Suchergebnisse

The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

The COVID-19 pandemic struck the world out of the blue and displayed unprecedented transmission rates. Part of the reason for its rapid worldwide spread, was the nature of the virus itself, its presentation (symptoms were visible well after a person was infected) and the highly complex, interconnected world we live in today. An equally important contributing factor is our, now apparent, collective inability to deal with a rapidly emerging global threat in a coherent and integrated manner across countries and continents. Our existing multilateral systems are simply not yet geared to respond to such an emerging global challenge in an adequate and timely manner. The plethora of national responses have also been shown to be inadequate. The extent of our inter-connectedness has led us to recognize that we live in a global village, and this pandemic has removed any remaining doubts. However, the underlying global order of pervasive tourism, trade, business, education has the potential to create vulnerabilities while also generating critical sector specific information that could be systematically harnessed in order to allow rapid and effective global and national responses to risks. Undoubtedly this data is being collected in some form. At a more operational level the world is still struggling to bring together the necessary data from across different sectors of society, across scales and a sufficiently integrated manner to fully enable a rapid analysis and a comprehensive disaster risk mitigation response. The looming era of machine learning and artificial intelligence too has the potential to fast-track our capabilities and responsiveness to such epidemics, but presently, we are still struggling to access relevant information and timely data at appropriate scales and resolutions. Early information from the COVID-19 pandemic suggested a greater vulnerability of older citizens to the virus. Current mortality patterns support the notion that the elderly, especially those with underlying medical conditions, are more vulnerable. However, clearly, all segments of the population are vulnerable. In the absence of an available cure for the virus, key measures deployed to limit transmission include to curb mobility, social distancing, to strengthen the medical infrastructure to improve the palliative treatment for vulnerable patients (ventilators) and protect key medical practitioners (protective clothing and masks). A fully functional coordinated system of international cooperation would help with the effective execution of many of these measures. Given that the pandemic has now reached nearly all countries around the world and is still spreading, countries are responding by shutting borders and are competing for scarce resources - medical, technical, and/or financial. The developing geography of the pandemic illustrates how different countries become more vulnerable at different times during the development of the pandemic - not all countries are necessarily equally vulnerable at the same time. The same principle applies to different parts within a country (Northern Italy, New York). In understanding these differences, mortality rates are probably a more robust indicator, albeit delayed, considering the different modes and extents of COVID-19 testing implemented around the world. Clearly COVID-19 has caught all of us o_ guard, yet we need to respond to the emerging crisis to the best of our ability. While numerous epidemiological analyses and models are currently informing and assisting global decision makers to respond to the virus, we at IIASA can assist by making available critical socioeconomic and demographic data that may be of use to policymakers and the health community to allocate scarce resources more strategically between countries and even within countries. This IIASA mapbook is made available to rapidly and urgently disseminate key demographic and population information in a visible form to assist health professionals, disaster response operations, governments and policymakers from across the European Union. This IIASA mapbook publishes and will continue to expand on a list of key indicators that can be used to better understand the socioeconomic and demographic contexts under which the current COVID-19 crisis is unfolding. Accessible data is presently limited to the EU.

IntroductionNew classes of drugs for metastatic or unresectable melanoma (MM) have shown improved survival in randomized trials (e.g., anti-CTLA-4, anti-PD-1, BRAF/MEK inhibitors). We sought to describe uptake of these new drugs and their impact on population-based survival outcomes of MM.
Objectives and ApproachWe sought to describe uptake of these new drugs and their impact on population-based survival outcomes of MM. This was a retrospective, population-based cohort study of all treated MM in Ontario 2007-2015. Administrative data sources from the Institute for Clinical Evaluative Sciences (ICES) were utilized. Within ICES, cutaneous and non-cutaneous primaries were identified in the Ontario Cancer Registry. Administrative sources from Cancer Care Ontario, Ministry of Health and Long-Term Care, and Canadian Institute for Health Information identified patients treated with palliative systemic therapy, radiotherapy and metastatectomy. Temporal trends in utilization and survival were investigated. Survival by drug class was described.
ResultsWe identified 2,793 MM patients. First treatment was systemic therapy (46%), radiotherapy (41%) or metastatectomy (14%). MM patient number increased from 270 in 2007 to 418 in 2015. Systemic treatment rose from 125 MM first treated in 2007 to 343 in 2015. New drug treatments increased from <6% of reported first-line regimens in 2007 to 82\% in 2015. 1-year and 2-year overall survival (OS) was 28% and 15% respectively for all MM in 2007-2009, rising to 46% and 35% for 2014-2015 (logrank p<0.001; adjusted hazard ratio (AHR) 0.56, 95% confidence interval (CI): (0.49,0.63)). Survival gains were largely in the subset treated primarily systemically, where new drugs were increasingly utilized (2-year OS 16% 2007-2009 vs. 44% 2014-2015 logrank p<0.001; AHR 0.46, 95% CI: (0.38,0.56)).
Conclusion/ImplicationsUtilization of systemic therapy for MM has increased considerably in routine practice during 2007-2015; at least some of this increase relates to use of novel agents since 2011. In line with randomized trial findings, new drug adoption was associated with substantial increases in population-based MM survival.

Deaths by Suicide is a devastating outcome in Psychiatry. From 2019 to 2020, deaths by Suicide in India have increased by more than 10%. A detailed Critical analysis of the updated socio demographics, preventive measures, role of helplines and awareness programs and updated genetics, intracellular mechanisms and neural networks are discussed. Futuristic Aspects of Legalization of Cannabis Use in India and Across the Globe. 1.Legal Aspects Of Cannabis Use: Rules & Regulations In India & Abroad. Seemingly the law varies across the globe. Each country has their rules & regulations to control the use of illicit drug and substances.(1;) 2.Patterns of use of cannabis: -This is being disseminated in the form of modak, sweets, grass, drink and joints predominately practicing in the country from where it was disseminated.(2;) 3.Overuse of and persistent use of cannabis: -It will lead to create lot of complications such as social, psychological & legal despite of its therapeutic uses.(3;) 4.Psychosocial consequences of over use of cannabis barrier of treatment and prevention of cannabis use prevention:-Since this substance has multiple indignation in treatment as well as special therapeutic indication in palliative care and end stage life care compels to restate the laws to form new legislative regulations to use this substance that is why the increasing demand of therapeutic uses in detoxification of other substances from more harmful to less harmful use favors legalization.(4,5.) Presenter: - 5: - Chairperson Prof. Dr. Gautam Anand (HOD Psychiatry Department, MMC&H) (Email ID: - drganandgwl@gmail.com) 4: -Co-Chairperson Prof. Dr. Kunal Kumar (HOD & Professor Sharda Hospital) 3: - Dr. Umang Gupta (P G JR-2 MMC& H) 2: - Dr. Shreya Kataria (P G JR-2 MMC& H) 1: - Dr. Srishti Arora (P G JR-2 MMC& H)

Introduction:The direct and side effects of the impact of the conflict on the general health condition of the population and the health infrastructure are evidenced, measurable as well as fact-based as is the case of Kosovo. These findings are also confirmed by interviews with interviewed health professionals who address this issue. Aim: The main purpose of this study is to explore and analyze data on cancer treatment during this post-conflict period in Kosovo, including the causes, ages and genders endangered, and measures taken by the Kosovo authorities to combat cancer disease. Methods:Through the qualitative method, using open interviews as an instrument and questionnaires in the electronic form for our research, we interviewed health professionals of the Oncology Clinic of the University Clinical Hospital Service of Kosovo in tertiary health care as the only specialized institution that treats cancer in Kosovo. Results:Since the end of the conflict there is a significant increase of cancer cases in Kosovo. This has proven to be a difficult extra burden for an already shattered health system. The main purpose of this study is to explore and analyze the available data on cancer treatment during this post-conflict period in Kosovo, including the causes, age and gender of those endangered by cancer, and measures taken by the Kosovo authorities to treat and contain these cases. Conclusions:The consequences of the conflict significantly complicate the enhancement and reforms in the health system of a country, especially in the areas of tertiary health care that require political will, sustainable and continuous funding, continuous education of health personnel, therapy based on modern protocols and advanced equipment, which the Kosovo health system and palliative care currently lack.

Lesbian, gay, bisexual and trans+a (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: a) social inequalities, including 'minority stress'; b) associated health-risk behaviours (e.g. smoking, excessive drug/alcohol use, obesity); c) loneliness and isolation, affecting physical/mental health and mortality; d) anticipated/experienced discrimination and e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: 1) Production of large datasets; 2) Comparative data collection; 3) Addressing diversity and intersectionality among LGBT+ older people; 4) Investigation of healthcare services' capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; 5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and sub-groups within this umbrella category; 6) Development an (older) LGBT+ health equity model; 7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.

Lesbian, gay, bisexual and trans+ a (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: a) social inequalities, including 'minority stress'; b) associated health-risk behaviours (e.g. smoking, excessive drug/alcohol use, obesity); c) loneliness and isolation, affecting physical/mental health and mortality; d) anticipated/experienced discrimination and e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: 1) Production of large datasets; 2) Comparative data collection; 3) Addressing diversity and intersectionality among LGBT+ older people; 4) Investigation of healthcare services' capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; 5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and subgroups within this umbrella category; 6) Development an (older) LGBT+ health equity model; 7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.

BACKGROUND: Coping with end-of-life issues is a major challenge for governments and health systems. Despite progress in legislation, many barriers exist to its full implementation. This study is aimed at identifying these end-of-life barriers in relation to Israel. METHODS: Qualitative in-depth interviews using professionals and decision makers in the health-care and related systems (n = 37) were carried out, along with two focus groups based on brainstorming techniques consisting of nurses (n = 10) and social workers (n = 10). Data was managed and analyzed using Naralyzer software. RESULTS: Qualitative analysis showed identification of six primary barriers: 1) law, procedures, and forms; 2) clinical aspects; 3) human aspects; 4) knowledge and skills of medical teams; 5) communication; and 6) resource allocation. These were further divided into 44 sub area barriers. CONCLUSIONS: This study highlights the role of the family doctor in end-of-life by training physicians in decision-making workshops and increasing their knowledge in the field of palliative medicine. Effectively channeling resources, knowledge, and support for medical teams, by accounting for the structure and response of the units for home treatment will improve patient's access to information on and support for end-of-life laws, as well as reduce legislative barriers in other countries that face the same issues.

Lesbian, gay, bisexual and trans+a (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: a) social inequalities, including 'minority stress'; b) associated health-risk behaviours (e.g. smoking, excessive drug/alcohol use, obesity); c) loneliness and isolation, affecting physical/mental health and mortality; d) anticipated/experienced discrimination and e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: 1) Production of large datasets; 2) Comparative data collection; 3) Addressing diversity and intersectionality among LGBT+ older people; 4) Investigation of healthcare services' capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; 5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and sub-groups within this umbrella category; 6) Development an (older) LGBT+ health equity model; 7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.

OBJECTIVE: To ascertain the extent to which family physicians in British Columbia agree with First Nations patients' using traditional Native medicines. DESIGN: Randomized cross-sectional survey. SETTING: Family medicine practices in British Columbia. PARTICIPANTS: A randomized volunteer sample of 79 physicians from the registry of the BC Chapter of the College of Family Physicians of Canada. Of 125 physicians contacted, 46 did not reply. MAIN OUTCOME MEASURES: Physicians' demographic variables and attitudes toward patients' use of traditional Native medicines. RESULTS: Respondents generally accepted the use of traditional Native medicines for health maintenance, palliative care, and the treatment of benign illness. More disagreement was found with its use for serious illnesses, both for outpatients and in hospital, and especially in intensive care. Many physicians had difficulty forming a definition of traditional Native medicine, and were unable to give an opinion on its health risks or benefits. A significant positive correlation appeared between agreement with the use of traditional Native medicines and physicians' current practice serving a large First Nations population, as well as with physicians' knowing more than five patients using traditional medicine. CONCLUSIONS: Cooperation between traditional Native and modern health care systems requires greater awareness of different healing strategies, governmental support, and research to determine views of Native patients and healers.