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Adverse childhood experiences (ACEs) are traumatic and stressful events during a person’s early life that can influence their later mental health, physical health, and wellbeing. Internalizing symptoms such as anxiety and depression are common mental health outcomes associated with ACEs. Two factors, religiosity/spirituality (R/S) and mindfulness, are possible protective factors that may help lessen the effects of ACEs on later mental health. This study hopes to examine whether R/S and mindfulness are protective factors in the relationship between ACEs from childhood and internalizing symptoms in adulthood. Further, this study examines whether the protective impact of R/S is further strengthened by an individual’s mindfulness (moderated moderation). Participants (N = 769, age M = 20.43, SD = 4.51) for this study were recruited through the SONA research platform at East Tennessee State University as a part of the REACH (Religion, Emotions, and Current Health) self-report survey. We used a retrospective measure, the Adverse Childhood Experiences (ACE) questionnaire, to assess childhood adversity. We used the Brief Multidimensional Measure of Religiosity and Spirituality (BMMRS) to assess current religiosity/spirituality of participants and the Five Facet Mindfulness Questionnaire (FFMQ) to assess current overall mindfulness of participants. To examine internalizing symptoms of the sample, we used the Generalized Anxiety Disorder-7 (GAD-7) questionnaire to assess anxiety symptoms, and the Center for Epidemiologic Studies Depression Scale Revised (CESD-R-20) to assess depression symptoms. The analyses for this project were conducted using the Statistical Package for the Social Sciences (SPSS). Bivariate analyses for this project will be conducted using Pearson’s correlations and the moderated moderation model will be tested using the Hayes Process Macro (version 3.0, Model 3). We predict that ACEs will be related to internalizing symptoms as is commonly demonstrated in the literature, such that more ACES are associated with more symptoms of anxiety and depression. Further, we expect that both R/S and mindfulness will weaken (i.e. moderate) this relationship. Additionally, we propose that mindfulness will impact the moderating (protective) effect of R/S on this relationship, such that the protective effect of R/S is greatest for those with high levels of mindfulness.

Children naturally seek support and comfort from birth on, especially when faced with negative life events. Support that comes from the primary care givers is necessary and useful but is not always available or the only considerably influential support the child receives. Other places support could come from include peers, school resources or religious resources and beyond. Religion and the support received from faith-based groups has been used in many ways to aid in coping with experienced trauma and times of adversity. Observing the perceived religious support that children feel they have allows for the support systems in a child’s life to understand the potentially useful practices in the resilience of adverse experiences faced by youth. Focusing on the relationship between how much religious support is perceived and the number of adverse childhood experiences (ACE) scores could lead to further research endeavors on religiosity’s role in coping with trauma and adversity. It is hypothesized that the more religious socialization support perceived by participants as children, the fewer ACE scores will be reported. Data collected from the REACH (Religion, Emotions, and Current Health) survey style study of the ARCH (Affect, Regulation, Coping and Health) research lab will be used. The college aged participant’s (N = 766) responses on reflective views of support perceived during youth in faith communities using the ARCH lab adapted version Faith Activities in the Home scale (FAITHS; Lambert & Dollahite, 2010) and number of ACEs will be analyzed. The proposed analysis to be conducted is a Pearson’s r correlation using SPSS. It is expected that there will be a negative correlation where the more religious support that is perceived during childhood, the fewer ACEs will be reported. Previous research has not directly observed the relationship of retrospective religious support and ACEs, so this study could direct to new investigations of coping through religious support for children. If the results are not statistically significant, past perceived religious support may not affect ACEs directly, and would lead to other ways of investigating the relationship of coping through religious means during adverse experiences.

Fostering a Trauma Informed Mindset in the Criminal Justice System Lauren Ledford, Mary Jo Oliver M.S., Meredith Jordan, Chloe Salyer, Adam Walker, Andrea D. Clements Ph.D. The presence of early childhood adversity and trauma is disproportionately high in individuals involved with the criminal justice system compared to the non-criminally involved population. Childhood adversity and trauma is consistently linked to many adverse lifelong outcomes such as increased mortality, increased risk of mental illness, and increased risk of substance use disorder. In order to respond to this increased risk, empathy and community-wide interventions have emerged as effective means of responding and resisting re-traumatization. Community and empathy-based training of law enforcement officials may assist in understanding trauma and combatting its effects as they are often some of the first people to come in contact with individuals experiencing the effects of childhood adversity and trauma. This study sought to evaluate the effectiveness of Trauma-Informed Care (TIC) training for police officers in their ability to have knowledge of, believe to be relevant, understand, feel confident implementing, and apply TIC principles. We hypothesized knowledge, relevance, understanding, implementation confidence, and application of TIC would all increase from pre-assessment to post-assessment. As part of an initiative to increase TIC awareness and implementation, 64 police officers participated in a one-day training that began with a pre-survey and ended with a post-survey. Both surveys contained measures concerning TIC knowledge, relevance, understanding, implementation confidence, and application. The post survey also included an additional measure regarding training quality satisfaction. The sample consisted primarily of White (N = 44), middle-aged males (M = 42.27, SD = 8.588). There was a significant difference between TIC knowledge t(56) = -4.593, p<.001, d = 1.096, TIC relevance t(56) = -2.488, p = .016, d = .912, TIC understanding t(56) = -8.611, p <.001, d = 2.932, and implementation confidence t(56)= -5.942, p <.001, d = 1.326 from the pre to post assessment. However, there was not a significant difference between TIC application t(56) = -1.826, p = .073, d = .585 from pre to post assessment. The consistently significant increase in TIC scores indicate that a TIC training is an effective means of improving officer perception of trauma and willingness to implement TIC practices.

Background: Studies show that when nurses are experiencing problems in the care of non-Swedish speaking patients, it is often due to obstacles in the communication. Studies also show that a prerequisite for adequate care is that there is a basis for a direct communication. Nurses perceive interpreters as an important link to the patient when they do not share a mutual language, the nurses perceive interpreters as a bridge in the conversation. Aim: The purpose of the study is to describe nurses' experiences of the quality of assessments done with the help of an interpreter. Method: The study was conducted through interviews with ten nurses, working at psychiatric clinics. Qualitative content analysis was used for the analysis, which resulted in five categories. Results: The analysis resulted in one theme: "it´s the interpreter who tells me and have not the feeling that the patient has" and five categories: "shades of the language", "conversation structure", "the interpreter's competence", "interpreting implementing" and "the interpreter's gender and origin". The nurses experience working with interpreters as a challenge. The difficulty of working with the help of an interpreter is that the nurse cannot see the spoken word in connection with the patient's body language. Communication through an interpreter also felt unnatural and the interpreter's participation is perceived as a filter. Conclusion: The quality of the assessments were not perceived as good with the interpreter as without, however, there was no risk to patient safety.

This research aims to understand the experiences of a new generation of Chinese international students in Canadian universities and the role of their identities in shaping such experiences, including their resistance toward stereotypes. Data was collected through semi-structural, in-depth interviews with eight international students who were studying at universities in Southern Ontario, were from mainland China and were born during 1990s. The study leads to several major findings. First, these students did not necessarily internalize stereotypes about Chinese international students, China and Chinese culture from other groups, producing from lack of culture exchange, language barrier, cultural difference and the biased mass media, and that they also made their efforts to change this situation. Second, participants appeared to have different relationships with three groups in Chinese student communities. Third, informal support from individual social network was perceived much more effective than formal services on campus. Fourth, they viewed challenges they had experienced as a process of growth, and advanced technology and globalization also helped them to better adapt to the new environment. Across these findings, there is a dynamic relationship between these students’ experiences in Canadian universities and their identities in relation to their national, ethno-cultural, generational and international backgrounds. Although their generally positive and critical thinking on their experiences of studying abroad is related to their generation-related resources, common challenges they collectively encountered also indicate the importance of accessible institutional support. / Thesis / Master of Social Work (MSW)

Bakgrund: Endometrios drabbar nästan var tionde kvinna i fertil ålder, ungefär 250 000 kvinnor i Sverige. Endometrios kan leda till funktionsnedsättning på grund av kronisk bäckensmärta och andra endometriosrelaterade symtom som smärtsamma menstruationer, rikliga blödningar, smärta vid samlag och infertilitet. Syfte: Syftet var att beskriva kvinnors upplevelser av endometrios. Metod: En litteraturöversikt - innehållsanalys av elva originalstudier för att beskriva kunskapsläget inom aktuell forskning. Datainsamlingen genomfördes med hjälp av två elektroniska forskningsdatabaser Cinahl Complete och PubMed och studier analyserades med hjälp av Fribergs fyrstegsmodell. Resultat: Endometrios har negativ inverkan på kvinnors liv i flera aspekter: fysiskt, psykiskt och socialt. Huvudsakligen handlar kvinnors upplevelser om smärta och dess effekter på det dagliga livet.Fastställning av diagnos kan ta lång tid för många kvinnor, detta harmed sig ofördelaktiga effekter på kvinnornas fysiska och psykiskahälsa, därför listas endometrios som en dold sjukdom i behov avmycket stöd från samhälle och familj. Sammanfattning: Litteraturöversikten har påvisat en klar bild av otillräckliga kunskap och information om endometrios både inom vården och samhället, en normalisering av symtompåverkan som har med sig ogynnsamma effekter på kvinnornas liv och välbefinnande. För att undvika normaliseringen av endometrios behövs ökade kunskapsinsatserfrämst hos sjukvårdspersonal. Trots att det finns mängder av beprövade kunskaper om endometrios, ändå hittas fortfarande brister på stöd i fokus att utforska endometrios omvårdnaden. Med den anledning tycks att endometrios ska vara ett intressant ämne för framtida forskningen. / Background: Endometriosis affects almost one in ten women of reproductive age, approximately 250,000 women in Sweden. Endometriosis can lead to disability due to chronic pelvic pain and other endometriosis related symptoms such as painful periods, heavy bleeding, pain during intercourse and infertility. Aim: The aim was to describe women's experiences of endometriosis. Method: A literature review - content analysis of eleven originalstudies to describe the state of knowledge in current research. Data collection was conducted using two electronic research databases Cinahl Complete and PubMed and studies were analysed using Friberg's four-step model. Results: Endometriosis has a negative impact on women's lives in several aspects: physical, psychological, and social. Mainly, women's experiences relate to pain and its effects on daily life. Diagnosis can take a long time for many women, which has unfavourable effects on their physical and mental health, therefore endometriosis is listed as a hidden disease in need of much support from society and family. Summary: The literature review has revealed a clear picture of inadequate knowledge and information about endometriosis in both health care and society, a normalisation of symptoms that has unfavourable effects on women's lives and well-being. In order to avoid the normalisation of endometriosis, there is a need to increase knowledge, especially among healthcare professionals. Even though there is a lot of proven knowledge about endometriosis, there is still a lack of support in the focus of exploring endometriosis care. Therefore, it seems that endometriosis should be an interesting topic for future research.

Many stories exist within the professional landscape of child weight management programming and health services. Grand narratives within these spaces story fat bodies as “unhealthy”, “risky” and in need of transformation, and often position the family and mothers in particular given gendered caregiving norms, as responsible for their children’s weight and poor health. Mothering stories and experiences are rarely told by the mothers themselves within this professional landscape. This study is a narrative inquiry that explores the in-depth experiences of two mothers who previously participated with their children in an Ontario paediatric weight management program. Given my work as a social worker within child weight management clinics I also explore my experiences alongside the participants. Clandinin and Connelly’s conceptualization of narrative inquiry and the three dimensional framework of temporality (past, present, future), sociality and place, inquiring inward, outward, backward and forward, were used in order to find meaning in mothering experiences of child weight management. Narrative beginnings share my own experiences of mothering and child weight management. Relational ethics were central as the inquiry unfolded, allowing for simultaneous exploration of experiences, continuous negotiation, awareness and re-evaluation with each mother, from recruitment, field work, to field text, interim text and the writing of the final text. Given the current social distancing restrictions related to the COVID-19 pandemic, conversations took place over zoom and telephone and were audio-recorded and transcribed verbatim. Detailed narrative accounts were written for each mother capturing individual experiences of child weight management as they intersected with many other experiences in their everyday lives. Narrative threads weaved together the mother’s experiences throughout the inquiry and focused on disrupting the grand narrative and resisting fragmentation. The inquiry contributes to the scholarship within fields of social work, social justice, mothering and health care by providing new ways of knowing about and engaging in conversations about mothering, weight, fatness and health. / Dissertation / Doctor of Philosophy (PhD) / This narrative inquiry explores the in-depth experiences of two mothers who previously participated in a child weight management program. As part of this research, I also explore my experiences in relation to the mothers, as a social worker who historically worked in the clinic. Mothers were often positioned as responsible for their children’s body weight and poor health and stories and experiences were rarely told by the mothers themselves across research and policy in the field. Clandinin and Connelly’s three-dimensional framework was used to find meaning in mothering experiences of child weight management. Conversations took place over zoom and telephone over a year. Detailed narrative accounts capture the individual mothering experiences of child weight management and come together in narrative threads that focus on disrupting the grand narrative and resisting fragmentation. The inquiry contributes to the scholarship within fields of social work and health care, providing new ways of knowing about and engaging in conversations about mothering, weight, fatness and health.

Growing evidence of the health risks associated with adverse childhood experiences (ACEs) has prompted public health and community initiatives to promote awareness, detection, and responses that are trauma informed. Nationwide programs to integrate trauma-informed care into education, health care, and child serving agencies, have thus far led to the proposal and advancement of trauma-informed policies and practices in many communities. While Mississippi agencies include trauma-specific intervention and training, statewide ACEs initiatives and relevant data are still limited. This project aimed to contribute to the larger goal of a statewide trauma-informed paradigm shift, by increasing ACEs awareness and developing recommendations for the integration of such research into programs aimed at serving vulnerable populations. Sixty-one child-serving professionals participated in adversity and resilience training (ART), a 3-hour workshop addressing childhood adversity, traumatic stress, resilience, and secondary traumatization. Outcomes measured were changes in trauma knowledge, trauma informed attitudes, attributions regarding difficult child-behaviors, and secondary trauma knowledge and self-care. Participants also provided ratings on a training evaluation survey. There were significant changes in trauma knowledge (F(1,22) = 6.418, p = .000, ηρ2 = .226) and trauma-informed attitudes (F(1,22) = 11.014, p = .003, ηρ2 = .334) between pre- and post-training. Training evaluations were generally positive (M = 4.61, SD = 0.13, on a 1 to 5 Likert scale). The current study contributes to the research an evaluation of a training intervention that offers feasible strategies for scalable training and assessment of outcomes.