What are the key challenges facing medicine internationally in the next 10 years to maximise the quality of people’s lives when they are living with progressive life-threatening illnesses?  This paper flags up 5 important challenges and areas for development which are relevant internationally, and which may also be relevant in Australasia.

The Australian draft National Palliative Care Strategy foreshadows an approach aimed at strengthening specialist palliative care services, and developing people with special interest in palliative care. It pays less attention to building up the skills of the health workforce with a general interest in palliative care. Yet this is where most of the palliative work is done. Has general practice deserved this sidelining?  Or is the draft strategy mistakenly reducing its focus on primary palliative care?

There are numerous barriers to the uptake of a Gold Standards Framework for palliative care in Australia. Such a framework may provide an evidence based model for Palliative care in the community. The authors examine the potential for such a structured approach to End of Life care in the community in Australia.

A laryngectomy is a stressful but life saving experience for patients with laryngeal carcinoma. Total laryngectomy extends the patient's life but at the expense of complete loss of natural voice and potentially poor quality of life. This study aimed to assess these issues for patients at the National Hospital of Sri Lanka and assess quality of life including physical and social well being.

Knowledge of cancer incidence, prevention and control was limited among students at this college of nursing in India. As nurses have a major influence on the help seeking behaviour of patients, they need to be aware of cancer risk factors and the importance of early detection through screening.

This paper describes the central role of addressing spirituality.  While this is focussed around the needs of palliative care patients, the principles relate to anyone suffering any sort of loss, which becomes all of us at some point. By understanding the dynamics of spirituality, and the essential role of developing a meaningful and trusting relationship with a patient, it is possible to assist them to use their deepest beliefs to make this most difficult part of life’s journey tolerable, and perhaps even to derive profound benefits from it.

 In a previous Editorial in the AMJ, Paul Ward  talked about the theoretical issues raised by research which begs the question “can the alcohol industry pursue the often contradictory goals of ‘health’ and ‘wealth’?”  On the basis of the new paper by Bond et al, he extends his previous Editorial by highlighting  what Graham Scambler has called the Greedy Bastard Hypothesis (GBH)

The findings of this study have implications for advancing public health measures for the control of alcohol by confirming the parallels between tobacco and alcohol industry operations and strategies to delay public health advances.

In this study from India the majority of the patients who were hospitalised with H1N1 flu were 16–35 years old, presented to the hospital within two days with fever, cough and breathlessness as the predominant symptoms and less than half of them had history of travel or contact. Most of the patients recovered, and death was reported in 23.2% of the patients.

In 2004, the Indian government began providing free antiretroviral therapy (ART)  through established ART centers. Despite the fact that ART is provided free by the government, there are a large number of sero positive people who do not come forward to receive treatment. Non-adherence is further confounds efforts to offer effective treatment. This study reports the profile of patients who attend an ART centres in southern India.

Even though the HIV epidemic is concentrated in urban India, there is a rising incidence of infection in rural areas. Existing studies document the profiles of people attending testing centres in urban areas or at  Government clinics but very few studies profile those attending private and rural clinics.

Someone in Iran is killed in an automobile accident every three hours. The loss of young people  or those who are likely to have dependents causes great hardship to Iranian society.  Furthermore, because of heavy traffic and road problems in Tehran, it is sometimes difficult to get to injured persons. For these reasons, it is essential to design the emergency services system so that the potential distances between injured people and the emergency bases are decreased. This paper reviews the emergency service provision in Iran.

Announcing a special edition on Ethics and Healthcare scheduled for Dec 2010, with guest editor A/ Prof. Stephan Millet, Curtin University of Technology. Submit your abstracts now!

Promoting Research, Nocturnal Enuresis, Healthcare in South Asia, Obesity in rural South India, Hepatitis vaccination of medical students, Teaching leadership in Nepal.