Clin Med
-
Children and adolescents are particularly vulnerable to the harmful effects of alcohol, with heavy drinking risking impaired brain development and future alcohol dependence. Advertisements increase expectancies about alcohol, leading to a greater likelihood of drinking. ⋯ All European countries, with the exception of the UK, have a ban on one or more types of advertising. Since self-regulation is reported as failing to prevent marketing which has an impact on younger people, and since advertising commonly crosses country borders, there is an argument to approximate advertising rules across Europe banning alcohol advertising targeted at young people, a highly cost-effective measure to reduce harmful alcohol use, and one supported by European citizens and case law.
-
The Royal College of Physicians (RCP) is to host the European School of Internal Medicine for two years from 2009-10. This affords a unique opportunity for specialist registrars to exchange ideas about professional development and training and to make contacts with young internists from across Europe. Such links should prove useful for future RCP initiatives in European medicine.
-
Despite a sustained and massive increase in spending with the NHS, the evidence that care has improved, other than in areas of performance that have been intensively managed or rewarded by additional cash bonuses, is poor to non-existent. This failure to achieve across-the-board improvement is attributable to the fact that the outcomes of healthcare are 'system properties' and are unlikely to improve as a result of more work being put through the same system, and instead will only improve if healthcare providers at all levels are actively encouraged to redesign the system to improve on current performance. ⋯ Examples are given from the centre-specific analyses published by the UK Renal Registry, a fully electronic registry that analyses data extracted direct from renal information technology systems used in each primary care trust that provides renal replacement therapy, and from other national and regional quality improvement programmes. The NHS has unrivalled opportunities to learn from high performance and to use this learning to narrow the gap between best and worst.