This article synthesises evidence on the experiences of immigrants in the United Kingdom who are engaged in precarious employment and explores the effects of precarious employment on their health and wellbeing. This study reveals that migrants in precarious employment often experience negative health outcomes including injury, anxiety and depression. Stress response theories and risk factors associated with occupational injury help explain how employment specific factors influence health. The study shows that immigrant-related factors like pre-migration experience and concerns around social exclusion mediate precarious employment’s effect on health.

Background Migration and precarious employment are social determinants associated with adverse health outcomes. In the United Kingdom, migration policy and labour market characteristics mean that migrants are often engaged in precarious work. We synthesise evidence on the experiences of migrants and explore the effects of precarious employment on their health and wellbeing. Methods Electronic databases were searched for peer-reviewed qualitative studies describing the experiences of United Kingdom migrants in precarious employment. Title and abstracts were screened, followed by full text screening using pre-specified inclusion and exclusion criteria. Data on employment experiences and effects of working conditions on physical and mental health and perceived wellbeing were extracted. The Centre for Reviews and Dissemination (2009) framework was used to conduct a narrative synthesis. Results Out of 1577 unique citations, 5 met our inclusion criteria. All included studies reported negative outcomes on physical and mental health. 2 reported positive or negative outcomes for perceived wellbeing depending on pre-migration experience. Musculoskeletal pain, exhaustion, anxiety and depression were commonly reported effects of precarious employment. Communication difficulties and over qualification were identified as migrant specific factors influencing health outcomes. Conclusions Stress response theories and risk factors associated with occupational injury explain how employment specific factors influence health. Extrinsic factors such as immigration policies, pre-migration experience, responsibilities in home country and acculturation mediate precarious employment effect on health. Key messages Migrants feel isolated in precarious employment and are vulnerable to negative mental and physical health impacts. Broader migration related policies impact on experiences of employment and health.

Patients with end-stage renal disease have limited options in the course of their management. Kidney transplantation (KT) remains the gold standard for the management of renal replacement therapy. There is increasing evidence supporting the viability of third and fourth KTs. Due to the complexities of carrying out a successful third KT and the scarcity of living organ donors, it is not a common procedure in Nigeria's few renal transplant centres. To date, there is no reported case of a successful third KT in Nigeria. Here, we present the first reported case of a third KT carried out in Nigeria on a 44-year-old hypertensive, hepatitis B-infected, non-diabetic male patient. He had the first living donor KT eight years ago, which he lost due to poor immunosuppressive medication adherence. He then had a second living donor, KT, four years ago. Both KTs were from altruistic donors and were performed in the same hospital outside Nigeria. He developed allograft nephropathy after receiving the AstraZeneca COVID-19 vaccine 16 months ago and lost the second graft as a result. He was worked up and transplanted at our centre. Third kidney transplantation can be performed successfully despite the challenges of human leukocyte antigen (HLA) sensitization, antibiotic resistance, and surgical placement of the graft.

Background: Haemodialysis is a live-saving process for patients with chronic kidney disease (CKD) that has saved millions of lives. Main problem: Like other interventional therapies, different complications are associated with it. We evaluated the prevalence, pattern and risk factors for post-dialysis complications in a centre in Nigeria, sub-Saharan Africa.Methods: A prospective cross-sectional descriptive study was conducted from 1st November to 31st December, 2021 at the dialysis unit of Zenith Medical and Kidney Centre, Abuja, Nigeria. Every dialysis session done in patients that are conscious was included in the study. Post-dialysis complications were assessed and data were entered into and analysed with SPSS.Results: One hundred and eighty-six patients had 1380 sessions of dialysis in the period. The male-female ratio was 2.6:1 and the mean age was 49.71±15.08 years. Hypertension, diabetes, and glomerulonephritis was CKD aetiology for about 75% of the patients. The most prevalent complications were headache (5.9%) and weakness (4.1%), these were closely followed by body pain (3.8%), and hypertensive crisis (3.6%). Sessions carried out with HD machine and with neckline had significantly more complications. Overweight and HD machine sessions were risk factors for at least one post-dialysis complications (OR= 1.594, CI= 1.029 – 2.470, and OR= 2.234, CI= 1.595 – 3.129 respectively).Conclusion: While some of these complications are serious, most are mild and do not require interventions. It is important for health care professionals in dialysis units to pay attention to patients that are overweight and those that dialyze using the HD machines because of increased risk.