No abstract

This study sought to find evidence for: (a) a relationship between increased levels of work‐related social support and decreased burnout, (b) a relationship between personality traits and burnout, and (c) a significant interaction of social support and extraversion in relation to burnout. Seventy‐six staff nurses and their supervisors at a private medical hospital participated as subjects. Two subscales of the Work Environment Scale measured social support. Personality was measured using an instrument known as PROSCAN, and Scale H of the 16PF. Burnout was measured by the Maslach Burnout Inventory. A strong negative correlation between work‐related social support and burnout was found. Also, nurses whose supervisors received positive‐feedback training showed significant reductions in emotional exhaustion, compared to those whose supervisors did not receive this training. Some dimensions of personality explained a significant amount of burnout. The study also provided further evidence of the interactive effect of social support and extraversion in relation to an emotional distress variable. That is, extraverted nurses required more work‐related peer support than did introverts to avoid emotional exhaustion. Suggestions for further research are given.

Objective(Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use.DesignMulti-method randomised control trial (RCT).SettingThree NHS Trusts.PopulationNulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness.MethodsRandomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal.Main outcome measuresPrimary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis.ResultsSix hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59).ConclusionsAllocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.Tweetable abstractGoing to 2 prenatal self-hypnosis groups didn't reduce labour epidural use but did reduce birth fear & anxiety postnatally at < £5 per woman.

Functional peptides have been produced by proteolysis of glucoamylase (glucan 1,4-alpha-glucosidase; EC 3.2.1.3) from Aspergillus niger and purified by affinity chromatography, gel filtration and two ion-exchange-chromatography steps. The peptides correspond to residues 499-616 and 509-616 of the original glucoamylase molecule. Together with G1C (residues 471-616 from glucoamylase 1) [Belshaw & Williamson (1990) FEBS Lett. 269, 350-353], the three peptides all contain the C-terminal domain (residues 509-616) but, in addition, contain different proportions of the O-glycosylated region. The properties of these peptides have been compared to define the function of the O-linked oligosaccharides in this protein. The O-glycosylated region plays only a minor role in binding to hydrogen-bond ordered starch. The difference between the apparent free energy (delta G) for binding between the non-glycosylated C-terminal domain (-26.0 kJ/mol) and the C-terminal domain containing the fully O-glycosylated region (-25.0 kJ/mol) is only 1.0 kJ/mol. Binding to beta-cyclodextrin suggests that even this difference may reflect a small conformational change in the C-terminal domain rather than a direct effect of the O-linked sugars. The c.d. spectrum of the O-glycosylated region is deduced by comparison of the three peptides and is predominantly that of a random-coil structure. Two-dimensional n.m.r. spectra of glucoamylase and of the glycosylated peptide 499-616 show that the binding domain is more mobile than the catalytic domain and that its mobility is further increased on removal of the catalytic domain. The O-glycosylated region is more mobile still, and there is a marked increase in its mobility on removal of the catalytic domain. The O-glycosylated region in the intact protein can therefore be envisaged as a semi-rigid rod. The results show that a major function of O-glycosylation in glucoamylase 1 is to provide an extended peptide backbone and hence a fixed distance in linking the catalytic and binding domains. It does not in itself significantly increase the binding affinity for starch.