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BackgroundOn its establishment, the World Health Organization (WHO) defined health as a fundamental human right deserving legal protection. Subsequently, the Ottawa Charter reaffirmed health as a fundamental right, and emphasized health promotion as the most appropriate response to global health issues. Here we suggest that the WHO definition of health as more than simply the absence of illness is not normative, and therefore requires standardization. To date such standardization unfortunately is lacking.DiscussionNational legislatures must actively ensure fair access to health care, both nationally and internationally, and also must reduce social inequality. To achieve this requires practical action, not statements of intentions, commitments or targets. Protecting fundamental rights to health care can be a fruitful focus for legislatures. Legislative action can build an objective legal framework for health care law, and guide its interpretation and application. Additionally, it is important to ensure the law is appropriate, useful and sustainable.SummaryAction is needed to protect the fundamental right to health care. Legislators should appropriately incorporate the WHO recommendations regarding this right into national law. Additionally, professional experts should help interpret and codify concepts of health and join the interdisciplinary discussion of a variable health standard.

This study was initiated to identify how physicians inform women about specific side effects of endocrine therapy for early breast cancer. It is recommended that women with early breast cancer receive endocrine treatment for at least 5 years. Although this medication is an important step in curing breast cancer, continued application by patients is far below 100%; 30-50% of all women prematurely end their prescribed therapy. In an online survey, physicians specializing in treating breast cancer (members of the Austrian Breast and Colorectal Cancer Study Group, ABCSG) were asked about their practice of informing patients about potential side effects of endocrine therapy for breast cancer. Two hundred and five members of the ABCSG completed the online questionnaire. The physicians indicated that patients were primarily informed regarding joint pain/muscle pain and flushes/sleep disturbances during the initial consultation as well as during the first follow-up visit. Patients were informed considerably less regarding side effects that influence quality-of-life areas, such as pain during intercourse, reduced orgasm capability, and hair loss. During the initial consultation, and during first follow-up visit, patients are not uniformly and are insufficiently informed about substantial side effects of endocrine therapy.

Purpose -The objectives of the study, which focuses on reproductive health care services, are to identify factors that impede adequate access to care for migrant women and to identify possible solutions.Design/methodology/approach -In this case study, problem-based, semi-structured individual interviews were conducted with 12 migrant women, eight staff members of non-governmental organizations (NGOs), and eight staff members of a public hospital (physicians, nurses). The transcripts were analyzed using a grounded thematic approach.Findings -Problems in access to services were identified in four areas: accessibility/information; institutional infrastructure; language barriers; and cultural competences.Social implications -There is a need to develop culture-specific understanding of health amongst service providers working in public hospitals. It is also necessary to raise awareness of traditional beliefs and behavior of migrant women to maximize good quality care. A closer collaboration of hospitals and NGOs is recommended, not least in order to ensure the demand-and needs-orientation, appropriateness, effectiveness, and efficiency of health care for migrant women. Migrant women mentioned different approaches to delivering care -these solutions should, where possible, be applied in practice. Originality/value -The study correlates and supports knowledge from existing literature regarding possible barriers to the use of health care services by women with migrant backgrounds. Recommendations for overcoming existing barriers are also identified by research participants.

BackgroundA special challenge for research studies of breast cancer among females is low patient participation rates. We compiled this systematic review to identify reasons why women with, or at high risk of, breast cancer do or do not participate in medicinal studies of breast cancer.MethodA systematic literature search in the databases Cochrane Library, EMBASE, Medline, Pascal Biomed, ACP Journal Club and CINAHL, as well as searches through reference lists of relevant texts, was performed.ResultsOf 39 relevant full texts, ultimately, nine studies (1 qualitative, 8 quantitative) were included after applying the inclusion criteria. Despite a lack of data material, it was possible to identify various factors influencing women's willingness to participate in medicinal studies and group them into three categories: person-related, study-related, and physician-related.ConclusionReasons for or against participation in studies of medicinal therapies by women with, or at high risk of, breast cancer are multi-dimensional, and should be considered when planning such studies to garner higher participation rates. For a more comprehensive picture of factors that affect participation, further studies in this field are recommended.