Does type of hospital ownership influence physicians' daily work schedules? An observational real-time study in German hospital departments

Background: During the last two decades the German hospital sector has been engaged in a constant process of transformation. One obvious sign of this is the growing amount of hospital privatization. To date, most research studies have focused on the effects of privatization regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Yet little attention has been devoted to the effects of privatization on physicians' working routines. The aim of this observational real-time study is to deliver exact data about physicians' work at hospitals of different ownership. By analysing working hours, further impacts of hospital privatization can be assessed and areas of improvement identified. Methods: Observations were made by shadowing 100 physicians working in private, for-profit or non-profit as well as public hospital departments individually during whole weekday shifts in urban German settings. A total of 300 days of observations were conducted. All working activities were recorded, accurate to the second, by using a mobile personal computer. Results: Results have shown significant differences in physicians' working activities, depending on hospital ownership, concerning working hours and time spent on direct and indirect patient care. Conclusion: This is the first real-time analysis on differences in work activities depending on hospital ownership. The study provides an objective insight into physicians' daily work routines at hospitals of different ownership, with additional information on effects of hospital privatization

Preliminary non-invasive study of Carolingian pigments in the churches of St. John at M\ufcstair and St. Benedict at Malles

The monastery church of M\ufcstair (Val M\ufcstair, Switzerland) and the church of St. Benedict in Malles (Obervinschgau, Italy) contain painting cycles dating to the late eighth/early ninth century which are considered among the best preserved in Europe. Located inside a region of strategic importance at least since Roman times, during the medieval era both areas formed part of the diocese of Chur and were politically and culturally closely linked; the present border, in fact, developed in the course of the early modern period. The two painting cycles have been studied with a non-invasive approach using spectral multiband imaging, UV-visible diffuse reflectance spectrophotometry with fiber optics (FORS) and X-ray fluorescence spectrometry (XRF). The combined application of these techniques gave important insights into the painting techniques used in the two cycles. Clear similarities in the palette of pigments appeared; the colour palette included mainly materials typically used in medieval mural paintings, such as red and yellow ochres, carbon black, Bianco di San Giovanni and green earth, but lead pigments, such as red lead and massicot, which are less suited for use on plaster surfaces, were used as well. Of particular interest is the use of Egyptian blue and ultramarine blue that makes these paintings among the first in which the precious lapis lazuli pigment had been used in Europe. The occurrence of Egyptian blue and ultramarine blue puts the paintings closer to the ancient Roman than to the Romanesque tradition. A surprising result was the identification of As, which might indicate the use of orpiment for the creation of the wall paintings

Modulation by simvastatin of iberiotoxin-sensitive, Ca2+-activated K+ channels of porcine coronary artery smooth muscle cells

Background and Purpose: Statins (3-hydroxy-3-methyl-glutaryl coenzyme A (HMG CoA) reductase inhibitors) have been demonstrated to reduce cardiovascular mortality. It is unclear how the expression level of HMG CoA reductase in cardiovascular tissues compares with that in cells derived from the liver. We hypothesized that this enzyme exists in different cardiovascular tissues, and simvastatin modulates the vascular iberiotoxin-sensitive Ca 2+- activated K + (BK Ca) channels. Experimental Approaches: Expression of HMG CoA reductase in different cardiovascular preparations was measured. Effects of simvastatin on BK Ca channel gatings of porcine coronary artery smooth muscle cells were evaluated. Key Results: Western immunoblots revealed the biochemical existence of HMG CoA reductase in human cardiovascular tissues and porcine coronary artery. In porcine coronary artery smooth muscle cells, extracellular simvastatin (1, 3 and 10 μM) (hydrophobic), but not simvastatin Na + (hydrophilic), inhibited the BK Ca channels with a minimal recovery upon washout. Isopimaric acid (10 μM)-mediated enhancement of the BK Ca amplitude was reversed by external simvastatin. Simvastatin Na + (10 μM, applied internally), markedly attenuated isopimaric acid (10 μM)-induced enhancement of the BK Ca amplitude. Reduced glutathione (5 mM; in the pipette solution) abolished simvastatin -elicited inhibition. Mevalonolactone (500 μM) and geranylgeranyl pyrophosphate (20 μM) only prevented simvastatin (1 and 3 μM)-induced responses. simvastatin (10 μM) caused a rottlerin (1 μM)-sensitive (cycloheximide (10 μM)-insensitive) increase of PKC-δ protein expression. Conclusions and Implications: Our results demonstrated the biochemical presence of HMG CoA reductase in different cardiovascular tissues, and that simvastatin inhibited the BK Ca channels of the arterial smooth muscle cells through multiple intracellular pathways. © 2007 Nature Publishing Group All rights reserved.link_to_subscribed_fulltex