‘County lines’: racism, safeguarding and statecraft in Britain

Government policies relating to dealers in ‘county lines’ drugs trafficking cases have been welcomed as a departure from punitive approaches to drugs and ‘gang’ policing, in that those on the bottom rung of the drugs economy of heroin and crack cocaine are no longer treated as criminals but as potential victims and ‘modern slaves’ in need of protection. However, our research suggests not so much a radical break with previous modes of policing as that the term ‘county lines’ emerged as a logical extension of the government’s racist and classist language surrounding ‘gangs’, knife crime and youth violence. Policies implemented in the name of safeguarding the vulnerable also act as a gateway for criminalisation not just under drugs laws but also modern slavery legislation. The government’s discovery of, and responses to, ‘county lines’ hinge on a moral crisis in the making, which ultimately deepens the state’s pre-emptive and violent criminalisation of the ‘Black criminal other’ at a time of deep political crisis

COVID-19: changing fields of social work practice with children and young people

Drawing on the theoretical work of Wacquant, Bourdieu and Foucault, we interrogate how the COVID-19 pandemic has weaponised child and family social work practices through reinvigorated mechanisms of discipline and surveillance. We explore how social workers are caught in the struggle between enforcement and relational welfare support. We consider how the illusio of social work obscures power dynamics impacting children, young people and families caught in child welfare systems, disproportionately affecting classed and racialised individuals

Community-facility linkage models and maternal and infant health outcomes in Malawi’s PMTCT/ART program: a cohort study

Background: In sub-Saharan Africa, 3 community-facility linkage (CFL) models—Expert Clients, Community Health Workers (CHWs), and Mentor Mothers—have been widely implemented to support pregnant and breastfeeding women (PBFW) living with HIV and their infants to access and sustain care for prevention of mother-to-child transmission of HIV (PMTCT), yet their comparative impact under real-world conditions is poorly understood. Methods and findings: We sought to estimate the effects of CFL models on a primary outcome of maternal loss to follow-up (LTFU), and secondary outcomes of maternal longitudinal viral suppression and infant “poor outcome” (encompassing documented HIV-positive test result, LTFU, or death), in Malawi’s PMTCT/ART program. We sampled 30 of 42 high-volume health facilities (“sites”) in 5 Malawi districts for study inclusion. At each site, we reviewed medical records for all newly HIV-diagnosed PBFW entering the PMTCT program between July 1, 2016 and June 30, 2017, and, for pregnancies resulting in live births, their HIV-exposed infants, yielding 2,589 potentially eligible mother–infant pairs. Of these, 2,049 (79.1%) had an available HIV treatment record and formed the study cohort. A randomly selected subset of 817 (40.0%) cohort members underwent a field survey, consisting of a questionnaire and HIV biomarker assessment. Survey responses and biomarker results were used to impute CFL model exposure, maternal viral load, and early infant diagnosis (EID) outcomes for those missing these measures to enrich data in the larger cohort. We applied sampling weights in all statistical analyses to account for the differing proportions of facilities sampled by district. Of the 2,049 mother–infant pairs analyzed, 62.2% enrolled in PMTCT at a primary health center, at which time 43.7% of PBFW were ≤24 years old, and 778 (38.0%) received the Expert Client model, 640 (31.2%) the CHW model, 345 (16.8%) the Mentor Mother model, 192 (9.4%) ≥2 models, and 94 (4.6%) no model. Maternal LTFU varied by model, with LTFU being more likely among Mentor Mother model recipients (adjusted hazard ratio [aHR]: 1.45; 95% confidence interval [CI]: 1.14, 1.84; p = 0.003) than Expert Client recipients. Over 2 years from HIV diagnosis, PBFW supported by CHWs spent 14.3% (95% CI: 2.6%, 26.1%; p = 0.02) more days in an optimal state of antiretroviral therapy (ART) retention with viral suppression than women supported by Expert Clients. Infants receiving the Mentor Mother model (aHR: 1.24, 95% CI: 1.01, 1.52; p = 0.04) and ≥2 models (aHR: 1.44, 95% CI: 1.20, 1.74; p < 0.001) were more likely to undergo EID testing by age 6 months than infants supported by Expert Clients. Infants receiving the CHW and Mentor Mother models were 1.15 (95% CI: 0.80, 1.67; p = 0.44) and 0.84 (95% CI: 0.50, 1.42; p = 0.51) times as likely, respectively, to experience a poor outcome by 1 year than those supported by Expert Clients, but not significantly so. Study limitations include possible residual confounding, which may lead to inaccurate conclusions about the impacts of CFL models, uncertain generalizability of findings to other settings, and missing infant medical record data that limited the precision of infant outcome measurement. Conclusions: In this descriptive study, we observed widespread reach of CFL models in Malawi, with favorable maternal outcomes in the CHW model and greater infant EID testing uptake in the Mentor Mother model. Our findings point to important differences in maternal and infant HIV outcomes by CFL model along the PMTCT continuum and suggest future opportunities to identify key features of CFL models driving these outcome differences

Review: Contribution of transgenic models to understanding human prion disease

J. D. F. Wadsworth, E. A. Asante and J. Collinge (2010) Neuropathology and Applied Neurobiology36, 576–597Contribution of transgenic models to understanding human prion diseas

When Helping Hurts: A Zemiological Analysis of a Child Protection Intervention in Adolescence—Implications for a Critical Child Protection Studies

This paper presents data from a three-year, mixed methods study into the rate and impact of ‘relocation’ as a response to extra-familial harm in adolescence by children’s social care teams. Participatory approaches to research design, data collection and analysis are used to gain insights from young people, parents/carers and professionals about the impact of relocations on safety. Professionals and young people report a range of harms implicated in the use of relocations, whilst sharing that the intervention often increases safety. Data are analysed zemiologically to understand this ambivalence, connecting micro accounts of harm with meso, institutional and macro structures that determine child protection intervention. Zemiology is put forward as a promising approach for a Critical Child Protection Studies

When Helping Hurts: A Zemiological Analysis of a Child Protection Intervention in Adolescence&mdash;Implications for a Critical Child Protection Studies

This paper presents data from a three-year, mixed methods study into the rate and impact of &lsquo;relocation&rsquo; as a response to extra-familial harm in adolescence by children&rsquo;s social care teams. Participatory approaches to research design, data collection and analysis are used to gain insights from young people, parents/carers and professionals about the impact of relocations on safety. Professionals and young people report a range of harms implicated in the use of relocations, whilst sharing that the intervention often increases safety. Data are analysed zemiologically to understand this ambivalence, connecting micro accounts of harm with meso, institutional and macro structures that determine child protection intervention. Zemiology is put forward as a promising approach for a Critical Child Protection Studies

Relationship of trust and surveillance in the first national piloting of Contextual Safeguarding in England and Wales

This article analyses data collected as part of a three-year study supporting the implementation of Contextual Safeguarding across nine children’s social care teams in England and Wales as an approach to safeguarding adolescents at risk of harm in ‘extra-familial’ contexts. The article asks to what extent the first national testing of Contextual Safeguarding features relationships of trust or relationships of surveillance with young people, families and communities. Data collected for the National Scale Up study are analysed against the Watching Over Working With framework. Findings indicate that further guidance is required to support an uptake of Contextual Safeguarding that aligns with the framework’s values and with children’s rights

‘Already doing the work’: social work, abolition and building the future from the present

Social work internationally is currently subject to debate. Some call for the abolition of social work, detailing legacies of harm, inadequate practices and theoretical limitations. Central to abolitionist thought is the tradition of community work to build alternative futures in the present, an area currently receiving less attention. This article adopts an auto-ethnographic method, drawing on the authors’ experiences of social work in the UK – in childhood and as a professional career, respectively – to consider the limitations of social work responses to childhood harm, alongside existing community harm-reduction practices. Four themes are identified that capture the limitations of social work intervention, as well as acts of community care and resistance. These are: the extent of engagement with context and community knowledge; resources for caring; legacies of harm; and the role of social work in relation to community harm-reduction work. Implications for research methods and social work practice are discussed

Watching over or Working with? Understanding Social Work Innovation in Response to Extra-Familial Harm

This paper critically reflects on the role of surveillance and trusted relationships in social work in England and Wales. It explores the characteristics of relationships of trust and relationships of surveillance and asks how these approaches apply to emerging policy and practices responses to extra-familial forms of harm (EFH). Five bodies of research that explore safeguarding responses across a range of public bodies are drawn on to present an analytical framework that explores elements of safeguarding responses, constituting relationships of trust or relationships of surveillance and control. This analytic framework is applied to two case studies, each of which detail a recent practice innovation in response to EFH studied by the authors, as part of a larger body of work under the Contextual Safeguarding programme. The application of this framework signals a number of critical issues related to the focus/rationale, methods and impact of interventions into EFH that should be considered in future work to address EFH, to ensure young people&rsquo;s rights to privacy and participation are upheld