The SWIS trial: Protocol of a pragmatic cluster randomised controlled trial of school based social work.

BACKGROUND: Child and family social workers in the UK work closely with other agencies including schools and the police, and typically they are based in local authority offices. This study will evaluate the effectiveness of placing social workers in schools (SWIS) on the need for social care interventions. SWIS was piloted in three local authorities in 2018-2020, and findings from a feasibility study of the pilots suggests SWIS may operate through three key pathways: (1) by enhancing schools' response to safeguarding issues, (2) through increased collaboration between social workers, school staff, and parents, and (3) by improving relationships between social workers and young people. METHODS: The study is a two-arm pragmatic cluster randomised controlled trial building on three feasibility studies which found SWIS to be promising. Social workers will work within secondary schools across local authorities in England. 280 mainstream secondary schools will be randomly allocated with a 1:1 ratio to SWIS or a comparison arm, which will be schools that continue as normal, without a social worker. The primary outcome will be the rate of Child Protection (Section 47) enquiries. Secondary outcomes will comprise rate of referrals to children's social care, rate of Child in Need (Section 17) assessments, days spent in care, and educational attendance and attainment. The study also includes an economic evaluation, and an implementation and process evaluation. Social care outcomes will be measured in July 2022, and educational outcomes will be measured in July 2023. Days in care will be measured at both time points. DISCUSSION: Findings will explore the effectiveness and cost-effectiveness of SWIS on the need for social care interventions. A final report will be published in January 2024. TRIAL REGISTRATION: The study was registered retrospectively with the International Standard Randomised Controlled Trial Number registry on 13.11.2020 (ISRCTN90922032).

Young carers, mental health and psychosocial wellbeing: A realist synthesis.

Growing evidence demonstrates that the mental and psychosocial health impacts of caring vary significantly for individual children, depending on who they are, the person that they care for, their responsibilities and the wider family situation. Although individual studies have made progress in identifying the range of impacts, there is a lack of clarity around which impacts affect who and in what circumstances. This synthesis, based on RAMESES realist protocols, aims to increase clarity concerning how and why the mental and psychosocial health impacts of caring for a family member vary for different children. There were 12 391 unique search results screened at title, abstract and full-paper levels. Forty-four retained studies were analysed, resulting in the development of a model with 17 context-mechanism-outcome configurations. The model divides the configurations into three interlinking domains. The caregiving responsibilities domain considers how the impacts of caring vary with the circumstances of the individual young carer, the person they care for and their family. The identity domain details the development of a caring identity that potentially mitigates the negative effects of caring and enables positive benefits. The support domain concerns the support provided from family, community and services that, depending on quality, can mitigate or exacerbate the impacts of caring. Support also moderates the care identity by affecting self-perception of the caring role. The model has the potential to inform the development of interventions that target particular mechanisms to enable positive change for young carers. This potential can be enhanced by further research to test the model, with a focus on refining configurations where less evidence is available. There is a particular need to focus on identification which is under-represented in the model as both a mechanism and a contextual factor due to unidentified young carers being largely absent from past research.

A scoping review of system-level mechanisms to prevent children being in out-of-home care.

Identifying which approaches can effectively reduce the need for out-of-home care for children is critically important. Despite the proliferation of different interventions and approaches globally, evidence summaries on this topic are limited. This study is a scoping review using a realist framework to explore what research evidence exists about reducing the number of children and young people in care. Searches of databases and websites were used to identify studies evaluating intervention effect on at least one of the following outcomes: reduction in initial entry to care; increase in family reunification post care. Data extracted from papers included type of study, outcome, type and level of intervention, effect, mechanism and moderator, implementation issues and economic (EMMIE) considerations. Data were coded by: primary outcome; level of intervention (community, policy, organisation, family or child); and type of evidence, using the realist EMMIE framework. This is the first example of a scoping review on any topic using this framework. Evaluated interventions were grouped and analysed according to system-level mechanism. We present the spread of evidence across system-level mechanisms and an overview of how each system-level mechanism might reduce the number of children in care. Implications and gaps are identified.

Intensive Family Preservation Services to prevent out-of-home placement of children: A systematic review and meta-analysis.

BACKGROUND: Intensive Family Preservation Services (IFPS) are in-home crisis intervention services designed to help families with children at imminent risk of out-of-home placement. OBJECTIVES: To assess the evidence of the effectiveness and cost-effectiveness of IFPS in reducing the need for children to enter out-of-home care. PARTICIPANTS AND SETTING: Children <18 years and their families in the home setting. METHODS: A systematic review and meta-analysis was carried out by searching 12 databases and 16 websites for publications up to January 2019. RESULTS: 1948 potentially relevant papers were identified, of which 37 papers, relating to 33 studies, met our inclusion criteria. Studies reported outcomes at child or family level. There were significant reductions in relative risk (RR) of out-of-home placements in children who received IFPS compared with controls at child level at three, six, 12 and 24 months' follow-up (RR 0.57, 95 % CI 0.35 to 0.93, RR 0.51, 95 % CI 0.27 to 0.96, RR 0.60, 95 % CI 0.48 to 0.76, RR 0.51, 95 % CI 0.30 to 0.87 respectively). At family level, there was not a significant reduction in RR of placement. Economic evidence was limited to cost analyses or cost-cost offset analyses. CONCLUSION: The available evidence, at child level, suggests that IFPS are effective in preventing children from entering care up to 24 months after the intervention. Placement outcomes reported at family level did not demonstrate a significant reduction in out-of-home placements. The economic analyses suggest that IFPS could be cost-saving; however, evidence of cost-effectiveness generated by full economic evaluations is needed.

Mapping the evidence about what works to safely reduce the entry of children and young people into statutory care: a systematic scoping review protocol.

INTRODUCTION: The increasing number of children and young people entering statutory care in the UK is a significant social, health and educational priority. Development of effective approaches to safely reduce this number remains a complex but critical issue. Despite a proliferation in interventions, evidence summaries are limited. The present protocol outlines a scoping review of research evidence to identify what works in safely reducing the number of children and young people (aged ≤18 years) entering statutory social care. The mapping of evidence gaps, clusters and uncertainties will inform the research programme of the newly funded Department for Education's What Works Centre for Children's Social Care. METHODS AND ANALYSIS: The review uses Arksey and O'Malley's scoping review methodology. Electronic database and website searches will identify studies targeting reduction of care entry, reduction of care re-entry and increase in post-care reunification. Supplementary searching techniques will include international expert consultation. Abstracts and full-text studies will be independently screened by two reviewers. Ten per cent of data abstraction will be independently conducted by two reviewers, with the remainder being extracted and then verified by a second reviewer. Descriptive numerical summaries and a thematic qualitative synthesis will be generated. Evidence will be synthesised according to primary outcome, intervention point (mapped across socioecological domains) and the realist EMMIE categorisation of evidence type (Effectiveness; Mechanisms of change; Moderators; Implementation; Economic evaluation). ETHICS AND DISSEMINATION: Outputs will be a conceptual evidence map, a descriptive table quantitatively summarising evidence and a qualitative narrative summary. Results will be disseminated through a peer-reviewed publication, conference presentations, the What Works Centre website, and knowledge translation events with policy-makers and practitioners. Findings will inform the primary research programme of the What Works Centre for Children's Social Care and the subsequent suite of systematic reviews to be conducted by the Centre in this substantive area.

Nematodes collected by gastric lavage from live American alligators, Alligator mississippiensis, in Florida.

Stomach nematodes were collected from 151 live American alligators, Alligator mississippiensis, from 3 lakes (Apopka, Griffin, and Woodruff) in north-central Florida using a gastric lavage technique. Four species were identified: Dujardinascaris waltoni, Ortleppascaris antipini, Brevimulticaecum tenuicolle, and larvae of Contracaecum sp. Of these, D. waltoni was the most prevalent species in all 3 lakes and was more prevalent in Lake Apopka than in the other 2 lakes. This is the first record of Contracaecum larvae in the American alligator and the second record of O. antipini.

Gastrointestinal helminths of free-ranging Florida panthers (Puma concolor coryi) and the efficacy of the current anthelmintic treatment protocol.

Thirty-five Florida panthers (Puma concolor coryi [Bangs, 1899]) collected from six counties in southern Florida between 1978 and 2003 were examined at necropsy for gastrointestinal helminths. The panthers were placed into two groups: 1) treated with anthelmintics (n = 17), and 2) untreated (n = 18). Nine species of helminths (one trematode, six nematodes, and two cestodes) were identified in the untreated panthers. The most prevalent helminths were Alaria marcianae (LaRue, 1917) (100%), Spirometra mansonoides (Mueller, 1935) (91%), and Ancylostoma pluridentatum (Alessandrini, 1905) (89%). Ancylostoma caninum (Ercolani, 1859) is reported from the Florida panther for the first time. The intensities of helminths with prevalences >10% did not differ between untreated panthers collected in 1978-1983 and 1996-2003. Treated panthers had helminth faunas similar to those of untreated panthers. The current anthelmintic treatment being used reduced the intensity of both A. marcianae and A. pluridentatum in panthers < or =6 mo posttreatment (PT); however, treated panthers between 6 and 9 mo PT, and >9 mo PT were similar to untreated panthers. Treatment was less effective on S. mansonoides and Taenia omissa Lühe, 1910. Treated panthers had slightly lower intensities of S. mansonoides at < or =6 mo PT; however, between 6 and 9 mo PT and >9 mo PT they had significantly higher intensities than untreated panthers. At all periods PT, the intensity of T. omissa for the treated panthers was similar to that of untreated panthers. We suggest that Mesocestoides sp. may not be present in the Florida panther population as reported earlier by Forrester et al. (1985), due to parasite misidentification by those authors.

Interactive effects of turkeypox virus and Plasmodium hermani on Turkey poults.

Two experiments were conducted to examine the interactive effects of two disease agents of wild turkeys (Meleagris gallopavo), turkeypox virus and the malarial organism, Plasmodium hermani, on the health of turkey poults. Groups of domestic broad-breasted white turkey poults of 1 and 10 wk of age were infected with either turkeypox virus, P. hermani, both turkeypox virus and P. hermani, or were maintained as uninfected controls. The strains of turkeypox virus and P. hermani had been isolated from wild turkeys in southern Florida (USA). The goals of these experiments were two-fold and included both an examination of age differences in response to infections, and an examination of the effects of dual versus singular infections with the two agents. Both singular and concomitant infections of turkeypox virus and P. hermani were more detrimental to poults infected at 1 wk of age than to those infected at 10 wk, based on mortality, weight gain, and parasitemia. Dual infections of turkeypox virus and P. hermani were found to be slightly more harmful to 1-wk-old poults than were singular infections. No such interactive effects were noted in the poults infected at 10 wk of age.

Survey of raccoons on Key Largo, Florida, USA, for Baylisascaris procyonis.

Numbers of the endangered Key Largo woodrat (KLWR; Neotoma floridana smalli) have been declining for at least 25 yr. The raccoon (Procyon lotor) roundworm, Baylisascaris procyonis, has been found to have an adverse effect on the survival of Alleghany woodrats (N. magister). High densities of raccoons can exacerbate this problem by increasing the amount of feces containing viable eggs of B. procyonis available to woodrats. In 2002, 64 fecal samples were collected and examined for eggs of B. procyonis from >32 raccoons within the KLWR's known range on Key Largo, Florida, USA. All samples were negative for eggs of B. procyonis. Raccoon density in this area was approximately 0.62 raccoons/ha. Despite this high density of raccoons, B. procyonis does not appear to be a threat to the KLWR population.

Parasitic helminths of Eurasian collared-doves (Streptopelia decaocto) from Florida.

Sixty-three Eurasian collared-doves (ECDs) (Streptopelia decaocto) from Florida were examined for parasitic helminths from June to December 2001. Nine species of helminths were identified (5 nematodes, 2 cestodes, and 2 trematodes). The most prevalent helminths were Ascaridia columbae (73.0%), Fuhrmannetta crassula (28.6%), Ornithostrongylus quadriradiatus (12.7%), and Bruscapillaria obsignata (11.1%). The helminths with the greatest mean intensity were Tanaisia bragai (13.5), A. columbae (9.3), and O. quadriradiatus (7.1). In Florida, the mean intensity of A. columbae in ECDs (9.3) was similar to that found in white-winged doves (Zenaida asiatica) (9.1) (P = 0.461), and both the intensities were significantly higher than that in the native mourning doves (Zenaida macroura) (3.7) (P = 0.001 and 0.005, respectively). Fuhrmannetta crassula is reported for the first time in columbids from Florida.

Epizootiology of Plasmodium hermani in Florida: chronicity of experimental infections in domestic turkeys and northern bobwhites.

A pen-reared northern bobwhite and a domestic turkey were infected with a strain of Plasmodium hermani obtained originally from a wild turkey in southern Florida. Blood films from these 2 birds were positive microscopically for 188 and 370 days postinfection (PI), respectively. Culicine mosquitoes (Culex nigripalpus and C. salinarius) were blood fed on the bobwhite and the turkey at different times during the infection and used to transmit the malaria to other bobwhites and turkeys up to days 298 and 473 PI, respectively. It was concluded that in nature, P. hermani could remain in a chronic phase in avian hosts for a year, or longer, allowing survival of the parasite between seasons of mosquito transmission.

Parasitic helminths of black bear cubs (Ursus americanus) from Florida.

Twenty-two Florida black bear (Ursus americanus floridanus) cubs (< or = 12 mo old) from Florida were examined for endoparasites between 1998 and 2003. Eleven species of helminths were found (8 nematodes, 2 trematodes, and 1 acanthocephalan). The most prevalent helminths were Ancylostoma caninum (64%), Macracanthorhynchus ingens (36%), Strongyloides sp. (27%), Baylisascaris transfuga (23%), and A. tubaeforme (14%). New host records include A. tubaeforme and Brachylaima virginianum. This is the first report of B. transfuga in black bears from Florida.

Haemoproteus balearicae and other blood parasites of free-ranging Florida sandhill crane chicks.

We obtained blood smears from 114 Florida sandhill crane (Grus canadensis pratensis) chicks in Osceola and Lake Counties, Florida, USA, during 1998-2000. Leucocytozoon grusi was observed in 11 (10%) chicks; Haemoproteus antigonis was observed in eight (7%) chicks; and three (3%) chicks were infected with Haemoproteus balearicae. One chick infected with H. balearicae suffered from severe anemia (packed cell volume = 13%) and was later found moribund. At necropsy this bird also had severe anemia and damage to the heart possibly due to hypoxia. This is the first report of H. balearicae in free-ranging North American cranes.

Hookworms of feral cats in Florida.

Thirty feral cats (Felis catus) from Alachua county (northern Florida) and 30 from Palm Beach county (southern Florida) were examined for hookworms. Two species, Ancylostoma tubaeforme and Ancylostoma braziliense, were identified. Forty-five cats (75%) were infected with A. tubaeforme, with a mean intensity of 48 hookworms per cat. Twenty cats (33%) were infected with A. braziliense, with a mean intensity of 28 worms per cat. The prevalence of A. tubaeforme was greater than that of A. braziliense in Alachua (P=0.002) and Palm Beach (P=0.004) counties. The intensity of A. tubaeforme infections was higher in Palm Beach county than Alachua county (P=0.013). The intensities of A. tubaeforme and A. braziliense were positively correlated (increased together) in Palm Beach county (P=0.011). These hookworms have also been identified in bobcats (Felis rufus), gray foxes (Urocyon cinereoargenteus), and red foxes (Vulpes vulpes) in Florida. The prevalence of A. tubaeforme was significantly greater in feral cats than those reported in bobcats (P<0.001). The prevalence of A. braziliense was significantly greater in feral cats than in those reported in gray foxes (P=0.008). The hookworm that infects Florida panthers and bobcats, A. pluridentatum, was not found.

Epizootiology of Eustrongylides ignotus in Florida: transmission and development of larvae in intermediate hosts.

Under laboratory conditions, 2 modes of transmission of Eustrongylides ignotus (Nematoda: Dioctophymatoidea) to fish were identified. Eastern mosquitofish (Gambusia holbrooki) became infected after ingestion of either eggs of E. ignotus containing first-stage larvae or aquatic oligochaetes (Limnodrilus hoffmeisteri) containing third-stage larvae of E. ignotus. After removal from the uterus of gravid E. ignotus females and incubation for 17-28 days, depending on temperature, it was found that parasite eggs contained first-stage larvae that were infective to fish and oligochaetes. Larvae developed to the third stage in oligochaetes and were infective to fish 35-77 days postinfection (PI) and when fed to fish, developed to the fourth stage between 127 and 184 days PI. Eggs containing first-stage larvae fed directly to fish developed to the fourth stage between 84 and 105 days PI. The amount of time for development from the undifferentiated egg to the fourth-stage larva was 78-156 days shorter when fish ingested eggs containing first-stage larvae than when fish ingested oligochaetes containing third-stage larvae. Three species of large piscivorous fish, including black crappie (Pomoxis nigromaculatus), largemouth bass (Micropterus salmoides), and warmouth (Lepomis gulosus), were fed mosquitofish containing fourth-stage larvae. At necropsy, live E. ignotus larvae were recovered from all 3 species. Several fish had multiple infections after ingesting > 1 larva, indicating that bioaccumulation of the parasite in the food chain may occur.

Epizootiology of Eustrongylides ignotus in Florida: distribution, density, and natural infections in intermediate hosts.

A total of 63,451 fish, representing 39 species, was collected from 176 foraging sites used by ciconiiform wading birds in peninsular Florida (USA) and examined for larvae of Eustrongylides ignotus. Infected fish were identified from 30 (17%) of the sites, all of which had been altered by human disturbance such as removal of sediment to construct ditches and dikes, improve water flow, or increase storage capacity and had a history of receiving anthropogenic nutrients such as sewage effluent, urban runoff, or agricultural runoff. The mosquitofish (Gambusia holbrooki) and several species of sunfish (Centrarchidae) were the most important intermediate hosts. Infected fish were not collected at any of the unaltered sites. A total of 10,508 oligochaetes (representing 36 species) was identified from 22 sites that had fish infected with E. ignotus and 36 sites where no infected fish were collected. None of the oligochaetes was infected with larvae of E. ignotus. Immature tubificids without hair setae (probably Limnodrilus sp.), Dero digitata, and L. hoffmeisteri were the most abundant oligochaetes at sites where infected fish occurred, making up 78% of the total collected. Compared to unaltered sites, altered sites were characterized by higher mean densities of fish and oligochaetes; surface waters with decreased dissolved oxygen and increased total nitrogen, total phosphorus, and chlorophyll-a; sediments with higher soil oxygen demand and total phosphorus; larger grain sizes; and higher percentage emergent vegetation and grasses.

Sarcoptic mange in free-ranging pampas foxes in the Gran Chaco, Bolivia.

Sarcoptes scabiei infestation was diagnosed in two freshly dead free-ranging pampas foxes (Pseudalopex gymnocercus) in the Gran Chaco, Bolivia. Diagnosis was made based on histologic evaluation of skin biopsies and identification of the parasite from skin scrapings. Characteristic gross lesions consistent with mange were noted in 19 of 94 observations of free-ranging pampas foxes in the region from December 1998 to January 2000. None of 16 crab-eating foxes (Cerdocyon thous) observed during the same time period had visible lesions consistent with scabies. These are the first case reports of S. scabiei in pampas foxes.

An epizootic of fibromatosis in gray squirrels (Sciurus carolinensis) in Florida.

Beginning in the fall of 1998 and extending into the spring and early summer of 1999 there was a large epizootic of squirrel fibromatosis in squirrels in seven counties in peninsular Florida. Hundreds of gray squirrels (Sciurus carolinensis) with multiple cutaneous tumors were submitted or reported to biologists, veterinary hospitals, and private wildlife rehabilitators. Most squirrels died or were euthanized soon after submission. Twenty squirrels were submitted for necropsy. The majority of the squirrels examined were adults (12/20) and male (15/20). The number and location of tumors varied widely among the affected squirrels; however, a consistent finding was involvement of the eyelids (20/20). Histopathology revealed a proliferative population of mesenchymal cells within the dermis and marked ballooning degeneration of keratinocytes in the overlying epidermis. Intracytoplasmic viral inclusions were present in the neoplastic mesenchymal cell population and the degenerating keratinocytes. Ulceration and necrosis of the surface of the tumors or associated tissues was present in 14 of the 20 squirrels. Virions consistent with poxvirus were observed via electron microscopy in samples collected from a representative tumor. Death of the squirrels was attributed to emaciation, tissue damage, and severe negative energy balance associated with poxvirus infection and massive tumor growth. The underlying cause of this unusual epizootic of fibromatosis in gray squirrels remains unknown.