Where is Spirituality in Social Work?

This article is a critical analysis of the existing literature on spirituality in the profession of social work. The NASW Code of Ethics (2003) and CSWE Educational Policy and Accreditation Standards (2008) acknowledge the importance of spiritual values and practices for the positive functioning of people. This analysis of the literature offers a forum for dialogue about the role of spirituality in social work education and practice. Greater understanding of spirituality and its value to diverse people in society is necessary for social workers to practice cultural competence social work. There are key approaches to education and practice that may hold much promise for enhancing social work’s commitment to a holistic understanding of the human condition, respect for diversity, and competent and ethical social service

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

PERSPECTIVES ON SOCIAL WORK VOLUME 10 (SPRING 2014)

This is the full-text volume of Perspectives on Social Work, vol. 10 (Spring 2014)

Direct Evidence for the Importance of Small Animals to Prehistoric Diets: A Review of Coprolite Studies

Researchers tend to underestimate or ignore the importance of small animals to the prehistoric diet due to the difficulty of separating cultural from noncultural faunal debris excavated from sites. Human coprolite analyses (dessicated human feces) indicate prehistoric dietary consumption of small animals. The large number of coprolites analyzed from North America reveals direct ingestion of small animals and indicates that small animal remains from sites indeed reflect human dietary patterns. The coprolites reveal that reptiles, birds, bats, and a large variety of rodents were an important and prevalent component of the prehistoric diet