BackgroundMorgellons 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 & ResultsBased 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.ConclusionsOur 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.

Burnout is a worldwide phenomenon among social welfare workers. This study examined how burnout affects student social workers and professional social workers. It first examined the construct validity of the Maslach Burnout Inventory‐General Survey (MBI‐GS) scale, using data from two Chinese samples (848 student social workers and 748 professional social workers). The original three‐factor model was regarded as superior to other competing models. Investigation of the second‐order factor model indicated that exhaustion and cynicism are core components but that personal efficacy is not. The research also revealed the differential predictability of the three subscales of the MBI‐GS. Our expectation that differential patterns of effects could be predicted was largely supported. Professional efficacy plays a key mediating role in the relationship between student social workers’ professional identity and their satisfaction with fieldwork, while social workers’ cynicism is the main mediator in the relationship between their professional identity and turnover intention. Therefore, identifying at‐risk students and professional social workers to undertake appropriate intervention strategies that focus on both their professional identity and different dimensions of burnout may be an effective way to prevent students’ dissatisfaction and reduce social worker turnover.

In order to address the ascending turnover rate among social workers in China, this article presents the idea, based on social identity theory, that professional identity is an important factor influencing turnover rate. Employing structural equation modelling (SEM) techniques, the study found that professional identity was negatively associated with social workers’ turnover intentions, and that social workers’ job satisfaction mediated the relationship between professional identity and their turnover intentions. The findings suggest that more work needs to be done on social work education and public image construction in China.

BackgroundEmerging 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.MethodUsing 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.ResultsThe 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.ConclusionThese 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.

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