Somatodendritic secretion in oxytocin neurons is upregulated during the female reproductive cycle

During the female reproductive cycle, hypothalamic oxytocin (OT) neurons undergo sharp changes in excitability. In lactating mammals, bursts of electrical activity of OT neurons result in the release of large amounts of OT in the bloodstream, which causes milk ejection. One hypothesis is that OT neurons regulate their own firing activity and that of nearby OT neurons by somatodendritic release of OT. In this study, we show that OT neuron activity strongly reduces inhibitory synaptic transmission to these neurons. This effect is blocked by antagonists of both adenosine and OT receptors and is mimicked by OT application. Inhibition of soluble N-ethylmaleimide-sensitive factor attachment protein receptor complex formation by tetanus toxin completely blocked the stimulation-induced reduction in inhibitory input, as did the calcium chelator BAPTA. During lactation, the readily releasable pool of secretory vesicles in OT cell bodies was doubled, and calcium currents were upregulated. This resulted in an increased inhibition of GABAergic synaptic transmission by somatodendritic release during lactation compared with the adult virgin stage. These results demonstrate that somatodendritic release is augmented during lactation, which is a novel form of plasticity to change the strength of synaptic transmission

An observational study of distractions in the operating theatre

Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed methods observational study design. We scored each distractor and interruption according to an established scheme during induction of anaesthesia and the surgical procedure for 58 general surgical cases requiring general anaesthesia. We made field notes of observations, small conversations and meetings. We observed 64 members of staff for 148 hours and recorded 4594 events, giving a mean (SD) event rate of 32.8 (16.3) h-1. The most frequent events observed during induction of anaesthesia were door movements, which accounted for 869 (63%) events, giving a mean (SD) event rate of 28.1 (14.5) h-1. These, however, had little impact. The most common events observed during surgery were case irrelevant verbal communication and smartphone usage, which accounted for 1020 (32%) events, giving a mean (SD) event rate of 9.0 (4.2) h-1. These occurred mostly in periods of low work-load in a sub-team. Participants ranged from experiencing these events as severe disruption through to a welcome distraction that served to keep healthcare professionals active during low work-load, as well as reinforcing the social connections between colleagues. Mostly, team members showed no awareness of the need for silence among other sub-teams and did not vocalise the need for silence to others. Case-irrelevant verbal communication and smartphone usage may serve a physical and psychological need. The extent to which healthcare professionals may feel disrupted depends on the situation and context. When a team member was disrupted, a resilient team response often lacked. Reducing disruptive social activity might be a powerful strategy to develop a habit of cross-monitoring and mutual help across surgical and anaesthetic sub-teams. Further research is needed on how to bridge cultural borders and develop resilient interprofessional behaviours.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Conditional regulation of neurosteroid sensitivity of GABAA receptors

Nongenomic gonadal steroid feedback to oxytocin containing neurons in the supraoptic nucleus of the hypothalamus is mediated via the neurosteroid allopregnanolone (3α-OH-DHP) that acts as an allosteric modulator of the postsynaptic GAB

Beyond the Quality Illusion: The Learning Era

By highlighting the intangible, personal, contextual, and illusory nature of "quality," the authors reconceptualize quality improvement as a pluralistic and moral journey. They imagine a new era of quality improvement in which patients and health care providers work together to understand and achieve quality. The authors recommend, for the path forward, a "travel kit" of 10 crucial elements-compassion, deliberation, flexible goals, ownership, the engagement of patients, the inclusion of payers, the involvement of learners, feedback loops, the fostering of learning, and the application of different sources of knowledge-to reframe quality improvement in a new era of learning

The influence of school type and perceived teaching style on students' creativity

School is an excellent place to foster young learners' creative thinking skills. However, the emphasis on creativity varies among schools. In two studies the putative influence of school education on the development of students' creativity was examined by means of a retrospective approach. We investigated whether two influential factors within school education (1) school type (i.e., traditional vs. alternative vs. religious) and (2) perceived teaching style (i.e., independence, judgment, flexibility, integration) associate with students' creativity at university entrance level. The difference was examined at the primary and secondary school level, respectively. Study 1a found that students who attended alternative schools at the secondary school level performed better on divergent thinking tasks as compared to students who attended traditional or religious schools. Relationship between students' creative performance and the perceived teaching styles were inconclusive. Finally, teaching styles in alternative schools during secondary education were perceived as high in independence and flexibility. Study 1b replicated the finding that university students who attended alternative schools during secondary education have an advantage in divergent thinking. Taken together, our results highlight the positive influence of alternative school education on students' creative performance at the university entrance level