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Patient work refers to the quotidian labour undertaken by individuals to manage health, often unrecognised by health systems. This article argues that anticipated and received stigma and inclusivity labour comprise additional forms of patient work specific to minority populations. We draw on a case study of gay and bisexual men's experiences accessing healthcare services related to HIV prevention and testing in New South Wales (NSW), Australia's most populous state. Although new HIV diagnoses have reduced in NSW, these declines have not been uniformly observed. This study aimed to understand experiences of stigma related to accessing healthcare amongst two priority populations identified in the state's HIV strategy: gay and bisexual men who are young or who are living in regional and outer metropolitan suburbs. We interviewed 32 participants in 2023, recruited via social media advertisements and email invitations, and analysed data thematically. Our findings emphasise how disclosure of sexual orientation and/or HIV status operates as a form of inclusivity labour, in which patients look for cues from health providers that disclosure will be safe and respected. Other forms of patient work required to navigate access to HIV prevention services included finding appropriate providers likely to prescribe HIV pre-exposure prophylaxis (PrEP) and managing service refusal from general practitioners. Patient work appeared to also be compounded by intersecting issues of anticipated and vicarious stigma, unavailability of sexual health services in regional areas, long waiting times, and increased costs of healthcare services. Although experiences of enacted stigma in healthcare were infrequently reported, interview accounts suggested that participants undertook extensive patient work to minimise or avoid stigmatising encounters with health providers. Focusing on patient work in the context of stigma illuminates the labour of underserved populations required to access safe and culturally competent healthcare services (including HIV prevention and testing), suggesting areas of unmet need from health systems., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest. PK has received consultancy fees from Gilead Sciences., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West., Methods: A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries., Results: Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population., Conclusions: This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations.

Aims: This paper reviewed the literature on diabetes prevalence and risk factors associated with diabetes among first-generation Chinese international migrants., Methods: MEDLINE, Scopus, Web of Science, CINAHL and Maternity and Infant Care were searched until March 2022, for articles written in English. The quality of the included articles was assessed using the Newcastle-Ottawa Scale., Results: In total, 17 articles were included (nine for gestational diabetes, six for type 2 diabetes, and none for type 1 diabetes). The average crude prevalence rate for type 2 diabetes and gestational diabetes was 12.1% and 9.3% respectively. Risk factors contributing to the occurrence of type 2 diabetes included older age, sex, family history of type 2 diabetes, higher BMI/waist circumference, longer time since migration, alcohol consumption, smoker, hypertension, and high triglycerides. Risk factors contributing to the occurrence of gestational diabetes included older maternal age, history of gestational diabetes, higher weight/pre-pregnancy BMI, longer time since migration, and Chinese ethnicity., Conclusions: We identified a research gap in the diabetes health of Chinese migrants, particularly for type 1 diabetes, highlighting the need for ethnic-specific diabetes research and care, including for subsequent generations of migrants and those living in developing countries., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: Chemsex refers to using illicit substances to facilitate sexual experiences in men who have sex with men. Chemsex has been linked to significant negative impacts on psychological, social, and physical wellbeing. Little is known about information-seeking behaviours in this population. This study aims to provide an in-depth understanding of seeking and engaging with health information., Methods: Self-identified Australian sexual minority men who engage in chemsex (N = 184) participated in an anonymous cross-sectional survey. Variables included chemsex engagement, knowledge, perception and use of harm-reduction information, and associated health and support services. Pearson correlation and ANOVAs were conducted. Wilcoxon-Signed-Rank and Friedman tests were applied to analyse the perceived trustworthiness of information sources., Results: Chemsex represented a meaningful part of sexual events. Most participants knew where to access professional help and harm-reduction information but worried about being judged. Most did not feel comfortable discussing chemsex with health professionals except with sexual health doctors/counsellors. Few users discussed health risks with a professional. Information on chemsex was received through multiple sources with significant differences in perceived relevance and trustworthiness, with sexual health doctors/nurses ranked the most trustworthy information. Interest in non-traditional sources of information was low except for formal peer networks and anonymous personal expert advice., Conclusion: Engagement with health professionals and harm-reduction information is limited in this population, despite high risk and potentially significant adverse health outcomes. Results suggest that new and combined approaches are necessary to reach this population, including peer support networks, anonymous personal advice and changing community attitudes towards chemsex., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Objectives: The literature suggests that sexual minority young people (SMYP) use alcohol at disproportionate levels when compared with their heterosexual counterparts. Little is known about alcohol dependency symptoms and correlations between high-risk alcohol use/dependency symptoms and minority stress in this population in general and between subgroups., Study Design: Cross-sectional study., Methods: Descriptive statistics, adjusted odds ratios, and analysis of covariance were used to determine high-risk alcohol use, dependency symptoms, differences between subgroups, and correlations between alcohol use, dependency symptoms, and minority stress., Results: A total of 1556 Australian SMYPs aged 18 to 35 years completed the survey. Fifty percent of the participants reported high-risk alcohol consumption with significant differences between subgroups. Typical dependency symptoms such as 'health, social, legal or financial problems due to alcohol consumption' (16.8%, n = 247) were identified in large parts of the sample. High-risk consumption and dependency symptoms were significantly correlated with minority stress., Conclusion: High levels of high-risk alcohol use and dependency symptoms were found, largely consistent with existing literature. However, disparities are not distributed equally in this population, suggesting that future health promotion interventions should focus on SMYP subgroups. Significant correlations between minority stress and dependency symptoms/high-risk use suggest a potential route for future interventions in these populations., (Copyright © 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Social media platforms are useful for creating communities, which can then be utilised as a mean for supportive, professional and social learning., Objective: To explore first year nursing student experiences with social media in supporting student transition and engagement into higher education., Design: Qualitative focus groups., Methods: Ten 1st year Bachelor of Nursing students were included in three face-to-face focus groups. Data were analysed using qualitative thematic content analysis., Results: Three key themes emerged that illustrates the experiences of transition and engagement of first year student nurses using social media at university. (1) Facilitating familiarity and collaboration at a safe distance, (2) promoting independent learning by facilitating access to resources, and (3) mitigating hazards of social media., Conclusion: This study has demonstrated the importance of social media in supporting informal peer-peer learning and support, augmenting online and offline relationships, and building professional identity as a nurse.

Objective: Cognitive impairments are prevalent in heart failure (HF) patients, worsening outcomes but often undetected.The aim of this study was to screen HF outpatients for mild cognitive impairment (MCI), determine the areas of cognition affected, patient awareness of cognitive change, and associated factors., Method and Results: HF patients (n = 128) newly registered for the Management of Cardiac Function program, free from neurocognitive disorder, and with sufficient visual acuity were assessed with the use of the Montreal Cognitive Assessment tool (MoCA). MCI was classified as MoCA score ≤22. The sample was elderly (mean, 80.65 years; SD, 11.52). Mean MoCA score was 24.58 (SD 3.45), 22% were classified as impaired, 45% had noticed a change in cognition, and 15% reported that they were affected in their daily lives. Patients noticing this impact had lower MoCA scores (22.74, SD 3.0) than those who did not (25.17, SD 2.96; P ≤ .02). Most impairments occurred for delayed recall, visuospatial/executive function, and abstraction. The odds of impairment increased by the presence of ischemic heart disease (odds ratio, 4.18; 95% confidence interval, 1.15-15.69)., Conclusions: In HF outpatients without a dementia diagnosis, MCI is prevalent. Screening for MCI and incorporation of compensatory strategies are essential., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: Anxiolytics are the most frequently prescribed psychotropic drugs in France. General practitioners (GPs) tend to prescribe anxiolytics and other benzodiazepines to patients with major depressive disorders (MDD). However, the extent to and reasons for which they prescribe these medications together are not well documented. This article assesses how often and why GPs coprescribe an anxiolytic when starting patients on antidepressant (AD) treatment, and which patient- and GP-related factors are associated with this coprescription., Methods: We used a survey of 131 GPs practising in southeastern France and of patients seen consecutively during June to October 2004 to whom they prescribed an AD. Data were collected from GPs (consultation-questionnaires focusing on their prescription, diagnosis, and symptom detection) and patients (self-administered questionnaires, including the Hospital Anxiety and Depression scale, and social and demographic characteristics). Factors associated with anxiolytic coprescription were analyzed with a multilevel logistic regression., Results: GPs completed 438 consultation-questionnaires for patients; 258 patients (58.9%) returned their questionnaires. Sixty percent of the patients received anxiolytics with ADs. Anxiolytics were prescribed more frequently by male GPs who reported feeling ill at ease treating MDD, or detected suicidal ideation or anxiety in their patients, and finally to patients with stable jobs., Conclusions: Although some practice guidelines and authors acknowledge that there might be some justification for coprescribing anxiolytics with ADs at the beginning of MDD treatment in specific situations, the high percentage of coprescriptions for anxiolytics observed in our study suggests that training and knowledge of GPs about MDD treatment are not optimal.

Background: This paper is aimed at investigating the extents to which illness modifies labour supply and employment conditions of people with chronic diseases (defined as severe diseases giving rise to 100% coverage of health expenditures by the Sickness Fund)., Methods: It is based on the data of 35073 individuals interviewed in the 2002-2003 French Decennial Health Survey, reporting their health, health care consumption and socioeconomic characteristics, and collected by the French National Institute of Statistics and Economic Studies. Models have been estimated with logistic strategies., Results: Participation in labour market appears, all other things being equal, to be less important for people with chronic diseases. Chronic diseases are more deleterious for blue collar than for white collars workers. The probability to have a part-time job is raised by 60% for people with chronic diseases (100% for men, 50% for women). Suffering from chronic diseases raises the probability to have a desired part-time job rather than a full-time job by 80% (170% for men, 60% for women) and the probability to have an undesired part-time job rather than a full-time job by 50% (30% for men, 50% for women). For the elderly (50-65 years), chronic diseases multiply by three the probability to be out-of-work (and not retired), by two the probability to be retired and by 1.5 the probability to be unemployed compared to being employed., Conclusion: The consequences of chronic diseases on the workplace are not negligible, creating new social inequalities that the French social protection system does not seem to be able to completely cover.

The study is based on a rare database with information about health status, socioeconomic characteristics and the complementary health insurance choices of the French population. We intend to characterise a two-stage decision process: first, the decision to purchase complementary health insurance, and then the factors related to choice of policy quality. Our econometric study indicates that (i) income level has a strong and significant effect on the decision to purchase complementary insurance, whilst there is no evidence that health risk considerations affect this decision at all; (ii) the individual decision about quality is associated barely if at all with any rational explanatory variables. The population's concrete behaviour, revealed by the study, is consistent with an allocation of low-risk people to private insurance and high-risk people to public insurance. Complementary insurance is not especially relevant to patients with serious diseases, who depend much more on the public system. If the public insurance system were to disengage significantly from coverage of serious illness, a vacuum would be created that would leave people at high risk without full coverage. These results have broad implications for numerous national systems of social protection seeking a new mix between private and public insurance.

We investigate the relationship between employability and obesity, particularly how obesity and overweight are associated with the percentage of working years spent unemployed and the ability to regain employment. Data for adults who responded to the 2003 Decennial Health Survey collected by the French National Institute of Statistics and Economic Studies revealed that the percentage of time spent unemployed during working years is significantly higher for each kg/m2 deviation from the mean body mass index (BMI) attained at age 20 and that the probability of regaining employment after a period of unemployment is much lower.

Advances in technology have enabled the implantation of defibrillators in the pectoral region. Complications encountered with pacemakers may also be observed with defibrillators. We describe two cases of twiddler's syndrome in patients with defibrillators implanted subcutaneously in the left pectoral region.

The Accufix atrial lead has a "J"-shaped retention wire at the distal end that has been reported to fracture. Our findings suggest that the more deformed the J, the higher the incidence of fracture.