natgillin/translations-raw huggingface dataset:
The prevalence of hepatitis B virus (HBV) antibody (6–85%)and hepatitis C virus (HCV) antibody (17–95%) among IDUs in the EU is generally extremely high, indicating asubstantial need for treatment and prevention (Figure15).The prevalence of HCV is lower (25–33%) in some of thecountries where HIV prevalence is also low (notably somenew EU countries: Hungary, Slovenia, Slovakia), suggestingthat highrisk behaviour is these countries is still notwidespread.
narkomaanide hulgas 10,7 prnarkomaanist) 2000. aastal 6,8 protsendini(2626 ge levimus noorte (alla 25aastased) hulgas ning uute langes 2000. aastal 8,6 protsendilt miljoni elaniku kohta5,1 protsendini ja 6,9 protsendini 2001. ja 2002. aastal.
In Poland, national prevalence data from public healthlaboratories suggest a decline in prevalence among tested IDUs, from 10.7%(of 3106) in 2000 to 6.8%(of 2626)in 2002.
lisandumine (Euroopa Narkootikumide ja Narkomaania
HIVprevalence was on average less than 1%in the Czech Republic, Slovenia and Slovakia, similar to the findings inneighbouring EU candidate countries Romania and Bulgaria (EMCDDA, 2003a).
Seirekeskus, 2003b)(96 get levimust Pomorskie piirkonnas 2002. aastal seksuaalpartneritele ning emalt lapsele.
In the ‘old’ 15 EU Member States, the HIV epidemic among IDUs seems mostly to have stabilised or to be in declineaccording to HIV case reporting data, with rates in 2002ranging from 1.3 new cases per million population in Greece to 115.7 in Portugal (the latter declining to 88.4 in
B- ja C-hepatiit ja muud nakkused narkomaanide hulgas tervikuna. Teistes Euroopa Liidu
Injecting drug use can be a route for the transmission of arange of other infectious diseases; for example, in recentyears outbreaks of IDU-related tetanus and wound botulismhave occurred in the United Kingdom, possibly related tocontamination of heroin and/or specific injection practices(Hope et al., 2004).
Euroopa Liidus on B-hepatiidiviiruse (HBV) antikehadelevimus (6%–85%) ja C-hepatiidiviiruse (HCV) antikehade ennetustegevuse vajadusele (joonis15).
The prevalence of tuberculosis (TB)among IDUs in the EU seems to be generally low and is notincreasing, except perhaps in the Baltic countries (Miglioriand Centis, 2002).
HCV-levimus on kuigi uuemad andmed enamikus puuduvad.
However, in the neighbouring countriesof eastern Europe it is increasingly becoming a problembecause of its increasing resistance to treatment andbecause of its very high prevalence among prisoners, many
HIV levimusoli keskmiselt alla 1% Tšehhi Vabariigis, Sloveenias ja Slovakkias, samalaadsed andmed olid ka naaberriikides,Euroopa Liidu kandidaatriikides Rumeenias ja Bulgaarias(Euroopa Narkootikumide ja Narkomaania Seirekeskus, gmised Euroopa Liidu uued riigid: Ungari, Sloveenia, Slovakkia), ning see
Norway
Märkused:
For primary sources, study details and data before 2001, see IDisease_Tbl 8 in the 2004 statistical bulletin.
= kohaliku/piirkondliku katvusega valimid.
drug users at any time they get in contact with healthservices as well as ensuring sufficient resources forprevention and treatment.
valimistrateegiad on erinevad.te uimastitarbijate hulgas
Reducing drugrelated infections
P ortugali andmed ei ole teada).
Since 2001, there has been a further increase in thenumber and geographical coverage of needle and syringe of whom are drug users.
kinnipeetavate hulgas, kellest paljud on uimastitarbijad.
Currently, the prevalence of STIs is increasingrapidly in several EU countries, mainly among homosexualmen.
Praegu suurestisugulisel teel nakkavate haiguste levimus mitmes Euroopa ea muude
Among drug users, STIs are very common in somecountries, e.g. Ireland and Italy (Giuliani and Suligoi,2004), but in others (e.g. Sweden and Norway) are rarelyreported; however, in most countries surveillance dataspecific for drug users seem to be lacking.
T narkomaanide hulgas teetanuse- ja haigusetekitajatega saastunud her uberkuloosi (TB) levimus seotud konkreetsed seireandmed.
This calls for systematic screening of programmes (NSPs) in several Member States (97).
Kui soovitakse, etsugulisel teel nakkavate haiguste seireandmed oleksid
See Table 6 OL: Provision and types of needle and syringe programmes (NSPs), pharmacy involvement, numbers of syringes distributed/sold.
Ida-Euroopa naaberriikidesemaks probleemiks pidevalt suureneva r nakkuse sugulisel teel leviku potentsiaali (Wiessing ja
For primary sources, study details and data before 2001 see IDisease_Tbl 11 in the 2004 statistical bulletin.
= kohaliku/piirkondliku katvusega valimid.
established in Northern Ireland (pharmacy based) and in Flanders (Belgium).
valimistrateegiad on erinevad.
France and Portugal report that the numbers of syringesbeing obtained from pharmacies is decreasing.
Inglismaa ja WBelgia, Itaalia, Ungari, P rbijate hulgas ega tarvitse
In France,the sale of syringes decreased by 45%between 1999 and2002, falling from 16.5 million to 9 million.
Narkootikumide ja Narkomaania Euroopa Tvt IDisease_Tbl 11 2004.
Where studies on syringe access have been conducted, theresults show that purchase from pharmacies is the mostcommon source of injecting equipment (e.g. 30–45 % of NSP clients in Belgium, 32%in Luxembourg and 30–40%in Hungary).
1997–2002 ning eeldatakse, et suur esinevate nakkushaiguste epidemioloogiline olukor korpiisavate ennetus- ja ravivahendite tagamist.
As a result of the involvement ofpharmacies, these four countries have achieved a goodgeographical coverage of needle exchange points.
Uimastitega seotud nakkuste vähendamine ogrammide laiendamine praegu arutusel.
In theother countries, drug users have to purchase syringes (andother paraphernalia), and the high price in some countriesis a matter of concern (98).
Alates 2001. aastast on veelgi suurogrammide arv ja geograafiline katvus mitmes liikmesriigis(97 esti uute teenuste ring, toetudes ulatusliku HIV
Annual report 2004: the state of the drugs problem in the European Union and Norway important role in supplying sterile equipment to drug users (McVeigh et al., 2003).
Aastaaruanne 2004: Narkoprobleemide olukord Euroopa Liidus ja Norras
Developments in the treatment of drug-relatedinfections
Narkootikumide ja Narkomaania Seir
High rates of hepatitis C virus (HCV) infection among drugusers are causing increasing concern among healthcareprofessionals. Between 60%and 80%of people whocontract the virus become chronically infected, leading toend-stage liver disease in up to 20%of cases, but accessof drug users to treatment for hepatitis C is low.
Luksembur nakkuse ravijuhiseid Euroopa Liidu 15 “vanas” liikmesriigis ja Norras(100 gmises neljas riigis: Hispaania, Portugal ja par ning Prantsusmaa, kus riigi subsideeritavad steriilsed uimastitarbijatele juhul, kui raviga tegelevadteadusharudevahelised hepatoloogide ja
The need for lowthreshold services is greater in countrieswith ‘older’ epidemics, where longterm injectors haveconsiderable health problems and are more marginalisedand socially excluded: the increasing range of servicesoffered might also reflect an increasing service dependencyof this group.
Arahalised vahendid, et kindlustada retroviiruste vastaneravi patsientidele Eestis ja kandidaatriigis Bulgaarias:eeldatav isikute arv, kes hakkavad saama retroviirusteravi, on Eestis 500 ning Bulgaarias 200 (GFATMisekretariaat, 2004).
Opiates are present in most cases of ‘drug-related deaths’ (
Hollandi uimastiravitalitused, seistes silmitsi kaootiliseltuimasteid tarbivate isikute suureneva arvuga, kelle
) due to illegal substances reported in the EU, although inmany cases other substances are also identified during the toxicological examination (Figure 16) (103).
Tšehhi Vabariigis, Poolas, Sloveenias ja Bulgaarias), aga varustamisel steriilsete vahenditega (McVeigh jt, 2003).
The main trends in the provision of lowthreshold service fordrug users, originally centred on needle and syringeexchange, include increased integration with other survivalorientated services, for example shelters, and healthcareand medical services, and the extension of opening hoursinto evenings, nights and weekends.
“interferentsravi” (‘interferential’ care) nime all tuntudmeetod on toetav ja sisendav raviteenus paljudepr eolukorrast ei kasuta
Between 1995 and 2001, there were 8000–9000overdose deaths reported each year by the EU countries (
Arengud uimastitega seotud nakkuste ravis
This approach — called ‘interferential’
C-hepatiidi viirusest (HCV) tingitud nakkuste suur osakaal ge rohkem muret.
These figures can be considered as minimum estimates as itis likely that, in most countries, there is some level of underreporting. The majority of overdose victims are young men(70–93%) in their late 20s or 30s, with a mean age
elektrooniliselt saadaval (Euroopa Narkootikumide ja Narkomaania Seirekeskus, 2003c; Euroopa Narkootikumide ja Narkomaania Seirekeskus, 2004d)(
See the EMCDDA protocol for drugrelated death(http://www.emcdda.eu.int/?nnodeid=1419).
uimastiraviasutuste r tuleb enamikus riikides parandada. Ravijuhiseid peetakseoopa
)See DRDeaths_Tbl 1 in the 2004 statistical bulletin.)See DRDeaths_Tbl 2 and DRDeaths_Tbl 3 in the 2004 statistical bulletin.
)odes.)Lahter 4 OL: C-hepatiidiga seotud põhiküsimusedsisaldab Euroopa Narkootikumide ja Narkomaania Seirekeskuse kolmes hiljutises C-hepatiiti
Figure 16:Proportion of drugrelated deaths with or without the
Joonis 16: Uimastitega seotud surmade osakaal, oopa Liidu opiaaditarbijad juurriigis ajavahemikul 2001–2002 (
Figure 17:Mean age of drugrelated death victims in some EUcountries, 1990–2002 presence of opiates in some EU countries in 2001–02 (1
1) abi huvitab isegi neid uimastitarbijaid, kellega on muiduraske kontakti saavutada, ning kontakt
Austria
0 korral (102
Without opiates
Märkused:(1) (2)
the United Kingdom, such a trend is not apparent, a findingthat deserves attention as it might indicate an increasedincidence of injection or opiate use in recent years(Figure17).
) kuritarvitamise vastase riikliku programmi (St. George’i haiglameditsiinikool) andmetel, mis omakoroneri viimastel aastatel (joonis17).
During the period 1990–2000, and despite decreases insome countries, the overall increasing trend continued,although at a lower rate.
Euroopa Liidu eri riikidest tulevad regulaarsed aruandeduimastitega seotud surmade ohvrite kohta, kelle puhul
Between 2000 and 2001–02, many EU countries reporteda decrease in the numbers of drugrelated deaths, which insome cases (Germany, Greece, Ireland, Italy and Portugal)reached statistical significance.
Allikad: surmajuhtumeid.Narkootikumide ja Narkomaania Euroopa Tgu riikideteabekeskuste 2003.aasta aruanded, andmed siseriiklikestsurmajuhtumite r emuse ohtu programmis liikmesriikides“. Vt ka DRDeaths_Tbl 1 2004.
Several studies have indicated that
) emus uimastitarbijate hulgas” eelmises aastaaruandes
)See Figure 10 OL: Evolution of the proportion of people over 35 years among victims of acute drugrelated deaths in the EU countries from 1990 until 2001–02.)See Figure 11 OL: Longterm EU trend in acute deaths directly related to drug use (1985–2001).
(Euroopa Narkootikumide ja Narkomaania Seirekeskus, 2003b).‘Drug-related deaths EMCDDA definition’ in the 2004 Statistical bulletin.Vt EMCDDA protocol for drug-related
Annual report 2004: the state of the drugs problem in the European Union and Norway some countries), and current figures remain high from alonger-term perspective.
Aastaaruanne 2004: Narkoprobleemide olukord Euroopa Liidus ja Norras eldes 6284 surmajuhuga 1990.
reported a significant decrease in drugrelated deaths in2002.
Iirimaa, Itaalia ja PNorras registreeris politsei samuti uimastitega seotud
Overall mortality among opiate users reduction (6%) (Figure 18) (107
Üldine suremus opiaaditarbijate hulgas alesis aasta
An increasing trend in drugrelated deaths might beexpected in the new Member States or in the candidatecountries.
Narkootikumide ja Narkomaania Euroopa Tgu riikideteabekeskuste 2003.aasta aruanded, andmed siseriiklikestsurmajuhtumite r
At present, the quality of information on drugrelated deaths in some of these countries is limited andtrends observed should be interpreted with caution.
Suremuskohoremusopiaaditarbijate hulgas on kuni 20 korgemsuremusest kogu samaealise elanikkonna hulgas.
Estoniaand Slovenia show an increasing trend, whereas in Bulgaria and the Czech Republic there is no discernibletrend.
Euroopa Narkootikumide ja Narkomaania Seirekeskus koordineerib surmad, mille puhul viidatakse metadoonile, on paljusuur esgemale ohutegurilemetadooni asendusravi algetappidel.
Mortality cohort studies have shown that mortality amongopiate users is up to 20 times higher than in the generalpopulation of the same age.
ojekti, mille esialgsed tulemused on esitatudeelmistes Euroopa Narkootikumide ja Narkomaania Seirekeskuse raportites.
The EMCDDA is coordinatinga cooperative project of mortality cohorts in eight countries,and preliminary results have been presented in previous EMCDDA reports.
Tkusjuures lisatud on kohordid Prantsusmaalt ja Šotimaalt.Tulemused esitatakse tulevastes aastaaruannetes.
Further analysis is being conducted, withthe addition of cohorts from France and Scotland.
Teadmiste hulk sotsiaalsete ja isiklike ohutegurite,uimastitega seotud surmade riski ja neid suure
It isexpected that the results will be presented in future annualreports.
Uimastitega seotud surmade arengutendentsid on riigitioopa
Reduction in drugrelated deaths
(106 (107 oopa Liidu eri riikides ja Euroopa Liidus tervikuna 1985–2001.
Despite favourable factors such as a shift away frominjection among opiate users in a number of countries andincreased treatment provision, the decrease in drug-relateddeaths observed in the last two years is low (non-existent in
Euroopa Narkootikumide ja Narkomaania Seirekeskuse Euroopa standar alik B”).
Figure 18:Changes in the number of acute drugrelated deaths —EU and Norway total 1990–2001 (indexed to 100 for the averageover the period 1990–2001)
Joonis 18: Uimastitega seotud äkksurmajuhtumite arvu muutumine– Euroopa Liidus ja Norras kokku ajavahemikul 1990–2001(keskmine näitaja 100 kohta ajavahemikul 1990–2001)
The reductions in overdose deaths recentlyobserved in several countries (France, Spain) have beenattributed to increased availability of substitutiontreatment (e.g. in France: national report, 2002, 2003)as well as to changes in the mode of administration,witha reduction in injecting (EMCDDA, 2004b).
80 geollitud uimastitarbimispunktepiirkondades, kus tarbimine on laialdaselt levinud: sellisedteenistused on olemas Saksamaal, Hispaanias ja Hollandis ning ettevalmistamisel Luksemburgis, Sloveenias
NB:Due to insufficient data 2002 index not computed.Individual country trends are available in Figure 11 OL.
Märkused: 2002.
Data on the number of cases per country can be found in DRDeaths_Tbl 2 and Tbl 3 (2004statistical bulletin).In the United Kingdom, data from the Office of National Statistics (ONS)have been selected because they are available for a longer time period.Sources: Reitox national reports 2003, taken from general mortality registries or special registries (forensic or police).
Uimastitarbimispunktid arv riigi kohta on esitatud tabelites DRDeaths_Tbl 2 ja Tbl 3(2004.
Based on national definitions as presentedin the methodological notes on national definitions of acute drug-relateddeaths (2004 statistical bulletin).
“Uimastitarbimispunktid“ – ruumid, kus uimastitarbijad,kellele on antud vastav luba, saavad tarbida oma
Other evidencebased responses,such as peer intervention in the case of drug emergenciesand the encouragement of ambulance calls among drugusers who might witness overdoses, are reported fromseveral countries, but systematic knowledge about the levelof provision of such courses is still not available. Thedistribution of an opiate antagonist (naloxone) to drug
Allikad: andmed, sest need olid olemas pikema ajavahemiku kohta.Narkootikumide ja Narkomaania Euroopa Tgu riikideteabekeskuste 2003.aasta aruanded, andmed siseriiklikestsurmajuhtumite reave liikmesriikides. (2004.
)See also Figure 12 OL: Trends in acute drugrelated deaths in the different EU countries and the EU as a whole 1985–2001.
elevalve all ning kinnipidamise kartuseta – onoopa linnas.
For the United Kingdom see also in the ‘Methodological notes on national definitions of drugrelated deaths’ (statistical bulletin): ‘drugs strategy definition’ and ‘ONS traditional definition’.The drugs strategy definition produces estimates very closely related to EMCDDA standard European definition (‘Selection B’).
Euroopaaruandes uimastitarbimispunktide kohta (Euroopa Narkootikumide ja Narkomaania Seirekeskus, 2004a)selgitatakse, mis on tarbimispunktid ning miks ja kuidasneed rajati, kirjeldatakse nende konkr riigis (Prantsusmaa, Hispaania), seostatakse asendusravi olemasolevatest toenditest.
)See Table 8 OL: Strategies and selected measures to reduce drugrelated deaths in the 25 EU Member States and Norway.)Ibid.
riiklik aruanne, 2002, 2003), aga ka manustamisviiside oopa Narkootikumide ja Narkomaania Seirekeskus, 2004b).
Chapter 6: Heroin and injecting drug use users is one measure taken, or being considered, in some
selgub, et nad kontakteeruvad edukalt uimastitarbijatepresmaabi ning sotsiaal- ja raviteenuste osutamist.
If coverage isadequate, these rooms may help to reduce drug-relateddeaths at city level.
T gustikus kontrollitava keskkonna loomine uimastitarbimiselemusriske ning avalikus
‘Drug consumption rooms’, facilities where confirmed drugusers are allowed to consume their drugs in hygienicconditions, under supervision by qualified staff and withoutfear of arrest, operate in 39 European cities.
)oopa Liidu 25 liikmesriigis ja Norras.)oopa Liidu 25 liikmesriigis ja Norras.)Vt Austria EDDRA projekti kontakti EDDRA andmebaasis (http://eddra.emcdda.eu.int/eddra/plsql/ShowQuest?Prog_ID=2066).
Chapter 7Treatment — meeting the needs of those with problems from drugs.
7. peat ü kk Ravi – probleemidega inimeste vajaduste rahuldamine
Traditionally, drug-free treatment has beenresidential and long-term, e.g. in therapeutic communities.Today, it is often also community-based. Medication may beused to alleviate withdrawal symptoms.
Paljud inimesed, kellel on tekkinud probleeme seoses statsionaarne ja pikaajaline, st kommuunilaadsetes kogu Eur dub tavaliselt ajaloolist konteksti kui ka erinevaid abivajavatele kas antidepr
As medically assisted treatment is usually available only foropioid users, some form of drug-free treatment is generallythe only therapeutic option available for those experiencingproblems with non-opioid drugs.
Arvestades, et ravimite abiga teostatav ravi on tavaliselt pr endatud. Tundub siiski,eneva mahuga ravimivaba ravivorm.
These are summarisedbelow.
obleemidega inimestele.
Medically assisted treatment
Ravimite abil teostatav ravi
Medically assisted drug treatment includes both substitutiontreatment with agonists and treatment with antagonists.Typically this sort of pharmacological intervention makesuse of naltrexone (an antagonist) or one of the followingopioid agonists: methadone, buprenorphine,dihydrocodeine, heroin, slow-release morphine.
Uus arengusuund selles valdkonnas on uuekommunikatsioonitehnoloogia (nt Internet) kasutamine, et ollile uimastite kasutamise prriigid nagu Holland ja Soome on omal initsiatiivil hakanud
Methadone continues to be the most commonly prescribedsubstitution substance in the enlarged EU.
Ravimitega uimastiravi sisaldab nii agonistidegaasendusravi kui ka antagonistidega ravi.
Activities have included exploitingthe direct communication links provided by e-mail andmobile phones, and also looking at how e-counsellingservices and SMS (text) services can benefit drug users.
ja mobiiltelefoni kasutamist otsesuhtluseks, aga ka
Ireland (where it is only used for detoxification)(112
(kasutatakse ainult detoksifitseerimiseks)(112), aruannete
Characteristics of treatment services
Absoluutarvudes on asendusravi opiaaditarbijatele
Drug-free treatment
Raviteenuste iseloomustus
Drug-free treatment involves the application of psychosocialand educational techniques to achieve longterm abstinence
Ravimivaba ravi narkomaaniaravi vorm kogu Euroopa Liidus, ligi 400000inimest saavad sellist ravi.
In terms of absolute numbers, substitution treatment hasbecome the most commonly available form of specialiseddrug treatment for opiate users in the EU, with over400000 individuals receiving treatment of this kind.However, with the exception of Slovenia, this form ofintervention is far less available within the new Member States of the EU, where drug-free treatment optionsdominate (114).
Selline ravivorm on siiski paljuoopa Liidu uutes liikmesriikides, kuses rakendamist, mille abil saavutatakse pikaajaline uimastite erandiks on Sloveenia(114
)See Figure 13 OL: Inpatient drug-free treatment modes.)In Ireland, buprenorphine is used for treatment of withdrawal symptoms only.)See Table 9 OL: Applied substitution substances in the EU Member States.)See Figure 14 OL: Substitution treatment or drug-free treatment predominance for opiate use.
)Vt joonis 13 OL: Ravimiteta haiglaravi meetodid.)Iirimaal kasutatakse bupr)Vt tabel 9 OL: Rakendatavad asendusained Euroopa Liidu liikmesriikides.)
Annual report 2004: the state of the drugs problem in the European Union and Norway
Aastaaruanne 2004: Narkoprobleemide olukord Euroopa Liidus ja Norras toetust, tarbivad oluliselt rohkem teiseseid uimasteid,
One Danish study found thatmethadone clients who do not receive any psychosocialsupport use a secondary drug significantly more often thanthose who do receive such support.
Asendusravi kättesaadavus ja vastuvõtukriteeriumid ar obleeme peeti eriti kr kelle probleemne uimastitarbimine on kestnud 1–2 aastat(nt Belgia, Iirimaa, Holland).
In Greece, it is reported that patientsinmethadone treatment programmes make frequent useofpsychosocial counselling, whereas in Latvia only a fewpatients are willing to receive this kind of intervention.
Kreeka aruannetest selgub, et metadoon-asendusravipatsiendid kasutavad ravikuuri jooksul sageli
The trend towards making admission criteria for substitutiontreatment less restrictive continues.
Sloveenia asendusravi alates 16. eluaastast.
Relatively strict inclusion criteria are also foundin Greece, Finland, Sweden and Norway, with the minimumage for treatment ranging from 20 to 25, and arequirement of 4–5 years of problematic use.
Kreekas,Soomes, Rootsis ja Norras kehtivad samuti suhteliselt
Access can also be limited by the way inwhich drug services are organised; for example, in Lithuania patients have to pay for their medication, and thisreduces service uptake.
Kvaliteedi tagamine vahemikus 20–25 eluaastat ja probleemneuimastitarbimine peab olema kestnud 4–5 aastat.
Quality assurance of treatment can be defined as a‘systematic attempt to monitor, document and improve thequality of services provided’.
Olenemata asendusravi suur abariigis, Kreekas, Eestis, pakutavate teenuste kvaliteeti“.
Five quality assurancemechanisms are generally accepted in the EU: accreditationof treatment services, standards for treatment, training ofstaff, monitoring of clients and outcomes and, finally,evaluation of retention rates, outcomes, satisfaction,discharge, etc. (Figure 19).
Eurheakskiidetud viis kvaliteedi tagamise mehhanismi:raviteenuste akrkoolitamine, klientide ja tulemuste seire ja viiendaks ravil piirata ka raviteenuste osutamise korpatsiendid Leedus oma ravimite eest ise tasuma, mis jne hindamine (joonis19).
Introduction of substitution treatment
Asendusravi kasutuselevõtmine
There is considerable variation between Member Statesregarding the timing of the implementation of substitutiontreatment.
Uueks suundumuseks uimastiravi teenuste kvaliteeditagamisel on selle kaasamine riiklikesse narkoennetusestrateegiatesse (Kreeka, Hispaania, Prantsusmaa, Iirimaa, abariik, Saksamaa,
Some Member States introduced methadonesubstitution programmes as long ago as the late 1960s andearly 1970s, whereas some countries did not introduce thisform of treatment on a widespread basis until the 1990s(Belgium, Greece, France, Norway).
Holland, PRaviteenuste akrediteerimine on kvaliteedi tagamisevahendiks reas riikides (Saksamaa, Hispaania,Prantsusmaa, Iirimaa, Luksemburg, Holland, Poola,Pselle rakendamine veel kestab (Tšehhi Vabariik ja seda ravimeetodit laiemalt kasutusele enne 1990ndaid(Belgia, Kreeka, Prantsusmaa, Norra).