables. Potential covariates were assessed (e.g., age, income, education, race/ethnicity, sex, SNAP participation, number of children and adults in the household, and marital status) and included in the final logistic regression model through backward elimination. All statistics were conducted using SAS (version 9.4, SAS Institute Inc., Cary, NC). Participants (N=252) were 75% female, 42% Non-Hispanic Black, 31% Non-Hispanic White, 12% Hispanic, and 15% other race categories. The mean number of children in households was 2.33 (SD=1.58), and half of the respondents reported earning =$10,000/year. Chi-Square tests showed univariate relationships between study variables and varying household food security levels. Those in the "high" and "medium" groups for depression and CHAOS were both more likely than the "low" groups to experience low or very low food security. Income and education were also related to food security, with low levels of education and low income being associated with low or very low food security. Age, sex, race/ethnicity, and marital status were not associated with food security status. The fully adjusted logistic regression models of depression and CHAOS accounted for 10% and 14% of the variance in food security, respectively (depression: (OR=0.31, CI=0.15-0.65; pp In the current study, CHAOS demonstrated a stronger relationship with food security than depression, when controlling for sociodemographics. CHAOS is a measurement that has not been tested widely among food insecure populations, but has been shown to be an influencing factor on child development, and might help explain some of the stress experienced by low-income families. Understanding more about the psychological aspects of food insecurity may help inform the development of tailored interventions to alleviate food insecurity in low-income households, and ultimately improve health, achievement and related outcomes in children.

Purpose: The purpose of this study was to examine relationships between monthly Supplemental Nutrition Assistance Program (SNAP) benefit duration (i.e., the number of weeks each month a participants' SNAP benefits provide food), and five primary outcome variables: food security, three hunger-coping behavior scales (rationing food supplies, financial strategies, making trade-offs), and physiological hunger symptoms, among a sample of families with children 0-18 years currently receiving SNAP benefits. Methods: Baseline survey data were collected as part of a community-based intervention to alleviate child hunger. Participants included in the analytic sample were current SNAP recipients, parents (or caregivers), and 19 years of age and older (n=161). The survey assessed sociodemographics, household characteristics, food and financial assistance use, food security, three hunger-coping behavior scales, diet intake frequency, and one physiological hunger symptoms scale. The three hunger-coping scales and the physiological hunger scale were dichotomized into a "high" group (if above the sample median score) and a "low" group (if at or below the sample median score). Sociodemographic and family characteristics were included as covariates. Logistic regression models were used to assess relationships between monthly SNAP benefit duration and the five primary outcome variables in this study. Results: Respondents were predominately mothers/female caregivers (78%), a majority reported annual family incomes below $10,000 (58%), and 80% were experiencing "low" or "very low" food security. The sample was 43% non-Hispanic black, 30% non-Hispanic white, 10% Hispanic/Latino, 17% American Indian or other racial/ethnic groups. Monthly SNAP benefit duration (M=2.8, SD=1.0) was not likely driven by allotment amount, because households' percent of the federal poverty line (a proxy measure for allotment amount) was not associated with the number of weeks each month that benefits lasted (p=0.36). After controlling for relevant sociodemographic variables and household characteristics, the more weeks each month participants reported their SNAP benefits lasting, the lower their odds of experiencing "low" or "very low" food security (OR=0.444, 95%CI=0.259-0.761; p Conclusions: These findings suggest that monthly SNAP benefit duration may be useful as a proxy for SNAP allotment adequacy in the context of food security and hunger. Families that were not able to make monthly benefits extend as long as other families were more likely to be food insecure and experience "high" levels of physiological hunger symptoms. While associations with hunger-coping behaviors were only significant in univariate analysis, they were in the direction expected and should be further examined in future studies as these behaviors may be exacerbate, buffer, or be symptoms of the experience of food insecurity and hunger among low-income families. Policies are needed to better tailor SNAP benefit allotments to the needs of disadvantaged families, and research and programming is needed to investigate ways these families can better utilize their current allotments as a potential path to address food insecurity and hunger.

Digital literacy is required for all university students to thrive in today's online environment and is especially important for Accounting Students who, as professionals, must apply critical evaluation techniques to digital information. This study looks at how university Accounting Students perceive their digital literacy abilities against the perceptions of students in other disciplines. Researchers used a ten-item survey based on the digital framework of Hobbs to measure differences in perceived digital literacy across students. Research subjects included students of multiple disciplines across three schools at a large urban university. Research results indicate that all students outside of the accounting disciple perceived themselves to be significantly better at being able to: a) analyze messages in a variety of forms; b) evaluate the quality and credibility of content in a message; c) use powerful search strategies; and d) develop multimedia creations. On the other hand, our research results indicate that Accounting Students perceive themselves as significantly better than Finance Students in their ability to a) use the Internet to connect with others with shared interests; b) use the power of communication as a tool for advocacy; c) understand the meaning of copyright; and, d) apply social responsibility and ethical principles to communication behavior. In addition, Computer Science Students perceive themselves as significantly better than Accounting Students in their ability to a) use powerful search strategies; b) develop multimedia creations; c) use the Internet to connect with others with shared interests; d) reflect on online conduct and online social responsibilities; e) use the power of communication as a tool for advocacy; and f) apply social responsibility and ethical principles to communication behavior. Lastly, younger students perceived themselves as better than older students in their ability to a) use the Internet to connect with others with shared interests and b) to use the power of communication as a tool for advocacy. This research concludes that there is a pressing need to focus on and include digital literacy skills into curriculum for Accounting Students., INTRODUCTION Digital literacy is no longer an optional skill for Accounting Students. In fact, it is important for accounting professionals because it enables them to better collect, analyze and synthesize [...]

Introduction: Preterm birth and small for gestational age (SGA) are significant public health concerns in the United States, with pronounced disparities across racial and ethnic groups. Traditional prenatal care adequacy indices have limitations in fully capturing their multifaceted nature. Our study introduces the Comprehensive Prenatal Care Index (CPCI) to provide a more holistic assessment of prenatal care by integrating key elements of prenatal counseling and health promotion. Methods: This cross‐sectional study used the Pregnancy Risk Assessment Monitoring System 2016‐2021 data. The CPCI was developed based on a comprehensive literature review, incorporating components such as timing, frequency, and content of prenatal visits. The index was validated using Item Response Theory (IRT) and compared with the Kotelchuck and Kessner Indices. Results: The study included 139,181 pregnant women. The CPCI demonstrated strong internal consistency (Cronbach's α, 0.75; ω total, 0.81). IRT analysis confirmed the index's ability to capture variability in the quality of prenatal care, with item difficulty parameters ranging from −2.93 to +2.10. CPCI scores were significantly associated with reduced odds of adverse birth outcomes. Adequate CPCI care was linked to a 63% reduction in the odds of preterm birth among non‐Hispanic White women, with similar reductions observed in Hispanic women (odds ratio [OR], 0.59) and Asian women (OR, 0.38). For SGA, adequate care was protective among non‐Hispanic White (OR, 0.86) and Hispanic women (OR, 0.82) but showed mixed results in other groups. Discussion: The CPCI provides a more inclusive measure of the quality of prenatal care compared with traditional indices. The study's findings suggest a significant role of comprehensive prenatal care in reducing adverse birth outcomes and addressing racial and ethnic disparities. Future research should focus on refining the CPCI and exploring its applicability in diverse populations to inform targeted and culturally sensitive prenatal care strategies. [ABSTRACT FROM AUTHOR]

This qualitative metasummary literature review study explores transgender and gender diverse (TGD) children's experiences of parents responding to their gender identities. In data collection for this study, we identified 31 peer-reviewed articles addressing this research topic. Studies included qualitative data collected from TGD children. Data analysis yielded three themes, six subthemes, and 35 findings. The primary three themes highlight TGD children's experiences of supportive, unsupportive, and intermediate parental responses to their gender identities. In this paper, we provide examples of study findings and implications that healthcare providers may consider when offering gender-affirming care to TGD children with accompanying parents. [ABSTRACT FROM AUTHOR]