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Deal A, Crawshaw AC, Salloum M, Hayward SE, Knights F, Goldsmith LP, Carter J, Rustage K, Mounier-Jack S, Hargreaves S. Strategies to increase catch-up vaccination among migrants: a qualitative study and rapid review. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
WHO’s Immunization Agenda 2030 has placed renewed focus on catch-up vaccination across the life course to meet global targets for reduction in vaccine-preventable diseases through increased vaccine coverage, including among migrant groups who may require catch-up vaccination to align them with host country vaccination schedules.
Methods
We did a global rapid review (01/2010 to 04/2022) to explore drivers of vaccine hesitancy among migrants followed by an in-depth qualitative study (semi-structured, telephone interviews) among recently arrived adult migrants (foreign-born, >18 years old, residing in the UK < 10 years). Interviews explored views on routine vaccination including accessibility, confidence and awareness. Data were analysed iteratively using thematic analysis.
Results
63 papers were included in the rapid review, including data from 22 countries/regions. Multiple factors driving under-immunisation and hesitancy in migrants were reported, including language barriers, low health literacy, social exclusion, low cultural competency and accessibility in healthcare systems. Our qualitative study recruited 40 migrants (mean age: 36.7 years; 62.5% female) resident in the UK (6 refugees, 19 asylum-seekers, 8 undocumented, 7 labour migrants). Major barriers to catch-up vaccination included a lack of provider recommendation and low awareness, with vaccination viewed as only relevant to children. Hesitancy around specific vaccines, such as MMR, was often influenced by misinformation. Participants suggested that novel strategies such as walk-in or mobile access points, consistent provider recommendations, and translation of information into relevant languages, may enhance accessibility and uptake of routine vaccinations.
Conclusions
Targeted and tailored information campaigns, versatile and proactive access pathways and education for healthcare staff on cultural competency will be needed to ensure uptake of catch-up vaccination among marginalised migrant groups.
Key messages
• Newly arrived adult migrants face barriers to catch-up vaccination in host countries, which may hinder immunisation coverage and increase the risk of vaccine-preventable disease outbreaks.
• Health systems must develop novel mechanisms to proactively offer culturally competent and accessible catch-up vaccination services to adult migrants on and after arrival.
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Affiliation(s)
- A Deal
- Institute for Infection and Immunity, St George’s, University of London , London, UK
- Faculty of Public Health and Policy, LSHTM , London, UK
| | - AC Crawshaw
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | - M Salloum
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | - SE Hayward
- Institute for Infection and Immunity, St George’s, University of London , London, UK
- Faculty of Public Health and Policy, LSHTM , London, UK
| | - F Knights
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | - LP Goldsmith
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | - J Carter
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | - K Rustage
- Institute for Infection and Immunity, St George’s, University of London , London, UK
| | | | - S Hargreaves
- Institute for Infection and Immunity, St George’s, University of London , London, UK
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Crawshaw A. Community engagement to co-design and deliver public health interventions in newly arrived migrants. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Alison Crawshaw will talk about her participatory research that uses design thinking to develop community-based strategies to improve health outcomes in migrant populations. She will summarise the benefits of using community-based approaches and co-designing public health initiatives with affected migrant communities, bringing in lessons learned from a recent project with the Congolese community in London.
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Affiliation(s)
- A Crawshaw
- The Migrant Health Research Group , St Georges, , London, UK
- University of London , St Georges, , London, UK
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Crawshaw A, Warren A, Trincao J, Lunnon M, Duller G, Evans G. VMXm: a new micro/nanofocus protein crystallography beamline at Diamond Light Source. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322093202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Crawshaw A, Toledano M, Pozniak A, Kennedy A, Davies N. Parkinsonism in HIV patients: A descriptive case series. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Crawshaw A, Kendrik Y, Repapi E, Taylor S, Ho LP. P25 Distinct Pro-inflammatory Gene Expression Profile In Monocytes From Sarcoidosis Patients With Active Disease. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Crawshaw A, Kendrik Y, Estrada FM, Ho LP. P24 Vitamin D Levels Are Low In Sarcoidosis And Contribute To Abnormal Monocyte Activity. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Crawshaw A, Kendrick Y, Ho LP. Invariant natural killer T (iNKT) cells regulate function of IL-10 producing monocytes in sarcoidosis. Pneumologie 2012. [DOI: 10.1055/s-0032-1329828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Peri-operative radiotherapy has been used widely in addition to surgery in an attempt to reduce local recurrence (LR) following surgical resection of rectal cancer. Currently different groups follow different approaches with some routinely administering one weeks pre-operative radiotherapy to all cases of operable mobile cancer with others favouring postoperative chemoradiotherapy for selected high risk groups. In this review we bring together the changes in surgery, pathology and imaging that have occurred in recent years and together with the data from recent randomized pre-operative radiotherapy trials propose a logical and optimal way of managing rectal cancer. This third way is selective and pre-operative and should ensure a low rate of LR with radiotherapy reserved for those cases that need it.
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Affiliation(s)
- A Crawshaw
- Department of Clinical Oncology, Guy's and St Thomas' Hospitals Trust, London, UK.
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Abbas SZ, Abbas AB, Crawshaw A, Shaw S, English J, McGovern D, Vivian G, Dalton HR. Diagnosis and eradication of Helicobacter pylori in patients with duodenal ulceration in the community. J PAK MED ASSOC 2003; 53:90-4. [PMID: 12779020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To determine the value of Helicobacter pylori (Hp) serology in diagnosis of active Hp infection in patients with documented duodenal ulcer (DU) and to directly compare the efficacy and side-effects profiles of metronidazole or tinidazole in a triple therapy regimen to eradicate active Hp infection. DESIGN OF STUDY Prospective, single-blinded, randomised trial. METHODS One hundred patients from General Practice with documented DU and Hp seropositivity had a C14 Urea Breath Test (UBT). Those who tested positive were randomised to receive one-week, twice daily omeprazole 20 mgs and clarithromycin 250 mgs in combination with metronidazole 400 mgs (OCM) or tinidazole 500 mgs (OCT). Eradication was confirmed by a repeat UBT. RESULTS Eighty five sero-positive patients had a positive pre-treatment UBT. On intention to treat basis, OCT (100%) had a significantly better eradication rate than OCM (87.8%), p = 0.023. There was no difference in side effects. CONCLUSION (1) Positive Hp serology in patients with DU does not always mean active infection and (2) for patients in the community with active Hp and DU disease OCT is significantly better than OCM for eradicating Hp.
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Affiliation(s)
- S Z Abbas
- Gastrointestinal Unit, Royal Cornwall Hospital, Truro, The Cornwall General Practice Training Group, Truro, UK
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Crawshaw A. Carcinoma of the breast and hormone replacement therapy for osteoporosis. Int J Clin Pract 2000; 54:99-103. [PMID: 10824364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
The benefits of hormone replacement therapy for postmenopausal women, especially in the prevention and treatment of osteoporosis, are well known. It is still not clear whether oestrogen replacement therapy can be given safely to women with breast cancer. The incidence and survival of breast cancer is rising in the UK and increasing numbers of young women with breast cancer treated systemically experience an early menopause and are at prolonged risk of osteoporosis. This review discusses the risk/benefit analysis of oestrogen replacement therapy for breast cancer patients, and alternative therapies: SERMs, phyto-oestrogens and bisphosphonates. A schedule for monitoring osteoporosis for breast cancer patients with a therapeutic early menopause is suggested.
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Affiliation(s)
- A Crawshaw
- Department of Clinical Oncology, St Thomas's Hospital, London, UK
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de Vries EG, Gietema JA, Workman P, Scott JE, Crawshaw A, Dobbs HJ, Dennis I, Mulder NH, Sleijfer DT, Willemse PH. A phase II and pharmacokinetic study with oral piritrexim for metastatic breast cancer. Br J Cancer 1993; 68:641-4. [PMID: 8353055 PMCID: PMC1968400 DOI: 10.1038/bjc.1993.400] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Piritrexim is a lipid-soluble antifolate which, like methotrexate, has a potent capacity to inhibit dihydrofolate reductase. We performed a multicentre phase II study with piritrexim in patients with locally advanced or metastatic breast cancer. Twenty-four patients of which sixteen had received prior chemotherapy, were initially treated with 25 mg piritrexim orally administered trice daily for four days, repeated weekly, with provision for dose escalation or reduction according to observed toxicity. Of twenty-one patients evaluable for tumour response, one patient achieved a partial response which lasted for 24 weeks. Three patients had stable disease during 12 weeks of treatment, seventeen had progressive disease. Pirtrexim was generally well tolerated, in eighteen patients the dose could be escalated. Myelotoxicity was the most frequent observed toxicity of this piritrexim regimen. Leucopenia and thrombocytopenia grade 3/4 occurred in 38% of the patients sometime during treatment. Pharmacokinetic analysis of piritrexim in three patients during the first treatment cycle, revealed peak levels 1 to 2 h after an oral dose, with a trend towards a higher peak plasma levels and AUCs on the fourth dosing day compared with the first dosing day. In conclusion, orally administered piritrexim appears to be a regimen with little activity in patients with locally advanced or metastatic breast carcinoma.
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Affiliation(s)
- E G de Vries
- Department of Internal Medicine, University Hospital Groningen, The Netherlands
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Crawshaw A. Intravenous indomethacin therapy. J Paediatr Child Health 1992; 28:198. [PMID: 1562379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Crawshaw A. Unit planning. Getting to grips with delegation. Health Serv J 1986; 96:602. [PMID: 10300793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Crawshaw A, Jones AG. The Synthesis and Cyclopolymerization of the N, N-Diallyl- and N, N-Dimethallyl-Derivatives of Methanesulfonamide and Ethanesulfonamide. ACTA ACUST UNITED AC 1972. [DOI: 10.1080/00222337208061119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Crawshaw A, Henbest HB, Jones ERH, Wagland AA. Studies in the steroid group. Part LXX. Reactions at C(11)in 9β-steroids. ACTA ACUST UNITED AC 1955. [DOI: 10.1039/jr9550003420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Crawshaw A, Henbest HB, Jones ERH. Studies in the steroid group. Part LXV. Reactions of 11-hydroxy- and 11-oxo-5α-steroids. ACTA ACUST UNITED AC 1954. [DOI: 10.1039/jr9540000731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Clayton RB, Crawshaw A, Henbest HB, Jones ERH, Lovell BJ, Wood GW. 409. Studies in the steroid group. Part LIX. Preparation and reactions of 5α : 8α-epoxy-Δ9(11)-steroids. ACTA ACUST UNITED AC 1953. [DOI: 10.1039/jr9530002009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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