For G an almost-connected Lie group, we study G-equivariant index theory for proper co-compact actions with various applications, including obstructions to and existence of G-invariant Riemannian metrics of positive scalar curvature. We prove a rigidity result for almost-complex manifolds, generalising Hattori's results, and an analogue of Petrie's conjecture. When G is an almost-connected Lie group or a discrete group, we establish Poincaré duality between G-equivariant K-homology and K-theory, observing that Poincaré duality does not necessarily hold for general G.