Effects of a worker participatory program for improving work environments on job stressors and mental health among workers: a controlled trial.

The Mental Health Action Checklist for a Better Workplace Environment (MHACL) is a tool for a worker participatory approach to improve work environments for worker mental health. The present study investigated the effects of an organizational intervention using the MHACL on reducing job stressors and the psychological distress of workers of a manufacturing enterprise in Japan with a controlled study design. Nine of 45 departments participated in a work environment improvement program, including planning workshops, implementation and monitoring, between July and December 2005 (intervention group, n=321). The remaining 36 departments served as the control group (n=750). Outcomes (job stressors, worksite support, psychological distress, etc.), measured using the Brief Job Stress Questionnaire, as well as sick leave days taken from the company record, were recorded before and six months after the program for both groups. Among women, skill underutilization, supervisor and coworker support, psychological distress, and job satisfaction changed more favorably in the intervention group than in the control group (p<0.05). No significant favorable effect of the program was observed among men. Improvements in the outcomes were more prominent among departments with a 50% or higher rate of worker participation in the planning workshops and among departments with a 50% or higher rate of implemented vs. planned actions. A worker participatory organizational intervention using the MHACL seems effective for promoting mental health among Japanese white-collar women.

[A case of elderly non-small-cell lung cancer (NSCLC) treated in cooperation with a local hospital and with vinorelbine monotherapy].

We report an elderly advanced NSCLC patient effectively treated with vinorelbine on an outpatient basis in cooperation with his family doctor. A 79-year-old man was referred to our hospital for evaluation of a nodular shadow in his right lung. Chest CT scan showed a 2.0 cm tumor shadow in right S1, and small nodular shadows in right S4 and left S5. Neck lymph node biopsy yielded a diagnosis of adenocarcinoma. The clinical stage was IV, and he underwent chemotherapy of vinorelbine 25 mg/m2 on days 1 and 8. The regimen opted for a setup of a schedule, while the dose of vinorelbine and evaluation by CT were done in our hospital. This regimen was well tolerated and suitable. The patient could receive long-term continuation of the chemotherapy medication, and showed improvement in terms of prolongation of life and QOL.