Background —Mental stress has been linked to increased morbidity and mortality in coronary artery disease and to atherosclerosis progression. Experimental studies have suggested that damage to the endothelium may be an important mechanism. Methods and Results —Endothelial function was studied in 10 healthy men (aged 50.4±9.6 years) and in 8 non–insulin-dependent diabetic men (aged 52.0±7.2 years). Brachial artery flow-mediated dilation (FMD, endothelium dependent) and response to 50 μg of sublingual glyceryl trinitrate (GTN, endothelium independent) were measured noninvasively by use of high-resolution ultrasound before and after (30, 90, and 240 minutes) a standardized mental stress test. The same protocol without mental stress was repeated on a separate occasion in the healthy men. In healthy subjects, FMD (5.0±2.1%) was significantly ( P <0.01) reduced at 30 and 90 minutes after mental stress (2.8±2.3% and 2.3±2.4%, respectively) and returned toward normal after 4 hours (4.1±2.0%). Mental stress had no effect on the response to GTN. In the repeated studies without mental stress, FMD did not change. The diabetic subjects had lower FMD than did the control subjects (3.0±1.5% versus 5.0±2.1%, respectively; P =0.02) but showed no changes in FMD (2.7±1.1% after 30 minutes, 2.8±1.9% after 90 minutes, and 3.1±2.3% after 240 minutes) or GTN responses after mental stress. Conclusions —These findings suggest that brief episodes of mental stress, similar to those encountered in everyday life, may cause transient (up to 4 hours) endothelial dysfunction in healthy young individuals. This might represent a mechanistic link between mental stress and atherogenesis.

Objective: This study examined the association between three conceptualisations of work-related rumination (affective rumination, problem-solving pondering and detachment) with sleep quality and work-related fatigue. It was hypothesised that affective rumination and poor sleep quality would be associated with increased fatigue; and problem-solving pondering, and detachment would be associated with decreased fatigue. The mediating effect of sleep quality on the relationship between work-related rumination and fatigue was also tested. Method: An on-line questionnaire was completed by a heterogeneous sample of 719 adult workers in diverse occupations. Results: The following variables were entered as predictors in a regression model: affective rumination, problem-solving pondering, detachment, and sleep quality. The dependent variables were chronic work-related fatigue (CF) and acute work-related fatigue (AF). Affective rumination was the strongest predictor of increased CF and AF. Problem-solving pondering was a significant predictor of decreased CF and AF. Poor sleep quality was predictive of increased CF and AF. Detachment was significantly negatively predictive for AF. Sleep quality partially mediated the relationship between affective rumination and fatigue; and between problem-solving pondering and fatigue. Conclusions: Work-related affective rumination appears more detrimental to an individual's ability to recover from work than problem-solving pondering. In the context of identifying mechanisms by which demands at work are translated into ill-health, this appears to be a key finding; and suggests that it is the type of work-related rumination, not rumination per se, that is important.

Australia remote area nursing see remote area nursing (RAN) studies on correctional offi cers 244, 246, 270-71 studies in dentistry 114-15 studies in emergency services 206-7, 222 studies in farming 388, 392, 396 intervention programme 395 studies in medical occupations 59, 97 studies in teaching 165, 167, 168 head teachers 178 Australian Nursing Federation (ANF) 22, 24 autogenic training (AT) 235 autonomy/control bureaucracy and 59-60, 209 intellectual discretion 138 burnout risk 56 decision latitude (DL) 433-4 eff ect on weight status 330-31 emotion, and illusion of 345-5 Health and Safety standard 347-8 importance of, to entrepreneurs 364-5 and failure to delegate 365, 374 studies in well-being 246, 342 avoidant behaviour 148-9, 301, 458, 493 Baas, M. 493 bullying consequences of, on target 7-8 absenteeism 9 productivity 9 consequences of, on witnesses 8-9 development of 6-7 distinguishing characteristics 7 examples 7 Health and Safety standard 348 see also incivility Burke, F.J. 113 burnout defi nition/description 53, 73 among dentists 113-14 job satisfaction relationship 58-60 strategies to prevent stress eff ects 61-3 among medical interns 94 reduction strategies 99-100 among psychiatrists 53-7 perceived organizational factors 56 personal characteristics and 55 among the socially marginalized 475 among sport offi cials 457-8 among surgeons 34-5, 38 among teachers 167 see also stress Bush Support Services (BSS) 26-7