Clin Med
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Significant hypercalcaemia can cause electrocardiogram (ECG) changes mimicking an acute myocardial infarction. It is important to recognise that some ECG changes are due to conditions other than cardiac disease so that appropriate treatment is given, and importantly, inappropriate treatments are avoided.
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Climate change was originally expected to have its main impact on countries in temperate latitudes which, because of their relative wealth, would be best able to cope. It is now far more likely that much poorer states in the tropics and sub-tropics will experience severe impacts. ⋯ The dangerous response to the prospects of mass migration and radical social movements is to attempt to maintain control without addressing underlying problems. Instead, there is an urgent need to embrace new concepts of sustainable security.
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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.
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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.
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Every year in the 27 member states of the European Union, patients are harmed when receiving healthcare. Sometimes this is the fault of individual or multiple healthcare workers but more often than not organisational or system failures are to blame. The injuries and deaths from unsafe healthcare can never be completely eradicated. ⋯ Patient safety is an area of healthcare where economies of scales can be achieved through a European Community approach to tackling the problems. Share experiences, expertise, best practice and research findings can help member states to improve the safety of their health systems. This is why the European Commission put forward its patient safety proposal at the end of 2008.