Common P-glycoprotein (ABCB1) polymorphisms do not seem to be associated with the risk of rivaroxaban-related bleeding events: Preliminary data.

Introduction: Considering conflicting previous reports, we aimed to evaluate whether the common ABCB1 polymorphisms (rs1128503, rs2032582, rs1045642, rs4148738) affected the risk of bleeding in rivaroxaban-treated patients. Materials and methods: We report preliminary data from a larger nested case-control study. Consecutive adults started on rivaroxaban for any indication requiring > 6 months of treatment were followed-up to one year. Patients who experienced major or non-major clinically relevant bleeding during the initial 6 months were considered cases, whereas subjects free of bleeding over > 6 months were controls. The polymorphisms of interest (rs1128503, rs2032582, rs1045642, rs4148738) were in a strong linkage disequilibrium, hence patients were classified regarding the "load" of variant alleles: 0-2, 3-5 or 6-8. The three subsets were balanced regarding a range of demographic, comorbidity, comedication and genetic characteristics. A logistic model was fitted to probability of bleeding. Results: There were 60 cases and 220 controls. Raw proportions of cases were similar across the subsets with increasing number of ABCB1 variant alleles (0-2, N = 85; 3-6, N = 133; 6-8, N = 62): 22.4%, 21.8%, and 19.4%, respectively. Fully adjusted probabilities of bleeding were also similar across the subsets: 22.9%, 27.5% and 17.7%, respectively. No trend was observed (linear, t = -0.63, df = 273, P = 0.529; quadratic, t = -1.10, df = 273, P = 0.272). Of the 15 identified haplotypes, the completely variant (c.1236T_c.2677T(A)_c.3435T_c.2482-2236A) (40.7%) and completely wild-type (C_G_C_G) (39.5%) haplotypes prevailed, and had a closely similar prevalence of cases: 21.1% vs. 23.1%, respectively. Conclusions: The evaluated common ABCB1 polymorphisms do not seem to affect the risk of early bleeding in patients started on rivaroxaban.

Serum Fibrinogen and Renal Dysfunction as Important Predictors of Left Atrial Thrombosis in Patients with Atrial Fibrillation.

BACKGROUND: As has been shown previously, patients with atrial fibrillation (AF) who have left atrial thrombus (LAT) also have elevated plasma concentrations of fibrinogen. In this study, we tried to determine if this is the consequence of a genetic trait and whether elevated concentrations of fibrinogen could be used to predict LAT in patients with AF. METHODS: We recruited 181 consecutive patients scheduled for pulmonary vein isolation (PVI) or direct current cardioversion. The primary endpoint was the presence of LAT on transesophageal echocardiography (TOE). We recorded routine clinical and biochemical data as well as the polymorphism type of the fibrinogen gene for the ß chain. To control potentially interfering variables, we performed propensity score matching (PSM). Multivariable and univariable logistic regression models (LRM) were computed using the CHA2DS2-Vasc score, the fibrinogen concentration and creatinine clearance as estimated by the Cockcroft-Gault equation. RESULTS: 60 of 181 patients had LAT as detected by TOE. As expected, patients with LAT had significantly higher concentrations of fibrinogen (3.9 vs. 3.6 g/L); p = 0.01 in the unadjusted analysis. After performing PSM, there were no statistically significant differences between the groups, except for creatinine clearance (79.9 vs. 96.8 mL/min); p = 0.01. There were also no differences regarding the -455 G/A ßfibrinogen polymorphism distribution between the two groups. After constructing the LRM, we found no performance enhancement for the CHA2DS2-Vasc score by adding the fibrinogen concentration or creatinine clearance alone, but when all three variables were put together, there was a significant improvement in LAT prediction (AUC 0.64 vs. 0.72), p = 0.026. CONCLUSION: Our study found no evidence of elevated levels of circulating fibrinogen in patients with LAT or a connection between those levels and the A/A and A positive polymorphism. When used together with renal function markers such as creatinine clearance, plasma fibrinogen concentrations can provide additional power to the CHA2DS2-Vasc score for predicting LAT.

The Roles of Personal and Environmental Resources in Predicting Work-Family Facilitation and Mental Health among Employed Parents of Children with Disabilities in Croatia.

Quantitative research on the positive aspects of work-life integration and the well-being of families with children with disabilities is scarce, especially in the national context. The family can provide gains that enhance work domain functioning (family-to-work facilitation; FWF), and work can provide gains that enhance family domain functioning (work-to-family facilitation; WFF). The aim of this study is to examine the contributions of some personal and environmental resources in explaining WFF and FWF and the mental health of parents of children with disabilities residing in Croatia. The mediational role of WFF and FWF in the relationship between resources and mental health was tested, while controlling for some general socio-demographic variables. A total of 571 employed parents of a child/children with disabilities completed an online self-assessment questionnaire. The results show that higher WFF (19%) was predicted by higher levels of social support at work, a higher level of education, posttraumatic growth (PTG) of personal strength, and recovery management. Higher FWF (46%) was predicted by higher levels of social support in the family, PTG of personal strength, the emotional regulation strategy of reorienting to planning, optimism, a younger age, the male gender, a greater number of children, and a higher level of education. A higher level of mental health (47%) was predicted directly by higher levels of optimism, recovery management, FWF, emotional regulation strategies of positive refocusing and planning, and a greater number of children, and was indirectly predicted by all the predictors of FWF through a higher level of FWF (but not WFF).

"I Constantly Feel Worn Out": Mixed-methodology Approach to Seafarers' Sleep on Board.

Although seafaring is one of the most important professions for trade in goods in the 21st century, the results of recent research indicate that seafarers face various sources of stress in their work, including high workload and long working hours. These stressors can be reflected in low job satisfaction and poor mental health, which can result in sleep problems, and consequently lead to various somatic symptoms. The main goal of this mixed method research was, therefore, to expand knowledge about seafarers' sleep on board, whereby a sequential explanatory design was used. Study 1 (N = 286 male seafarers from Croatia) examined whether the number of sleep hours on board has a mediating role in explaining the relationship between job satisfaction and mental health as predictors of somatic symptoms. The results of the path analysis showed that higher job satisfaction directly and indirectly through longer sleep on board reduces the number of somatic symptoms, while better mental health directly contributes to fewer somatic symptoms. Study 2 (N = 205 seafarers from Croatia) aimed to get a deeper insight into the sleep of seafarers on board, whereby 39% (N = 80) of the participants had difficulties related to sleep problems on board. The thematic analysis of their answers (N = 76) showed the sleeping difficulties experienced by seafarers on board and gave an insight into the consequences of sleeping difficulties and the coping strategies they use. The results of this research indicate the importance of developing healthy work environments for seafarers.

Risk Factors for Rivaroxaban-Related Bleeding Events-Possible Role of Pharmacogenetics: Case Series.

Non-vitamin K antagonist oral anticoagulants' interindividual trough concentration variability affects efficacy and safety, especially in bleeding events. Rivaroxaban is metabolised via CYP3A4/5-, CYP2J2-, and CYP-independent mechanisms and is a substrate of two transporter proteins: ABCB1 (MDR1, P-glycoprotein) and ABCG2 (BCRP; breast-cancer-resistance protein). The polymorphisms of these genes may possibly affect the pharmacokinetics of rivaroxaban and, consequently, its safety profile. Rivaroxaban variability may be associated with age, liver and kidney function, concomitant illness and therapy, and pharmacogenetic predisposition. This case series is the first, to our knowledge, that presents multiple risk factors for rivaroxaban-related bleeding (RRB) including age, renal function, concomitant diseases, concomitant treatment, and pharmacogenetic data. It presents patients with RRB, along with their complete clinical and pharmacogenetic data, as well as an evaluation of possible risk factors for RRB. Thirteen patients were carriers of ABCB1, ABCG2, CYP2J2, and/or CYP3A4/5 gene polymorphisms. Possible drug-drug interactions with increased bleeding risk were identified in nine patients. Six patients had eGFR <60 mL/min/1.73 m2. Our data suggest a possible role of multiple factors and their interactions in predicting RRB; however, they also indicate the need for further comprehensive multidisciplinary research to enable safer use of this product based on a personalised approach.

Euglycemic diabetic ketoacidosis: A rare but serious side effect of sodium-glucose co-transporter 2 inhibitors.

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an insulin-independent class of oral antihyperglycemic medication and from recently established therapy in chronic heart failure patients. A rare, but potentially life-threatening complication of SGLT2 inhibitor use is euglycemic diabetic ketoacidosis. We described a case of a middle-aged male patient with type 2 diabetes who developed metabolic ketoacidosis after a few days of empagliflozin administration. SGLT2 inhibitor related ketoacidosis presents with euglycemia or only modestly elevated glucose blood concentrations, which causes delayed detection and treatment of ketoacidosis. There are multiple possible risk factors and mechanism that might contribute to the pathogenesis of ketoacidosis. It is implied that SGLT2 inhibitor use and prescription by non-diabetologists (cardiologists, nephrologists, family physicians, etc.) will continue to grow in the future. It is important to inform the general cardiac public about this rare but serious side effect of SGLT2 inhibitors.

Vascular Ehlers-Danlos syndrome, an often unrecognized clinical entity: a case report of a novel mutation in the COL3A1 gene.

Due to life-threatening complications, vascular Ehlers-Danlos syndrome (vEDS) is the most severe form of EDS. Because the syndrome is associated with a shortened life expectancy and variable clinical presentation, diagnosis confirmed by genetic testing is crucial to determining appropriate treatment. Despite some distinguishing features, this rare disease often goes unrecognized. Apart from surgical or endovascular treatment of serious vascular complications, medical treatment based on celiprolol helps reduce arterial complications. We report on a case of vEDS in a young man who suffered several episodes of severe vascular complications. The diagnosis of vEDS was established based on clinical manifestations and confirmed by genetic testing. A novel heterozygous pathogenic variant in the COL3A1 gene was found. To our knowledge, this is the first case of vEDS caused by this variant.

New Therapeutic Approaches in Treatment of Dyslipidaemia-A Narrative Review.

Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leading cause of morbidity and mortality in developed countries. As a consequence, the medical community has been dealing with this problem for decades, and traditional statin therapy remains the cornerstone therapeutic approach. However, clinical trials have observed remarkable results for a few agents effective in the treatment of elevated serum lipid levels. Ezetimibe showed good but limited results when used in combination with statins. Bempedoic acid has been thoroughly studied in multiple clinical trials, with a reduction in LDL cholesterol by approximately 15%. The first approved monoclonal antibodies for the treatment of dyslipidaemia, PCSK9 inhibitors, are currently used as second-line treatment for patients with unregulated lipid levels on statin or statin combination therapy. A new siRNA molecule, inclisiran, demonstrates great potential, particularly concerning compliance, as it is administered twice yearly and pelacarsen, an antisense oligonucleotide that targets lipoprotein(a) and lowers its levels. Volanesorsen is the first drug that was designed to target chylomicrons and lower triglyceride levels, and olezarsen, the next in-line chylomicron lowering agent, is currently being researched. The newest possibilities for the treatment of dyslipidaemia are ANGPTL3 inhibitors with evinacumab, already approved by the FDA, and EMA for the treatment of familial hypercholesterolemia. This article provides a short summary of new agents currently used or being developed for lipid lowering treatment.

Current concept in the diagnosis, treatment and rehabilitation of patients with congestive heart failure.

Heart failure (HF) is a major public health problem with a prevalence of 1%-2% in developed countries. The underlying pathophysiology of HF is complex and as a clinical syndrome is characterized by various symptoms and signs. HF is classified according to left ventricular ejection fraction (LVEF) and falls into three groups: LVEF ≥ 50% - HF with preserved ejection fraction (HFpEF), LVEF < 40% - HF with reduced ejection fraction (HFrEF), LVEF 40%-49% - HF with mid-range ejection fraction. Diagnosing HF is primarily a clinical approach and it is based on anamnesis, physical examination, echocardiogram, radiological findings of the heart and lungs and laboratory tests, including a specific markers of HF - brain natriuretic peptide or N-terminal pro-B-type natriuretic peptide as well as other diagnostic tests in order to elucidate possible etiologies. Updated diagnostic algorithms for HFpEF have been recommended (H2FPEF, HFA-PEFF). New therapeutic options improve clinical outcomes as well as functional status in patients with HFrEF (e.g., sodium-glucose cotransporter-2 - SGLT2 inhibitors) and such progress in treatment of HFrEF patients resulted in new working definition of the term "HF with recovered left ventricular ejection fraction". In line with rapid development of HF treatment, cardiac rehabilitation becomes an increasingly important part of overall approach to patients with chronic HF for it has been proven that exercise training can relieve symptoms, improve exercise capacity and quality of life as well as reduce disability and hospitalization rates. We gave an overview of latest insights in HF diagnosis and treatment with special emphasize on the important role of cardiac rehabilitation in such patients.

Seafarers' well-being in the context of the COVID-19 pandemic: A qualitative study.

BACKGROUND: The public health strategies for prevention of SARS-CoV-2 infection have included closing the national borders and cancelling international flights, which has severely affected free crew changes. This caused prolonged stay on board or at home for seafarers, who should be recognized as 'key' workers regarding their essential role in maintaining the flow of vital goods. OBJECTIVE: Using a general inductive approach, this qualitative study aims to describe how the COVID-19 pandemic reflects on seafarers' well-being. The study focused on obtaining personal experiences from seafarers on board, and seafarers at home, relating to the current world pandemic. METHODS: A convenience sample consisting of 752 seafarers from the international seafarers' population participated in an online study in spring 2020. The questionnaire used included questions relating to basic sociodemographic and work characteristics, and one open question which addressed seafarers' personal experiences. The data obtained was analysed by thematic analysis. RESULTS: The emerged themes included mental, physical, social and economic well-being. Most of the answers of seafarers located on board related to threatened mental, physical and social well-being, while seafarers at home reported mostly on threats to their economic well-being. CONCLUSION: Seafarers' well-being is seriously threatened by preventive measures relating to the COVID-19 pandemic. Results are discussed in relation to earlier findings in the area of occupational stress in seafaring. Overall, the data obtained portrays existing underlying occupational structures in the seafaring sector, which are rendered more visible due to the COVID-19 pandemic. In short, seafarers describe their reality as far away from the concept of 'key' or 'essential' workers.

Teachers' Emotions and Self-Efficacy: A Test of Reciprocal Relations.

Previous research has suggested that higher levels of teachers' self-efficacy (TSE) tend to be positively related to positive teachers' emotions (e.g., joy, pride) and negatively to negative teachers" emotions (e.g., anger, anxiety). However, these studies predominately relied on cross-sectional design and therefore were unable to test the reciprocal relations between the two constructs. Based on the propositions of social-cognitive theory (Bandura, 1997), TSE may be viewed as an antecedent or as a consequence of emotions. More specifically, TSE may shape emotions since it directs teachers' attentional, appraisal, and regulatory processes, while emotions may shape TSE since they act as a source of information about teachers' performance in a given task (i.e., emotions can serve as a filter that determines which efficacy information is seen as salient and how it is interpreted). To test these assumptions, an initial sample of 3010 Croatian teachers (82% female) participated in a longitudinal study based on a full panel design with three measurement points and time lags of approximately 6 months. Teachers taught at different educational levels (i.e., elementary, middle, and secondary schools) and had on average 15.30 years (SD = 10.50) of teaching experience. They completed self-report measures that assessed their self-efficacy beliefs and six discrete emotions experienced in relation to teaching and students - joy, pride, love, anger, hopelessness, and exhaustion. An autoregressive cross-lagged analysis showed that teachers' emotions and TSE are indeed related to each other. However, the direction of this association is not bidirectional as was suggested by theoretical assumptions; instead, it is asymmetrical - higher levels of TSE beliefs predicted higher levels of positive emotions of joy and pride, while higher levels of teachers' negative emotions of anger, exhaustion, and hopelessness predicted lower levels of teachers' self-efficacy beliefs.

Stress among Anesthesiology Nurses/Technicians Working in the Intensive Care Unit (ICU): Experiences and Comparisons.

BACKGROUND: The International Labour Organization (ILO, 2000) has defined stress and exhaustion from working shifts and night work, and psychological and organizational stressors conditions that create health risks for surgical nurses. Among the OR nurses/ technicians 41.9% reported that causes of their stress included inadequate teamwork, ineffective communication, and especially surgeons' negative attitudes. SUBJECTS AND METHODS: The stuudie has been held in Clinical Hospital Centre Split, the sample consists of a total of 62 out of 109 possible respondents participated in the study. A total of 23 (37%) anesthesiology technicians and 39 (63%) ICU nurses / technicians participated in the survey. In the empirical part of this research, the importance of selected stressors was tested using quantitative methods in biomedicine. The existence of stress was tested by the Wilcoxon test. Stress level in the ICU was tested by T-test The analysis was elaborated in the statistical software STATISTICA 12. Conclusions were made at a significance level of 5%. The research was conducted through the questionnaire taken from the paper Milan Milosevic entitled: "Development of a measuring instrument of stress in the workplace hospital health professionals and an assessment of its use value" (2010). RESULTS: Based on the empirical t value of 3.42 at 59 degrees of freedom the conclusion is that there was found a statistically significant difference in the level of stressors in the workplace between nurses / technicians in the ICU and anesthesiology technicians. The conclusion was reached at an empirical level of significance <0.001. CONCLUSION: The highest level of stress among medical staff is caused by the factor of insufficient number of employees, followed by work overload, inadequate material resources for work (financial constraints), poor organization at work, and the factor of poor communication with superiors.

The relations between Principal support and work engagement and burnout: Testing the role of teachers' emotions and educational level.

BACKGROUND: One of the resources that may prevent burnout and foster the work engagement of teachers is Principal support. In this study we aimed to further explore the links between Principal support and work engagement and burnout, by testing the role of the teachers' emotions and the educational levels of primary schools. OBJECTIVES: Testing 1) the mediating role of teachers' emotions in explaining the relationship between perceived Principal support and work engagement and burnout, 2) differences in tested constructs, and the structural equivalence of the proposed relationship among constructs, between teachers from two educational levels of primary schools. METHODS: The study included subsamples of 868 class teachers (lower grades) and 1057 subject teachers (upper grades) employed at 104 primary schools in Croatia. Teachers filled out self-report scales measuring burnout, work engagement, perceived Principal support and the positive and negative emotions experienced in relation to students. RESULTS: Emotions partially mediate the relationship between perceived Principal support and work engagement and burnout among teachers. Although class teachers experience higher levels of positive emotions and work engagement compared to subject teachers, the results confirmed the structural equivalence of the hypothesized model across two education levels of primary school. CONSLUSION: The Principal support predicts work engagement and burnout in teachers both directly and indirectly via emotions.

General mental health of seafarers' partners: Testing the role of personal resources and human-resource practices.

BACKGROUND: The dual life of seafarers and their families is recognized as a unique life which may bring various sources of stress for seafarers' partners. OBJECTIVE: The study focuses on the explanation of the mental health of seafarers' partners, by testing the role of different individual characteristics, and the organizational characteristics of their partners' job. METHODS: The sample consisted of 539 women who declared themselves as seafarers' partners (age range: 18-60 years). The on-line survey consisted of questions, relating to demographic characteristics of the participants and characteristics of their partners' jobs, and a set of scales measuring general mental health, relationship satisfaction, stress coping strategies, perceived social support, and resilience. RESULTS: The results showed that, after controlling for demographic characteristics, significant contributions in the explanation of the mental health of seafarers' partners are made by the following measures: resilience, relationship satisfaction, perceived social support, and use of stress coping strategies (a lower level of dysfunctional coping strategies, and a higher level of emotion-focused strategies). In addition, a favourable ratio between working and non-working days on the part of their seafaring partners contributed to the explanation of their general mental health. CONCLUSIONS: The results obtained confirmed the role of personal resources and human-resource practices in the explanation of the mental health of seafarers' partners.

A two-wave panel study on teachers' emotions and emotional-labour strategies.

The aim of this study was to examine the reciprocal relations between discrete emotions that teachers typically experience while teaching and interacting with students (i.e., joy, love, anger, and hopelessness) and emotional labour strategies (i.e., deep acting and two forms of surface acting-hiding feelings and faking emotions) over time. To address these research aims, two-wave panel design and cross-lagged structural equation modeling were implemented. An initial sample of 2,022 teachers filled in questionnaires with a time lag of 6 months. The results showed that teachers' emotions and emotional labour are related to each other over time. Love positively predicted deep acting and anger positively predicted hiding feelings and faking emotion over time. The opposite direction of association was also established-deep acting positively predicted joy, whereas hiding feelings positively predicted hopelessness. The results highlight the importance of taking a discrete approach to emotions and triadic approach to emotional labour when examining their reciprocal relations and may have important practical implications in promoting teachers' emotional well-being.

Lifestyle factors in Croatian seafarers as relating to health and stress on board.

BACKGROUND: Seafaring is characterized by specific stressors and health risks. OBJECTIVE: The purpose of this article was to compare the prevalence of various lifestyle factors between the shipping and home environments, and in addition to test the relations between lifestyle factors, perceived stress on board, and health in seafarers. METHODS: A total of 530 Croatian seafarers participated in an on-line survey. The questionnaire contained requests for demographic data and a set of questions relating to lifestyle, stress on board, physical health symptoms, and mental health. RESULTS: The data showed higher sleep deprivation, higher levels of smoking and unhealthier diet at sea than at home, with prevalence of alcohol consumption and physical exercise being more favourable for the shipping environment. Sleep deprivation, unhealthy diet, lack of physical exercise, and smoking are shown as negative correlates of various measures of health. Stress on board was associated with sleep deprivation and unhealthy diet, and with more unfavourable physical and mental health. CONCLUSIONS: The results give practical implications for promoting health in seafarers. Some of the lifestyle factors tested, such as alcohol use, smoking and physical exercise, fall rather under individual control, but others, such as a healthy, balanced diet on board and sleeping hygiene at sea, should be improved by shipping management.

Testing the associations between different aspects of seafarers' employment contract and on-board internet access and their job and life satisfaction and health.

The aim of this study was to test for associations between different aspects of contract and on-board internet access and seafarers' satisfaction and health. Altogether 298 Croatian seafarers, all officers, employed on cargo ships, with a minimum work experience of two years with their current shipping company, participated in an online survey. The questionnaire included sociodemographic items, questions relating to their employment contract and internet access, and measures of job satisfaction, life satisfaction, mental health, and gastrointestinal and cardiovascular symptoms. Their job- and lifesatisfaction levels were higher for shorter duration on board, favourable ratio of work to non-work days, and compliance with the employment contract regarding the changes to work and non-work days. Mental health differed likewise but only in relation to two aspects of the contract: on-board duration and compliance with the contract. The level of gastrointestinal symptoms was lower in cases of shorter on-board duration and compliance with the contract, and in seafarers who have free, unlimited internet access on board. Lower level of cardiovascular symptoms was found in seafarers with free, unlimited internet access on board. Our findings suggest that in promoting satisfaction and health in seafaring, attention should be given to reducing on-board duration, compliance with the contract, and internet accessibility on board.

Descriptive study of job satisfaction and job dissatisfaction in a sample of Croatian seafarers.

BACKGROUND: Given the general lack of studies on well-being in Croatian seafarers, the aim of this study was to determine the level and sources of their job satisfaction and job dissatisfaction. MATERIALS AND METHODS: This descriptive study was conducted on a sample of Croatian seafarers (n = 530), employed in various functions on cargo ships. Using an online survey, we examined overall job satisfaction, and satisfaction with some specific aspects of work. Participants additionally responded to two open questions relating to the sources of their job satisfaction and job dissatisfaction, and these data were analysed using a qualitative approach. RESULTS AND CONCLUSIONS: The results showed a moderate level of overall job satisfaction, while analysis of the 10 specific facets indicated that the participants are, on average, most satisfied with payment, and least satisfied with the achieved benefits and work organisation on board. The results of the qualitative analysis showed that among the main sources of job satisfaction are: financial stability and security, the ratio of work days to days off, and the quality of days off, and the nature and dynamics of the work. On the other hand, sources of dissatisfaction relate primarily to: separation from home and family, the status of Croatian seafarers in the Republic of Croatia, and working and living conditions on board.

Work stress among university teachers: gender and position differences.

The aim of this study was to investigate exposure to stress at work in university teachers and see if there were differences between men and women as well as between positions. The study was carried out online and included a representative sample of 1,168 teachers employed at universities in Croatia. This included all teaching positions: assistants (50%), assistant professors (18%), associate professors (17%), and full professors (15%). Fifty-seven percent of the sample were women. The participants answered a questionnaire of our own design that measured six groups of stressors: workload, material and technical conditions at work, relationships with colleagues at work, work with students, work organisation, and social recognition and status. Women reported greater stress than men. Assistant professors, associate professors, and full professors reported greater stress related to material and technical conditions of work and work organisation than assistants, who, in turn, found relationships with colleagues a greater stressor. Full professors, reported lower exposure to stress at work than associate professors, assistant professors, and assistants.