Publications by authors named "Jessica Lewis"

99 Publications

The benefits of action to reduce household air pollution (BAR-HAP) model: A new decision support tool.

PLoS One 2021 22;16(1):e0245729. Epub 2021 Jan 22.

Sanford School of Public Policy, Duke University, Durham, NC, United States of America.

Cooking with polluting and inefficient fuels and technologies is responsible for a large set of global harms, ranging from health and time losses among the billions of people who are energy poor, to environmental degradation at a regional and global scale. This paper presents a new decision-support model-the BAR-HAP Tool-that is aimed at guiding planning of policy interventions to accelerate transitions towards cleaner cooking fuels and technologies. The conceptual model behind BAR-HAP lies in a framework of costs and benefits that is holistic and comprehensive, allows consideration of multiple policy interventions (subsidies, financing, bans, and behavior change communication), and realistically accounts for partial adoption and use of improved cooking technology. It incorporates evidence from recent efforts to characterize the relevant set of parameters that determine those costs and benefits, including those related to intervention effectiveness. Practical aspects of the tool were modified based on feedback from a pilot testing workshop with multisectoral users in Nepal. To demonstrate the functionality of the BAR-HAP tool, we present illustrative calculations related to several cooking transitions in the context of Nepal. In accounting for the multifaceted nature of the issue of household air pollution, the BAR-HAP model is expected to facilitate cross-sector dialogue and problem-solving to address this major health, environment and development challenge.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245729PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822293PMC
January 2021

Assessment of Reliability and Validity of the Cochlear Implant Skills Review: A New Measure to Evaluate Cochlear Implant Users' Device Skills and Knowledge.

Am J Audiol 2021 Jan 13:1-23. Epub 2021 Jan 13.

Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus.

Purpose The Cochlear Implant Skills Review (CISR) was developed as a measure of cochlear implant (CI) users' skills and knowledge regarding device use. This study aimed to determine intra- and interrater reliability and agreement and establish construct validity for the CISR. Method In this study, the CISR was developed and administered to a cohort of 30 adult CI users. Participants included new CI users with less than 1 year of CI experience and experienced CI users with greater than 1 year of CI experience. The CISR administration required participants to demonstrate skills using the various features of their CI processors. Intra- and interrater reliability were assessed using intraclass correlation coefficients, agreement was assessed using Cohen's kappa, and construct validity was assessed by relating CISR performance to duration of CI use. Results Overall reliability for the entire instrument was 92.7%. Inter- and intrarater agreement were generally substantial or higher. Duration of CI use was a significant predictor of CISR performance. Conclusions The CISR is a reliable and valid assessment measure of device skills and knowledge for adult CI users. Clinicians can use this tool to evaluate areas of needed instruction and counseling and to assess users' skills over time.
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http://dx.doi.org/10.1044/2020_AJA-20-00038DOI Listing
January 2021

An Analysis of Adherence to Vaccination Recommendations in a Thoracic Organ Transplant Cohort.

Vaccines (Basel) 2020 Oct 22;8(4). Epub 2020 Oct 22.

Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.

(1) Background: Vaccination of solid organ transplant (SOT) candidates and recipients is vital to decrease infection-related morbidity and mortality. Here we describe our heart and lung transplant programs' rates of completion of hepatitis B and pneumococcal vaccinations and identify potential opportunities for improvement. (2) Methods: This is a single-center retrospective study that included all heart and lung transplant recipients between 1 July 2013 and 31 July 2018. We assessed demographics, causes of organ failure, pretransplant hepatitis B immune status, and completion rates for hepatitis B vaccine series, pneumococcal conjugate vaccine (PCV13), and pneumococcal polysaccharide vaccine (PPSV23). (3) Results: A total of 41 patients were included in the heart transplant cohort. Twelve (29.3%) had baseline hepatitis B immunity. Only 8/29 (27.6%) completed the entire 3-dose hepatitis B vaccination series pretransplant. Pretransplant PCV13 and PPSV23 vaccination rates were 58.5% (24/41) and 48.8% (20/41), respectively; no additional patients received PCV13 or PPSV23 post-transplant. In the heart transplant cohort, a majority (82.9%) of patients were evaluated by the Transplant Infectious Diseases consultative service (TxID) pretransplant, and this had a statistically significant association with increased pneumococcal vaccination rates ( = 0.0017, PCV13 and = 0.0103, PPSV23). In total, 55 patients were included in the lung transplant cohort. Five (9.1%) had baseline hepatitis B immunity; 33/50 (66.0%) completed the hepatitis B vaccine series in the pretransplant setting. Pretransplant PCV13 and PPSV23 vaccination rate was 40.0% (22/55) and 69.1% (38/55), respectively. There was only a 47.3% and 72.3% completion rate overall in the post-transplant setting. (4) Conclusions: There continues to be a need for a comprehensive and coordinated effort to increase vaccine adherence for all SOT candidates in the pretransplant setting.
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http://dx.doi.org/10.3390/vaccines8040622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712276PMC
October 2020

Considerations for Building Sustainable Community Health Worker Programs to Improve Maternal Health.

J Prim Care Community Health 2020 Jan-Dec;11:2150132720953673

Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.

Objectives: Community health workers (CHWs) are a critical part of the healthcare workforce and valuable members of healthcare teams. However, little is known about successful strategies for sustaining CHW programs. The aim of this study is to identify institutional and community factors that may contribute to the sustainability of CHW programs to improve maternal health outcomes.

Methods: We conducted focus groups and in-depth interviews with 54 CHWs, CHW program staff, and community partners involved in implementing three Merck for Mothers-funded CHW programs in the United States serving reproductive-age women with chronic health conditions. Additionally, a review of documents submitted by CHW programs during the evaluation process provided context for our findings. Data were analyzed using an inductive qualitative approach.

Results: Three themes emerged in our analysis of factors that may influence the sustainability of CHW programs to improve maternal health: CHW support from supervisors, providers, and peers; relationships with healthcare systems and insurers; and securing adequate, continuous funding. Key findings include the need for CHWs to have strong supervisory structures, participate in regular care team meetings, and interact with peers; advantages of CHWs having access to electronic health records; and importance of full-cost accounting and developing a broad base of financial support for CHW programs.

Conclusion: Research should continue to identify best practices for implementation of such programs, particularly regarding effective supervisory support structures, integration of programs with healthcare systems, and long-term revenue streams.
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http://dx.doi.org/10.1177/2150132720953673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495927PMC
September 2020

Feasibility and potential benefits of an attention and executive function intervention on metacognition in a mixed pediatric sample.

Appl Neuropsychol Child 2020 Jul 23:1-13. Epub 2020 Jul 23.

Psychology Department, University of Victoria, Victoria, British Columbia, Canada.

The term "metacognition" describes thinking about a cognitive phenomenon or, more simply put, thinking about thinking . Metacognition involves using knowledge about one's cognitive processes to change behavior, including monitoring and controlling cognition. Metacognition is vital for learning and is often more difficult for children with neurodevelopmental concerns (e.g. Attention Deficit Hyperactivity Disorder [ADHD], Fetal Alcohol Spectrum Disorder [FASD], Autism Spectrum Disorders [ASD]), possibly due to underlying deficits in attention and executive functioning (EF). The present study evaluated a 6- to 8-week cognitive intervention aimed at improving attention and EF and children's metacognitive abilities. Participants included a mixed sample of 50 children ages 6-12 years presenting with attention and/or EF deficits. Children within the active intervention group completed a game-based attention/EF intervention called (CQ), which combines process-specific and compensatory approaches to remediate attention and EF. Educational Assistants (EAs) supported children during gameplay by teaching explicit metacognitive strategies. Pre/post assessments included measures of attention and working memory (WM), metacognitive awareness (child, parent, and EA questionnaires), and metacognitive regulation (metacognitive monitoring and control). Results indicated post-intervention gains in WM, metacognitive awareness, and metacognitive regulation (self-monitoring and metacognitive control). These results provide preliminary support for CQ as potentially beneficial in improving aspects of EF and metacognition in children.
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http://dx.doi.org/10.1080/21622965.2020.1794867DOI Listing
July 2020

Perinatal Depressive Symptom Trajectories Among Adolescent Women in New York City.

J Adolesc Health 2020 Jul 5;67(1):84-92. Epub 2020 Apr 5.

Yale School of Public Health, New Haven, Connecticut.

Purpose: The aim of the study was to estimate distinct trajectories of depressive symptoms among adolescent women across the perinatal period.

Methods: Using longitudinal depressive symptom data (Center for Epidemiologic Studies Depression Scale) from control participants in the Centering Pregnancy Plus Project (2008-2012), we conducted group-based trajectory modeling to identify depressive symptomatology trajectories from early pregnancy to 1-year postpartum among 623 adolescent women in New York City. We examined associations between sociodemographic, psychosocial, and pregnancy characteristics and the outcome, depressive symptom trajectories.

Results: We identified three distinct trajectory patterns: stable low or no depressive symptoms (58%), moderate depressive symptoms declining over time (32%), and chronically high depressive symptoms (11%). Women with chronically high symptoms reported higher levels of pregnancy distress and social conflict and lower perceived quality of social support than other women.

Conclusions: This study found heterogeneity in perinatal depressive symptom trajectories and identified a group with chronically high symptoms that might be detected during prenatal care. Importantly, we did not identify a trajectory group with new-onset high depressive symptoms postpartum. Findings have important implications for screening and early treatment.
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http://dx.doi.org/10.1016/j.jadohealth.2019.12.017DOI Listing
July 2020

Applying concepts of life course theory and life course epidemiology to the study of bladder health and lower urinary tract symptoms among girls and women.

Neurourol Urodyn 2020 04 2;39(4):1185-1202. Epub 2020 Mar 2.

Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri.

Aims: Although lower urinary tract symptoms (LUTS) may occur at different periods during the life course of women, a little research on LUTS has adopted a life course perspective. The purpose of this conceptual paper is to demonstrate how life course theory and life course epidemiology can be applied to study bladder health and LUTS trajectories. We highlight conceptual work from the Prevention of Lower Urinary Tract Symptoms Research Consortium to enhance the understanding of life course concepts.

Methods: Consortium members worked in transdisciplinary teams to generate examples of how life course concepts may be applied to research on bladder health and LUTS in eight prioritized areas: (a) biopsychosocial ecology of stress and brain health; (b) toileting environment, access, habits, and techniques; (c) pregnancy and childbirth; (d) physical health and medical conditions; (e) musculoskeletal health; (f) lifestyle behaviors; (g) infections and microbiome; and (h) hormonal status across the life span.

Results: Life course concepts guided consortium members' conceptualization of how potential risk and protective factors may influence women's health. For example, intrapartum interventions across multiple pregnancies may influence trajectories of bladder health and LUTS, illustrating the principle of life span development. Consortium members also identified and summarized methodologic and practical considerations in designing life course research.

Conclusions: This paper may assist researchers from a variety of disciplines to design and implement research identifying key risk and protective factors for LUTS and bladder health across the life course of women. Results from life course research may inform health promotion programs, policies, and practices.
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http://dx.doi.org/10.1002/nau.24325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659467PMC
April 2020

Prey-switching does not protect a generalist turtle from bioenergetic consequences when its preferred food is scarce.

BMC Ecol 2020 02 18;20(1):11. Epub 2020 Feb 18.

School of Science, Hawkesbury Institute, Western Sydney University, Locked Bag, 1797, Penrith, NSW, 2751, Australia.

Background: Optimal foraging theory explains how animals make foraging decisions based on the availability, nutritional content, and handling times of different food types. Generalists solve this problem by consuming a variety of food types, and alter their diets with relative ease. Specialists eat few food types, and may starve if those food types are not available. We integrated stable isotope analyses with previously-published stomach contents and environmental data to investigate how the foraging ecologies of three sympatric freshwater turtle species vary across four wetlands that differ in turbidity and primary producer abundance.

Results: We found that the generalist Emydura macquarii consumes a varied diet (but mostly filamentous green algae) when primary producers are available and water is clear, but switches to a more carnivorous diet when the water is turbid and primary producers are scarce, following the predictions of optimal foraging theory. In contrast, two more-specialized carnivorous species, Chelodina expansa and Chelodina longicollis, do not differ in diet across wetlands, and interspecific competition may increase where E. macquarii is carnivorous. When forced to be more carnivorous, E. macquarii exhibits higher rates of empty stomachs, and female turtles have reduced body condition, but neither Chelodina species are affected.

Conclusions: Our results provide support for optimal foraging theory, but also show that the ability to change diet does not protect the generalist from experiencing lower foraging success when its preferred food is rare, with direct consequences for their energy budgets. Our results have conservation implications because wetlands in the Murray-Darling river system are increasingly turbid and have low macrophyte abundance, and all three species are declining.
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http://dx.doi.org/10.1186/s12898-020-00279-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027299PMC
February 2020

Development of Conceptual Models to Guide Public Health Research, Practice, and Policy: Synthesizing Traditional and Contemporary Paradigms.

Health Promot Pract 2020 Jul 7;21(4):510-524. Epub 2020 Jan 7.

University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

This applied paper is intended to serve as a "how to" guide for public health researchers, practitioners, and policy makers who are interested in building conceptual models to convey their ideas to diverse audiences. Conceptual models can provide a visual representation of specific research questions. They also can show key components of programs, practices, and policies designed to promote health. Conceptual models may provide improved guidance for prevention and intervention efforts if they are based on frameworks that integrate social ecological and biological influences on health and incorporate health equity and social justice principles. To enhance understanding and utilization of this guide, we provide examples of conceptual models developed by the revention of ower rinary Tract ymptoms (PLUS) Research Consortium. PLUS is a transdisciplinary U.S. scientific network established by the National Institutes of Health in 2015 to promote bladder health and prevent lower urinary tract symptoms, an emerging public health and prevention priority. The PLUS Research Consortium is developing conceptual models to guide its prevention research agenda. Research findings may in turn influence future public health practices and policies. This guide can assist others in framing diverse public health and prevention science issues in innovative, potentially transformative ways.
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http://dx.doi.org/10.1177/1524839919890869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869957PMC
July 2020

Cognitive Functions in Adults Receiving Cochlear Implants: Predictors of Speech Recognition and Changes After Implantation.

Otol Neurotol 2020 Mar;41(3):e322-e329

Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Hypotheses: Significant variability in speech recognition outcomes is consistently observed in adults who receive cochlear implants (CIs), some of which may be attributable to cognitive functions. Two hypotheses were tested: 1) preoperative cognitive skills assessed visually would predict postoperative speech recognition at 6 months after CI; and 2) cochlear implantation would result in benefits to cognitive processes at 6 months.

Background: Several executive functioning tasks have been identified as contributors to speech recognition in adults with hearing loss. There is also mounting evidence that cochlear implantation can improve cognitive functioning. This study examined whether preoperative cognitive functions would predict speech recognition after implantation, and whether cognitive skills would improve as a result of CI intervention.

Methods: Nineteen post-lingually deafened adult CI candidates were tested preoperatively using a visual battery of tests to assess working memory (WM), processing speed, inhibition-concentration, and nonverbal reasoning. Six months post-implantation, participants were assessed with a battery of word and sentence recognition measures and cognitive tests were repeated.

Results: Multiple speech measures after 6 months of CI use were correlated with preoperative visual WM (symbol span task) and inhibition ability (stroop incongruent task) with moderate-to-large effect sizes. Small-to-large effect size improvements in visual WM, concentration, and inhibition tasks were found from pre- to post-CI. Patients with lower baseline cognitive abilities improved the most after implantation.

Conclusions: Findings provide evidence that preoperative cognitive factors contribute to speech recognition outcomes for adult CI users, and support the premise that implantation may lead to improvements in some cognitive domains.
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http://dx.doi.org/10.1097/MAO.0000000000002544DOI Listing
March 2020

Systematic Identification and Analysis of Type VI Secretion System Effector and Immunity Components.

Front Microbiol 2019 30;10:2440. Epub 2019 Oct 30.

Infection and Immunity Program, Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.

Many Gram-negative bacteria use a type VI secretion system (T6SS) for microbial warfare and/or host manipulation. is an important nosocomial pathogen and many strains utilize a T6SS to deliver toxic effector proteins to surrounding bacterial cells. These toxic effectors are usually delivered together with VgrG proteins, which form part of the T6SS tip complex. All previously identified T6SS effectors are encoded within a three- or four-gene locus that also encodes a cognate VgrG and immunity protein, and sometimes a chaperone. In order to characterize the diversity and distribution of T6SS effectors and immunity proteins in this species, we first identified all genes in 97 strains via the presence of the highly conserved VgrG domain. Most strains encoded between two and four different VgrG proteins. We then analyzed the regions downstream of the identified genes and identified more than 240 putative effectors. The presence of conserved domains in these effectors suggested a range of functions, including peptidoglycan hydrolases, lipases, nucleases, and nucleic acid deaminases. However, 10 of the effector groups had no functionally characterized domains. Phylogenetic analysis of these putative effectors revealed that they clustered into 32 distinct groups that appear to have been acquired from a diverse set of ancestors. Corresponding immunity proteins were identified for all but two of the effector groups. Effectors from eight of the 32 groups contained N-terminal rearrangement hotspot (RHS) domains. The C-terminal regions of these RHS proteins, which are predicted to confer the toxic effector function, were very diverse, but the N-terminal RHS domains clustered into just two groups. While the majority of strains contained an RHS type effector, no strains encoded two RHS effectors with similar N-terminal sequences, suggesting that the presence of similar N-terminal RHS domains leads to competitive exclusion. Together, these analyses define the extreme diversity of T6SS effectors within and, as many have unknown functions, future detailed characterization of these effectors may lead to the identification of proteins with novel antibacterial properties.
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http://dx.doi.org/10.3389/fmicb.2019.02440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833914PMC
October 2019

The Relationship between Parent-reported PEDI-CAT Mobility and Gross Motor Function in Children with Cerebral Palsy: Brief Report.

Dev Neurorehabil 2020 Feb 14;23(2):140-144. Epub 2019 Nov 14.

The Ohio State University, Columbus, OH, USA.

: The PEDI-CAT mobility domain (PEDI-mob) is a parent-reported measure of mobility for children up to 21 years of age. The purpose of this research is to investigate the relationship between the PEDI-mob and Gross Motor Function Measure (GMFM)-66 and Gross Motor Function Classification Scale (GMFCS) levels.: Fifty-seven children (N = 57), ages 2-8.8 years participated. PEDI-mob and GMFM were administered and GMFCS was confirmed during the same session. A Pearson correlation coefficient was calculated for PEDI-mob and GMFM-66 scores to evaluate the association between these two measures. An ANOVA was used to analyze PEDI-mob across GMFCS levels.: Large, statistically significant correlation was found between PEDI-mob and GMFM-66 scores (r = 0.894, -value<0.001). Differences in PEDI-mob scores were found across GMFCS levels (-value <0.001), where patients with higher GMFCS levels had lower PEDI-mob scores.: These results support a strong relationship between parent-reported and clinically measured motor function.
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http://dx.doi.org/10.1080/17518423.2019.1687601DOI Listing
February 2020

How Does Quality of Life Relate to Auditory Abilities? A Subitem Analysis of the Nijmegen Cochlear Implant Questionnaire.

J Am Acad Audiol 2020 04 15;31(4):292-301. Epub 2020 Apr 15.

Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Columbus, OH.

Background: Objective speech recognition tasks are widely used to measure performance of adult cochlear implant (CI) users; however, the relationship of these measures with patient-reported quality of life (QOL) remains unclear. A comprehensive QOL measure, the Nijmegen Cochlear Implant Questionnaire (NCIQ), has historically shown a weak association with speech recognition performance, but closer examination may indicate stronger relations between QOL and objective auditory performance, particularly when examining a broad range of auditory skills.

Purpose: The aim of the present study was to assess the NCIQ for relations to speech and environmental sound recognition measures. Identifying associations with certain QOL domains, subdomains, and subitems would provide evidence that speech and environmental sound recognition measures are relevant to QOL. A lack of relations among QOL and various auditory abilities would suggest potential areas of patient-reported difficulty that could be better measured or targeted.

Research Design: A cross-sectional study was performed in adult CI users to examine relations among subjective QOL ratings on NCIQ domains, subdomains, and subitems with auditory outcome measures.

Study Sample: Participants were 44 adult experienced CI users. All participants were postlingually deafened and had met candidacy requirements for traditional cochlear implantation.

Data Collection And Analysis: Participants completed the NCIQ as well as several speech and environmental sound recognition tasks: monosyllabic word recognition, standard and high-variability sentence recognition, audiovisual sentence recognition, and environmental sound identification. Bivariate correlation analyses were performed to investigate relations among patient-reported NCIQ scores and the functional auditory measures.

Results: The total NCIQ score was not strongly correlated with any objective auditory outcome measures. The physical domain and the advanced sound perception subdomain related to several measures, in particular monosyllabic word recognition and AzBio sentence recognition. Fourteen of the 60 subitems on the NCIQ were correlated with at least one auditory measure.

Conclusions: Several subitems demonstrated moderate-to-strong correlations with auditory measures, indicating that these auditory measures are relevant to the QOL. A lack of relations with other subitems suggests a need for the development of objective measures that will better capture patients' hearing-related obstacles. Clinicians may use information obtained through the NCIQ to better estimate real-world performance, which may support improved counseling and development of recommendations for CI patients.
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http://dx.doi.org/10.3766/jaaa.19047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103517PMC
April 2020

Response to Letter to the Editor from Peck.

J Am Acad Audiol 2019 Nov/Dec;30(10):927. Epub 2019 Aug 16.

The Ohio State University, Department of Speech and Hearing Science.

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http://dx.doi.org/10.3766/jaaa.19011DOI Listing
May 2020

Associations between intimate partner violence profiles and mental health among low-income, urban pregnant adolescents.

BMC Pregnancy Childbirth 2019 Apr 26;19(1):120. Epub 2019 Apr 26.

Yale School of Public Health, New Haven, CT, USA.

Background: Intimate partner violence (IPV) during pregnancy is associated with adverse maternal and child health outcomes, including poor mental health. Previous IPV research has largely focused on women's victimization experiences; however, evidence suggests young women may be more likely to engage in bilateral violence (report both victimization and perpetration) or perpetrate IPV (unilateral perpetration) during pregnancy than to report being victimized (unilateral victimization). This study examined prevalence of unilateral victimization, unilateral perpetration, and bilateral violence, and the association between these IPV profiles and mental health outcomes during pregnancy among young, low-income adolescents.

Methods: Survey data were collected from 930 adolescents (14-21 years; 95.4% Black and Latina) from fourteen Community Health Centers and hospitals in New York City during second and third trimester of pregnancy. Multivariable regression models tested the association between IPV profiles and prenatal depression, anxiety, and distress, adjusting for known predictors of psychological morbidity.

Results: Thirty-eight percent of adolescents experienced IPV during their third trimester of pregnancy. Of these, 13% were solely victims, 35% were solely perpetrators, and 52% were engaged in bilateral violence. All women with violent IPV profiles had significantly higher odds of having depression and anxiety compared to individuals reporting no IPV. Adolescents experiencing bilateral violence had nearly 4-fold higher odds of depression (OR = 3.52, 95% CI: 2.43, 5.09) and a nearly 5-fold increased likelihood of anxiety (OR = 4.98, 95% CI: 3.29, 7.55). Unilateral victims and unilateral perpetrators were also at risk for adverse mental health outcomes, with risk of depression and anxiety two- to three-fold higher, compared to pregnant adolescents who report no IPV. Prenatal distress was higher among adolescents who experienced bilateral violence (OR = 2.84, 95% CI: 1.94, 4.16) and those who were unilateral victims (OR = 2.21, 95% CI: 1.19, 4.12).

Conclusions: All violent IPV profiles were associated with adverse mental health outcomes among pregnant adolescents, with bilateral violence having the most detrimental associations. Comprehensive IPV screening for both victimization and perpetration experiences during pregnancy is warranted. Clinical and community prevention efforts should target pregnant adolescents and their partners to reduce their vulnerability to violence and its adverse consequences.

Trial Registration: ClinicalTrials.gov, NCT00628771 . Registered 29 February 2008.
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http://dx.doi.org/10.1186/s12884-019-2256-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485079PMC
April 2019

Transforming prenatal care: Multidisciplinary team science improves a broad range of maternal-child outcomes.

Am Psychol 2019 04;74(3):343-355

Department of Obstetrics, Gynecology and Reproductive Sciences.

Every 8 seconds a baby is born in the United States. Maternal and newborn care are the nation's most expensive clinical services, and despite spending more per capita on health services, the United States experiences worse perinatal outcomes than most other developed countries, and even worse than many developing countries when it comes to maternal and infant mortality, preterm birth, and other comorbid conditions. We established a transdisciplinary clinical research team nearly 2 decades ago to improve maternal and child health through an innovative approach to maternal care delivery: group prenatal care. Our team has included psychologists (social, health, clinical, community), physicians (obstetrics, maternal fetal medicine, pediatrics), nurse-midwives, epidemiologists, biostatisticians, sociologists, social workers, and others. Though we come from different disciplines, we share a commitment to women's health, to using empirical evidence to design the best interventions, to social justice and health equity, and to transdisciplinary team science. In authentic collaboration, we have drawn on the best of each discipline to meet the triple aim (enhanced quality, improved outcomes, lower costs) for maternal care and to develop a deeper understanding of risk and protective factors for pregnant women and their families. This article describes how we leveraged and integrated our diverse perspectives to achieve these goals, including the theoretical and clinical foundations underlying the development and evaluation of the group prenatal care approach, research methodology employed, impact on the field, and lessons learned. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/amp0000435DOI Listing
April 2019

Factors associated with pregnant adolescents' access to sexual and reproductive health services in New York City.

Sex Reprod Healthc 2019 Mar 21;19:50-55. Epub 2018 Dec 21.

Yale School of Public Health, New Haven, CT, United States.

Objective: This longitudinal study examined access to, and factors associated with, receipt of sexual and reproductive health services deemed essential by the World Health Organization among pregnant adolescents in New York City.

Methods: Participants included 649 pregnant adolescents, ages 14-21 who were enrolled in a clustered randomized controlled trial from 2008 to 2012. Data were collected via medical record abstraction and structured surveys during the second and third trimesters of pregnancy and 12-months postpartum. We used multivariable logistic regression to test associations between measures of social and economic vulnerability (age, race/ethnicity, immigration status, food and housing security, relationship status, perceived discrimination) and access to core sexual and reproductive health services (perinatal care, contraception, HIV testing, sexual health knowledge).

Results: Only 4% of participants received all four core aspects of sexual and reproductive health assessed. Adolescents <18 years old had lower odds of contraception use (OR = 0.46, CI 0.27-0.78), having had an HIV test (OR = 0.35, CI 0.16-0.78), and high sexual health knowledge (OR = 0. 59, CI 0.37-0.95), compared to those ≥18 years. Black women were significantly more likely to have high sexual health knowledge compared to other women (OR = 1.84, CI 1.05, 3.22). Immigrants had higher odds of adequate perinatal care (OR = 1.60, CI 1.09-2.36) and contraception use (OR = 1.64, CI 1.07-2.53), but lower likelihood of high sexual health knowledge (OR = 0.52, CI 0.34-0.81), compared to US-born counterparts. Food insecurity was associated with lower likelihood of comprehensive perinatal care (OR = 0.63, CI 0.45-0.90).

Conclusions: Access to sexual and reproductive health services in New York City is poor among vulnerable adolescents. Health practice and policy should assure access to fundamental sexual and reproductive health services among vulnerable populations in the United States.
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http://dx.doi.org/10.1016/j.srhc.2018.12.003DOI Listing
March 2019

Commentary on "Validity of the Early Activity Scale for Endurance and the 6-Minute Walk Test for Children With Cerebral Palsy".

Pediatr Phys Ther 2019 04;31(2):164

Kettering College Kettering, Ohio Nationwide Children's Hospital Columbus, Ohio.

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http://dx.doi.org/10.1097/PEP.0000000000000597DOI Listing
April 2019

Utilization of the Maryland Environmental Justice Screening Tool: A Bladensburg, Maryland Case Study.

Int J Environ Res Public Health 2019 01 26;16(3). Epub 2019 Jan 26.

Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD 20742, USA.

Maryland residents' knowledge of environmental hazards and their health effects is limited, partly due to the absence of tools to map and visualize distribution of risk factors across sociodemographic groups. This study discusses the development of the Maryland EJSCREEN (MD EJSCREEN) tool by the National Center for Smart Growth in partnership with faculty at the University of Maryland School of Public Health. The tool assesses environmental justice risks similarly to the U.S. Environmental Protection Agency's (USEPA) EJSCREEN tool and California's tool, CalEnviroScreen 3.0. We discuss the architecture and functionality of the tool, indicators of importance, and how it compares to USEPA's EJSCREEN and CalEnviroScreen. We demonstrate the use of MD EJSCREEN through a case study on Bladensburg, Maryland, a town in Prince George's County (PG) with several environmental justice concerns including air pollution from traffic and a concrete plant. Comparison reveals that environmental and demographic indicators in MD EJSCREEN most closely resemble those in EPA EJSCREEN, while the scoring is most similar to CalEnviroScreen. Case study results show that Bladensburg has a Prince George's environmental justice score of 0.99, and that National Air Toxics Assessment (NATA) air toxics cancer risk is concentrated in communities of color.
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http://dx.doi.org/10.3390/ijerph16030348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388180PMC
January 2019

Recommendations for the Pilot Expansion of Medicaid Coverage for Doulas in New York State.

Am J Public Health 2019 02;109(2):217-219

Renee Mehra is with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Shayna D. Cunningham, Jessica B. Lewis, and Jordan L. Thomas are with the Department of Social and Behavioral Sciences, Yale School of Public Health. Jeannette R. Ickovics is with the Department of Social and Behavioral Sciences, Yale School of Public Health, and Yale-NUS College, Singapore.

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http://dx.doi.org/10.2105/AJPH.2018.304797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336076PMC
February 2019

Global household air pollution database: Kitchen concentrations and personal exposures of particulate matter and carbon monoxide.

Data Brief 2018 Dec 27;21:1292-1295. Epub 2018 Oct 27.

School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.

The Global Household Air Pollution (HAP) Measurements database, commissioned by the World Health Organization, provides an organized summary of data reported in the literature describing HAP microenvironments, methods and measurements. As of June 2018, the database contains measurements from 43 countries obtained from 196 studies published through 2016. The database includes information useful for understanding the range of household and personal air pollution measurements that have been collected in a country, as well as characteristics of the cooking environment, including primary cooking fuel type, stove type, heating fuel type and kitchen location. Quantitative particulate matter (PM) of various size fractions and/or carbon monoxide (CO) exposure measurements included in the database can be aggregated and analyzed to generate summary statistics (e.g. average sub-national, national, regional and global HAP exposures) to assess temporal and spatial relationships. The quantitative PM exposure measurements in the database have been used in global predictive modeling of HAP-PM exposures ("Global Estimation of Exposure to Fine Particulate Matter (PM2.5) from Household Air Pollution" (Shupler et al., 2018) [1]).
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http://dx.doi.org/10.1016/j.dib.2018.10.120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231029PMC
December 2018

Establishing an Antifungal Program to Reduce Invasive Fungal Infections in Patients With Acute Myeloid Leukemia Receiving Induction and Reinduction Chemotherapy.

J Oncol Pract 2018 Nov 15:JOP1800307. Epub 2018 Nov 15.

University of Virginia Health System, Charlottesville, VA; Atlanta Cancer Care, Atlanta, GA; and Medical University of South Carolina, Charleston, SC.

Purpose:: Twenty percent of patients with acute myeloid leukemia (AML) undergoing induction or reinduction chemotherapy at the University of Virginia Health System from May 2011 to August 2014 had a proven or probable invasive fungal infection (IFI). The purpose of our initiative was to reduce the percentage of proven or probable IFIs in patients with AML undergoing induction or reinduction chemotherapy at the University of Virginia Health System to 10% or less by June 2017, in concordance with national averages.

Methods:: A multidisciplinary team was formed to lead the comprehensive quality improvement (QI) initiative. The team generated both current process state and ideal process state workflow diagrams, a cause-and-effect diagram, and a Pareto diagram to determine the most relevant etiology for proven or probable IFIs in patients with AML undergoing induction or reinduction chemotherapy.

Results:: Analysis led to the creation of a program standardizing antifungal prophylaxis in this patient population, along with a suggested work-up for recalcitrant fevers. Through two tests of change (Plan-Do-Study-Act cycles 1 and 2), the QI initiative was able to effectively reduce the proven or probable IFI rate to 0% since program implementation in August 2016, thus surpassing both QI initiative goals and national rates of IFI. Mean length of stay (LOS) decreased by 3.4 days, and median intensive care unit LOS decreased by 2 days.

Conclusion:: Creation of a standardized antifungal prophylaxis program led to a marked decrease in LOS and the proven or probable IFI rate of patients with AML undergoing induction or reinduction chemotherapy.
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http://dx.doi.org/10.1200/JOP.18.00307DOI Listing
November 2018

Comparison of risk factors and outcomes of daptomycin-susceptible and -nonsusceptible vancomycin-resistant Enterococcus faecium infections in liver transplant recipients: A reply to Jorgenson et al.

Transpl Infect Dis 2019 02;21(1):e13028

Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia.

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http://dx.doi.org/10.1111/tid.13028DOI Listing
February 2019

Group Prenatal Care Reduces Risk of Preterm Birth and Low Birth Weight: A Matched Cohort Study.

J Womens Health (Larchmt) 2019 01 25;28(1):17-22. Epub 2018 Sep 25.

1 Yale School of Public Health, New Haven, Connecticut.

Background: Group prenatal care is a promising strategy to improve perinatal outcomes. Research in larger more diverse populations with attention to adherence is needed to inform clinical practice recommendations. We examined the impact of group prenatal care on preterm birth and low birth weight in a large metropolitan hospital, accounting for patient adherence, over an 8.5-year period.

Materials And Methods: We analyzed data from 9,348 pregnant women with a live, singleton birth who received group (CenteringPregnancy or Expect With Me) or individual prenatal care at Vanderbilt University Medical Center from January 2009 through June 2016. Propensity scores were used for matching based on year of delivery, age, race, pregnancy risk, and adequacy of care. The propensity score matched sample included 1,384 group and 5,055 individual prenatal care patients (total = 6,439 women). Preterm birth (<37 weeks gestation) and low birth weight (<2,500 g) were obtained from systematic medical review. Risks were estimated using Poisson regression.

Results: Controlling for individual visits, receiving group prenatal care resulted in significantly lower risk of having a preterm birth (Rate ratio [RR] 0.63, 95% confidence interval [CI] 0.49-0.81) and low birth weight baby (RR 0.62, 95% CI 0.47-0.81), compared to receiving individual care only. Women with ≥5 group prenatal care visits experienced even greater benefits: 68% (RR = 0.32; 95% CI 0.22-0.45) and 66% (RR = 0.34; 95% CI 0.23-0.50) risk reduction in preterm birth and low birth weight, respectively.

Conclusions: Participation in group prenatal care may improve birth outcomes. Efforts to promote adoption and sustainability of group prenatal care by health systems may be warranted.
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http://dx.doi.org/10.1089/jwh.2017.6817DOI Listing
January 2019

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda.

Neurourol Urodyn 2018 11 22;37(8):2951-2964. Epub 2018 Aug 22.

Division of Female Pelvic Medicine & Reconstructive Surgery, University of California San Diego, San Diego, California.

Aims: The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium was established by the National Institutes of Health in 2015 to expand research beyond the detection and treatment of lower urinary tract symptoms (LUTS) to the promotion and preservation of bladder health and prevention of LUTS in girls and women. While many multi-disciplinary scientific networks focus on pelvic floor dysfunction and LUTS, the PLUS Consortium stands alone in its focus on prevention. This article describes the PLUS approach to developing a conceptual framework to guide the Consortium's initial prevention research agenda.

Methods: The conceptual framework was informed by traditional social ecological models of public health, biopsychosocial models of health, Glass and McAtee's Society-Behavior-Biology Nexus, and the World Health Organization's conceptual framework for action on the social determinants of health.

Results: The PLUS conceptual framework provides a foundation for developing prevention interventions that have the greatest likelihood of promoting and preserving bladder health among diverse populations.

Conclusions: PLUS Consortium work is premised on the notion that programs, practices, and policies designed to promote health will have optimal impact if the conceptual foundation upon which efforts are based is comprehensive and informed by multiple disciplines. The PLUS conceptual framework is broadly applicable to domains of health that have historically focused on the treatment of illness and symptoms rather than the promotion of health. It is also applicable to domains of health that have been examined from a predominantly biological or social ecological perspective, without integration of both perspectives.
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http://dx.doi.org/10.1002/nau.23787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451314PMC
November 2018

Mild-Gain Hearing Aids as a Treatment for Adults with Self-Reported Hearing Difficulties.

J Am Acad Audiol 2018 06;29(6):477-494

The Ohio State University, Columbus, OH.

Background: There is a growing body of evidence demonstrating self-reported hearing difficulties (HD; i.e., substantial difficulty in understanding speech in complex listening situations) in adults with normal pure-tone sensitivity. Anecdotally, some audiologists have tried personal mild-gain amplification as a treatment option for adults with HD. In 2008, Kuk and colleagues reported positive results of a mild-gain hearing aid trial for children with auditory processing disorders. To date, however, there have been no studies investigating the benefit of mild-gain amplification to treat HD in adults with normal audiograms.

Purpose: The effectiveness of a four-week trial with mild-gain amplification for adults with self-reported HD and clinically normal hearing sensitivity was investigated.

Research Design: Two participant groups with normal pure-tone audiograms (thresholds ≤20 dB HL 250-8000 Hz) were recruited to study the effects of self-reported HD on hearing handicap, self-perceived auditory processing difficulties, and performance on a speech-in-noise task. Furthermore, the benefit of mild-gain amplification was examined after a four-week hearing aid trial on self-perceived hearing handicap and auditory processing difficulties, and performance on an aided speech-in-noise task. Effects were analyzed using a mixed-model repeated measures analysis of variance. Posthoc analyses were performed for each significant main effect.

Study Sample: Thirty-nine participants participated in two groups. Twenty normal hearing adults (19-27 yr) without complaints of HD were recruited as a control group. Nineteen normal hearing adults (18-58 yr) with self-reported HD were recruited for the mild-gain hearing aid trial.

Data Collection And Analysis: Subjective complaints of HD were assessed with two questionnaires (the Hearing Handicap Inventory for Adults [HHIA] and the Auditory Processing Questionnaire [APQ]) and an auditory processing test battery (SCAN:3-A, dichotic digit recognition, gaps-in-noise test, and the 500-Hz masking level difference). Speech-in-noise abilities were assessed before and after hearing aid trial using the Revised Speech Perception in Noise Test (R-SPIN) at multiple signal-to-noise ratios. Hearing aid use and impressions during the hearing aid trial were recorded.

Results: Results demonstrated that participants with HD perceived significantly greater hearing handicap (HHIA) and greater self-perceived auditory processing difficulties (APQ) than the control group. Participants with HD performed significantly poorer on the R-SPIN relative to controls, especially for low-predictability items. Results of the hearing aid trial for participants with HD revealed significant improvements in hearing handicap, self-perceived auditory processing difficulties, and speech-in-noise performance relative to prehearing aid trial measures. The hearing aids were well tolerated by the majority of participants with HD , with most of them wearing the hearing aids an average of 1-4 h per day.

Conclusions: The results from the present study suggest that adults who present with complaints of HD even in the presence of normal hearing sensitivity represent a unique population that warrants further evaluation beyond the standard hearing test. Furthermore, results from the hearing aid trial suggest that mild-gain amplification is a viable treatment option for at least some individuals with HD.
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http://dx.doi.org/10.3766/jaaa.16111DOI Listing
June 2018

Septic arthritis due to oral streptococci following intra-articular injection: A case series.

Am J Infect Control 2018 11 24;46(11):1301-1303. Epub 2018 May 24.

Department of Medicine, University of Virginia Health System, Charlottesville, VA; Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA.

Oral streptococcal species are a rare cause of septic arthritis. We describe 4 cases of septic arthritis due to oral streptococcal species following joint injection. The routine use of face masks during joint injection may prevent this rare but serious complication.
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http://dx.doi.org/10.1016/j.ajic.2018.04.227DOI Listing
November 2018

A Novel Research Definition of Bladder Health in Women and Girls: Implications for Research and Public Health Promotion.

J Womens Health (Larchmt) 2018 08 24;27(8):974-981. Epub 2018 May 24.

16 Division of Epidemiology and Community Health, University of Minnesota School of Public Health , Minneapolis, Minnesota.

Background: Bladder health in women and girls is poorly understood, in part, due to absence of a definition for clinical or research purposes. This article describes the process used by a National Institutes of Health funded transdisciplinary research team (The Prevention of Lower Urinary Tract Symptoms [PLUS] Consortium) to develop a definition of bladder health.

Methods: The PLUS Consortium identified currently accepted lower urinary tract symptoms (LUTS) and outlined elements of storage and emptying functions of the bladder. Consistent with the World Health Organization's definition of health, PLUS concluded that absence of LUTS was insufficient and emphasizes the bladder's ability to adapt to short-term physical, psychosocial, and environmental challenges for the final definition. Definitions for subjective experiences and objective measures of bladder dysfunction and health were drafted. An additional bioregulatory function to protect against infection, neoplasia, chemical, or biologic threats was proposed.

Results: PLUS proposes that bladder health be defined as: "A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of LUTS. Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being (e.g., travel, exercise, social, occupational, or other activities)." Definitions for each element of bladder function are reported with suggested subjective and objective measures.

Conclusions: PLUS used a comprehensive transdisciplinary process to develop a bladder health definition. This will inform instrument development for evaluation of bladder health promotion and prevention of LUTS in research and public health initiatives.
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http://dx.doi.org/10.1089/jwh.2017.6786DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104253PMC
August 2018

Identification of Novel Acinetobacter baumannii Type VI Secretion System Antibacterial Effector and Immunity Pairs.

Infect Immun 2018 08 23;86(8). Epub 2018 Jul 23.

Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Australia

The type VI secretion system (T6SS) is a macromolecular machine that delivers protein effectors into host cells and/or competing bacteria. The effectors may be delivered as noncovalently bound cargo of T6SS needle proteins (VgrG/Hcp/PAAR) or as C-terminal extensions of these proteins. Many strains produce a T6SS, but little is known about the specific effectors or how they are delivered. In this study, we show that AB307-0294 encodes three loci, each containing a gene, a T6SS toxic effector gene, and an antitoxin/immunity gene. Each of the T6SS toxic effectors could kill when produced in unless the cognate immunity protein was coproduced. To determine the role of each VgrG in effector delivery, we performed interbacterial competitive killing assays using AB307-0294 mutants, together with prey cells expressing pairs of immunity genes that protected against two toxic effectors but not a third. Using this approach, we showed that AB307-0294 produces only three T6SS toxic effectors capable of killing and that each VgrG protein is specific for the carriage of one effector. Finally, we analyzed a number of genomes and identified significant diversity in the range of encoded T6SS VgrG and effector proteins, with correlations between effector types and global clone lineages.
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http://dx.doi.org/10.1128/IAI.00297-18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056853PMC
August 2018

Listening to a conversation with aggressive content expands the interpersonal space.

PLoS One 2018 28;13(3):e0192753. Epub 2018 Mar 28.

Department of Psychology, Anglia Ruskin University, Cambridge, United Kingdom.

The distance individuals maintain between themselves and others can be defined as 'interpersonal space'. This distance can be modulated both by situational factors and individual characteristics. Here we investigated the influence that the interpretation of other people interaction, in which one is not directly involved, may have on a person's interpersonal space. In the current study we measured, for the first time, whether the size of interpersonal space changes after listening to other people conversations with neutral or aggressive content. The results showed that the interpersonal space expands after listening to a conversation with aggressive content relative to a conversation with a neutral content. This finding suggests that participants tend to distance themselves from an aggressive confrontation even if they are not involved in it. These results are in line with the view of the interpersonal space as a safety zone surrounding one's body.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192753PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873936PMC
June 2018