The home as a workplace: work-family interaction and psychological well-being in telework.

Home-based telework is a growing phenomenon with great potential to affect employees' psychological well-being. Although prior studies show both positive and negative effects on work-family interaction, conclusions are limited by the way telework, well-being, and work-family interaction have been modeled. The authors present a conceptual framework that describes telework as a multidimensional phenomenon and separates the effects of the home environment from those of distance from the organization. Propositions concerning work-family interaction are developed from P. Warr's (1987) model of the environmental antecedents of well-being, prior telework studies, and the work-family literature. Spillover between work and nonwork domains of well-being is discussed, and suggestions for future research on this complex issue are presented.     

Cardiovascular effects of social support in the work place: twenty-four-hour ECG monitoring of men and women

Psychosocial work characteristics, such as work demand, work control, and social support at work, have been shown to be related to the development of coronary heart disease in epidemiological studies. However, the mechanisms which mediate the social and psychological effects on the cardiovascular system are not known. We have studied the direct cardiovascular effects of psychosocial work environment characteristics in 148 working men and women, representing seven different occupational groups (physicians, teachers, musicians, policemen, train engineers, prison personnel, and saw mill workers). Besides standardized measures of work demand, work control, and social support, ambulatory 24-hour monitoring of electrocardiograms in the customary work and home environment was performed. Systolic and diastolic blood pressure were measured as well as other standard physiologic risk factors for coronary heart disease. Mean heart rates were found to be significantly higher in persons reporting low social support at work. This effect was maintained during working hours as well as during leisure time and rest. Of the other related physiologic risk factors, systolic, but not diastolic blood pressure was found to be higher in persons reporting low social support. Smoking, alcohol consumption and relative body mass index were not related to social support at work. Controlling for age, sex and physical strain at work, strengthened the association of low social support with elevated heart rates.     

Urinary excretion of epinephrine and norepinephrine in asthmatic children

Urinary excretion rates of free epinephrine and norepinephrine were measured in children with chronic asthma: (1) during asymptomatic periods, (2) during the stress of asthmatic symptoms, and (3) in response to insulin-induced hypoglycemia. Epinephrine excretion was significantly higher in asymptomatic asthmatic children than in normal children whose urines were collected at home under minimum stress. Urinary epinephrine and norepinephrine excretion rates did not change significantly when children were symptomatic with asthma. Conversely, there was a seven- to tenfold increase in epinephrine excretion after insulin-induced hypoglycemia. In conjunction with the mobilization of endogenous hormones (cortisol and epinephrine), children who were moderately symptomatic with asthma at the beginning of the insulin test had spontaneous relief of asthma. It was concluded that children with asthma are capable of responding normally to certain stresses, but during episodes of mild or moderately severe asthma they do not mobilize sufficient quantities of the endogenous hormones which might help to relieve symptoms.     

Urinary catecholamines and cortisol in recent-onset posttraumatic stress disorder after motor vehicle accidents

OBJECTIVE: This study examined relationships among stress hormone levels, posttraumatic stress disorder (PTSD) diagnosis and symptoms, and gender shortly after a common civilian trauma. METHODS: Levels of catecholamines and cortisol in 15-hour urine samples were examined in 55 adults who had been in serious motor vehicle accidents and in 22 age-matched control. RESULTS: Catecholamines were related to PTSD diagnosis and symptoms, but only among men: PTSD-symptomatic men who had been in an accident exhibited elevated levels of epinephrine and norepinephrine 1 month after the accident and had higher epinephrine levels 5 months later. Intrusive thoughts predicted catecholamine levels at 1 month, and avoidance of trauma-relevant stimuli was associated with higher epinephrine levels 5 months later. These effects were not significant among women. Urinary cortisol was also elevated among PTSD-symptomatic men, but not women, and only immediately (1 month) after the accident. For men and women, greater emotional numbing predicted a lower cortisol level 6 months after the accident. CONCLUSIONS: These findings were interpreted as limited support for the generalizability of findings in men with chronic, combat-related PTSD and indicate the need for additional research on psychoendocrine assessment of traumatized women and specific dimensions of PTSD symptomatology.     

Activity, arousal, and the MSLT in patients with insomnia

OBJECTIVES: It has recently been shown that physiological arousal following walking increased sleep latencies during daytime naps as compared to sleep latencies following TV viewing. Patients with insomnia have been shown to have increased physiological arousal and to also have longer MSLT latencies. It was hypothesized that insomnia patients, who are at a higher state of physiological arousal, would be unable to relax while lying in bed and watching TV and therefore would have relatively longer sleep latencies in naps following TV watching (due to inability to relax) as compared to walking. DESIGN: Twelve patients with psychophysiological insomnia took Multiple Sleep Latency Tests after either watching television for 15 minutes or after a 5-minute walk following baseline, sleep deprivation, and recovery sleep conditions. SETTING: Sleep Laboratory PATIENTS: Twelve patients with psychophysiological insomnia INTERVENTIONS: Manipulation of state arousal and sleep deprivation RESULTS: Sleep latencies were significantly longer following the walk as compared to watching TV (11.9 vs. 6.9 min. respectively). Sleep latencies were 13.4 and 3.8 min. following baseline and sleep deprivation conditions. Heart period, used as a measure of physiological arousal, was significantly elevated throughout naps following the walk as compared to naps following TV viewing. Heart period was also significantly correlated with nap sleep latency. CONCLUSIONS: The insomnia patients in this study had significantly increased arousal, as measured by heart rate, and significantly longer sleep latencies after walking as compared to resting. The magnitude of these changes was similar to that seen in normal subjects in a previous study. These data, in concert with previous work, support the contention that measured sleep tendency is a combination of sleep drive and level of central nervous system arousal, where arousal has both state and trait components.     

Risk of illness after exposure to a pediatric office

To determine whether well children visiting a pediatrician's office are at risk of acquiring common communicable diseases, we conducted a prospective cohort study during the winter of 1983-1984. The occurrence of respiratory or gastrointestinal illness or fever in young children in the week after a visit to a pediatric office (office group) was compared with the occurrence of these illnesses in a similar group of children (home group) not exposed to the office during the study period. One home comparison subject was matched by age and sex to each of 127 children three years of age and under who were seen for well-child care in a private pediatric office with a common waiting room. The adjusted relative risk of the development of illness during the study week for the office group as compared with the home group was 0.95 (95 per cent confidence interval, 0.66 to 1.37), indicating no effect. We conclude that exposure to a pediatric office is not an important cause of the common infections in young children that have incubation periods of a week or less.     

Stress and workload of men and women in high-ranking positions

Psychological and physiological stress responses related to work and family were investigated in 21 female and 21 male managers and professional specialists in high-ranking positions. The main result was that both women and men experienced their jobs as challenging and stimulating, although almost all data indicated a more favorable situation for men than for women. In addition, women were more stressed by their greater unpaid workload and by a greater responsibility for duties related to home and family. Women had higher norepinephrine levels than men did, both during and after work, which reflected their greater workload. Women with children at home had significantly higher norepinephrine levels after work than did the other participants. The possible long-term health consequences of women's higher stress levels are discussed.     

Job stress and family social behavior: the moderating role of neuroticism

We investigated the role of neuroticism in the associations between job stress and working adults' social behavior during the first hour after work with their spouse and school-age children. Thirty dual-earner families were videotaped in their homes on two weekday afternoons and evenings. An observational coding system was developed to assess behavioral involvement and negative emotion expression. Participants also completed self-report measures of job stressors and trait neuroticism. There were few overall associations between job stress and social behavior during the first hour adults were at home with their spouse and school-age children. However, significant moderator effects indicated that linkages between work experiences and family behavior varied for men who reported different levels of trait neuroticism, which captures a dispositional tendency toward emotional instability. Among men who reported high neuroticism, job stress was linked to more active and more negative social behavior. Conversely, for men reporting low neuroticism, job stress was related to less talking and less negative emotion. These patterns were not found for the women in the study. The findings suggest that when work is stressful, men who are higher on neuroticism (i.e., less emotionally stable) may show a negative spillover effect, whereas men who are lower on neuroticism (i.e., more emotionally stable) may withdraw from social interactions.     

Effects of age,ethnicity and menopause on ambulatory blood pressure: Japanese‐American and Caucasian school teachers in Hawaii

Ambulatory blood pressure (BP) measurements of 120 female teachers of Japanese‐American or Caucasian ethnicity working in public schools located in Hilo, Hawaii, were recorded. BP was measured at 15‐min intervals during waking hours and 30‐min intervals during sleep over a 24‐hr period that included a full work day. These measurements were averaged during three daily settings: at work, at home while awake (“home”), and during sleep. ANCOVAs using ethnicity as a predictor variable of BP, with age and the body mass index (BMI) as covariates, show a significant interaction effect between age and ethnicity in some daily settings. Among Japanese‐Americans partial correlations between age and systolic BP controlling for the BMI are significant in these settings, while among Caucasians none of the correlations are significant. Menopausal status is not significantly related to BP when age is controlled in analyses. There was no significant ethnic difference in number of symptoms reported, including frequency of “hot flushes/flashes,” within the past two weeks. Those who reported hot flushes had significantly elevated BP in waking settings but not during sleep. The greater increase in BP with age in Japanese‐Americans may be related to their elevated risk for development of hypertension. The lack of a significant relationship between menopausal status and BP may be due to the high rate of usage of hormonal replacement therapy in this sample, as well as an unusually high rate of hysterectomy. Am. J. Hum. Biol. 13:486–493, 2001. © 2001 Wiley‐Liss, Inc.     

Job strain and anger expression predict early morning elevations in salivary cortisol

OBJECTIVE: The objectives of this study were to test the hypothesis that high job demands and low job control (job strain) are associated with elevated free cortisol levels early in the working day and with reduced variability across the day and to evaluate the contribution of anger expression to this pattern. METHODS: One hundred five school teachers (41 men and 64 women) classified 12 months earlier as high (N = 48) or low (N = 57) in job strain according to the demand/control model sampled saliva at 2-hour intervals from 8:00 to 8:30 hours to 22:00 to 22:30 hours on a working day. Anger expression was assessed with the Speilberger State-Trait Anger Expression Inventory, and negative affect was also measured. RESULTS: Free cortisol was significantly elevated at 8:00 to 8:30 hours in the high job strain group but not at later times of the day or evening. After adjustment for age and negative affect, cortisol was an average of 21.7% higher early in the working day in the high job strain group. This effect was significantly greater in high job strain teachers, who also reported high anger-out. The cortisol decline from morning to evening was greater in the high than low job strain individuals. Independently of job strain, women had a higher cortisol concentration at 8:00 to 8:30 hours than men, whereas cortisol concentration was greater in men than women in the middle of the working day between 12:00 and 16:30 hours. CONCLUSIONS: Job strain is associated with elevated free cortisol concentrations early in the working day but not with reduced cortisol variability. The interaction with outward anger expression suggests that individual characteristics modulate the impact of chronic work stress on the hypothalamic-pituitary-adrenocortical system.     

Association of active and passive smoking with sleep disturbances and short sleep duration among Japanese working population

Background: The relationship between passive smoking and sleep is uncertain. Purpose: To examine the association of passive/active smoking with sleep disturbances. Method: 732 women and 1,896 men, working in a suburb of Tokyo, were surveyed using a self-administered questionnaire. Information on smoking, passive smoking exposure, and sleep was elicited. Exposure levels to passive smoking were assessed separately at work and at home as no, occasional, or regular exposure. Risk of sleep disturbances according to smoking status was estimated using logistic regression with odds ratios (OR) and 95% confidence intervals (CIs) as measures of association. Results: Compared to never smokers, odds of difficulty awakening in the morning (DAM) in current smokers were significantly higher for women (OR 1.95) and men (OR 1.50), while increased difficulty initiating sleep (OR 1.88) and decreased early morning awakening (OR 0.31) were found only in women. Never smoking men occasionally exposed to passive smoking at work but not at home had increased odds (OR 1.81) of short sleep duration (SSD, <6 h) than unexposed counterparts. Conclusions: The analyses suggest that exposure to passive smoking at work is associated with SSD in men, while current smoking relates to various subtypes of sleep disturbances in both sexes.     

Influence of the menstrual cycle on proenkephalin peptide F responses to maximal cycle exercise

Proenkephalin peptide F [107–140] is an enkephalin-containing peptide found predominantly within the adrenal medulla and is co-packaged with epinephrine within adrenal medullary chromaffin granules. Peptide F has been shown to have the classic opioid analgesia effects along with immune cell interactions. This is only the second peptide F study in women, and in it we compare the responses of peptide F to a maximal cycle exercise test and recovery values over the follicular and luteal phases of the menstrual cycle. Eight untrained (directly documented in this study) women who were eumenorrheic performed a progressive maximal exercise test to volitional exhaustion on a cycle ergometer, once during the follicular phase, and once during the luteal phases of the menstrual cycle. Blood was obtained pre-exercise, immediately post-exercise and at 0, 15, and 30 min into recovery. Typical exercise changes in response to the cycle tests were observed with blood lactate increases that remained elevated 30 min into recovery. No significant exercise-induced elevations were observed for peptide F concentrations with exercise nor were any differences observed between the two menstrual phases. Thus, the effects of the menstrual cycle on peptide F concentrations appear to be minimal under the conditions of this investigation. With high concentrations of peptide F observed at rest (approx. 0.2–0.3 pmol ml⁻¹) pre-exercise arousal mechanisms may have obviated any exercise-induced response. In addition, inhibition via elevated epinephrine may have inhibited any post-exercise increases and finally adrenal medullary capacity for circulatory concentrations of peptide F may have been reached in such untrained women. Pre-exercise arousal mechanisms potentially related to analgesia may also be involved to prepare untrained women for the stress of maximal exercise.     

Acute hormonal responses to a single bout of heavy resistance exercise in trained power lifters and untrained men.

The purpose of this study was to investigate the acute responses of both stress and fluid regulatory hormones to a single bout of resistance exercise in both trained and untrained men. Seven competitive power lifters (PL) and 12 untrained subjects (UT) performed one set of the leg press exercise to exhaustion at 80% of their respective one-repetition maximum. Blood samples were obtained twice prior to exercise (at P1 and P2), immediately postexercise (IP), and at 5 minutes postexercise (5PE). Compared to P1 and P2, plasma epinephrine, norepinephrine, dopamine, atrial peptide, osmolality, and blood lactic acid increased significantly (p < or = 0.05) at IP. Plasma epinephrine, norepinephrine, atrial peptide, and blood lactic acid concentrations remained elevated at 5PE compared to P1 and P2. Plasma renin activity and angiotensin II were significantly elevated at 5PE compared to P1, P2, and IP, and this increase was significantly greater in PL compared to UT at 5PE. These data indicate that an acute bout of resistance exercise dramatically affects secretion of stress and fluid regulatory hormones.     

The impact of music upon sleep tendency as measured by the multiple sleep latency test and maintenance of wakefulness test

Previous work has shown that background noise or music has a small positive impact on performance during sleep deprivation. The current study examined the effect of background music on the ability to fall asleep or remain awake. Twelve normal-sleeping young adults took multiple sleep latency tests (MSLT) and maintenance of wakefulness tests (MWT) after baseline sleep and one night of total sleep deprivation either with background music or under standard (quiet) conditions. It was hypothesized that the music would help maintain wakefulness both under baseline and sleep deprivation conditions. The results of the study showed that sleep latencies were increased in both MSLT and MWT when music was presented, but that this effect occurred primarily before subjects were sleep-deprived (a significant Music by Sleep Deprivation interaction). Sleep latencies were 15 and 11 min on the MSLT (33 and 26 min on the MWT) with Music as compared to Quiet after baseline sleep. Heart rate, used as a measure of physiological arousal, was significantly elevated in MWT and MSLT trials where music was presented. These data support previous work showing that level of arousal has an impact on measured sleep tendency which is independent of that of the sleep system. On a practical level, these data indicate that music may play a small beneficial role in helping to maintain arousal.     

Blood pressure measurements taken by patients are similar to home and ambulatory blood pressure measurements

OBJECTIVE: To compare blood pressure measurements taken at home by physicians, nurses, and patients with office blood pressure measurement , ambulatory blood pressure monitoring and home blood pressure measurement. METHODS: A total of 44 patients seen by a home care program were studied. Protocol 1 a) blood pressure was measured by the patient, a physician and a nurse during a regular home visit (Home1); b) home blood pressure measurement was measured for 4 days (HBPM1); c) office blood pressure measurement was measured by a physician, a nurse, and the patient; and by 24-hour ambulatory blood pressure monitoring. Protocol 2 blood pressure was measured by the patient, a physician, and a nurse during a special home visit in the presence of a physician and a nurse only (Home2); and b) home blood pressure measurement was taken for the second time (HBPM2). Echocardiography, guided by a two-dimensional echocardiograph, was performed. RESULTS: Protocol 1: a) office blood pressure measurement and Home1 were significantly higher than ambulatory blood pressure monitoring, except for systolic and diastolic office blood pressure measurement taken by the patient or a family member, systolic blood pressure taken by a nurse, and diastolic blood pressure taken by a physician. b) ambulatory blood pressure monitoring and HBPM1 were similar. Protocol 2: a) HBPM2 and Home2 were similar. b) Home2 was significantly lower than Home1, except for diastolic blood pressure taken by a nurse or the patient. There were significant relationships between: a) diastolic blood pressure measured by the patient and the thickness of the interventricular septum, posterior wall, and left ventricular mass; and b) ambulatory and HBPM2 diastolic and systolic blood pressure taken by a physician (home2) and left ventricular mass. Therefore, the data indicate that home blood pressure measurement and ambulatory blood pressure monitoring had good prognostic values relative to "office measurement." CONCLUSION: This study showed that the measurement most similar to home blood pressure measurement and ambulatory blood pressure monitoring was blood pressure measured by the patient, and that home blood pressure measurement and ambulatory blood pressure monitoring had good prognostic value relative to "office measurements".     

Coping with unfair treatment at work--what is the relationship between coping and hypertension in middle-aged men and Women? An epidemiological study of working men and women in Stockholm (the WOLF study)

BACKGROUND: An important hypothesis in psychosomatic medicine is that exposure to psychosocial factors that arouse anger may accelerate the onset of hypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and women, being treated in an unfair way at work may be crucial. The present study was designed to answer the question whether the pattern of coping - primarily directed towards the aggressor (open) or directed inwards or towards others (covert) - is associated with hypertension among working men and women. STUDY GROUP: Five thousand seven hundred and twenty working men and women aged 15-64 participated in the study. The participation rate was 76%. METHODS: The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg et al. RESULTS: Significant results were confined to the age group 45-54. All analyses were adjusted for age and body mass index. Smoking habits and social class had no effect on the relationships. Low scores (lowest quartile) for open coping tended to be associated with an elevated prevalence ratio (PR) of hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9-1.7) and women (PR 1.4, 95% CI 1.0-2.0). High scores for covert coping (highest quartile) were associated with an elevated PR of hypertension among men (PR 1.6, 95% CI 1.2-2.2) but not in women. If the analysis was confined to cases without medication, the relationship between a high level of covert coping and high blood pressure was still significant for men. For women, however, no significant findings were made after this operation. Accordingly, the relationship between a low level of open coping and hypertension in women was confined to women with medication. Coping patterns were correlated with psychosocial work environment factors, in particular decision latitude. CONCLUSION: In men, covert coping was associated with prevalence of hypertension. In women, there tended to be a relationship between low scores for open coping and hypertension.     

Social support at work, heart rate, and cortisol: a self-monitoring study

This study assessed the influence of work social support on self-monitored heart rate, blood pressure, and salivary cortisol recorded on 3 work days and 2 leisure days from 61 nurses and 32 accountants (40 men, 53 women). Heart rate and blood pressure were higher during the day at work than in the evening or on leisure days. Cortisol was higher on leisure than work days and was lower in the evening than in the day. Low social support at work was associated with elevated heart rate during the daytime and evening of work days, an effect that persisted after controlling for psychological distress, age, sex, smoking, and physical activity. Work social support was not related to cortisol on work days, but on leisure days cortisol was elevated among individuals reporting high social support. There were few differences between men and women, and no important occupational effects.     

Male bisexual arousal: A matter of curiosity?

Conflicting evidence exists regarding whether bisexual-identified men are sexually aroused to both men and women. We hypothesized that a distinct characteristic, level of curiosity about sexually diverse acts, distinguishes bisexual-identified men with and without bisexual arousal. Study 1 assessed men's (n = 277) sexual arousal via pupil dilation to male and female sexual stimuli. Bisexual men were, on average, higher in their sexual curiosity than other men. Despite this general difference, only bisexual-identified men with elevated sexual curiosity showed bisexual arousal. Those lower in curiosity had responses resembling those of homosexual men. Study 2 assessed men's (n = 72) sexual arousal via genital responses and replicated findings of Study 1. Study 3 provided information on the validity on our measure of sexual curiosity by relating it to general curiosity and sexual sensation seeking (n = 83). Based on their sexual arousal and personality, at least two groups of men identify as bisexual.     

The influence of happiness, anger, and anxiety on the blood pressure of borderline hypertensives

Differences in blood pressure associated with reported happiness, anger, and anxiety are examined among 90 borderline hypertensives during 24-hr blood pressure monitoring. There were 1152 individual ambulatory blood pressure readings for which subjects classified their emotional state as happy (n = 628), angry (n = 67), or anxious (n = 457) on scales from one (low) to ten (high). Pressures were transformed to z-scores using the subject's 24-hr mean and standard deviation to assess relative elevation during reported emotional arousal. The results show that emotional arousal significantly increases systolic and diastolic pressure (p less than 0.00001), an effect independent of posture and location of subject during measurement (at work, home, or elsewhere). On average, pressures during reported angry or anxious states were higher than those during a happy state (p less than 0.01). Examination of arousal intensity showed that scores on the happiness scale were inversely related to systolic pressure (p less than 0.01) whereas the degree of anxiety was positively associated with diastolic pressure (p less than 0.02). Emotional effects were also related to the degree of individual daily pressure variation such that the greater the variability, the larger the blood pressure change associated with the emotions. The results suggest that happiness, anger, and anxiety increase blood pressure to differing degrees and that emotional effects may be greater in individuals with more labile blood pressure.     

Sleep as a tool for evaluating autonomic drive to the heart in cardiac transplant patients

STUDY OBJECTIVES: The aim of this study was to investigate the autonomic drive to the heart in cardiac transplant patients (CTP) using heart rate (HR) and HR variability (HRV) analysis during non-rapid eye movement (NREM)-rapid eye movement (REM) sleep cycles, in particular during arousal associated with the emergence from slow wave sleep (SWS). In healthy subjects, this arousal is characterized by a pronounced HR surge, and HRV is lower during SWS than during the subsequent "active" sleep stage 2 and REM sleep. PARTICIPANTS: The participants were 24 adults, 14 CTP (men, n = 11; women, n = 3; mean age, 62.2 +/- 2.2 years; time after transplantation, 4-14 years) and 10 control subjects (men, n = 7; women, n = 3; mean age, 61.0 +/- 1.8 years). DESIGN: The subjects underwent polygraphic sleep, cardiac, and respiratory recordings during an experimental night. HR was measured during the arousal. HRV was estimated from the R-R intervals in 5-minute stationary segments preceding and following arousal, ie, during SWS and active sleep stage 2 from the first 2 complete NREM-REM sleep cycles. RESULTS: In controls, HR increased during arousal associated with the emergence from SWS during the 2 sleep cycles (P < .05). Sleep-stage-dependent increases of all HRV indexes were observed in the 2 sleep cycles. Concerning CTP, 5 of them displayed a smaller HR increase at arousal, whereas 9 other patients had no HR variation. This distinction between the 2 groups of CTP was confirmed by HRV analysis. The patients with HR reactivity to arousal presented significant sleep-stage-dependent increases in global HRV and sympathetic HRV indexes, whereas the nonreactive group was characterized by an inability of HRV to change with sleep-stage alternation. Sympathetic HRV indexes were significantly higher in the reactive patients than in nonreactive patients, but high frequency power reflecting parasympathetic activity did not differ. However, the absolute HRV indexes were greatly decreased in both groups of patients compared to controls. CONCLUSION: HR reactivity during arousal associated with the emergence from SWS, corroborated by HRV surrounding arousal, may suggest a partial improvement of the sympathetic drive to the heart in some CTP, with no indication of increased parasympathetic activity. Other signs of reinnervation have to be identified to validate this hypothesis.