Parvalbumin- and vasoactive intestinal polypeptide-expressing neocortical interneurons impose differential inhibition on Martinotti cells.

Disinhibition of cortical excitatory cell gate information flow through and between cortical columns. The major contribution of Martinotti cells (MC) is providing dendritic inhibition to excitatory neurons and therefore they are a main component of disinhibitory connections. Here we show by means of optogenetics that MC in layers II/III of the mouse primary somatosensory cortex are inhibited by both parvalbumin (PV)- and vasoactive intestinal polypeptide (VIP)-expressing cells. Paired recordings revealed stronger synaptic input onto MC from PV cells than from VIP cells. Moreover, PV cell input showed frequency-independent depression, whereas VIP cell input facilitated at high frequencies. These differences in the properties of the two unitary connections enable disinhibition with distinct temporal features.

Mediation training enhances conflict management by healthcare personnel.

OBJECTIVES: Mediation training can prepare healthcare professionals to manage conflict effectively in today's changing healthcare system. The primary purpose of the study was to measure the perceived comfort level of healthcare professionals with conflict before and after mediation training and to determine the extent to which mediation principles were applied within and outside the work setting. Secondary objectives were to observe firsthand transfer of skills and to identify subjects' perceptions of the impact of mediation training. STUDY DESIGN: A cross-sectional, descriptive experimental design was used. PATIENTS AND METHODS: Over a 3-year period, 173 healthcare personnel, chosen from a community not-for-profit hospital, a health maintenance organization, a managed care insurance company, and a skilled nursing rehabilitation setting, received 25 hours of mediation training; of the personnel who underwent training, 130 participated in the pre- and posttraining survey. A Likert scale with a Cronbach alpha of .82 was used to measure perceived differences in comfort level with conflict before and after the training intervention. RESULTS: The comfort level of healthcare personnel with conflict increased significantly (P < .01 or P < .001) for all groups of participants after training. The mean pretraining score was 5.92, compared with a mean score of 7.57 after training. Active listening, summarizing, and reframing were the mediation skills most often used by participants after training. Skills were transferred to interactions with patients and peers, and participants noted that they were able to intervene successfully early in problem cases. CONCLUSIONS: Mediation training significantly increased healthcare workers' comfort level with conflict, and the skills were transferable to the healthcare workplace. Mediation training in healthcare settings can help resolve conflicts with clients at an early stage and prevent progression to costly litigation.

Mediation: a response to aid-in-dying and the Supreme Court decision.

The recent U.S. Supreme Court decision concerning aid-in-dying has drawn attention to the complexity of end-of-life care. The authors summarize the recent Supreme Court's decision and the problems surrounding this complex issue. A case study is provided to demonstrate how mediation facilitates collaborative problem solving. Finally, the authors demonstrate how nurse leaders can apply this three-stage process and its attendant principles to facilitate ethical decision making in end-of-life care.