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New positions have recently become available in the military and will eventually lead to increases in the number of female veterans in America. These women are influenced by adverse childhood events (ACE), post-traumatic stress disorder, and other life-altering incidents. Some female veterans show positive mental health status, resiliency, and lead healthy lives, while others female veterans battle high rates of alcohol abuse, substance abuse, homelessness, and suicide. Uncovering factors that lead to a positive mental health status is a critical component towards implementing gender-specific strategies to help female veterans build resiliency and coping mechanisms. An analysis of the ACE module included from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS) was used to build multiple linear regression models, Page 118 2016 Appalachian Student Research Forum and evaluate prevalence of three ACE events. These negative sexual events included being touched sexually by another, being forced to touch another sexually, or being forced to have sex as a child. Female veterans show higher prevalence of negative sexual ACE events when compared to civilian women. The biggest difference was being touched sexually prior to the age of 18 with 19% of veterans reporting this experience, compared to 14% of civilian women. The multiple linear regression model analyzed self-reported mentally healthy days of women within the last 30 days. Female veterans had 0.59 (p = 0.044) fewer mentally unhealthy days than civilian women during a 30-day period. The three sexual ACE variables significantly predicted unhealthy days for female veterans and civilians. Women forced to have sex had 2.5 (p = 0.000) more mentally unhealthy days and 1.9 (p = 0.000) more mentally unhealthy days when forced to touch another sexually. Older age, additional education, and increased income were significant and lowered the number of mentally unhealthy days, while marriage led to an increase of 0.18 (p = 0.005) unhealthy days. Results indicated that female veterans had1.35 (p = 0.002) fewer physically unhealthy days. It is noteworthy that female veterans are reporting a significant increase in mentally healthy days compared to their civilian counterparts, despite the higher prevalence of negative sexual ACEs. Further investigation is needed to discover the mental, behavioral, and demographic features that help some female veterans overcome the typical dose-response relationship between negative ACEs and unhealthy days. Evidence -based resiliency programs can then better assist female veterans who are struggling to survive.

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Abstract available through American Journal of Epidemiology.

Abstract available through Clinical Pharmacology in Drug Development.

Background: Diabetes is the sixth leading cause of death in the United States (U.S), and a major risk factor for cardiovascular disease (CVD). The prevalence of diabetes in central Appalachian region is higher than the rest of the nation (14.4% versus 9.0%, respectively). Objectives: Examine the association between multiple risk factors for CVD and diabetes in asymptomatic adults in central Appalachia. Methods: Between January 2012 and July 2016, 3,000 community-dwelling asymptomatic individuals from central Appalachia participated in screening for sub-clinical atherosclerosis. Participants were asked to report their diabetes status (yes/no). In addition, data on coronary artery calcium (CAC), a marker for sub-clinical coronary atherosclerosis, in quartiles (0, 1-99, 100-399, ≥400), obesity (body mass index ≥30 kg/m2), hypercholesterolemia (yes/no), hypertension (yes/no), current smoking (yes/no), sedentary lifestyle (yes/no), and family history of coronary artery disease (CAD) (yes/no), were collected. Multivariable logistic regression analyses were conducted to assess association between CVD risk factors and diabetes. Results: Of the 3,000 participants, 2,509 subjects (mean age: 58.3 years; SD = 9.8 years) had complete data on variables of interest. Approximately, 14% of the study population reported having type 2 diabetes. Among subjects with diabetes, 58% had a CAC score ≥1, 22% were obese, 17% had hypercholesterolemia, 20% had hypertension, 16% were current smokers, 17% had a sedentary lifestyle, and 15% had a family history of CAD. After adjusting for sex and age, having a CAC score of 1-99, 100-399, and ≥400 increased the odds of having diabetes (Odds ratio (OR): 1.4, 95% Confidence interval (CI) = 1.02-1.9; OR: 2.0, 95% CI = 1.4-2.8; OR: 3.1, 95% CI = 2.1-4.7, respectively) in a linear fashion. Being obese (OR: 3.2; 95% CI = 2.5-4.0), having hypercholesterolemia (OR: 1.8; 95% CI=1.4-2.4), being hypertensive (OR: 3.0; 95% CI= 2.3-3.8), being a smoker (OR: 1.5; 95% CI = 1.1-2.1), and being sedentary (OR: 1.6; 95% CI = 1.3-2.0) were significantly associated with diabetes. Having three (OR: 3.0; 95% CI=1.3-6.6), four (OR: 4.4; 95% CI=2.0-9.7), five (OR: 7.0; 95% CI=3.1-16.1) or six (OR: 9.9; 95% CI= 3.5-27.7) CVD risk factors significantly increased the odds of diabetes. Subjects with any of the seven risk factors under study were 1.7 times (95% CI= 1.5-1.9) more likely to have diabetes. Conclusion. Odds of type 2 diabetes increase with higher number of risk factors for CVD. Results support the use of multifaceted CVD and diabetes prevention programs to lower the incidence of type 2 diabetes.