A decline in perceived social status leads to post-traumatic stress disorder symptoms in adults half a year after the outbreak of the COVID-19 pandemic: consideration of the mediation effect of perceived vulnerability to disease.

Background/purpose: In December 2019, Wuhan, Hubei, China firstly reported the existence of the COVID-19 virus. It is crucial to prioritize the psychological well-being of citizens in lockdown cities and make more strides in the academic field of post-traumatic stress disorder (PTSD) to prepare for the post-pandemic era. Methods: We took the cognitive-relational theory as our basis and collected Hubei province-level data (N = 3,465) to examine the impact of perceived social status decline on the prevalence of PTSD symptoms, and checked the mediating effect of perceived vulnerability to disease (PVD) during the period of psychological adjustment. Results: Using propensity score matching, we estimate the average treatment effect of perceived social status decline on PTSD level, and we robustly regress the two with weight adjustment generated in matching. We found that more decline in perceived social status is associated with a worse degree of PTSD symptoms, and confirmed PVD's buffering role although the mediating effect was not as high as hypothesized. Conclusion and implications: Our study confirmed the decisive role of subject social status in health prediction compared to traditional socioeconomic measures, which extends the cognitive-relational in examining socioeconomic status and contributes to the dialog on socioeconomic inequality. We also suggested providing more social support at the community level and enhancing individuals' positive understanding to protect mental health.

Immersive Virtual Reality to Distract From Pain in Children Treated With L-asparaginase by Intramuscular Injection.

Background Treatment-related pain and discomfort are two of the most common manifestations in children with acute lymphoblastic leukemia (ALL). Patients with ALL are usually treated with L-asparaginase (L-ASP) by intramuscular injection. Children receiving L-ASP chemotherapy must bear adverse reactions such as pain caused by intramuscular injections. The use of virtual reality (VR) distraction technology could be a non-pharmacological intervention to bolster patients' comfort and decrease anxiety and procedure-related pain within hospital settings. Methodology The study explored the potential benefits of VR as a psychological intervention to induce positive emotions and reduce pain levels in participants receiving L-ASP injections. Participants in the study had the opportunity to select a nature theme of their choosing during their treatment session. The study provided a noninvasive solution that promoted relaxation to reduce anxiety by shifting an individual's mood positively during treatment. The objective was met by measuring participants' mood and pain levels before and after the VR experience and participant satisfaction with the use of the technology. This mixed-methods study of children aged six to 18 received L-ASP between April 2021 and March 2022, using a Numerical Rating Scale (NRS) with sheer numbers ranging from 0 (no pain) to 10 (extreme or most pain possible). Semi-structured interviews were conducted to collect new data and explore participants' thoughts and beliefs about a particular topic. A total of 14 patients participated. Descriptive statistics and content analysis are used to describe the data analyzed. VR is an enjoyable distraction intervention for managing treatment-related pain in ALL with intramuscular chemotherapy. Results Eight of 14 patients found a reduction in perceived pain after wearing VR. During the intervention implementation, the primary caregivers felt that the patient's pain perception was more positive when using the virtual reality device, and there was less resistance and less crying. Conclusions This study describes changes and experiences associated with pain and physical discomfort in children with ALL receiving intramuscular chemotherapy. This teaching model is applied to developing medical personnel, providing information about the disease and daily care, and educating the participants' family members. This study may expand the usage of VR applications so that more patients can benefit from them.

Pull and Push: The Effect of Social Support and Professional Resilience on the Relationship Between Correctional Officers' Cynicism and Service Impact.

This research examines the protective influences of social support and professional resilience to probation officers' cynicism and service impact simultaneously. Data on psychological characteristics of a sample of 382 forensic social workers in Chinese legal systems were collected. Confirmatory factor analysis, structural equation modeling, and multiple-group analyses were used in a three-step analysis process to test our research model. Results identified that cynicism was negatively associated with probation officers' service impact, ascertained that social support functioned as an extrinsic pull mediating the relationship between probation officers' cynicism and service impact, and determined that professional resilience served as an intrinsic push moderating the impact of cynicism and social support on service impact, respectively. This research proposed a push and pull mechanism by which probation officers' service impact is increased and their work pressure is alleviated, providing tentative recommendations for the alleviation of probation officers' job pressure and improvement of their service impact.

Striving for Organizational Impact through Individual Impact: A Humanistic Management Approach Involving Social Work Supervisors.

In today's era of new public management, respecting the dignity and worth of social workers in organizational management poses a challenge to social work agencies. This research explores whether individual self-actualization can be integrated with organizational development by using a humanistic management approach. Authors sampled 672 supervisors from Chinese social work agencies. A structural equation model was built and tested to examine the relationships between four latent variables: (1) professional competence (PC), (2) organizational citizenship behaviors (OCBs), (3) individual impact, and (4) organizational impact, taking into account the moderating effect of professional associations. The results indicate that individual impact is a mediator between supervisors' PC/OCBs and organizational impact. Meanwhile, professional associations play a moderating role in the relationship between supervisors' PC and organizational impact. Findings provide the basis for a humanistic management strategy for social work agencies that focuses on the individual impact of key people to maximize organizational impact. Moreover, professional associations should strengthen the link between individual impact and organizational impact.

Perception of Gender Equality Matters: Targets' Responses to Workplace Sexual Harassment in Chinese Metropolises.

Workplace sexual harassment (WSH) has been recognized in the literature as a serious problem for the past 40 years. Since 2017, the global #MeToo movement has fostered local awareness of WSH and inspired researchers in China to pay increasing attention. Guided by the gender empowerment theory, this study investigated the relationships between women's responses as targets of WSH (e.g., choosing avoidance or confrontation) and both their perceptions of gender equality and their knowledge of the relevant national laws. We used data from a recent large-scale online survey conducted on the topic of sexual harassment among Chinese women in four metropolitan cities in 2018 and selected 862 women who had experienced WSH during the previous 12 months as the study sample. The results revealed that 545 of the respondents chose to show resistance when faced with WSH, while 287 identified their boss as their harasser. In addition, respondents' perceptions of gender equality and their knowledge of national laws on anti-domestic violence were shown to have positive effects on their responses as targets of WSH. Moreover, monthly income, household registration, and type of WSH were found to be associated with targets' responses in a statistically significant way, whereas their marital status, educational background, and age were not. Furthermore, the study found that the boss as harasser weakened the relationship between women's perception of gender equality and their active response to WSH incidents. With this study, we advance our understanding of the important role that perceptions of gender equality play in women's responses as targets of WSH, and we discuss implications for prevention and intervention efforts that encourage targets to actively respond. We advocate promoting education on gender equality, fostering awareness of the laws and regulations relevant to WSH, and cultivating an organizational culture and environment that is hostile toward WSH.

The Strengthening Mechanism of the Relationship between Social Work and Public Health under COVID-19 in China.

Social work and public health have always shared a common mission and vision in promoting human health. However, existing research tends to view social work and public health as two separate fields at both practice and policy levels, and these studies have largely neglected the consideration of how to integrate public health and social work. In the context of the COVID-19 epidemic, the link between the two has been strengthened and health social work has been given more importance. The question addressed in this article is through what mechanisms or practices the social work profession can strengthen its professional status and engage in interprofessional collaboration. Based on key informant interviews and case studies (one community and two cabin Hospitals), this study points out that three legitimacy mechanisms are needed: operationalizing policy, extending value, and completing justification. Furthermore, the future and possible limitations in relation to the development of health social work in China are discussed and specific recommendations are provided. Health social work needs to conduct practices and summarize its experiences and methods, to create a more friendly political environment by translating its results into policies that are conducive to the development of health social work through a political agenda. It needs to improve upon its practical abilities and methodologies, as well as professional education relating to professional values and ethics, in addition to identifying the deeper social needs of residents and discovering new, undeveloped areas of service. Moreover, because long-term change is difficult to justify due to China's policy agendas, the question of whether the professional status of health social work in the post-epidemic context can be improved is something that needs to be further explored in future studies.

The relevance of transformational leadership for promoting professional social work competence with EBPA.

Health care social workers' attitudes towards evidence-based practice (EBP) are an indispensable precursor of implementing EBP. Using a subset including 405 health care social workers from the first nationally representative survey of social workers in China, this study empirically assesses how transformational leadership (TFL) promotes health care social workers' attitudes towards EBP. The results show that organisational learning capacity (OLC) and professional competence (PC) fully mediate the positive relationship between TFL and EBP attitudes. Furthermore, TFL, OLC and PC explain 56% of the variance in health care social workers' attitudes towards EBP. This result supports the perspective that both organisational factors and individual factors may facilitate social workers' positive attitudes towards EBP, but organisational factors are more important. Therefore, to adopt, use and sustain EBP in health care social work, learning and innovation in the organisation should be increased. Furthermore, it is important to help social workers improve their PC.

The Moderating Effect of Professional Self-Care Training on Novice Practitioners' Organizational Citizenship Behavior in China.

Due to recent challenges and the great burdens faced by social workers to provide social services, self-care is becoming more and more important to research and practice. This study empirically tested the long-term impact of self-care training provided during MSW education. In line with previous research on self-care among other social services practitioners, the panel data of MSW graduates nationwide showed the longitudinal impact of the self-care training in MSW programs on their organizational citizenship behaviors (OCBs) as novice practitioners. Specifically, authors identify self-care as a critical work contextual moderator of the effects of supervisor behavior, workplace social capital, and burnout on OCB. The study offers implications for education, practice, research, and the culture of the profession in China, and explicates the utility of the findings of self-care training's impact for practitioners, students, educators, social service agency supervisors, and organizational and professional leaders. It is crucial to create a "culture of self-care" by integrating self-care in education and building a healthy workplace culture, which may shed light on how to sustain the social work profession in China and globally.

Does internet use affect levels of depression among older adults in China? A propensity score matching approach.

BACKGROUND: Emerging research on the use of new technology suggests that internet use is generally associated with high levels of efficiency among older adults in the following areas: quality of life, mood, positive psychological well-being, and the individual and societal costs of caring for them. However, there is little empirical evidence specifically concerning the causal effects of older adults' internet use on their depression level. There is a need for more replication studies to help confirm that the emerging evidence on the impact of internet use is accurate and applicable to different populations and in different situations. METHOD: Using national data from the China Family Panel Study in 2016, this study helps to fill the above mentioned research gap. This study followed a two-step analytical strategy to empirically examine the association between internet use and reported depression in older adults. In the first step, we estimated a binary logistic regression model with internet use as the dependent variable and 8 demographic and socioeconomic factors as the confounding variables. In the second step, we performed a propensity score analysis to control for potential bias using the confounding variables confirmed in the first step. RESULTS: The results show that older adults who reported internet use have lower depression levels than did those who did not use the internet, with adjustments made for gender, age, urban or rural residence, pension status, educational background, physical health, life satisfaction, and intelligence level. CONCLUSION: These findings suggest that it is critical to advocate for technology-based policies and programs that promote older adults' internet use to improve their social well-being, which can also serve as a policy strategy to help alleviate older adults' depression.

Pain perception of older adults in nursing home and home care settings: evidence from China.

BACKGROUND: In the past decade, the number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%. Older adults, their family members, and policymakers in China are concerned about patient outcomes in different care settings because older adults who have a similar functional status and LTC needs may choose either nursing home care or home care. The aim of this study was to compare pain perception in nursing home care and home care settings for physically dependent older adults in China. METHODS: Multi-stage sampling method was used to recruit respondents aged 65 and older from Yichang City, China, in 2015. The researchers employed a two-step analytical strategy-zero-inflated ordered probit regression followed by propensity score matching method-to model the effect of contrasting residence types on pain perception. RESULTS: Zero-inflated ordered probit regression analysis with participants unmatched (n = 484) showed that compared with older adults who received home care, those who received nursing home care did not have more severe pain (ß = 0.088, SE = 0.196, p = 0.655). After propensity-score matching, the research found that older adults in the home care group perceived less pain compared with the nursing home group (ß = 0.489, SE = 0.169, p = 0.004). CONCLUSIONS: The older adults who received home care perceived significantly less pain than the nursing home residents. The pain of older adults may differ based on the type of LTC services and therapy intensity they received, and home care might lead to less pain and better comfort than nursing home care.

Geographical Variation and Social Work Students' Job Intentions in China: A Geographic Information Systems Approach.

Social work education in China is undergoing far-reaching development. However, an important issue, low professional commitment, has been identified. Why do social work graduates-especially master's level graduates-take jobs unrelated to social work? To answer this question, it is important to take into account that the professionalization of social work is happening unevenly across China as a result of uneven social and economic development. Models used in past research do not consider the possibility that the low intention for social work jobs and its potential predictors may vary across regions. To address this problem, Geographic Information Systems software is being adopted to explore the varying degrees of social work graduates' job intention, its predictors across China, and the association between job intention and predictors at both national and regional levels. Authors of this study found substantial geographic variation in predictors of social work graduates' job intention across regions. Their findings also suggest some heterogeneity in the association between job intention and specific correlates that would be masked in the traditional nationwide model. Policymakers aiming to improve the job intention of social work graduates should consider regional variation as part of their approach.

Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients.

BACKGROUND: Morgellons disease (MD) is a complex skin disorder characterized by ulcerating lesions that have protruding or embedded filaments. Many clinicians refer to this condition as delusional parasitosis or delusional infestation and consider the filaments to be introduced textile fibers. In contrast, recent studies indicate that MD is a true somatic illness associated with tickborne infection, that the filaments are keratin and collagen in composition and that they result from proliferation and activation of keratinocytes and fibroblasts in the skin. Previously, spirochetes have been detected in the dermatological specimens from four MD patients, thus providing evidence of an infectious process. METHODS & RESULTS: Based on culture, histology, immunohistochemistry, electron microscopy and molecular testing, we present corroborating evidence of spirochetal infection in a larger group of 25 MD patients. Irrespective of Lyme serological reactivity, all patients in our study group demonstrated histological evidence of epithelial spirochetal infection. Strength of evidence based on other testing varied among patients. Spirochetes identified as Borrelia strains by polymerase chain reaction (PCR) and/or in-situ DNA hybridization were detected in 24/25 of our study patients. Skin cultures containing Borrelia spirochetes were obtained from four patients, thus demonstrating that the organisms present in dermatological specimens were viable. Spirochetes identified by PCR as Borrelia burgdorferi were cultured from blood in seven patients and from vaginal secretions in three patients, demonstrating systemic infection. Based on these observations, a clinical classification system for MD is proposed. CONCLUSIONS: Our study using multiple detection methods confirms that MD is a true somatic illness associated with Borrelia spirochetes that cause Lyme disease. Further studies are needed to determine the optimal treatment for this spirochete-associated dermopathy.

Culture and identification of Borrelia spirochetes in human vaginal and seminal secretions.

Background: Recent reports indicate that more than 300,000 cases of Lyme disease are diagnosed yearly in the USA. Preliminary clinical, epidemiological and immunological studies suggest that infection with the Lyme disease spirochete Borrelia burgdorferi (Bb) could be transferred from person to person via intimate human contact without a tick vector. Detecting viable Borrelia spirochetes in vaginal and seminal secretions would provide evidence to support this hypothesis. Methods: Patients with and without a history of Lyme disease were selected for the study after informed consent was obtained. Serological testing for Bb was performed on all subjects. Semen or vaginal secretions were inoculated into BSK-H medium and cultured for four weeks. Examination of genital cultures and culture concentrates for the presence of spirochetes was performed using light and darkfield microscopy, and spirochete concentrates were subjected to Dieterle silver staining, anti-Bb immunohistochemical staining, molecular hybridization and PCR analysis for further characterization. Immunohistochemical and molecular testing was performed in three independent laboratories. Positive and negative controls were included in all experiments. Results: Control subjects who were asymptomatic and seronegative for Bb had no detectable spirochetes in genital secretions by PCR analysis. In contrast, spirochetes were observed in cultures of genital secretions from 11 of 13 subjects diagnosed with Lyme disease, and motile spirochetes were detected in genital culture concentrates from 12 of 13 Lyme disease patients using light and darkfield microscopy. Morphological features of spirochetes were confirmed by Dieterle silver staining and immunohistochemical staining of culture concentrates. Molecular hybridization and PCR testing confirmed that the spirochetes isolated from semen and vaginal secretions were strains of Borrelia, and all cultures were negative for treponemal spirochetes. PCR sequencing of cultured spirochetes from three couples having unprotected sex indicated that two couples had identical strains of Bb sensu stricto in their semen and vaginal secretions, while the third couple had identical strains of B. hermsii detected in their genital secretions. Conclusions: The culture of viable Borrelia spirochetes in genital secretions suggests that Lyme disease could be transmitted by intimate contact from person to person.