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Background: Adverse Childhood Experiences (ACEs) are a risk factor for the development of future physical and mental health problems. Programs are needed that prevent and address the impact of ACEs on a population-based level. As a pediatric primary care clinic serving Northeast Tennessee, our goal was to better understand the knowledge and perceptions of the effects of ACEs among parents/caregivers and health professionals in Northeast Tennessee. Methods: During the summer of 2017, 51 parents/caregivers visiting a health education table at a family event in a local public library completed an anonymous survey to help us understand what people think about how ACEs affect children and adults. 20 health care professionals at a local pediatric primary care clinic completed the same anonymous survey. Survey results were entered into Excel and analyzed using Excel and SPSS. Results: Fewer than one-third of parents/caregivers in this sample had heard of the term "ACEs" prior to receiving this survey. However, after being provided with a definition of ACEs, most respondents agreed that ACEs could affect children's behavior and adult mental health. Agreement was less for perceptions of effects on physical health in adults. Most respondents recognized that a parent’s own ACE exposure could make parenting more difficult and that having a strong support system is helpful in counteracting these negative effects. Healthcare providers were more likely than parents/caregivers to have heard of the term ACEs before, however only half were familiar with the term. After being provided with a definition of ACEs, most healthcare providers agreed on their effects on children and adults. Perceptions that having a strong support system could counteract the effects of ACEs were slightly lower among health care providers as compared to parents/caregivers. Conclusion: The low awareness of ACEs found by our survey confirms the need for a new initiative to screen for ACEs and provide trauma-informed care in our clinic. The project, Baby Steps for Success, will involve screening children and parents/caregivers for ACEs, providing brief education on ACEs, and building resilience. Engaging and supporting families around healthy behaviors and interactions will be accomplished using Reach Out and Read and ReadNPlay for a Bright Future beginning in early infancy. Intervention with the Incredible Years program and Ecomap assessments will be provided to high-risk families with 2 or more ACEs. Families with four or more ACEs will be offered the Nurturing Parenting curriculum through a series of home and group visits. Partners for this project will include ETSU Pediatrics, Families Free, and the Northeast TN Regional Health Office.

Adverse Childhood Experiences (ACEs) are events that occur during a person’s childhood that can affect their physical, mental, and social health later in life. Abuse, neglect or household disfunction are common events labeled as ACEs to study the effects of childhood trauma. ACEs have been linked to several negative physical and mental health outcomes, such as substance abuse, heart and lung diseases, anxiety and depression. Furthermore, several studies have shown that emotion dysregulation and attachment anxiety mediate the relationships between ACEs and negative health outcomes. Emotion dysregulation and attachment anxiety can also be linked to a commonly studied social aliment, imposter phenomenon. Individuals experiencing imposter phenomenon may feel as though they are undeserving of their personal accomplishments or have achieved them by luck or chance. Emotion dysregulation can lead to a lack of control, or perceived control, over one’s emotions. This lack of control could theoretically lead to feelings of inadequacy and fakeness experienced by those suffering from imposter phenomenon. Likewise, attachment anxiety can lead to fear of abandonment in relationships caused by the similar feelings of inadequacy. The aim of the present research was to therefore determine whether ACEs may predict greater feelings of the imposter phenomenon through emotion dysregulation and attachment anxiety. A total of 464 participants completed measures of ACEs, emotion dysregulation, attachment anxiety, and the imposter phenomenon online in REDCap. A bootstrap (5000 repetitions) mediation analysis conducted in JASP indicated that although ACEs do not directly predict the imposter phenomenon, greater ACEs indirectly predicted greater feelings of being an imposter through both emotion dysregulation and attachment anxiety. That is, the more ACEs one experiences theoretically leads to greater emotion dysregulation and higher attachment anxiety, both of which predict greater feelings of being an imposter. These results suggest that ACEs may disrupt the development of healthy coping mechanisms and regulation strategies that could feed into an inability to recognize one’s abilities and successes. Furthermore, experiencing negative mental and physical outcomes due to ACEs could produce a negative self-worth, leading to feelings of being an imposter. Likewise, anxiety in other aspects of life, such as relationships, could lead to these same feelings. Although the present research suggests that ACEs indirectly predict the imposter phenomenon, future research may show numerous factors impacting the imposter phenomenon with multiple interacting variables. Future research should aim to examine these factors prospectively and in different populations other than the one studied here. As with any self-report research, there could be discrepancies in data reported due to recall and impression management, especially when participants are asked about sensitive subjects, such as ACEs and intimate relationships. Despite these limitations, these results help provide a greater understanding of the effect ACEs and childhood trauma can have on social well-being and can also lead to a better understanding of development of and treatments for the imposter phenomenon.

Adverse childhood experiences (ACEs) have been studied for the last two decades and are associated with a large number of mental health problems. However, existing research has yet to explore the underlying mechanisms that might affect the relationship between ACEs and mental health outcomes, particularly in terms of contextual influence. The present study examined the individual and conjoint effects of ACEs, coping, and campus climate on depressive and posttraumatic stress disorder (PTSD) symptoms, exploring the moderating effects of coping and campus climate among a diverse sample of young adults. In addition to that, racial/ethnic identity and gender/sexual identity were tested as a potential moderator in the relationship among ACEs, coping strategies, campus climate and mental health outcomes, in which the relationship was hypothesized to be different depending on one’s identity. Data for this study were collected from 423 college students who completed a set of questionnaires. The survey assessed socio-demographic variables, ACEs, coping strategies, campus climate, depressive, and PTSD symptoms. By examining the effects of ACEs, campus climate, coping, and individual identity on mental health outcomes simultaneously, the study results suggest that coping and campus climate moderate the relationship between ACEs and PTSD, and it varies depending on individual identity. The findings highlight the importance of culturally sensitive and appropriate interventions and services for diverse college students who are at elevated risk for the development of mental health problems.

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Recent advances in materials engineering have given rise to a new class of materials known as active materials. These materials when used appropriately can aid in development of smart structural systems. Smart structural systems are adaptive in nature and can be utilized in applications that are subject to time varying loads such as aircraft wings, structures exposed to earthquakes, electrical interconnections, biomedical applications, and many more. Materials such as piezoelectric crystals, electrorheological fluids, and shape memory alloys (SMAs) constitute some of the active materials that have the innate ability to response to a load by either changing phase (e.g., liquid to solid), and recovering deformation. Active materials when combined with conventional materials (passive materials) such as polymers, stainless steel, and aluminum, can result in the development of smart structural systems (SSS). This Dissertation focuses on characterization of SMAs and structures that incorporate SMAs. This characterization is based on a hybrid analytical, computational, and experimental solutions (ACES) methodology. SMAs have a unique ability to recover extensive amounts of deformation (up to 8% strain). NiTiNOL (NOL: Naval Ordinance Lab) is the most commonly used commercially available SMA and is used in this Dissertation. NiTiNOL undergoes a solid-solid phase transformation from a low temperature phase (Martensite) to a high temperature phase (Austenite). This phase transformation is complete at a critical temperature known as the transformation temperature (TT). The low temperature phase is softer than the high temperature phase (Martensite is four times softer than Austenite). In this Dissertation, use of NiTiNOL in representative engineering applications is investigated. Today, the NiTiNOL is either in ribbon form (rectangular in cross-section) or thin sheets. In this Dissertation, NiTiNOL is embedded in parent materials, and the effect of incorporating the SMA on the dynamic behavior of the composite are studied. In addition, dynamics of thin sheet SMA is also investigated. The characterization is conducted using state-of-the- art (SOTA) ACES methodology. The ACES methodology facilitates obtaining an optimal solution that may otherwise be difficult, or even impossible, to obtain using only either an analytical, or a computational, or an experimental solution alone. For analytical solutions energy based methods are used. For computational solutions finite element method (FEM) are used. For experimental solutions time-average optoelectronic holography (OEH) and stroboscopic interferometry (SI) are used. The major contributions of this Dissertation are: 1. Temperature dependent material properties (e.g., modulus of elasticity) of NiTiNOL based on OEH measurements. 2. Thermomechanical response of representative composite materials that incorporate NiTiNOL“fibers". The Dissertation focuses on thermomechanical characterization of NiTiNOL and representative structures based on NiTiNOL; this type of an evaluation is essential in gainfully employing these materials in engineering designs.

Individuals exposed adverse childhood experiences (ACEs) are at increased risk of developing chronic illnesses in adulthood including heart disease, cancer, diabetes, and chronic pain. A relationship between ACEs and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. There is evidence that higher that individuals in forensic inpatient mental health samples are disproportionally exposed to ACEs, which may increase odds of chronic disease development. Despite this evidence, little research has examined the prevalence of ACEs and relationships between ACEs and chronic health conditions and risky health behaviors in this population. This study evaluated these variables using archival data collected as part of a large interdisciplinary study from a forensic psychiatric facility. A list of clients (N=182) meeting inclusion criteria was randomly generated and a comprehensive record review was used to ascertain ACE scores and rates of health-risk behaviors and chronic conditions. Findings offered support for increased rates of childhood adversity and a significant relationship between ACE scores and health-risk behaviors within a forensic inpatient mental health population. However, relationships between ACEs and chronic illnesses and health-risk behaviors and chronic illnesses failed to reach significance. The lack of significance in these relationships suggests that ACEs are less singularly predictive of chronic illness within this population and instead different factors may drive the development of chronic illness.

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Researchers and practitioners have increasingly focused on institutional responses to campus gender-based violence/harassment, yet they have paid far less attention to graduate student experiences than to undergraduate student experiences. Graduate students operate in a different context from undergraduates, and therefore specific knowledge of gender-based violence/harassment in the lives of graduate students is needed. The purpose of this exploratory, nonexperimental study was to better understand the prevalence of adult gender-based violence/harassment and adverse childhood experiences (ACEs) among graduate students, as well as to understand the relationship between those experiences and participants’ mental health and academic functioning. The study’s theoretical framework combined critical adult learning theories with cognitive perspectives on adult learning, including the neurobiology of trauma. Data used in the current study were originally collected as part of an institutional campus climate survey on gender-based violence; responses from n = 684 of the randomly selected participants were used in the current study’s analyses. Participants commonly reported both adult gender-based violence/harassment experiences and ACEs. The results of two OLS regressions indicated that experiencing more types of adult gender-based violence/harassment or more types of ACEs was associated with higher levels of negative affect and lower levels of mindfulness. Among participants who experienced gender-based violence/harassment in graduate school, independent samples t-tests showed that individuals who reported at least occasional academic functioning difficulties had lower levels of mindfulness and higher levels of negative affect than those who did not experience difficulties. Overall, the findings suggest the need for trauma-informed policies and practices within graduate education and higher education in general.