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Background Alcohol use during pregnancy can have a variety of harmful consequences on the fetus. Lifelong effects include growth restriction, characteristic facial anomalies, and neurobehavioral dysfunction. This range of effects is known as fetal alcohol spectrum disorders (FASD). There is no amount, pattern, or timing of alcohol use during pregnancy proven safe for a developing embryo or fetus. Therefore, it is important to screen patients for alcohol use, inform them about alcohol's potential effects during pregnancy, encourage abstinence, and refer for intervention if necessary. However, how and how often nurses and midwives inquire about alcohol drinking during pregnancy or use recommended screening tools and barriers they perceive to alcohol screening has not been well established. Methods This survey was sent to about 6,000 American midwives, nurse practitioners, and nurses who provide prenatal care about their knowledge of the effects of prenatal alcohol exposure, the prevalence of alcohol use during pregnancy, and practices for screening patients’ alcohol use. Participants were recruited by e‐mail from the entire membership roster of the American College of Nurse‐Midwives. Results There were 578 valid surveys returned (about 9.6%). Analyses showed that 37.7% of the respondents believe drinking alcohol is safe during at least one trimester of pregnancy. Only 35.2% of respondents reported screening to assess patient alcohol use. Only 23.3% reported using a specific screening tool, and few of those were validated screens recommended for use in pregnant women. Respondents who believe alcohol is safe at some point in pregnancy were significantly less likely to screen their patients. Conclusions Respondents who reported that pregnancy alcohol use is unsafe felt more prepared to educate and intervene with patients regarding alcohol use during pregnancy and FASD than respondents who reported drinking in pregnancy was safe. Perceived alcohol safety and perceived barriers to screening appeared to influence screening practices. Improving prenatal care provider knowledge about the effects of prenatal alcohol exposure and the availability of valid alcohol screening tools will improve detection of drinking during pregnancy, provide more opportunities for meaningful intervention, and ultimately reduce the incidence of FASD.

Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health.

Problem University students experience stress and fatigue often affecting their health, academic success, and social adjustment. Many also have histories of childhood trauma that may result in posttraumatic stress symptoms. The purpose of this study was to determine the associations between perceptions of stress, symptoms of fatigue, and symptoms of posttraumatic stress disorder (PTSD) among university students, many of whom report childhood adversity. Methods Sixty‐nine students from one university campus participated in this study. A cross‐sectional design was used to gather data across six self‐report measures. Findings Childhood adversity was associated with PTSD symptoms and acute stress, and PTSD symptoms were related to all three measures of fatigue. PTSD symptoms mediated the relationship between stress and fatigue, but not other fatigue domains. Conclusions The implications of an association between PTSD, stress, and fatigue are relevant to students' health and academic success. It is important to note that even subclinical levels of PTSD impact fatigue.

Purpose The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students. Design and methods A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test–retest reliability analyses were performed. Findings Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test–retest reliability were identified. Practice implications This study provides evidence for the validity and reliability of a self‐report measure of college students' acute stress experiences.