Background and Objectives: Europe has experienced a major resurgence of measles in recent years, despite the availability and free access to a safe, effective, and affordable vaccination measles, mumps and rubella vaccine (MMR). The main driver for this is suboptimal vaccine coverage. Parental attitudes and beliefs toward measles vaccination are of paramount importance in influencing vaccine coverage. The three objectives of this study are to synthesize and critically assess parental attitudes and beliefs toward MMR uptake, to develop strategies and policy recommendations to effectively improve MMR vaccine uptake accordingly, and ultimately to identify areas for further research. Methods: A systematic review was conducted using primary studies from PubMed, Medline, Embase, and Scopus published between 2011 and April 2019. Inclusion criteria comprised primary studies in English conducted in Europe and studying parental attitudes and behavior regarding MMR uptake. Data were extracted using an inductive grounded theory approach. Results: In all, 20 high-quality studies were identified. Vaccine hesitancy or refusal were mainly due to concerns about vaccine safety, effectiveness, perception of measles risk and burden, mistrust in experts, and accessibility. Factors for MMR uptake included a sense of responsibility toward child and community health, peer judgement, trust in experts and vaccine, and measles severity. Anthroposophical and Gypsy, Roma, and Traveler populations presented unique barriers such as accessibility. Conclusion: A multi-interventional, evidence-based approach is vital to improve confidence, competence, and convenience of measles vaccination uptake. Healthcare professionals need an understanding of individual contextual attitudes and barriers to MMR uptake to tailor effective communication. Effective surveillance is needed to identify under-vaccinated populations for vaccination outreach programs to improve accessibility and uptake.

Purpose -The purpose of this paper is to examine the careers of skilled migrants from Indian Punjab. This study complicates the normalization of skilled migration as a "win-win" situation by examining the career trajectories of skilled migrants from the Indian Punjab who are trying to establish themselves in Britain. Design/methodology/approach -The paper examines 20 life history interviews undertaken with skilled migrants from the Indian Punjab to Britain, in IT, media, law and hospitality industries, health and welfare professionals, and student migrants. Findings -Skilled migrants were able to migrate on their own auspices through migration economies in Punjab. Once in Britain, however, they were directed to universities and labour markets in which they were not able to use their skills. They experienced under-employment, devaluation of their qualifications and downward mobility, which forced them into ethnic and gendered markets within their home networks and created ambivalence about migrant success and issues of return.Research limitations/implications -The study emphasizes the need to take a transnational lens when looking at skilled migration, address how migrants' career trajectories are limited by racism, anti-immigration sentiment and gender inequality, and consider temporality and uncertainty. Originality/value -The paper raises questions concerning the ways in which rapidly changing "managed migration" policies in Britain have burdened individual migrants.

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms 1 Marital instability among British Pakistanis: transnationality, conjugalities and Islam AbstractThis article offers insights into the dynamics underlying an increase in marital instability in British Pakistani families, thus challenging stereotypes of British South Asian populations as representing 'old fashioned' families, with their lower rates of divorce in contrast with the wider British population. In addition to problems of compatibility, domestic violence and infidelity, we explore dynamics that may be more specific to the British Pakistani population, namely the transnational nature of many marriages, attitudes to parental involvement in arranging marriages, and the place of Islam. We suggest that, while arranged marriages were conventionally seen as safer than love marriages, both young people and their parents may now be viewing arranged marriages as riskier. In an arranged marriage that brings family approval but not personal fulfilment, young people are increasingly supported to divorce and remarry, with a greater degree of personal say in spouse selection.

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In England, health inequalities policy shifted during the Labour term (1997-2010) from initially strong commitments to tackling the 'upstream' social determinants of health to a technically-driven emphasis on lifestyle risk factors and healthcare access. This multi-sited study, based in and around Westminster (2006-2007), extends our understanding of how political context influences policy-making by drawing from anthropological studies of policy. Qualitative material from central government is put into conversation with theory concerning policy as zones of practices. The paper explores the bristly process through which public health, healthcare and corporate interests vied to shape the political agenda for health inequalities; the selective use of evidence by civil servants in accordance with their perceptions of what politicians conceive to be electorally palatable; the silencing of critique of the dominant narrative about evidence-based policy; and how technical aids developed a life of their own - as a result of which, health inequalities policy ended up being depoliticised.