Objectives To explore the relationship of serious infection risk with current and prior oral glucocorticoid (GC) therapy in elderly patients with rheumatoid arthritis (RA). Methods A case-control analysis matched 1947 serious infection cases to fi ve controls, selected from 16207 RA patients aged ≥65 between 1985-2003 in Quebec, Canada. Adjusted odds ratios for infection associated with different GC patterns were estimated using conventional models and a weighted cumulative dose (WCD) model. Results The WCD model predicted risks better than conventional models. Current and recent GC doses had highest impact on current risk. Doses taken up to 2.5 years ago were also associated with increased risk, albeit to a lesser extent. A current user of 5mg prednisolone had a 30%, 46% or 100% increased risk of serious infection when used continuously for the last 3 months, 6 months or 3 years, respectively, compared to a non-user. The risk associated with 5mg prednisolone taken for the last 3 years was similar to that associated with 30mg taken for the last month. Discontinuing a two-year course of 10mg prednisolone six months ago halved the risk compared to ongoing use. Conclusions GC therapy is associated with infection risk in older patients with RA. The WCD model provided more accurate risk estimates than conventional models. Current and recent doses have greatest impact on infection risk, but the cumulative impact of doses taken in the last 2-3 years still affects risk. Knowing how risk depends on pattern of GC use will contribute to an improved benefi t/harm assessment.
In the last two decades, provincial and local governments in Canada took a new series of measures to regulate urban disorder and control how public spaces were used by homeless people. Ontario became the first province to adopt new legislation with the passage of the Safe Streets Act, 1999. British Columbia soon followed the same path and enacted its own Safe Streets Act in 2004. This article focuses on the enforcement of the Safe Streets Act in Ontario and BC. Using quantitative data on tickets delivered to homeless people, it examines the extent of the penalization of homeless populations and establishes trends in the application of these statutes in both provinces. It concludes that the application reflects tensions around the visibility of homeless people in public spaces, particularly relating to squeegeeing, in both Ontario and British Columbia.
This paper documents court-imposed bail and sentencing conditions with spatial dimensions, such as red zones, no contact conditions, curfews and prohibitions to demonstrate, issued in the context of criminal proceedings. These conditional orders, which are growing in importance and have a significant impact on the lives of marginalized groups of people, have not received the attention they deserve in the literature. As opposed to better publicized forms of spatial regulation such as legislation or policing strategies, these conditional orders are a distinctive form of spatial tactic that rely on ancient and routinized rules of criminal procedure and the practices of the courts. In order to understand this spatial tactic, and its impact on marginalized people's rights and uses of spaces, we argue that it is necessary to pay attention to the legal rationalities, knowledge and practices that sustain them. Résumé: Cet article porte sur le recours grandissant aux conditions à caractère spatial ou géographique, telles que des conditions de ne pas se trouver dans certains lieux publics, de respecter un quadrilatère ou un couvre-feu, une interdiction de communiquer ou encore une interdiction de manifester, imposées dans des ordonnances de mise en liberté ou lors de la détermination de la peine dans le cadre de procédures criminelles. Ces conditions ont des conséquences importantes sur les populations itinérantes et marginalisées et n'ont pas encore été explorées en profondeur dans la littérature. Contrairement à d'autres formes mieux connues de régulation spatiale, telles que la législation ou les stratégies policières, ces ordonnances s'appuient sur des règles de procédure criminelle bien établies et des pratiques judiciaires routinières. Afin de mieux comprendre ces tactiques spatiales ainsi que leurs conséquences sur les droits des personnes marginalisées et leur utilisation des espaces publics, nous suggérons qu'il est impératif de s'intéresser aux rationalités juridiques et aux pratiques qui soutiennent ces ordonnances.
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