SHIFTING JUDICIAL CONCEPTIONS OF 'RECONCILIATION': GEOGRAPHIC COMMITMENTS UNDERPINNING ABORIGINAL RIGHTS DECISIONS

Over the course of the past twenty years, the Supreme Court of Canada’s discourse concerning ‘reconciliation’ has shifted from moderating federal power to reconciling the preceding presence of Aboriginal people with an established sovereign (Crown) presence.  While scholars postulated that the Court was attempting to maintain colonial relations of power, substantive answers for this discursive shift are lacking within the literature.  This paper provides a comprehensive explanation of this shift by comparing the hearing transcripts in the ‘Aboriginal rights trilogy’ to their corresponding written decisions.  It argues that particular judicial and geographic commitments underlie the concept of ‘reconciliation’ and ultimately serve to represent Aboriginal identity as inescapably ‘Canadian.’   Au cours des vingt dernières années, le discours de la Cour suprême du Canada concernant la « réconciliation » est passé de l’atténuation du pouvoir fédéral à la conciliation entre la présence antérieure des Autochtones et une présence souveraine (de la Couronne) établie. Bien que les universitaires aient affirmé que la Cour tentait de maintenir des relations de pouvoir coloniales, l’évolution du discours n’est pas expliquée de façon concrète dans la littérature. Le présent article explique cette évolution de façon détaillée en comparant les transcriptions d’audience dans la « trilogie sur les droits ancestraux » à leurs décisions écrites correspondantes. Il fait valoir que des engagements judiciaires et géographiques particuliers sous-tendent le concept de la « réconciliation » et servent en définitive à représenter l’identité autochtone comme étant inévitablement « canadienne »

Paediatric pneumonia: a guide to diagnosis, investigation and treatment

Community-acquired pneumonia remains the leading cause of death in children under 5 years of age throughout the world. Community acquired pneumonia can include bacterial, viral and fungal causes but it is very difficult to clinically differentiate between them. Whilst viral pathogens have been identified as the most common aetiology, bacterial infections are considered the more likely to cause severe disease. It is important that the clinician has the ability to safely differentiate between those that may require further treatment or admission to hospital and those that can be managed at home. With a wide range of presenting symptoms and potential complications, pneumonia poses a challenge for paediatricians. This article aims to guide physicians in the management, diagnosis and follow up of children with suspected pneumonia, as well as discuss future developments in this field.</p

Can omalizumab be used effectively to treat severe conjunctivitis in children with asthma? A case example and review of the literature

A 14-year-old girl with poorly controlled asthma attended the difficult-to-treat asthma clinic for review. Although she has eosinophilia and significantly raised immunoglobulin E levels, she is not currently a candidate for omalizumab (Xolair). She also suffers from chronic urticaria, eosinophilic eosophagitis and severe conjunctivitis. You wonder if omalizumab would be effective in treating her multiple atopic conditions, in particular her troublesome conjunctivitis. PubMed was searched using the following search terms: (Omalizumab) or (Xolair) and (conjunctivitis). Searches were conducted in November 2020. Abstracts were selected for full text review if the study population identified asthma as a comorbidity. Non-paediatric studies and those that were not written in English were excluded. The use of omalizumab has the potential to be effective in the treatment of conjunctivitis associated with asthma and other atopic conditions. However, research is needed to address the question, in the form of multicenter, double-blind randomized control trials

Medication adherence in children with asthma

Asthma is the most common chronic disease in childhood. If untreated, asthma can lead to debilitating daily symptoms which affect quality of life, but more importantly can lead to fatal asthma attacks which unfortunately still occur globally. The most effective treatment strategy for controlling asthma is for the patient to follow a personalised asthma action plan (PAAP) which will invariably include regular use of an inhaled corticosteroid. To examine medication adherence in children with asthma, we collated recent evidence from systematic reviews in this area to address the following 5 key questions; What is adherence? Is there evidence that children are not adhering to preventer medication? Why is adherence poor and what are the barriers to adherence? Does good adherence improve outcomes in asthma? And lastly, how can treatment adherence be improved

The use of remote video directly observed therapy to improve both inhaler technique and adherence to asthma medications

Incorrect inhaler technique and non-adherence to inhaled preventer therapy often is the cause of poorly controlled asthma. Detecting and correcting non-adherence in asthma therapy has proven difficult. In addition, while patients may be able to demonstrate correct inhaler technique at the clinic recent evidence suggests that critical errors in inhaler technique occur in the home setting. Remote video directly observed therapy (vDOT) has recently been described as a potentially useful tool for addressing non-adherence while also allowing timely correction of inhaler technique errors. In this mini-review we describe the use of vDOT in asthma management