原始态度与人们在食用未经煮熟、部分煮熟和发酵的淡水鱼菜肴方面的食物文化、饮食习惯和行为相关，这将使人们面临乌汉绦虫和其他寄生虫感染的风险。本章回顾了大湄公河地区内以及泰国东北部、老挝人民民主共和国、越南和柬埔寨之间的国界之间的原始态度，而不是将每个国家视为单独的流行病学隔离盒。本章研究了与该地区景观的多个人为转变和对生态系统和生命周期的发展影响相关的跨境复杂性。经济项目如多个水电站、灌溉计划、引水工程、道路和养殖池塘对该自由贸易区生命周期动态产生了重大影响。此外，许多生态变化也是跨国界的，还存在与人口流动、改变的农业景观和大量外来工相关的额外复杂性。本章还研究了公共卫生计划和教育干预，这些干预逐渐改变了人们对乌汉绦虫和胆管癌的认识。一个关键论点是在多管齐下的卫生干预措施，如“CASCAP模型”之外，还需要跨学科的科学和社会科学策略。对于广泛的人为干预对生命周期、生活方式、生计和人类行为的影响，存在许多未知和缺口，需要跨社会经济、生态、地理和公共卫生动态的疾病研究项目。© 2023. 作者及独家授权给Springer Nature Switzerland AG。

Raw attitudes relate to the food cultures, eating habits, and behaviours of people in relation to the consumption of raw, partially cooked, and fermented freshwater fish dishes, which puts people at risk of Ophistochis viverrini and other parasitic infections. The chapter reviews raw attitudes within the countries and across the borders of the greater Mekong region, particularly northeast Thailand, Lao PDR, Vietnam, and Cambodia. Rather than treat each nation-state as an isolated epidemiological box, the chapter explores transborder complexity in relation to multiple anthropogenic transformations to the landscapes of the region and developmental impacts upon ecosystems and life cycles. Economic projects such as multiple hydropower dams, irrigation schemes, water-diversions, roads, and aquaculture ponds have significant impacts on FTZ life-cycle dynamics. In addition, many ecological changes are transboundary ones, and there are added complications relating human mobility, altered agrarian landscapes, and significant numbers of migrant workers. The chapter also examines public health programmes and educational interventions which are altering perceptions of O. viverrini and cholangiocarcinoma over time. A key argument is the need for transdisciplinary scientific and social science strategies alongside multi-pronged health interventions, such as 'the CASCAP model'. There exist many unknowns and gaps relating to widespread anthropogenic modifications upon life cycles, upon lifestyles, livelihoods, and human behaviours, which require research projects that span socio-economic, ecological, geographical, and public health dynamics of disease.© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.