Recommendations on the structure, personal, and organization of intensive care units

Background: Intensive care units (ICU) are central facilities of medical care in hospitals world-wide and pose a significant financial burden on the health care system. Objectives: To provide guidance and recommendations for the requirements of (infra)structure, personal, and organization of intensive care units. Design and setting: Development of recommendations based on a systematic literature search and a formal consensus process from a group of multidisciplinary and multiprofessional specialists from the German Interdisciplinary Association of Intensive Care and Emergency Medicine (DIVI). The grading of the recommendation follows the report from an American College of Chest Physicians Task Force. Results: The recommendations cover the fields of a 3-staged level of intensive care units, a 3-staged level of care with respect to severity of illness, qualitative and quantitative requirements of physicians and nurses as well as staffing with physiotherapists, pharmacists, psychologists, palliative medicine and other specialists, all adapted to the 3 levels of ICUs. Furthermore, proposals concerning the equipment and the construction of ICUs are supplied. Conclusion: This document provides a detailed framework for organizing and planning the operation and construction/renovation of ICUs

Recommendations on the structure, personal, and organization of intensive care units

BackgroundIntensive care units (ICU) are central facilities of medical care in hospitals world-wide and pose a significant financial burden on the health care system.ObjectivesTo provide guidance and recommendations for the requirements of (infra)structure, personal, and organization of intensive care units.Design and settingDevelopment of recommendations based on a systematic literature search and a formal consensus process from a group of multidisciplinary and multiprofessional specialists from the German Interdisciplinary Association of Intensive Care and Emergency Medicine (DIVI). The grading of the recommendation follows the report from an American College of Chest Physicians Task Force.ResultsThe recommendations cover the fields of a 3-staged level of intensive care units, a 3-staged level of care with respect to severity of illness, qualitative and quantitative requirements of physicians and nurses as well as staffing with physiotherapists, pharmacists, psychologists, palliative medicine and other specialists, all adapted to the 3 levels of ICUs. Furthermore, proposals concerning the equipment and the construction of ICUs are supplied.ConclusionThis document provides a detailed framework for organizing and planning the operation and construction/renovation of ICUs

Regulation of proteinaceous effector expression in phytopathogenic fungi

Effectors are molecules used by microbial pathogens to facilitate infection via effector-triggered susceptibility or tissue necrosis in their host. Much research has been focussed on the identification and elucidating the function of fungal effectors during plant pathogenesis. By comparison, knowledge of how phytopathogenic fungi regulate the expression of effector genes has been lagging. Several recent studies have illustrated the role of various transcription factors, chromosome-based control, effector epistasis, and mobilisation of endosomes within the fungal hyphae in regulating effector expression and virulence on the host plant. Improved knowledge of effector regulation is likely to assist in improving novel crop protection strategies

The Generation R Study: design and cohort update 2010

The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study is designed to identify early environmental and genetic causes of normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on four primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) diseases in childhood; and (4) health and healthcare for pregnant women and children. In total, 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. General follow-up rates until the age of 4 years exceed 75%. Data collection in mothers, fathers and preschool children included questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome wide association screen is available in the participating children. Regular detailed hands on assessment are performed from the age of 5 years onwards. Eventually, results forthcoming from the Generation R Study have to contribute to the development of strategies for optimizing health and healthcare for pregnant women and children

Surface-plasmon-enhanced strain-wave-induced optical diffraction changes from a segmented grating

We report on surface-plasmon-polariton-enhanced (SPP-enhanced), strain-wave-induced reflection and diffraction changes on a Au-covered, segmented grating. The segmented grating has a 6020nm period, and its lines are segmented into 7 periods of a 430nm period grating, which allows the excitation of SPPs. This grating has three SPP resonances at different optical wavelengths, for the same incident angle. Pump-pulse-induced strain waves are probed by measuring reflection and diffraction of a tunable probe pulse in a wavelength range that includes all three SPP resonances. Surface Acoustic Waves (SAWs) and Longitudinal Waves (LWs) are identified. When probing close to SPP resonances, the reflection changes from SAWs and LWs are strongly enhanced by factors of 23 and 36, respectively, compared with reflection changes observed when probing at off-resonance wavelengths. The relative SAW- and LW-induced diffraction changes are larger by additional factors of up to 3.3 and 2.6, respectively, compared to the reflection changes