Psychological Distress and Intimate Physical and Sexual Abuse among Women in Methadone Maintenance Treatment Programs

Guided by the cognitive theory of stress and coping and the comprehensive health“seeking and coping paradigm, this study examines associations among intimate partner abuse and psychological distress, posttraumatic stress disorder, childhood sexual abuse, and current drug use among a cohort of 416 women randomly recruited from New York City methadone treatment programs. Findings expand on past evidence of the high prevalence of psychological distress among adult victimized women and among those with a history of childhood sexual abuse. Women currently abused by their partners have more posttraumatic stress symptoms, depression, and psychological distress than women not abused by their partners

Learning to Establish a Therapeutic Doctor-Patient Communication: German and Israeli Medical Students Experiencing Integrative Medicine’s Skills

The doctors’ clinical time collides with the increasing of the use of telecare technologies in our digital era, reducing the actual doctor-patient interaction and the potential to engage with therapeutic doctor-patient communication. In our qualitative study, we followed a collaborative German-Israeli project that trained medical students to use complementary and integrative medicine (CIM) methods in order to improve doctor-patient communication. Interviews with the participants and participatory observation revealed the ways the mentors taught CIM methods, the meaning of therapuitic doctor-patient communication and how the students learned and implemented these skills in different ways. Our findings show that students expand their communication channels and skills, notice their own somatic-sensory states, and engage with somatic knowledge in different interactions. Our findings correspond with, and signify the intercorporeal space of doctor-patient interaction in the way in which doctors’ and patients’ soma-sensual aspects are interact, influence each another, and enable therapeutic communication

Perceptions of readiness to leave care among adolescents in foster care in Israel

The focus of this study is on how Israeli adolescents in their last years of stay in foster care view their readiness for independent living in multiple areas, such as work, education and money management. The study tests a series of hypotheses regarding factors associated with readiness: Background of family of origin, placement history, Relationships with foster family, relationships with biological family while in care and current functioning. A sample of 66 (32 females) adolescents in foster care in Israel ages 16-18 were interviewed face to face. In addition, their social workers completed a structured questionnaire to report on the adolescents' background and current functioning. Overall, adolescents presented a positive view of their readiness in most areas. They felt less ready mainly in their abilities to secure financial resources for school and housing. Background variables and workers' reports did not predict readiness. Youth's perceptions of relationships with foster family, social support, educational achievements and the avoidance of substance abuse were correlated positively with perceived readiness. The discussion examines the potential positive and negative implications of an optimistic view of readiness and presents implications for practice. Policy implications are suggested for preparing youth while in care and after they leave care.Foster care Readiness for independent living Leaving care Foster family Social support Israel

Benefits of a Transfer Clinic in Adolescent and Young Adult Kidney Transplant Patients

Background: Adolescent and young adult kidney transplant recipients have worse graft outcomes than older and younger age groups. Difficulties in the process of transition, defined as the purposeful, planned movement of adolescents with chronic health conditions from child to adult-centered health care systems, may contribute to this. Improving the process of transition may improve adherence post-transfer to adult care services. Objective: The purpose of this study is to investigate whether a kidney transplant transfer clinic for adolescent and young adult kidney transplant recipients transitioning from pediatric to adult care improves adherence post-transfer. Methods: We developed a joint kidney transplant transfer clinic between a pediatric kidney transplant program, adult kidney transplant program, and adolescent medicine at two academic health centers. The transfer clinic facilitated communication between the adult and pediatric transplant teams, a face-to-face meeting of the patient with the adult team, and a meeting with the adolescent medicine physician. We compared the outcomes of 16 kidney transplant recipients transferred before the clinic was established with 16 patients who attended the clinic. The primary outcome was a composite measure of non-adherence. Non-adherence was defined as either self-reported medication non-adherence or displaying two of the following three characteristics: non-attendance at clinic, non-attendance for blood work appointments, or undetectable calcineurin inhibitor levels within 1 year post-transfer. Results: The two groups were similar at baseline, with non-adherence identified in 43.75 % of patients. Non-adherent behavior in the year post-transfer, which included missing clinic visits, missing regular blood tests, and undetectable calcineurin inhibitor levels, was significantly lower in the cohort which attended the transfer clinic (18.8 versus 62.5 %, p = 0.03). The median change in estimated glomerular filtration rate (eGFR) in the year following transfer was smaller in the group that attended the transition clinic (–0.9 ± 13.2 ml/min/1.73 m 2 ) compared to those who did not (–12.29 ± 14.9 ml/min/1.73 m 2 ), p = 0.045. Conclusions: Attendance at a single kidney transplant transfer clinic was associated with improved adherence and renal function in the year following transfer to adult care. If these changes are sustained, they may improve long-term graft outcomes for adolescent kidney transplant recipients