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This article addresses the broad research aim of understanding migrants’ experiences of homelessness during the Coronavirus Disease of (COVID-19) pandemic through a novel combination of linguistic and sociological analysis. In our analysis of life story interviews, we find that the United Kingdom (UK) Government’s Everyone In initiative, which suspended eligibility criteria to provide support and accommodation to those experiencing homelessness or deemed to be at risk of rough sleeping, was hugely beneficial for migrants. This indicates what is possible when there is the political will to end rough sleeping. In its analysis of life stories gathered during the pandemic, the article proceeds to identify deeper-rooted problems relating to the weak and restricted structural position of migrants experiencing homelessness. Having spent time in the UK with an ‘inferior status’, with limited access to work and welfare, economic and social capital, and often with experiences of trauma in the UK and/or in their countries of origin, many of our research participants express a lack of control and a sense of being controlled in their conditions of existence. Further, their isolation and loneliness in the individual rooms provided in the emergency accommodation is indicative of a deeper-rooted sense of separation deriving from years spent sleeping rough or living in temporary and insecure accommodation. Experiences of isolation and the sense of a lack of control are corrosive to mental health, and during the pandemic, mental health problems were also exacerbated by welfare checks and other rule-based practices that are potentially re-traumatising. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) epidemiology in Europe differs by region and population risk group, and data are often incomplete. We estimated chronic HBV prevalence as measured by surface antigen (HBsAg) among general and key population groups for each country in the European Union, European Economic Area and the United Kingdom (EU/EEA/UK), including where data are currently unavailable. Methods: We combined data from a 2018 systematic review (updated in 2021), data gathered directly by the European Centre for Disease Control (ECDC) from EU/EEA countries and the UK and further country-level data. We included data on adults from the general population, pregnant women, first time blood donors (FTBD), men who have sex with men (MSM), prisoners, people who inject drugs (PWID), and migrants from 2001 to 2021, with three exceptions made for pre-2001 estimates. Finite Mixture Models (FMM) and Beta regression were used to predict country and population group HBsAg prevalence. A separate multiplier method was used to estimate HBsAg prevalence among the migrant populations within each country, due to biases in the data available. Results: There were 595 included studies from 31 countries (N = 41,955,969 people): 66 were among the general population (mean prevalence () 1.3% [range: 0.0-7.6%]), 52 among pregnant women ( 1.1% [0.1–5.3%]), 315 among FTBD ( 0.3% [0.0-6.2%]), 20 among MSM ( 1.7% [0.0-11.2%]), 34 among PWID ( 3.9% [0.0-16.9%]), 24 among prisoners ( 2.9% [0.0-10.7%]), and 84 among migrants ( 7.0% [0.2–37.3%]). The FMM grouped countries into 3 classes. We estimated HBsAg prevalence among the general population to be < 1% in 24/31 countries, although it was higher in 7 Eastern/Southern European countries. HBsAg prevalence among each population group was higher in most Eastern/Southern European than Western/Northern European countries, whilst prevalence among PWID and prisoners was estimated at > 1% for most countries. Portugal had the highest estimated prevalence of HBsAg among migrants (5.0%), with the other highest prevalences mostly seen in Southern Europe. Conclusions: We estimated HBV prevalence for each population group within each EU/EAA country and the UK, with general population HBV prevalence to be < 1% in most countries. Further evidence is required on the HBsAg prevalence of high-risk populations for future evidence synthesis. [ABSTRACT FROM AUTHOR]

Background/Aims: The prevalence of perinatal mental health issues is significantly higher among South Asian women in the UK. However, little attention has been given to examine the views and opinions of sub-groups of South Asians in the UK. Although the prevalence of perinatal mental health issues is much higher in Sri Lanka, so far, no studies have focused on Sri Lankan women in the UK. This study's aim was to examine the views and opinions of Sri Lankan women living in the UK about perinatal mental health. Methods: A convergent mixed-method online survey was administered in English and Sinhalese. A total of 34 Sri Lankan women living in the UK, from their baby's conception to 24 months postpartum, were recruited. Qualitative responses were interpreted using thematic analysis, supported by quantitative data. Results: The participants reported that they maintained good perinatal mental health with the support of their partner and family. Midwives were most involved in inquiring about and providing information on perinatal mental health. Social stigma was a dominant barrier to accessing support. Conclusions: Midwives need to ensure that perinatal mental health is discussed sensitively with Sri Lankan women. Future quantitative research needs to examine if existing tools are culturally sensitive and qualitative research should include women's partners and families to explore how best to care for this population. [ABSTRACT FROM AUTHOR]

The UK government's Everyone In scheme, announced in March 2020, required local authorities to temporarily house all homeless individuals in their area regardless of immigration status. In providing support through safe and secure accommodation, Everyone In also provided a crucial moment of visibility for migrants experiencing homelessness. Yet, just as it provided life-changing opportunities for some, the scheme was not straightforwardly a celebratory moment for migrants. It remained embedded within a wider context of immigration governance and social inequality in the UK, which has both invisibilised migrant homelessness as a crisis and hypervisibilised migrants as undeserving, suspicious or 'illegal' subjects. In this article, we explore life-story narratives co-produced with migrants across three urban contexts that capture their experiences of homelessness before and during the pandemic. In doing so, we introduce the notion of cultivated invisibility, referring to a habitual, deeply-ingrained mode of practice through which migrants respond to and navigate their experiences of being read as 'Other', in racialised or classed terms. It is developed through conditions of material scarcity and in the course of multiple engagements with racial capitalism's various 'faces of the state' in an increasingly hostile environment for migrants. Cultivated invisibility involves staying on the move and blending into the crowd or avoiding it altogether but it also includes the experience of being unseen despite having come forward for help. Importantly, we demonstrate that cultivated invisibility becomes a cause of illegalisation, just as much as a response to it. [ABSTRACT FROM AUTHOR]

Introduction. , the human threadworm, is a parasitic nematode with global distribution, estimated to infect over 600 million people. Chronic infection is often asymptomatic, but hyperinfection and dissemination syndromes can occur in the immunosuppressed with high case fatality rates. Whilst strongyloidiasis is endemic in Fiji, its prevalence in Fijian migrant groups in the UK is unknown. Strongyloides stercoralis , the human threadworm, is a parasitic nematode with global distribution, estimated to infect over 600 million people. Chronic infection is often asymptomatic, but hyperinfection and dissemination syndromes can occur in the immunosuppressed with high case fatality rates. Whilst strongyloidiasis is endemic in Fiji, its prevalence in Fijian migrant groups in the UK is unknown. Gap Statement. No previous studies have been conducted on the prevalence of Strongyloides We conducted a cross-sectional study of the prevalence of GIPs in a Fijian migrant population. Aim. We conducted a cross-sectional study of the prevalence of GIPs in a Fijian migrant population. Methodology. Participants completed a questionnaire on residence, travel and clinical symptoms and were asked to provide a serum sample for S. stercoralis IgG ELISA, venous blood samples for eosinophil count and a faecal sample for charcoal culture, multiplex real-time PCR (rtPCR) and microscopy after formalin-ethyl acetate concentration. Sequencing was performed on pooled Strongyloides larvae for nuclear 18S rRNA hyper-variable regions (HVRs) I and IV. Results. A total of 250 participants (94% male) with median (range) age 37 (20-51) years entered the study, 15 (1-24) years since leaving Fiji. S. stercoralis IgG ELISA was positive in 87/248 (35.1 %) and 14/74 (18.9 %) had a GIP detected in faeces. This included 7/74 (9.5 %) with Strongyloides and 5/74 (6.8 %) with hookworms. Dermatological symptoms were more common in those with Strongyloides, and eosinophilia (>0.5×10 9 cells per litre) was present in 55.6% of those with positive S. stercoralis IgG. rtPCR was the most sensitive faecal diagnostic test for Strongyloides and hookworms in faeces. Sequences of nuclear 18S rRNA for HVRs I and IV confirmed the presence of S. stercoralis . Conclusion. This first cross-sectional study in Fijian migrants found a high rate of chronic infection with GIPs, particularly S. stercoralis . Faecal microscopy was insensitive compared to charcoal culture, rtPCR or serology, demonstrating the importance of specialist parasitological tests when investigating people with a suspected chronic infection. Our study highlights an overlooked burden of strongyloidiasis in the UK and has implications for screening and treatment programmes in Fiji and for migrants from Fiji.

Introduction: The international recruitment of healthcare workers remains a UK strategy to manage workforce gaps and maintain service delivery. Although not a new phenomenon, this has been exacerbated by chronic shortages. There is a need to profile the current international recruits and identify individual motivators to understand the opportunities for future recruitment and retention initiatives., Method: A UK-wide electronic survey was conducted using the Jisc platform. The survey was promoted using social media and researcher networks. Eligibility criteria were diagnostic radiographers, internationally educated, and currently working in the UK., Results: 226 responses were received. Most were working in England (90.7%) and 58.0% were under 35 years of age. The majority had migrated having moved to the UK since 2020 (63.7%) and the main drivers were career and/or training opportunities. Initial education was in 30 different countries, the highest number originating from Africa and Asia, with a median of 6 years post-qualification experience (IQR 4-11yrs). Despite experience, most were employed in band 5 (n = 72) or band 6 posts (n = 95). 56% had postgraduate qualifications on entry and a third had undertaken postgraduate study in the UK., Conclusion: Based on the survey responses, the profile of internationally recruited diagnostic radiographers is relatively young but with pre-migration experience originating all over the globe. They are motivated to work in the UK particular for career progression opportunities., Implications for Practice: This study provides an insight into the motivations, demographics and employment patterns of internationally recruited radiographers working in the UK., Competing Interests: Conflict of interest statement None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Rheumatologists practising in the UK National Health Service (NHS) are likely to treat migrant patients from sub-Saharan Africa. This study aimed to conduct a literature review about rheumatoid arthritis prevalence in Africa and understand the experiences of patients with rheumatological conditions, about their past healthcare in sub-Saharan Africa and their transition of care to the United Kingdom (UK). Methods: A systematic search and a pilot study using semi-structured interviews to gain the views of migrants from sub-Saharan Africa with rheumatological conditions was conducted. Results: Thirty-two studies reported on the prevalence of rheumatoid arthritis in Africa. Studies were small and out-of-date, and there was significant heterogeneity in prevalence rates. For the qualitative study, seven participants were recruited. Four themes were highlighted: (i) the physical and emotional impact of rheumatological conditions on participants; (ii) limited rheumatology care in sub-Saharan Africa with high costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians; (iii) barriers to rheumatology care in the UK such as migrants' poor understanding of rheumatological conditions and NHS entitlements; (iv) and ways to improve access to care such as patient, public and general practitioner education. Conclusion: This study has highlighted the paucity of rheumatoid arthritis prevalence data in Africa and described, for the first time, the migrant's perspective of rheumatology care in sub-Saharan Africa and the transition of care to the UK. This description begins to allow healthcare providers in the UK to tailor management for this migrant population. Key Points • Rheumatological conditions are common in Africa, but there is a paucity of epidemiological data regarding the prevalence of specific conditions such as rheumatoid arthritis. • UK clinicians need to be mindful when treating migrants that access to rheumatologists and specialist investigations and treatment is limited in sub-Saharan Africa and that there is often limited public and patient understanding of rheumatological conditions. • Migrants continue to lack understanding of their NHS entitlements and fear data sharing with immigration services which can be a barrier to seeking care. • This study has exposed the lack of understanding about rheumatological conditions by the public and some general practitioners which needs to be addressed with effective education and awareness campaigns. [ABSTRACT FROM AUTHOR]

This paper explores ways in which first generation migrants living in a UK city engage with urban nature. Through understanding mundane connections with local nature (plants, animals and seasons), we attend to two questions 'what can narratives of urban nature tell us about experiences of migration', and inversely 'what can diverse migrant voices tell us about experiences of urban nature'? We draw on interview data with 23 participants, all born overseas, with a diverse mix in terms of age (young adults to older retired people), gender, country of origin and length of time resident in the United Kingdom. The analysis focuses on three areas: multisensory engagements with weather, care for nature and how transnational identities surface through the relational dimensions of nature narratives. We conclude by highlighting the potential of embodied nature engagement to support a sense of wellbeing and transnational identity across the life‐course, with potential to more broadly reflect pluralist understandings of the urban environment. [ABSTRACT FROM AUTHOR]

Background The aim of this review is to explore acceptability, barriers, and facilitators to PrEP use among African migrants in high-income countries.Methods: A systematic review was conducted to explore reasons that contribute to low PrEP uptake in this population. Three online databases, abstracts from key conferences and reference lists of relevant studies articles published between the 2 July 2018 and 3 March 2019 were searched. Narrative synthesis was performed on quantitative data and thematic synthesis was performed on qualitative data.Results: Of 1779 titles retrieved, two cross-sectional studies (United States (US) (n = 1), United Kingdom (UK) (n = 1)) and six qualitative studies (US (n = 2), UK (n = 3), Australia (n = 1)) met inclusion criteria. PrEP acceptability was reported in one cross-sectional article and two qualitative articles. Cross-sectional studies measured acceptability and willingness to use PrEP; in one study, 46% of African migrant men found PrEP use acceptable, and following PrEP education, another study categorised 60% of participants as willing to use PrEP if it were cost-free. Qualitative studies reported mixed acceptability, with higher acceptability reported for serodiscordant couples. Barriers and facilitators to PrEP use were coded into five themes: cultural aspects of stigma; knowledge gap in health literacy; risks unrelated to HIV transmission; practical considerations for PrEP use; and the impact of PrEP use on serodiscordant couples.Conclusions: Several common barriers to PrEP use, including stigma, health literacy and risk perception and cost, were identified. Findings were limited by there being no published data on uptake. Additional work is needed to understand PrEP acceptability and uptake among African migrants. [ABSTRACT FROM AUTHOR]

Background: A higher incidence of psychotic disorders has been consistently reported among black and other minority ethnic groups, particularly in northern Europe. It is unclear whether these rates have changed over time. Methods: We identified all individuals with a first episode psychosis who presented to adult mental health services between 1 May 2010 and 30 April 2012 and who were resident in London boroughs of Lambeth and Southwark. We estimated age-and-gender standardised incidence rates overall and by ethnic group, then compared our findings to those reported in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) study that we carried out in the same catchment area around 10 years earlier. Results: From 9109 clinical records we identified 558 patients with first episode psychosis. Compared with ÆSOP, the overall incidence rates of psychotic disorder in southeast London have increased from 49.4 (95% confidence interval (CI) 43.6–55.3) to 63.1 (95% CI 57.3–69.0) per 100 000 person-years at risk. However, the overall incidence rate ratios (IRR) were reduced in some ethnic groups: for example, IRR (95% CI) for the black Caribbean group reduced from 6.7 (5.4–8.3) to 2.8 (2.1–3.6) and the 'mixed' group from 2.7 (1.8–4.2) to 1.4 (0.9–2.1). In the black African group, there was a negligible difference from 4.1 (3.2–5.3) to 3.5 (2.8–4.5). Conclusions: We found that incidence rates of psychosis have increased over time, and the IRR varied by the ethnic group. Future studies are needed to investigate more changes over time and determinants of change. [ABSTRACT FROM AUTHOR]

This paper examines child refugees in the context of Calais in France, contextualizing them against the politics of the 'Jungle' (a makeshift camp) in policy and media discourses in the UK by delineating three distinct phases in the discursive production of these sites in the enactment of this ambiguous entity. These three phases trace the spatio-temporal emergence of the child refugee in the camps to their arrival in the UK. These camps, as transient and symbolic formations inhabited by the 'dispossessed' of forced global migration, provide a context in which the figure of the child is enacted from its incidental appearance to its visible manifestation to its final configuration as the 'suspect figure' in the UK. Through Derridean 'hauntology' of absent presence, the child refugee captures the conflicted morality of the West. As a disenfranchised entity, the child, forged through the turbulence of the Jungle, can be collapsed through the primal and deprived of his or her status as a child (and, in tandem, protection from harm) in public discourses. The child positioned as a 'suspect figure' becomes a spectral reflection of the beleaguered West, wrestling with the ideational image of the child and its recurrence as a threat to its moral reserve. [ABSTRACT FROM AUTHOR]

• Emphasis both nationally and internationally has switched to case-finding and subsequent linkage to care for hepatitis B and C, in accordance with the World Health Organization call for the elimination of chronic viral hepatitis (CVH) by 2030. • This entails evolving roles for clinicians, who are taking on more of this case-finding role, which has traditionally fallen to UK public health. • We describe the results of our study on an educational intervention (a short film) designed to encourage South Asian migrants to test for CVH. • Culturally relevant interventions including faith and culturally sensitive settings appear to minimize logistical issues and effectively engage minority groups, allowing ease of access to individuals 'at risk', including older members and women. Chronic viral hepatitis (CVH) is a leading contributor to the UK liver disease epidemic, with global migration from high prevalence areas (e.g., South Asia). Despite international guidance for testing high-risk groups in line with elimination targets, there is no consensus on how to achieve this. The objectives of this study were to assess the following: (1) the feasibility of recruiting South Asian migrants to view an educational film on CVH, (2) the effectiveness of the film in promoting testing and increasing knowledge of CVH, and (3) the methodological issues relevant to scale-up to a randomized controlled trial. South Asian migrants were recruited to view the film (intervention) in community venues (primary care, religious, community), with dried blood spot CVH testing offered immediately afterwards. Pre/post-film questionnaires assessed the effectiveness of the intervention. Two hundred and nineteen first-generation migrants ≥18 years of age (53% female) were recruited to view the film at the following sites: religious, n = 112 (51%), community n = 98 (45%), and primary care, n = 9 (4%). One hundred and eighty-four (84%) underwent CVH testing; hepatitis B core antibody or hepatitis C antibody positivity demonstrated exposure in 8.5%. Pre-intervention (n = 173, 79%) and post-intervention (n = 154, 70%) questionnaires were completed. This study demonstrated the feasibility of recruiting first-generation migrants to view a community-based educational film promoting CVH testing in this higher risk group, confirming the value of developing interventions to facilitate the global World Health Organization plan for targeted case finding and elimination, and a future randomized controlled trial. We highlight the importance of culturally relevant interventions including faith and culturally sensitive settings, which appear to minimize logistical issues and effectively engage minority groups, allowing ease of access to individuals 'at risk'. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to examine the challenges faced by migrant Arab Muslim women in accessing maternity services and to suggest ways to improve the childbirth experience for them. Methodology: An interpretive ontological–phenomenological perspective guided by the philosophical tenets of Heidegger was used to examine the childbirth experiences of Arab Muslim women. Results: The sample size was 24 in-depth semistructured audiotaped interviews with eight women in the United Kingdom. The "Vulnerable Woman" was the main theme of our findings, which was discussed in five subthemes: language exclusion, discrimination and prejudice, bureaucracy and "stiff upper lip," conflicting ideology, and the conventional as strange. Conclusions: Maternity care should be culturally competent and emphasize the importance of recognizing differences as well as creating trusting relationships. At the same time, midwives should be aware of the dangers of labeling women because of their cultural and religious beliefs. [ABSTRACT FROM AUTHOR]

With emerging debate regarding the place of migrants in the UK, it is ever more important for schools to promote belonging and wellbeing amongst their diverse pupils. Research has shown the influence of dance interventions on positive psychological and physical wellbeing. The aim of this study was to examine whether dance might influence the wellbeing of migrant pupils, in particular their sense of belonging (SOB), given evidence linking this basic human need to positive educational outcomes. Thirteen female migrant secondary school pupils took part in a dance intervention and qualitative methods were used to explore their experiences. Findings indicated that participation in the dance intervention fostered opportunities for pupils to connect with one another, to feel safe to build confidence and engage meaningfully, all factors that have been linked with SOB. The study gives strength to the use of dance to support the psychological wellbeing of newly arrived migrant pupils. [ABSTRACT FROM AUTHOR]

Background: The UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004, which raises the importance of equity and equality for the recent immigrants. Previous research on ethnic health inequalities focused on established minority ethnic groups, whereas Eastern European migrants are a growing, but relatively under-researched group. We aimed to conduct a systematic scoping review of published literature on Eastern European migrants' use and experiences of UK health services.Methods: An initial search of nine databases produced 5997 relevant publications. Removing duplicates reduced the figure to 2198. Title and abstract screening left 73 publications. Full-text screening narrowed this down further to 10 articles, with three more from these publications to leave 13 included publications. We assessed publications for quality, extracted data and undertook a narrative synthesis.Results: The included publications most commonly studied sexual health and family planning services. For Eastern European migrants in the UK, the most commonly cited barriers to accessing and using healthcare were limited understanding of how the system worked and language difficulties. It was also common for migrants to return to their home country to a healthcare system they were familiar with, free from language barriers. Familial and social networks were valuable for patients with a limited command of English in the absence of suitable and available interpreting and translating services.Conclusions: To address limited understanding of the healthcare system and the English language, the NHS could produce information in all the Eastern European languages about how it operates. Adding nationality to the Electronic Patient Report Form (EPRF) may reveal the demand for interpretation and translation services. Eastern European migrants need to be encouraged to register with GPs to reduce A&E attendance for primary care conditions. Many of the issues raised will be relevant to other European countries since the long-term outcomes from Brexit are likely to influence the level of Eastern European and non-Eastern European migration across the continent, not just the UK. [ABSTRACT FROM AUTHOR]

Background: The incidence of mental illness has risen since the coronavirus disease 2019 (COVID-19) pandemic. The number of healthcare workers (HCWs) needing mental health support has increased significantly. Objective: This secondary analysis of qualitative data explored the coping strategies of migrant HCWs living in the UK during the COVID-19 pandemic. Our aim was to identify the coping strategies used by migrant HCWs, and how they could be explored post-pandemic as support mechanisms of an increasingly diverse workforce. Method: As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers (UK-REACH), we conducted in-depth semi-structured interviews and focus groups with clinical and non-clinical HCWs across the UK, on Microsoft Teams, from December 2020 to July 2021. We conducted a thematic analysis using Braun and Clarke's framework to explore the lived experiences of HCWs born overseas and living in the UK during the COVID-19 pandemic. The key themes that emerged were described using Lazarus and Folkman's transactional model of stress and coping. Results: The emerging themes include stressors (situation triggering stress), appraisal (situation acknowledged as a source of stress), emotion-focused coping (family and social support and religious beliefs), problem-focused coping (engaging in self-care, seeking and receiving professional support), and coping strategy outcomes. The participants described the short-term benefit of the coping strategies as a shift in focus from COVID-19, which reduced their anxiety and stress levels. However, the long-term impact is unknown. Conclusion: We found that some migrant HCWs struggled with their mental health and used various coping strategies during the pandemic. With an increasingly diverse healthcare workforce, it will be beneficial to explore how coping strategies (family and social support networks, religion, self-care, and professional support) could be used in the future and how occupational policies and infrastructure can be adapted to support these communities.

This paper will discuss examples of mental health training developed and co-produced in active partnership with two communities, one in Britain and one in Sri Lanka. This work has taken place in community settings, not within the consulting room. The learning had a bi-directional flow; through these partnerships, both partners/groups shared and developed their understanding of different cultures, idioms of distress, explanatory mental health models and ways of dealing with these. This expanded everyone's knowledge, understanding, and repertoires of practice. The work in Britain was audited through a range of psychometric tests and that in Sri Lanka through questionnaires. Semi-structured interviews also took place with both groups as did meetings with a range of key informants. Working beyond the clinic can benefit people, who have obliquely been labeled, as 'hard to reach' groups and who may find it difficult to access mental health services or who find services inappropriate. Therefore, community groups may be well-positioned to bridge this gap in non-stigmatizing, accessible and culturally appropriate ways. Evidence has begun to emerge suggesting that mental health services developed in conjunction with service users and the wider community may lead to better usage, more appropriate and accessible services, and to an improved sense of inclusivity. The implications of this for the global mental health debate will be briefly considered as will health pluralism and the importance of language and using a mother tongue. [ABSTRACT FROM AUTHOR]

Using vignettes and interviews, this study examined understanding and awareness of autism, and (a)typical development more broadly, among 32 Somali parents living in the United Kingdom. Results demonstrated that parents of both autistic (n = 16) and non-autistic (n = 16) children were just as likely to identify vignettes of typically developing children, yet parents of autistic children appeared more astute to signs of atypical development. Across the whole sample, parents commonly identified and labelled vignettes of autistic children, but experienced more difficulty labelling vignettes that described children with other forms of atypical development, sometimes mislabeling these children as autistic. This suggests that there is a need for greater support in recognising and identifying different types of atypical development in the Somali community (to mitigate the risk that the term 'autism' may take on its own meaning within the Somali community, becoming a euphemism for a range of developmental conditions). Analysis of interview data identified key sociocultural factors that either helped or hindered the inclusion of families with autistic children within the community, including the Somali community's: (1) perceptions of disability, (2) beliefs about the causes of autism in the Western world and (3) strong reliance on religious beliefs in understanding and accepting an autism diagnosis. [ABSTRACT FROM AUTHOR]

Aim: To develop a simple health literacy intervention aimed at supporting informed reproductive choice among members of UK communities practising customary consanguineous marriage. Background: The contribution of 'health literacy' to reducing health inequalities and improving primary health-care efficiency is increasingly recognised. Enhancing genetic literacy has received particular attention recently. Consanguineous marriage is customarily practised among some UK minority ethnic communities and carries some increased risk of recessive genetic disorders among offspring compared with unions among unrelated partners. The need to enhance genetic literacy on this issue has been highlighted, but no national response has ensued. Instead, a range of undocumented local responses are emerging. Important knowledge gaps remain regarding how the development and implementation of culturally appropriate, effective and sustainable responses can be achieved. Methods: Our co-design approach involved active participation by local people. Initial insight generation employed six focus group discussions and 14 individual interviews to describe current understandings and information needs. A total of 11 personas (heuristic narrative portraits of community 'segments') resulted; four participatory workshops provided further understanding of: preferred information channels; feasible information conveyance; and responses to existing materials. Prototype information resources were then developed and feedback gathered via two workshops. Following further refinement, final feedback from health-care professionals and community members ensured accuracy and appropriateness. Findings: The project demonstrated the utility of co-design for addressing an issue often considered complex and sensitive. With careful planning and orchestration, active participation by diverse community members was achieved. Key learning included: the importance of establishing trusting and respectful relationships; responding to diversity within the community; and engendering a creative and enjoyable experience. The resultant materials were heavily shaped by local involvement. Evaluative work is now needed to assess impacts on knowledge and service uptake. Longer term sustainability will depend on whether innovative community-level work is accompanied by broader strategy including investment in services and professional development. [ABSTRACT FROM AUTHOR]

Black women in the UK face significantly higher risks of overweight and obesity and adverse pregnancy outcomes compared to women from other ethnic groups. Maternal nutrition plays a pivotal role in influencing the health outcomes of women and their children, especially during preconception and pregnancy. Cultural and environmental factors significantly influence the dietary experiences of African women after migration. This study explored the unique nutrition-related challenges faced by African migrant pregnant and postnatal women in the UK, and their nutrition support needs. Interviews were conducted with 23 African migrant women living in the UK, who were either pregnant or had a pregnancy within the past 3 years. These were analysed thematically, resulting in five overarching themes: food rituals and beliefs, pregnancy cravings, limited access to culturally appropriate food, limited access to culturally appropriate and evidence-based nutritional guidance, and the focus on healthy weight. The study identified challenges that African migrant women face in balancing their cultural heritage with the UK food environment and dietary recommendations, including potential implications on their health and pregnancy outcomes. It emphasised the importance of addressing these challenges through culturally sensitive approaches and tailored interventions, to enable informed decision making and enhance health outcomes for these women.

Background: Pregnant migrant women held in detention centres in the UK can be particularly vulnerable. They may have poor physical and mental health, which is exacerbated by their incarceration, and are at a disproportionally increased risk of maternal and perinatal mortality. Unpublished studies have found that pregnant migrant women have poor experiences in detention. Aim: To explore pregnant migrant women's experiences of living in detention. Method: Four migrant women who had been held in detention while pregnant and two volunteer health professionals were interviewed. Findings: Results suggest that migrant women have very poor experiences in detention. Four key themes emerged: ‘challenges to accessing UK healthcare’, ‘exacerbation of mental health conditions, ‘feeling hungry’ and ‘lack of privacy’. Conclusion: These findings could be used to review maternity care in detention and ensure that detention staff understand the experiences of detained pregnant women so that the needs of this vulnerable group can be met. [ABSTRACT FROM AUTHOR]

The UK’s Immigration Act 2016 is an assemblage of carceral elements targeting illegal working by migrants and their employers, and regulatory elements designed to enforce labour market regulation. This combination of immigration, criminal and labour law raises questions about how the UK government has framed the issue of labour exploitation. This article adopts a sociolegal approach in order to appreciate how making ‘illegal working’ a crime features in a specific governance project. Situating the Immigration Act 2016 within the context of neo-liberal globalisation, it develops a productive account of migrant illegality to which it adds a conception of liminal legality that emphasises both the agency of actors and the gap between legality and legitimacy. Using official documents, it shows how the Immigration Act 2016 is a response to a specific governance crisis, which is how to maintain the ‘British way’ of light touch labour market regulation in the face of deteriorating outcomes for many workers. [ABSTRACT FROM AUTHOR]

Increasing recognition of autism in Somali migrant communities means that appropriate support services are needed. Attitudes to autism and barriers related to help-seeking in these communities are poorly understood. We aimed to assess what families affected by autism need, and how health, education and social care services can support them. In partnership with the local Somali community the research team conducted 15 in-depth interviews with parents affected by autism. Two themes are reported; 'Perceptions of Autism' and 'Navigating the System'. Our research shows the importance of understanding cultural views of autism and the need to raise awareness, reduce stigma and provide support to encourage families not to delay seeking help for their children. [ABSTRACT FROM AUTHOR]

This paper is focused on a highly topical theme placed at the heart of international debates on regional security, namely the case of refugees in Europe. Approaching this theme is not the result of testing a purely theoretical assumption, but rather a reactive process driven by the need to understand a multitude of perspectives on one single reality. In this context, the author identifies a series of five so-called perspectives on the case of refugees in Europe and dysects each of them in order to detect their common and distinct features. This approach is completed by the clarification of terms used in this area and the theoretical framework on social construction of reality. [ABSTRACT FROM AUTHOR]

Bulgarian migrants and university students in particular have recently fallen into the spotlight of British media, firmly positioned within fervent immigration debates. Drawing on Brewer’s concept of nested identities, this paper explores how Bulgarian university students in the UK manage four different identifications: national, European, migrant and student. Thus, the process of establishing nested identities is investigated on three different contextual levels: the transnational, regional and the everyday (at university and at the workplace). Paying particular attention to the factors that influence the process, this article also scrutinises its implications for Bulgarian students’ values and perceptions. Utilising semi-structured interviews and participant observation with Bulgarian students, this paper will argue that the four identifications emerge as highly dynamic, context-specific and constantly negotiated relationships. Retrospectively, this article aims to contribute not only to current literature on Bulgarian migration but also to wider debates on transnational youth identities. [ABSTRACT FROM AUTHOR]

Rapid increase in the scale, speed and spread of immigration over the past two decades has led to an increase in complexity of populations termed superdiversity. Concerns have been expressed about impacts of the pressure that superdiversity is said to place upon maternity services. High migrant fertility and infant and maternal mortality rates have long been observed in diverse areas with inadequate antenatal monitoring seen as a major causal factor in migrants' maternity outcomes. Using qualitative data from a study of new migrants' access to maternity services in the UK's West Midlands region, with some of the highest infant and maternal mortality rates in Europe, this paper looks at the reasons migrants' access to antenatal care is poor. The paper finds that contrary to earlier studies which pointed to a lack of priority placed on such care by migrants, a combination of structural, legal and institutional barriers prevent migrant women accessing effective antenatal care. [ABSTRACT FROM AUTHOR]

Background Many countries with low prevalence of Hepatitis B Virus (HBV) infection recommend that migrants born in countries with higher prevalence are HBV tested. The cost effectiveness depends on the prevalence of HBV infection in the migrant population. In the UK the National Institute for Health and Care Excellence recommended HBV testing of migrants born in countries with HBV infection prevalence >2%, but the prevalence in migrant populations in the UK is not routinely measured. Objectives To estimate HBV infection prevalence by region of birth in migrant populations in a large UK city. Study Design By retrospective data linkage HBV infection prevalence in migrant women tested in pregnancy was determined by UN region and sub-region of birth. Results Of 5840 migrant women born in regions with HBV infection prevalence >2%, 101 were infected (prevalence 1.7%; 95% CI 1.4–2.1). Sub-regions of birth with low (<2%), intermediate (2–8%) and high (>8%) prevalence in the study population were: low – Northern Africa, Southern Asia, Western Asia, Eastern Europe, South Europe, Central America, Latin America and The Caribbean; intermediate – Eastern Africa, Middle Africa, Western Africa, and South Eastern Asia; high – Eastern Asia. Prevalence in the study populations, was generally lower than published estimates for the region of origin. Conclusion In a large ethnically diverse city in the UK the hepatitis B prevalence in migrant populations for whom HBV screening is recommended is below the estimated cost effectiveness threshold. We recommend more targeted screening based on measured prevalence in migrant populations. [ABSTRACT FROM AUTHOR]

This paper examines how the globalized nature of London's service sector redefines spatial relationships for recent migrants working in the health and hospitality industries. Findings from the qualitative data demonstrate that recent temporary migrants to the UK employ broader strategies to secure employment than accounted for by current theories. The migrants in our case studies overwhelmingly utilized global and local recruitment and employment agencies, as well as sought employment in industries already established as ‘ethnic economies’. We suggest that this might be attributed to a lack of interaction with established co-ethnic immigrant communities; temporary migration trajectories; and living arrangements with co-migrants. We conclude by emphasizing the need to broaden our understanding of ethnic economies and social networks in light of these changing spatial relationships that have emerged through the globalization of the service sector in the UK. [ABSTRACT FROM PUBLISHER]

Abstract: The impact of widowhood on well-being has been well-documented, but to date has not focused extensively on the experience of older migrants who have aged in a foreign land. This study aimed to examine the well-being of older migrant widows from two groups in South Australia: British-born (n=61) and Greek-born (n=60) Australian migrants, who had been widowed, on average, 13years. All participants completed a self-report questionnaire in their preferred language. Three indicators of current well-being (self-rated health, depression and loneliness) as well as variables expected to differ cross-culturally, and potentially influence well-being (mourning rituals; continuing bonds to one's spouse; religiosity; social support) were measured. Greek-born widows displayed higher levels of mourning rituals, continuing bonds and religiosity than the British. Both groups perceived similarly high levels of familial social support. Greek widows also reported worse self-rated health, and increased symptoms of depression and loneliness compared to the British. This paper suggests that the detrimental impact of widowhood on well-being may be greater for non-English speaking migrants who are ageing outside of their country of origin, and who, despite residing in an English-speaking host country for several decades, have retained the linguistic, cultural and religious practices and traditions of their home country. [Copyright &y& Elsevier]

Approximately 8% of UK construction workers are from overseas. Migrant workers face several barriers, including language and communication difficulties, which have obvious implications for the management of health and safety (H&S). This paper examines the effectiveness of pictorial aids for communicating hazards and controls to migrant workers on construction sites. A lexicon of critical H&S terms was developed through content analysis of worker induction guidance. A pictorial inventory of images was developed, tailored to the lexicon. The images were tested for comprehension among 50 migrant workers. A threshold of 85% correct interpretations of each image was set. 23 images failed and were altered before retesting to satisfactory levels. Workers from European countries identified more images correctly than workers of African and Indian origin. Workers with less than 5 years' experience scored lower than more experienced workers. Pictorial aids can communicate simple hazards and controls. Cultural differences may distort comprehension. Images should supplement existing communication methods, not substitute them. [ABSTRACT FROM AUTHOR]

This concluding essay integrates the various contributions of this special volume to conceptualize how South Asian migrant communities, whether in the UK, Bangladesh, or the US, respond to and negotiate multiple experiences of displacement and resettlement. I draw attention to the place of Islam – as religion, institutional context, social connection, and moral community – among young men and women in these multiple sites to highlight the salience of religious networks in the meaning of family, the identification of marriage partners, and the making of a moral compass to guide social and personal life. These networks unfold in a particular historical context where forms of Islamic othering and economic insecurity shape relations of social engagement and belonging among Muslim immigrants youth. [ABSTRACT FROM PUBLISHER]

To investigate the relationship between (i) khat use and (ii) traumatic events, with measures of common psychotic symptoms and symptoms of anxiety and depression. To undertake this work in a Somali population of emigrants who have sought asylum in a non-conflict zone country. Materials & Methods: A secondary analysis of data on a population sample of 180 Somali men and women. Results: Frequency of khat use was not associated with common psychotic symptoms or with symptoms of anxiety and depression, nor with traumatic events in this population. Traumatic events were related to low levels of psychotic symptoms and high levels of symptoms of anxiety and depression. Conclusions: Khat use is not inevitably linked to psychotic symptoms in population samples of Somali men and women. The contrasts between these findings and those from studies in conflict zones and studies of people with mental health problems using khat suggest further investigations are necessary. These should take account environmental and physiological interactions. [Copyright &y& Elsevier]

As part of an initial needs assessment for a community development project to improve access to health and social care services for new migrants, a local epidemiological profile of new migrants was produced for Walsall in the West Midlands. Data were compiled from Office for National Statistics estimates of international migration, National Insurance Number applications from overseas nationals, ‘Flag 4’ GP registrations by new immigrants, United Kingdom Border Agency asylum bulletins, and Citizens Advice Bureau immigration queries. It is estimated that there has been a steady influx of between 800 and 1,400 new migrants per year into Walsall. The majority are young adults from Asia and Eastern Europe, and are living in the southern part of the borough. This information needs to be updated regularly, shared with relevant partners and used to inform commissioning decisions. [ABSTRACT FROM AUTHOR]

This study describes the self‐reported health and well-being status of field and packhouse workers in UK vegetable horticulture, and tests the null hypothesis that there is no difference in the self-reported health of workers on organic and conventional horticultural farms. The majority of those sampled were migrant workers (93%) from Bulgaria, Latvia, Lithuania, Poland, Russia and the Ukraine. More than 95% of the respondents were aged 18-34 and recruited through university agricultural faculties in East European or employed via UK agencies. The health of 605 farm workers (395 males and 210 females) was measured through the use of four standard health instruments. Farm workers'' health was significantly poorer than published national norms for three different health instruments (Short Form 36, EuroQol EQ‐5D and the Visual Analogue Scale). There were no significant differences in the health status of farm workers between conventional and organic farms for any of these three instruments. However, organic farm workers scored higher on a fourth health instrument the Short Depression Happiness Scale (SDHS) indicating that workers on organic farms were happier than their counterparts working on conventional farms. Multiple regression analysis suggested that the difference in the SDHS score for organic and conventional farms is closely related to the range and number of tasks the workers performed each day. These findings suggest that a great deal of improvement in the self-reported health of farmers will need to occur before organic farms meet the requirements of the ‘Principle of Health’ as described by IFOAM. Ensuring that farm workers have a varied range of tasks could be a cost effective means of improving self-reported health status in both organic and conventional farming systems. [Copyright &y& Elsevier]

The modern history of the regulation of entry of non-citizens, the emergence of the nation-state in the nineteenth and twentieth centuries, and the history of public health, are all receiving increasing historical attention. This article explores the micro-politics of the tuberculosis screening debate in Britain between 1950 and 1965. It focuses on a key question. Given the pressure to adopt a policy of compulsory chest X-rays at ports of entry, why did the United Kingdom adopt the port of arrival system in which the major element comprised the forwarding of addresses of arriving migrants to public health doctors in intended districts of residence? The article explores the three main options available to policy-makers--screening before departure; screening on entry and screening after arrival. It also traces legal, economic, political, epidemiological and pragmatic arguments and debates. The article contributes to contemporary discussion about tuberculosis screening and the port of arrival system in the UK, and draws out broader themes to do with nationalism, migration and public health. [ABSTRACT FROM AUTHOR]

There has been little agreement on the role that socioeconomic factors play in the aetiology of cardiovascular diseases (CVDs), obesity, and diabetes among migrants in the United Kingdom (UK). We systematically reviewed the existing evidence on this association to contribute to filling this gap in the literature. Two reviewers were involved at each stage of the review process to ensure validity. We comprehensively searched through several electronic databases and grey literature sources to identify potentially eligible papers for our review. We extracted data from our finally included studies and appraised the methodological rigour of our studies. A narrative synthesis approach was used to synthesise and interpret the extracted data. We sieved through 2485 records identified from our search and finally obtained 10 studies that met our inclusion criteria. The findings of this review show that there is a trend towards an association between socioeconomic factors and CVDs, diabetes, and obesity among migrants in the UK. However, the picture was more complex when specific socioeconomic variables and migrant subgroups were analysed. The evidence for this association is inconclusive and its causal relationship remains speculative. There is, therefore, the need for further research to understand the exact association between socioeconomic factors and CVD, diabetes, and obesity among migrants in the UK.

Context: According to the World Health Organisation 'more people are on the move now than ever before with an estimated 1 billion migrants in the world today and 68 million forcibly displaced people'. GPs are on the frontline of healthcare in the UK and have a responsibility to provide free and equitable access for everyone. Aim: The main aim of our work was to assess GP trainees' current experience, knowledge and attitudes towards caring for refugees, asylum seekers and undocumented migrants. Description: 30 final year GP trainees on the Dorset Vocational Training Scheme (VTS) were asked to participate by completing a questionnaire. Outcomes: The results show that GP trainees lack knowledge regarding migrants health needs, rights to care, including whether there is a duty to disclose an illegal immigrant and what to do if a patient could not provide proof of identification. They lacked experience and confidence in caring for this group of patients, with the biggest perceived challenge being language barriers. Conclusions: Education in primary care needs to respond to meet the challenge of population movement (5), and this project highlighted a need to improve education on migrants' rights to care, local support groups, as well as common health problems. In response, we have reviewed our curriculum and introduced an education session on refugee health for all our GP trainees in Dorset. [ABSTRACT FROM AUTHOR]

Background: Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women's awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible., Method: Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts., Results: Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women., Conclusions: Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.

We aimed to evaluate a screening programme for infection in unaccompanied asylum seeking children and young people against national guidance and to described the rates of identified infection in the cohort. The audit was conducted by retrospective case note review of routinely collected, anonymised patient data from all UASC referred between January 2016 and December 2018 in two paediatric infectious diseases clinics.There were 252 individuals from 19 countries included in the study, of these 88% were male, and the median age was 17 years (range 11-18). Individuals from Afghanistan, Eritrea and Albania constituted the majority of those seen. Median time between arriving in the UK and infection screening was 6 months (IQR 4-10 months, data available on 197 UASC). There were 94% (238/252) of cases tested for tuberculosis (TB), of whom 23% (55/238) were positive, including three young people with TB disease. Of those tested for hepatitis B, 4.8% (10/210) were positive, 0.5% (1/121) were positive for hepatitis C and of 252 tested, none were positive for HIV. Of the 163 individuals who were tested for schistosomiasis, 27 were positive (16%).The majority of patients were appropriately tested for infections with a high rate of identification of treatable asymptomatic infection. Infections were of both individual and public health significance. Our findings of clinically significant rates of treatable infections in UASC highlight the importance of infection screening for all in this vulnerable patient group., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Recent findings indicate that wide international variation in the prevalence of disabling regional musculoskeletal pain among working populations is driven by unidentified factors predisposing to pain at multiple anatomical sites. As a step towards identification of those factors, it would be helpful to know whether the prevalence of multisite pain changes when people migrate between countries with differing rates of symptoms; and if so, whether the change is apparent in first generation migrants, and by what age it becomes manifest.Methods: To address these questions, we analysed data from an earlier interview-based cross-sectional survey, which assessed the prevalence of musculoskeletal pain and risk factors in six groups of workers distinguished by the nature of their work (non-manual or manual) and their country of residence and ethnicity (UK white, UK of Indian subcontinental origin and Indian in India). Prevalence odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression.Results: Among 814 participants (response rate 95.4%), 20.6% reported pain at ≥3 anatomical sites. This outcome was much less frequent in Indian manual workers than among white non-manual workers in the UK (adjusted OR 0.06, 95%CI 0.01-0.36), while rates in Indian non-manual workers were intermediate (OR 0.29, 95%CI 0.12-0.72). However, within the UK, there were only small differences between white non-manual workers and the other occupational groups, including those of Indian sub-continental origin. This applied even when analysis was restricted to participants aged 17 to 34 years, and when second and later generation migrants were excluded.Conclusions: The observed differences in the prevalence of multisite pain seem too large to be explained by healthy worker selection or errors in recall, and there was no indication of bias from differences in understanding of the term, pain. Our findings suggest that whatever drives the higher prevalence of musculoskeletal pain in the UK than India is environmental rather than genetic, affects multiple anatomical sites, begins to act by fairly early in adult life, and has impact soon after people move from India to the UK. [ABSTRACT FROM AUTHOR]

Recent research from the United Kingdom (UK) has highlighted some of the differences in breast cancer presentations between women of different ethnic groups. Analysis of a large database showed that Black women of African or Caribbean heritage living in England and Wales are more likely to present with stage 3 or 4 cancer than White British women and less likely to have their cancer detected through screening. In many countries around the world, migrant and cultural minority groups experience social and economic disadvantage and this is reflected in their health outcomes. With world migration at record levels, it is timely to reflect on ethnic disparities and to consider how developed nations can care for their minority groups, which are increasing in number and diversity. These issues and challenges are discussed, using the UK's migrant population and Australia's Indigenous and migrant populations as case studies., (Copyright © 2017 Elsevier B.V. All rights reserved.)

We report a retrospective cross-sectional study from Western Sydney that assessed the sexual health characteristics of Indian-born patients attending sexual health services compared with Australian-born controls. The sexual health needs of Indian-born patients differed significantly from controls with those born in India reporting more sexual dysfunction and controls having more sexually transmitted infections (STI). These issues should be considered when delivering services to people from culturally and linguistically diverse backgrounds., (© 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.)