Learning about COVID-19 across borders:public health information and adherence among international travellers to the UK

Objective: public health control measures at borders have long been central to national strategies for the prevention and containment of infectious diseases. Travel was inevitably associated with the rapid global transmission of COVID-19. In the UK, public health authorities tried to reduce the risks of travel-associated spread by providing public health information at ports of entry. This study investigates risk assessment processes, decision-making and adherence to official advice among international travellers, to provide evidence for future policy on the provision of public health information to facilitate safer international travel.Study design: this study is a qualitative study evaluation.Method: international air passengers arriving at the London Heathrow Airport on scheduled flights from China and Singapore were approached for interview after consenting to contact in completed surveys. Semi-structured interviews were conducted by telephone, using two topic guides to explore views of official public health information and self-isolation. Interview transcripts were coded and analysed thematically.Results: participants regarded official advice from Public Health England as adequate at the time, despite observing differences with intervention measures implemented in their countries of departure. Most participants also described adopting precautionary measures, including self-isolation and the use of face coverings that went beyond official advice, but reported adherence to guidance on contacting health authorities was more variable. Adherence to the official guidance was informed by the perceived salience of specific transmission possibilities and containment measures assessed in relation to participants’ local social and institutional environments.Conclusion: analysis of study findings demonstrates that international air travellers' responses to public health advice constitute a proactive process of risk assessment and rationalised decision-making to guide preventive action. This process incorporates consideration of the current living situation, trust in information sources, correspondence with cultural logics and willingness to accept potential risk to self and significant others. Our findings concerning international passengers’ understanding of, and compliance with, official advice and mitigation measures provide valuable evidence to inform future policy and generate recommendations on the presentation of public health information to facilitate safer international travel. Access to a central source of regularly updated official information would help minimise confusion between different national guidelines. Greater attention to the differentiated information needs of diverse groups in creating future public-facing guidance would help to minimise the uncertainties generated by the receipt of generic information

Impacts of Antibiotic Residues in the Environment on Bacterial Resistance and Human Health in Eastern China: An Interdisciplinary Mixed-Methods Study Protocol

Antibiotic resistance is a global health challenge that threatens human and animal lives, especially among low-income and vulnerable populations in less-developed countries. Its multi-factorial nature requires integrated studies on antibiotics and resistant bacteria in humans, animals, and the environment. To achieve a comprehensive understanding of the situation and management of antibiotic use and environmental transmission, this paper describes a study protocol to document human exposure to antibiotics from major direct and indirect sources, and its potential health outcomes. Our mixed-methods approach addresses both microbiological and pathogen genomics, and epidemiological, geospatial, anthropological, and sociological aspects. Implemented in two rural residential areas in two provinces in Eastern China, linked sub-studies assess antibiotic exposure in population cohorts through household surveys, medicine diaries, and biological sampling; identify the types and frequencies of antibiotic resistance genes in humans and food-stock animals; quantify the presence of antibiotic residues and antibiotic resistance genes in the aquatic environment, including wastewater; investigate the drivers and behaviours associated with human and livestock antibiotic use; and analyse the national and local policy context, to propose strategies and systematic measurements for optimising and monitoring antibiotic use. As a multidisciplinary collaboration between institutions in the UK and China, this study will provide an in-depth understanding of the influencing factors and allow comprehensive awareness of the complexity of AMR and antibiotic use in rural Eastern China

Comparative genomics reveals adaptive evolution of Asian tapeworm in switching to a new intermediate host

Taenia saginata, Taenia solium and Taenia asiatica (beef, pork and Asian tapeworms, respectively) are parasitic flatworms of major public health and food safety importance. Among them, T. asiatica is a newly recognized species that split from T. saginata via an intermediate host switch ∼1.14 Myr ago. Here we report the 169- and 168-Mb draft genomes of T. saginata and T. asiatica. Comparative analysis reveals that high rates of gene duplications and functional diversifications might have partially driven the divergence between T. asiatica and T. saginata. We observe accelerated evolutionary rates, adaptive evolutions in homeostasis regulation, tegument maintenance and lipid uptakes, and differential/specialized gene family expansions in T. asiatica that may favour its hepatotropism in the new intermediate host. We also identify potential targets for developing diagnostic or intervention tools against human tapeworms. These data provide new insights into the evolution of Taenia parasites, particularly the recent speciation of T. asiatica

International marriage, migration, and demographic reality in mainland China

Theoretical thesis.Includes bibliographic references.Chapter 1. Introduction -- Chapter 2. One decade of international marriage in China : migration, intimacy, and cultural perspectives, 2000–2010 -- Chapter 3. Gendered patterns and solidarity of the unions : differences between international marriages and domestic marriages in China -- Chapter 4. Social mobility through international marriage and the premium of relative advantages in the marriage market -- Chapter 5. Motivations and choices of international marriages, reflections from case studies -- Chapter 6. Conclusion -- Appendices.With the implementation of economic reforms, opening-up, and family planning policies, China has experienced profound socioeconomic and cultural changes since the 1970s. One of the significant changes is the increase in the number of people migrating within China and to other countries to pursue better opportunities for employment, education, life style, or marriage. With China’s economic success in recent decades, its internal and international migration has continued to increase while the number of international marriages experienced considerable fluctuation, and sometimes decline, over time. Although international marriage as a social phenomenon in China has attracted much attention, due to the lack of available data, knowledge of international marriage has been fragmented in the existing literature. Using a set of consolidated data of international and domestic marriage registration, supplemented by face-to-face interview data, this thesis investigates the nature of international marriage in mainland China by focusing on demographic reality and life experiences of couples in international marriage. The thesis first analyses the macro mechanisms and diverse geospatial patterns of international marriage in China and charts the connections between internal and international marriage and migration. The thesis then examines the demographic similarities and differentials between two types of marriage choices, and their effects on the formation and solidarity of the union for couples in both domestic and international marriages. The thesis also examines the premium of relative advantage between spouses and gendered differences of marriage choices. In addition, the analysis is supplemented by ethnographical data that provide insights into couples’ personal interpretation of their marriage and divorce, as well as their connections to social and institutional environment. The results suggest that marriage, including international marriage, has been affected by a number of institutional, structural, and individual factors, such as socioeconomic conditions, rural-urban disparities, gender norms, marriage behaviour, socioeconomic status, and personal experiences. Different from conventional understanding, the results from this study suggest that transnational couples experienced lower probability of divorce than couples who share more cultural similarities while younger birth cohorts might have weaker solidarity in both types of marriage. The differences in educational attainment between spouses show no significant effect on the solidarity of international marriage, but age gap does make a difference, marrying a younger husband will increase the risk of divorce. While providing a channel for upward mobility for underprivileged individuals, international marriage also polarises the marriage market by further strengthening hypergamous matches of spouses. The results also show that the nature of international marriage in mainland China nowadays is much more diverse and complex than simple status exchange or pursuit for romantic loveMode of access: World wide web1 online resource (x, 243 pages) graph

Understanding patterns of adherence to COVID-19 mitigation measures: a qualitative interview study

Background: evidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study, we examined the patterns of adherence to mitigation measures and reasons underpinning these behaviors.Methods: semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic and to explore the reasons underpinning this behavior.Results: we identified three categories of adherence to lockdown measures: (i) caution-motivated super-adherence (ii) risk-adapted partial-adherence and (iii) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures and perceived importance of/need for the behavior.Conclusions: this research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.<br/

Exploring the impact of shielding advice on the wellbeing of individuals identified as clinically extremely vulnerable amid the COVID-19 pandemic: A mixed-methods evaluation

BACKGROUND: The national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of “shielding” on the health and wellbeing of CEV individuals in Southwest England during the first COVID-19 lockdown. METHODS: A two-stage mixed methods study, including a structured survey (7 August—23 October 2020) and semi-structured telephone interviews (26 August—30 September 2020) with a sample of individuals who had been identified as CEV and advised to “shield” by Bristol, North Somerset & South Gloucestershire (BNSSG) Clinical Commissioning Group (CCG). RESULTS: The survey was completed by 203 people (57% female, 54% > 69 years, 94% White British, 64% retired) in Southwest England identified as CEV by BNSSG CCG. Thirteen survey respondents participated in follow-up interviews (53% female, 40% > 69 years, 100% White British, 61% retired). Receipt of ‘official’ communication from NHS England or General Practitioner (GP) was considered by participants as the legitimate start of shielding. 80% of survey responders felt they received all relevant advice needed to shield, yet interviewees criticised the timing of advice and often sought supplementary information. Shielding behaviours were nuanced, adapted to suit personal circumstances, and waned over time. Few interviewees received community support, although food boxes and informal social support were obtained by some. Worrying about COVID-19 was common for survey responders (90%). Since shielding had begun, physical and mental health reportedly worsened for 35% and 42% of survey responders respectively. 21% of survey responders scored ≥ 10 on the PHQ-9 questionnaire indicating possible depression and 15% scored ≥ 10 on the GAD-7 questionnaire indicating possible anxiety. CONCLUSIONS: This research highlights the difficulties in providing generic messaging that is applicable and appropriate given the diversity of individuals identified as CEV and the importance of sharing tailored and timely advice to inform shielding decisions. Providing messages that reinforce self-determined action and assistance from support services could reduce the negative impact of shielding on mental health and feelings of social isolation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14368-2