ORCID Profile
0000-0003-0487-4701
Current Organisation
University of Nottingham
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Publisher: MDPI AG
Date: 15-04-2021
Abstract: We aimed to explore university students’ perceptions and experiences of SARS-CoV-2 mass asymptomatic testing, social distancing and self-isolation, during the COVID-19 pandemic. This qualitative study comprised of four rapid online focus groups conducted at a higher education institution in England, during high alert (tier 2) national COVID-19 restrictions. Participants were purposively s led university students (n = 25) representing a range of gender, age, living circumstances (on/off c us), and SARS-CoV-2 testing/self-isolation experiences. Data were analysed using an inductive thematic approach. Six themes with 16 sub-themes emerged from the analysis of the qualitative data: ‘Term-time Experiences’, ‘Risk Perception and Worry’, ‘Engagement in Protective Behaviours’, ‘Openness to Testing’, ‘Barriers to Testing’ and ‘General Wellbeing’. Students described feeling safe on c us, believed most of their peers are adherent to protective behaviours and were positive towards asymptomatic testing in university settings. University communications about COVID-19 testing and social behaviours need to be timely and presented in a more inclusive way to reach groups of students who currently feel marginalised. Barriers to engagement with SARS-CoV-2 testing, social distancing and self-isolation were primarily associated with fear of the mental health impacts of self-isolation, including worry about how they will cope, high anxiety, low mood, guilt relating to impact on others and loneliness. Loneliness in students could be mitigated through increased intra-university communications and a focus on establishment of low COVID-risk social activities to help students build and enhance their social support networks. These findings are particularly pertinent in the context of mass asymptomatic testing programmes being implemented in educational settings and high numbers of students being required to self-isolate. Universities need to determine the support needs of students during self-isolation and prepare for the long-term impacts of the pandemic on student mental health and welfare support services.
Publisher: Oxford University Press (OUP)
Date: 09-2008
Publisher: Public Library of Science (PLoS)
Date: 16-02-2012
Publisher: Elsevier BV
Date: 02-2023
Publisher: Cold Spring Harbor Laboratory
Date: 31-07-2021
DOI: 10.1101/2021.07.29.21261196
Abstract: The impact of changing social restrictions on the mental health of students during the COVID-19 pandemic warrants exploration. To prospectively examine changes to university students’ mental health during the pandemic. Students completed repeated online surveys at three time points (October 2020 (baseline), February 2021, March 2021) to explore relationships between demographic and psychological factors (loneliness and positive mood) and mental health outcomes (depression, anxiety, and stress). A total of 893 students participated. Depression and anxiety levels were higher at all timepoints than pre-pandemic normative data ( p .001). Scores on all mental health measures were highest in February, with depression and anxiety remaining significantly higher in March than baseline. Female students and those with previous mental health disorders were at greatest risk of poor mental health outcomes. Lower positive mood and greater loneliness at baseline were associated with greater depression and anxiety at follow-ups. Baseline positive mood predicted improvement of depression and anxiety at follow-ups. Depression and anxiety were significantly higher than pre-pandemic norms, with female students and those with previous mental health difficulties being at greatest risk. Given these elevated rates, universities should ensure adequate support is available to meet potentially increased demand for services.
Publisher: Oxford University Press (OUP)
Date: 12-2006
Publisher: Elsevier BV
Date: 06-2023
Publisher: Oxford University Press (OUP)
Date: 21-08-2005
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.EPIDEM.2014.07.004
Abstract: The sociological and biological factors which gave rise to the three pandemic waves of Spanish influenza in England during 1918-19 are still poorly understood. Symptom reporting data available for a limited set of locations in England indicates that reinfection in multiple waves occurred, suggesting a role for loss of infection-acquired immunity. Here we explore the role that changes in host immunity, driven by a combination of within-host factors and viral evolution, may play in explaining weekly mortality data and wave-by-wave symptomatic attack-rates available for a subset of English cities. Our results indicate that changes in the phenotype of the pandemic virus are likely required to explain the closely spaced waves of infection, but distinguishing between the detailed contributions of viral evolution and changing adaptive immune responses to transmission rates is difficult given the dearth of sero-epidemiological and virological data available even for more contemporary pandemics. We find that a dynamical model in which pre-pandemic protection in older "influenza-experienced" cohorts is lost rapidly prior to the second wave provides the best fit to the mortality and symptom reporting data. Best fitting parameter estimates for such a model indicate that post-infection protection lasted of order months, while other statistical analyses indicate that population-age was inversely correlated with overall mortality during the herald wave. Our results suggest that severe secondary waves of pandemic influenza may be triggered by viral escape from pre-pandemic immunity, and thus that understanding the role of heterosubtypic or cross-protective immune responses to pandemic influenza may be key to controlling the severity of future influenza pandemics.
Publisher: Oxford University Press (OUP)
Date: 02-2009
Publisher: The Royal Society
Date: 08-2021
DOI: 10.1098/RSOS.210310
Abstract: In this paper, we present work on SARS-CoV-2 transmission in UK higher education settings using multiple approaches to assess the extent of university outbreaks, how much those outbreaks may have led to spillover in the community, and the expected effects of control measures. Firstly, we found that the distribution of outbreaks in universities in late 2020 was consistent with the expected importation of infection from arriving students. Considering outbreaks at one university, larger halls of residence posed higher risks for transmission. The dynamics of transmission from university outbreaks to wider communities is complex, and while sometimes spillover does occur, occasionally even large outbreaks do not give any detectable signal of spillover to the local population. Secondly, we explored proposed control measures for reopening and keeping open universities. We found the proposal of staggering the return of students to university residence is of limited value in terms of reducing transmission. We show that student adherence to testing and self-isolation is likely to be much more important for reducing transmission during term time. Finally, we explored strategies for testing students in the context of a more transmissible variant and found that frequent testing would be necessary to prevent a major outbreak.
Publisher: Cold Spring Harbor Laboratory
Date: 02-07-2022
DOI: 10.1101/2022.07.01.22277134
Abstract: During the SARS-CoV2 pandemic, epidemic models have been central to policy-making. Public health responses have been shaped by model-based projections and inferences, especially related to the impact of various non-pharmaceutical interventions. Accompanying this has been increased scrutiny over model performance, model assumptions, and the way that uncertainty is incorporated and presented. Here we consider a population-level model, focusing on how distributions representing host infectiousness and the infection-to-death times are modelled, and particularly on the impact of inferred epidemic characteristics if these distributions are misspecified. We introduce an SIR -type model with the infected population structured by ‘infected age’, i.e. the number of days since first being infected, a formulation that enables distributions to be incorporated that are consistent with clinical data. We show that inference based on simpler models without infected age, which implicitly misspecify these distributions, leads to substantial errors in inferred quantities relevant to policy-making, such as the reproduction number and the impact of interventions. We consider uncertainty quantification via a Bayesian approach, implementing this for both synthetic and real data focusing on UK data in the period 15 Feb–14 Jul 2020, and emphasising circumstances where it is misleading to neglect uncertainty.
Publisher: WHO Press
Date: 04-2012
Publisher: Oxford University Press (OUP)
Date: 11-08-2003
Publisher: Oxford University Press (OUP)
Date: 11-2002
Publisher: Public Library of Science (PLoS)
Date: 20-12-2013
Publisher: Public Library of Science (PLoS)
Date: 26-03-2015
Publisher: SAGE Publications
Date: 15-05-2022
DOI: 10.1177/17579139221094750
Abstract: Development and rollout of vaccines offers the best opportunity for population protection against the SARS-CoV-2 (COVID-19) virus. However, hesitancy towards the vaccines might impede successful uptake in the United Kingdom, particularly in young adults who demonstrate the highest rates of hesitancy. This prospective study explored COVID-19 vaccine hesitancy in young adults and whether the reasons behind these attitudes changed during the initial stages of the United Kingdom’s vaccine rollout. Data on vaccination intention were collected from a British university student cohort at three time points: October 2020, February 2021, and March 2021. This online survey included items on intention to receive a vaccine and a free-text response for the reasons behind this intention. Cochran’s Q tests examined changes in rates of hesitancy and acceptance over time and free-text responses were analysed thematically. At baseline, 893 students provided data, with 476 participants completing all three time points. Hesitancy declined over time, with 29.4% of participants expressing hesitancy at baseline, reducing to 9.1% at wave 2 and 5.9% at wave 3. The most commonly endorsed themes for those willing to accept a vaccine were self-protection against COVID-19 and pro-social reasons, including protecting the population or unspecific others, and ending the pandemic/returning to normal life. The most commonly endorsed hesitancy themes related to ‘confidence’ in the vaccines and potential personal risk, including insufficient testing/scientific evidence, concern about side effects, and long-term effects. These reasons remained the most commonly endorsed at both waves 2 and 3. While a decline in hesitancy was observed over time, the key reasons behind both vaccine acceptance and hesitancy remained consistent. Reasons behind hesitancy aligned with those of the general public, providing support for the use of generalist interventions. Pro-social reasons frequently underpinned vaccine acceptance, so cohort-specific interventions targeting those factors may be of benefit.
Publisher: Cold Spring Harbor Laboratory
Date: 22-12-2020
DOI: 10.1101/2020.12.21.20248467
Abstract: This study examined the COVID-19 risk perceptions and mental health of university students on returning to c us in the midst of the COVID-19 pandemic. An online survey was completed during the first four weeks of the academic year (October 2020) by 897 university students. The survey included demographics and measures of experiences of COVID-19 testing, self-isolation, shielding, perceived risk, mental health and indices capturing related psychological responses to the pandemic. We observed higher levels of depression and anxiety, but not stress, in students compared with pre- pandemic normative data, but lower than levels reported earlier in the pandemic in other similar cohorts. Depression, anxiety and stress were independently associated with greater loneliness and reduced positive mood. Greater worry about COVID-19 was also independently associated with anxiety and stress. Female students and those with pre-existing mental health disorders were at greatest risk of poor mental health outcomes. Although students perceived themselves at only moderate risk of COVID-19, the prevalence of depression and anxiety among university students should remain a concern. Universities should provide adequate support for students’ mental health during term-time. Interventions to reduced loneliness and worry, and improve mood, may benefit students’ overall mental well-being.
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2020
End Date: 2020
Funder: Medical Research Council
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