Factors of prescribing phage therapy among UK healthcare professionals: Evidence from conjoint experiment and interviews.

With the global challenge of antimicrobial resistance (AMR), interest in the development of antibiotic alternatives has surged worldwide. While phage therapy is not a new phenomenon, technological and socio-economic factors have limited its implementation in the Western world. There is now a resurged effort, especially in the UK, to address these challenges. In this study, we collect survey data on UK general practitioners (n = 131) and other healthcare professionals (n = 103), as well as interviews with medical professionals (n = 4) and a focus group with medical students (n = 6) to explore factors associated with their willingness to prescribe phage therapy to patients. The interviews with medical professionals show support for the expansion of bacteriophage clinical trials and highlight their role as a viable alternative to antibiotics. A conjoint experiment reveals that success rate, side effect rate, and patient attitude to treatment are the decisive factors when it comes to phage therapy prescription; in contrast, the effects of administration route, type of treatment, and severity of infection were not statistically significant. Moreover, we show that general practitioners overall are more likely to recommend phage treatment to patients, compared to other healthcare professionals. The results of the study suggest that phage therapy has a potential to be widely accepted and used by healthcare workers in the UK.

Authoritarianism, perceptions of security threats, and the COVID-19 pandemic: A new perspective.

This article offers a new perspective on when and why individual-level authoritarian perceptions of security threats change. We reexamine claims that authoritarian members of the public responded to the COVID-19 pandemic in a counterintuitive fashion. The response was counterintuitive in that, rather than a desire for a stronger government with the ability to impose measures to address the pandemic and its consequences, authoritarian individuals rejected a stronger government response and embraced individual autonomy. The article draws on perceptions of security threats-issues that directly or indirectly harm personal or collective safety and welfare-from surveys in two different contexts in England: 2012, when perceptions of the threat from infectious disease was low relative to most other security threats, and 2020, when perceptions of the personal and collective threat of COVID-19 superseded all other security threats. We argue that the authoritarian response was not counterintuitive once we account for the type of threat it represented.

Phage therapy and the public: Increasing awareness essential to widespread use.

Today, the antimicrobial resistance (AMR) crisis is shaping a world where previously treatable infections can kill. This has revitalised the development of antibiotic alternatives, such as phage therapy. The therapeutic use of phages, viruses that infect and kill bacteria, was first explored over a century ago. However, most of the Western world abandoned phage therapy in favour of antibiotics. While the technical feasibility of phage therapy has been increasingly investigated in recent years, there has been minimal effort to understand and tackle the social challenges that may hinder its development and implementation. In this study, we assess the UK public's awareness, acceptance, preferences and opinions regarding phage therapy using a survey, fielded on the Prolific online research platform. The survey contained two embedded experiments: a conjoint and framing experiment (N = 787). We demonstrate that acceptance of phage therapy among the lay public is already moderate, with a mean likelihood of acceptance of 4.71 on a scale of 1 (not at all likely to accept phage therapy) to 7 (very likely to accept phage therapy). However, priming participants to think about novel medicines and antibiotic resistance significantly increases their likelihood of using phage therapy. Moreover, the conjoint experiment reveals that success and side effect rate, treatment duration, and where the medicine has been approved for use has a statistically significant effect on participants' treatment preferences. Investigations altering the framing of phage therapy, to highlight positive and negative aspects, reveal a higher acceptance of the treatment when described without using perceived harsh words, such as "kill" and "virus". Combined, this information provides an initial insight into how phage therapy could be developed and introduced in the UK to maximise acceptance rate.

Adoption and continued use of mobile contact tracing technology: multilevel explanations from a three-wave panel survey and linked data.

OBJECTIVE: To identify the key individual-level (demographics, attitudes, mobility) and contextual (COVID-19 case numbers, tiers of mobility restrictions, urban districts) determinants of adopting the NHS COVID-19 contact tracing app and continued use overtime. DESIGN AND SETTING: A three-wave panel survey conducted in England in July 2020 (background survey), November 2020 (first measure of app adoption) and March 2021 (continued use of app and new adopters) linked with official data. PARTICIPANTS: N=2500 adults living in England, representative of England's population in terms of regional distribution, age and gender (2011 census). PRIMARY OUTCOME: Repeated measures of self-reported app usage. ANALYTICAL APPROACH: Multilevel logistic regression linking a range of individual level (from survey) and contextual (from linked data) determinants to app usage. RESULTS: We observe initial app uptake at 41%, 95% CI (0.39% to 0.43%), and a 12% drop-out rate by March 2021, 95% CI (0.10% to 0.14%). We also found that 7% of nonusers as of wave 2 became new adopters by wave 3, 95% CI (0.05% to 0.08%). Initial uptake (or failure to use) of the app associated with social norms, privacy concerns and misinformation about third-party data access, with those living in postal districts with restrictions on mobility less likely to use the app. Perceived lack of transparent evidence of effectiveness was associated with drop-out of use. In addition, those who trusted the government were more likely to adopt in wave 3 as new adopters. CONCLUSIONS: Successful uptake of the contact tracing app should be evaluated within the wider context of the UK Government's response to the crisis. Trust in government is key to adoption of the app in wave 3 while continued use is linked to perceptions of transparent evidence. Providing clear information to address privacy concerns could increase uptake, however, the disparities in continued use among ethnic minority participants needs further investigation.