Explaining employees' health care costs: a prospective examination of stressful job demands, personal control, and physiological reactivity.

The authors tested the ability of stressful demands and personal control in the workplace to predict employees' subsequent health care costs in a sample of 105 full-time nurses. Both subjective and objective measures of workload demands interacted with personal control perceptions in predicting the cumulative health care costs over the ensuing 5-year period. Tonic elevations in salivary cortisol, moreover, mediated the effects of demands and control on health care costs. Neither the job demands variables nor physiological reactivity measures, however, explained subsequent mental health. The results support findings from the epidemiological literature that demonstrate an important role for employees' control in explaining occupational inequalities in coronary heart disease and mortality. The authors argue that the results also encourage control-enhancing job design interventions by suggesting that their outcomes can benefit both organizations and their members.

Reducing stress by increasing control.

The concept of having control over your work has long been viewed as an essential part of human motivation and is linked with the idea that individuals seek to master their environments and to be effective in producing change. Over the past decade, the notion of control also has become an important factor in helping to alleviate job-related stress. Considerable evidence exists to suggest that workers actually might have improved physical and mental health and be more productive under stressful conditions if they possess the requisite level of control.

An investigation of the effects of time and involvement in the relationship between stressors and work-family conflict.

Previous researchers have proposed that the time and energy involved in family and paid work should affect the relationship between stressors and conflict in both the work and family domains. Using a sample of 113 registered nurses, the authors hypothesized that the amount of time and involvement in both domains would moderate the stressor-conflict relationships. Results supported many of the interactions in predicting conflict in each domain, and implications for the health of working women with family responsibilities were discussed.

Stripping analyses of mercury using gold electrodes: irreversible adsorption of mercury.

The electrochemical deposition and stripping of mercury on gold surfaces was investigated to assess whether gold electrodes would return to mercury-free states after stripping analyses. X-ray photoelectron spectroscopy studies demonstrate the presence of mercury on gold foil electrodes that have undergone controlled-potential deposition procedures in Hg(2+) solutions (10 nM-0.1 mM) followed by stripping and cleaning in mercury-free electrolyte. Results show that mercury is not completely removed electrochemically from the gold electrodes, even when the oxidizing potential is +2.5 V vs Ag/AgCl. Bulk electrolyses deposition and stripping procedures coupled with cold vapor atomic absorption spectroscopic analyses of solutions after deposition and stripping are also reported. Results suggest that the nature of the gold electrode is fundamentally altered by irreversible adsorption of mercury; that is, mercury is adsorbed during deposition and some of the mercury is retained even after stripping and cleaning. The implications and strategies for using stripping analysis and gold electrodes for the measurement of mercury under the experimental conditions employed in this study are discussed.

Effects of stressful job demands and control on physiological and attitudinal outcomes in a hospital setting.

We tested the job demands--job control model of stress with a group of 136 registered nurses. Significant interactions between subjective and objective measures of work load and a measure of perceived control predicting physiological and attitudinal outcomes indicated support for the model. In addition, objectively assessed job demands were significantly associated with blood pressure and cortisol levels. The model also predicted elevations in physiological responses after individuals left work, suggesting that potentially health-impairing reactions to jobs that have high demands and low controllability might carry over to home settings and thus pose a high risk of long-term health impairment. The results have implications for the role of personal control in occupational stress generally and for nurse-management practices specifically.

Decision-making autonomy in nursing.

Current nursing literature has suggested that nurses may have low needs or preferences for decision-making autonomy. In this study, the authors found that nurses differed in their preferences for decision-making autonomy in three types of work-related decisions. Employed nurses with a greater preference for autonomy were more satisfied with their jobs, and those with little or no such preference were less satisfied, as they gained decision-making influence over patient care and unit management. The authors discuss implications for designing and implementing decision-making programs.

Changes in small airway function after live attenuated influenza vaccination.

Live, attenuated influenza vaccine was given by intranasal inoculation to 15 young, adult volunteers. Modest symptoms occurred within 3 days of challenge, but the agent was otherwise well tolerated. Hemagglutinin-inhibition antibodies increased in 9 of the 12 subjects whose initial volumes, but closing volume did not change. These changes in airflow reverted to previous levels after 1 week. On a second challenge 2 weeks after the first, symptoms were far less frequent, and no changes in airflow were detected. We conclude that this agent is biologically active and that the airflow changes observed may reflex involvement of small airways.