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7 záznamů v Medvik Filtry

Článek

The implementation of quality standards (QS) at coolmine therapeutic community

Coughlan, E
Autor Coughlan, E Coolmine Therapeutic Community, Dublin, Ireland University College Cork, Emergency Medicine and Pre-Hospital Care, Cork, Ireland
McKeown, P
Autor McKeown, P Coolmine Therapeutic Community, Dublin, Ireland
Corrigan, N
Autor Corrigan, N Health Service Executive, National Social Inclusion Office
Harris, A
Autor Harris, A Coolmine Therapeutic Community, Dublin, Ireland

Adiktologie. 2023 ; 23 (1) : 47-53.

ISSN 1213-3841
Medvik
Zdroj

BACKGROUND: Coolmine’s implementation of quality standards involves a period of change management, strategic planning, and national policy development. METHODS: A narrative case study focusing on national policy and internal strategic planning. CONCLUSIONS: From 2000, Coolmine embarked on a change management journey that kept the organisation at the forefront of drug and alcohol treatment in Ireland and internationally while maintaining fidelity to the Therapeutic Community. The strategy for quality assurance is replicable across similar organisations

Abstrakt

The treatment pathways and outcomes of therapeutic community clients: preliminary findings from a longitudinal mixed-methods study

14th Conference of EFTC on Rehabilitation and Drug Policy. 2013 ; () : 46.

ISBN 978-80-7492-070-7
Medvik
Zdroj

Publikační typ
abstrakt z konference MeSH

Článek online

Je časné zahájení dialyzační léčby u nemocných s CKD výhodné? Studie IDEAL
[Randomized, controlled trial of early versus late initiation of dialysis]

Postgraduální nefrologie. 2010 ; 8 (4) : 54-55.

Medvik
Zdroj

In clinical practice, there is considerable variation in the timing of the initiation of maintenance dialysis for patients with stage V chronic kidney disease, with a worldwide trend toward early initiation. In this study, conducted at 32 centers in Australia and New Zealand, we examined whether the timing of the initiation of maintenance dialysis influenced survival among patients with chronic kidney disease. METHODS: We randomly assigned patients 18 years of age or older with progressive chronic kidney disease and an estimated glomerular filtration rate (GFR) between 10.0 and 15.0 ml per minute per 1.73 m2 of body-surface area (calculated with the use of the Cockcroft-Gault equation) to planned initiation of dialysis when the estimated GFR was 10.0 to 14.0 ml per minute (early start) or when the estimated GFR was 5.0 to 7.0 ml per minute (late start). The primary outcome was death from any cause. RESULTS: Between July 2000 and November 2008, a total of 828 adults (mean age, 60.4 years; 542 men and 286 women; 355 with diabetes) underwent randomization, with a median time to the initiation of dialysis of 1.80 months (95% confidence interval [CI], 1.60 to 2.23) in the early-start group and 7.40 months (95% CI, 6.23 to 8.27) in the late-start group. A total of 75.9% of the patients in the late-start group initiated dialysis when the estimated GFR was above the target of 7.0 ml per minute, owing to the development of symptoms. During a median follow-up period of 3.59 years, 152 of 404 patients in the early-start group (37.6%) and 155 of 424 in the late-start group (36.6%) died (hazard ratio with early initiation, 1.04; 95% CI, 0.83 to 1.30; P=0.75). There was no significant difference between the groups in the frequency of adverse events (cardiovascular events, infections, or complications of dialysis). CONCLUSIONS: In this study, planned early initiation of dialysis in patients with stage V chronic kidney disease was not associated with an improvement in survival or clinical outcomes. (Funded by the National Health and Medical Research Council of Australia and others; Australian New Zealand Clinical Trials Registry number, 12609000266268.)