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Background Skeletal muscle injury in Ebola virus disease (EVD) has been reported, but its association with morbidity and mortality remains poorly defined. Methods This retrospective study included patients admitted to 2 EVD treatment units over an 8-month period in 2019 during an EVD epidemic in the Democratic Republic of the Congo. Results An overall 333 patients (median age, 30 years; 58% female) had at least 1 creatine kinase (CK) measurement (n = 2229; median, 5/patient [IQR, 1–11]). Among patients, 271 (81%) had an elevated CK level (>380 U/L); 202 (61%) had rhabdomyolysis (CK >1000 IU/L); and 45 (14%) had severe rhabdomyolysis (≥5000 U/L). Among survivors, the maximum CK level was a median 1600 (IQR, 550–3400), peaking 3.4 days after admission (IQR, 2.3–5.5) and decreasing thereafter. Among fatal cases, the CK rose monotonically until death, with a median maximum CK level of 2900 U/L (IQR, 1500–4900). Rhabdomyolysis at admission was an independent predictor of acute kidney injury (adjusted odds ratio, 2.2 [95% CI, 1.2–3.8]; P =.0065) and mortality (adjusted hazard ratio, 1.7 [95% CI, 1.03–2.9]; P =.037). Conclusions Rhabdomyolysis is associated with acute kidney injury and mortality in patients with EVD. These findings may inform clinical practice by identifying laboratory monitoring priorities and highlighting the importance of fluid management. [ABSTRACT FROM AUTHOR]

Young people in long-term foster care are at risk of experiencing poor social, emotional, behavioural and educational outcomes. Moreover, these placements have a significantly greater chance of breaking down compared with those involving children. This article critically evaluates the factors associated with this particular outcome. The article was researched through a literature review conducted by a social work practitioner in one Health and Social Care Trust in Northern Ireland. The findings evidenced that, apart from overriding safety concerns, placement breakdown was not a one-off event but rather a complex process involving the interplay between a range of dynamic risk and protective factors over time, operating in the wider context of the young person's history and life experiences. The significance of these findings for social work practitioners is finally considered by identifying key theories to inform understanding and intervention.

It is self-evident that we live in the age of inquiry where the negative impact of risk has been examined through numerous formal processes. In the wake of such scrutiny, there have been repeated recommendations for better training of the professionals charged with safeguarding the welfare of vulnerable individuals. Yet there has been very little examination of how student social workers, in particular, evaluate this training. This exploratory study responded to this gap through a mixed-methods design centring on the views of qualifying and post-qualifying social work students attending courses within two regional universities in Northern Ireland. The study found that, in the main, the cohorts responded favourably to certain aspects of the curriculum and how they were delivered. That said, the emotive nature of the case review and inquiry reports was inadequately addressed in the classroom and was not processed afterwards through a psycho-social framework. In effect, students were often left with residual anxieties that potentially hampered learning. On the basis of the findings, the study calls for further research into this highly significant area of professional competence.

This paper describes an action research project aimed at enhancing resilience in young people in a residential children's home. Two core areas were explored, namely: the needs of the young people as captured through a resilience framework; and the experiential and role-related issues arising from the attempts to enhance the young people's resilience. The findings showed that the young people faced a number of intrapersonal and interpersonal challenges. Yet, despite a number of organisational and role limitations, the residential social workers were able to respond resourcefully to these challenges by engaging in practices that simultaneously met agency imperatives, therapeutic goals and instrumental needs. (Contains 2 tables.)

The role of social support in child welfare policy and practice continues to engender widespread debate. Yet the moral and philosophical underpinnings of this topical area have received less attention in the literature. This is of concern, not least because academic debates on the "politics of identity" have a significant contribution to make to our understanding of self-development and social justice. In this article the authors show how Axel Honneth's account of the "struggle for recognition" can be adapted to invigorate theories of social support. The result is a conceptual framework for reflective practice that can illuminate, and interrogate, the moral and operational dimensions of preventative work with children and families.

Assessment is a pivotal part of social work process and is meant, amongst other things, to identify the deep-seated causes of human behaviour and well-being. This search for causation, it is argued, can be illuminated through a critical realist understanding of the person in society. In line with this philosophical stance, this article introduces a little considered causative mechanism pertinent to social work assessment: that of psychological abjection. Formulated by the French psychoanalytical theorist, Julia Kristeva, abjection serves to differentiate the self from the 'abject' or what is viewed as atypical in presentation. This concept is then scrutinised leading to the enlarged notion of social abjection; that is, the 'othering' and shaming of social groups which are viewed as anomalous. The implications of both psychological and social abjection for social workers are subsequently considered. At this point, the countervailing causative mechanism of recognition is proposed to mitigate abjection, and an argument is made for applying it within narrative social work and emancipatory groupwork. Finally, it is contended that social workers must commit to abjection work. This effort involves professionals gaining insight into how the abjection mechanism affects their inner world of perception and emotion, assessment of situations, and approach to service users. [ABSTRACT FROM AUTHOR]