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Surveys in five automobile plants in Canada and the United Kingdom (n=2,600+) indicated that implementation of lean production methods has been uneven across companies and countries and is not associated with greater employee involvement or control. Variations may reflect company-specific responses to the pressures of international competition. (Contains 38 references.) (SK)

The author reflects on being involved in the planning of the 2007 Collaborative Conference in March 2007. The author states that his group's collaborative effort with Canada has expanded the benefit of networking with professional colleagues. One of his personal satisfactions from serving on the 2007 Steering Committee was the opportunity to become friends with his cohorts from the Canadian Federation of Music Teachers.

Gold mining is the largest source of mercury (Hg) pollution worldwide. The discharge of mercury in the environment bears direct human health risks and is likely to increase cascading effects throughout local food chains. In the Peruvian Amazon the mining process consists of slashing and burning trees, followed by extraction of gold-bearing sediment, amalgamation with Hg and gold recovery, leading each year to the degradation of 6,000-10,000 ha and the release of 180 metric tons of Hg per year to the enviroment. The purpose of this study was to determine soil Hg levels in soils of abandoned alluvial gold mine spoils and undisturbed forest in the Madre de Dios region, the epicenter of alluvial gold mining in Peru. We selected gold mine spoils of the two most important technologies locally applied for gold extraction, i.e., Minimally Mechanized Mining (MMM) and Highly Mechanized Mining (HMM), in the native communities of Laberinto and Kotzimba, respectively. We collected 127 and 35 soil samples (0-20cm depth) from potentially contaminated sites and undisturbed forest, respectively. Physicochemical analysis and determination of Hg levels were determined for all soil samples. None of the samples had Hg concentrations above Peruvian, Canadian and British Environmental Quality Standards for Agricultural Soil (6.6mg/kg). Hg levels in MMM and HMM were not significantly different between the two areas. The main variables explaining variation of soil Hg concentrations were the vegetation cover, soil organic matter, soil pH and clay particle content, which explained up to 80% of data set variation. Surprisingly, highest Hg concentrations were found in untouched old-growth forest bordering the mine spoils, but there was also a trend of increasing Hg concentrations with the regenerating vegetation. Our findings suggest that Hg concentrations in old mine spoils are low and shouldn't stand in the way of efforts to restore soil conditions and develop sustainable land uses. However, it is urgent to end the use of Hg in mining operation to decrease human and environmental risks., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Patients with resected oral cavity squamous cell carcinoma (OCSCC) are often treated with adjuvant radiation (RT) ± concomitant chemotherapy based on pathological findings. Standard RT volumes include all surgically dissected areas, including the tumour bed and dissected neck. RT has significant acute and long-term toxicities including odynophagia, dysphagia, dermatitis and fibrosis. The goal of this study is to assess the rate of regional failure with omission of radiation to the surgically dissected pathologically node negative (pN0) hemi-neck(s) compared to historical control, and to compare oncologic outcomes, toxicity, and quality of life (QoL) profiles between standard RT volumes and omission of RT to the pN0 neck., Methods: This is a multicentre phase II study randomizing 90 patients with T1-4 N0-2 OCSCC with at least one pN0 hemi-neck in a 1:2 ratio between standard RT volumes and omission of RT to the pN0 hemi-neck(s). Patients will be stratified based on overall nodal status (nodal involvement vs. no nodal involvement) and use of concurrent chemotherapy. The primary endpoint is regional failure in the pN0 hemi-neck(s); we hypothesize that a 2-year regional recurrence of 20% or less will be achieved. Secondary endpoints include overall and progression-free survival, local recurrence, rate of salvage therapy, toxicity and QoL., Discussion: This study will provide an assessment of omission of RT to the dissected pN0 hemi-neck(s) on oncologic outcomes, QoL and toxicity. Results will inform the design of future definitive phase III trials., Trial Registration: Clinicaltrials.gov identifier: NCT03997643 . Date of registration: June 25, 2019, Current version: 2.0 on July 11 2020.

Purpose: In pediatric practice, the official drug label often does not accurately reflect the contemporary use of many drugs prescribed to children. Therefore, clinicians frequently use contemporary drug references as a source of prescribing information instead of national formularies. The objective of this study was to compare drug prescriptions between two national formularies and two commonly used contemporary pediatric reference guidelines in the operating room/postanesthetic care unit (OR/PACU), pediatric intensive care unit (PICU), and neonatal intensive care unit (NICU)., Methods: We performed a retrospective chart review of patients admitted over a one-month period to the NICU and PICU, and for one week during the same month, we reviewed charts of patients in the OR/PACU. The data collected included patients' demographic information, drugs prescribed, and dosage information. We assessed conformity with two national formularies, the Canadian Compendium of Pharmaceuticals and Specialties (CPS) and France's 2009 Dictionnaire Vidal (Vidal), and two contemporary pediatric references, the Hospital for Sick Children Handbook and Formulary and the Lexi-Comp Pediatric Dosage Handbook., Results: Across the three clinical units, 59.7% (95% confidence interval [CI] 57.1-62.1%) of prescriptions were identified as being off-label, as defined by the CPS formulary. The odds of having an off-label prescription would have been substantially lower if the contemporary pediatric references (odds ratio [OR] = 0.074; 95% CI 0.065-0.084) or Vidal (OR = 0.70; 95% CI 0.63-0.77) had been used to define the label (both P < 0.001 compared with the CPS)., Conclusion: Drugs are less likely to be off-label if prescribed according to a contemporary pediatric reference rather than according to national formularies. Methodologies used to compile contemporary references might serve as templates to inform a drug's official label.