General Counsel Research Articles

Viral Suppression among Men Who Have Sex with Men Living With HIV on Risk Reduction Interventions in Mvita Sub-County, Mombasa County, Kenya

Purpose: The aim of this study was to compare viral load suppression levels among men who have sex with men (MSM) living with HIV who were put on risk reduction interventions versus a control group in Mvita sub-county, Mombasa County, Kenya between December 2020 and June 2021. Methodology: A quasi-experimental study design using quantitative methods was conducted among MSM living with HIV from December 2020 to June 2021. The study involved a questionnaire and various laboratory investigations. The respondent-driven sampling (RDS) was used to obtain the sample of respondents. A total of 114 HIV positive MSM completed the study and were all subjected to a battery of tests. Blood was drawn for alcohol, syphilis, hepatitis B, and viral load tests, while urine was used to screen for drugs and gonorrhoea. Half (57) of the HIV positive MSM were actively followed and risk reduction interventions such as adherence to ARVs, general counselling, and HIV prevention measures such as prompt treatment of STI/OI and condom use were offered after every 2 months. The control group (57) received no risk reduction interventions. Thereafter, both groups were asked to respond to a questionnaire. Since the study was carried out during COVID-19, the risk reduction interventions were conducted over the phone to minimize transmission. Log-binomial univariate and the multivariate regression analysis model was used to identify the variables which were associated with undetectable viral load. Undetectable viral load was defined as having an HIV viral load of less than 50 copies/ml. Data generated from the questionnaires were collected, cleaned, coded and analysed using STATA software, Version 17. Level of significance was fixed at 5% (95% confidence interval). Findings: Majority of MSM living with HIV were between 19-20 years and 49% were actively followed by the researcher and received risk reduction interventions while 54% were in the control group. However, the baseline demographic characteristics were not significantly different (all p>0.05). MSM in the control group who were neither Christian nor Muslim (11%) and had a lower income (35%), were likely to have detectable viral load. However, MSM who had a higher income in both groups (1.8%), were likely to have undetectable viral load. MSM in the control group, who reported ever use of PEP/PrEP (44%), were likely to have detectable viral load while MSM who received interventions, who reported condom break more than once during anal sex (61%), who had more than one regular anal sex partner (61% both groups), and those who drunk more than 2 bottles of beer (33% both groups) were likely to have undetectable viral load. However, MSM who received interventions but used non-prescribed injectables drugs 1 to 2 times in a week (15%), were likely to have detectable viral load. MSM in the control group who reported being always high on alcohol during anal sex (19%), were likely to have detectable viral load but those chewing muguka (type of khat) (79%) were likely to have undetectable viral load. MSM who received interventions who reported feeling uneasy while seeking health services (75%), had detectable viral load while those in the control group who attended private clinics (42%), had undetectable viral load. Overall, after six months, the proportion of MSM achieving viral load suppression was significantly higher in the intervention group as compared to control group by 60% (95% CI 49‒70)), p-value < 0.001. Unique Contribution to Theory, Practice and Policy: The study found out that majority of HIV positive MSM who received risk reduction intervention, had undetectable viral load as compared to those in the control group. HIV viral suppression is the desirable outcome for MSM on ART, since once achieved, MSM cannot transmit the virus to their sex partners. The Government/NGO should encourage peer-led HIV services to run the HIV programmes involving MSM with other stakeholders. Thus, many MSM will be able to access the HIV services where their needs will be addressed and supported in a non-judgemental environment.

Is it really all about the money? The future of European standardization after PublicResourceOrg

Abstract On 5 March 2024 the European Court of Justice (CJEU) issued a landmark decision on access to harmonised standards that grant presumption of conformity with legal requirements. The CJEU ruled that such standards should be made available free of charge because, once incorporated in EU legislation, they form part of EU law. While the decision was positively received in the scholarly community, it is expected to carry profound consequences for European standards organisations, who hold copyrights over harmonised standards and rely on their sales to finance their standardisation activities. The judgment may also affect the European Commission, whom the Advocate General and the CJEU placed at the centre of European standardisation due to its role in transforming harmonised standards into EU law. This case note engages with the ruling and aims to shed light onto its possible implications for the European standardisation system.

Mapping the influence: Institutional blockholder coordination and climate change risk disclosure

This study investigates the relationship between institutional blockholder coordination, proxied by geographic proximity, and climate change risk disclosure. Using a sample of 2,887 firm-year observations for S&P 500 companies from 2010 to 2022, we reveal that a firm's climate change risk disclosure decreases when its institutional blockholders are more coordinated. In addition, we find that the negative relationship between institutional blockholder coordination and climate change risk disclosure manifests more in firms with less diversified institutional blockholders, a smaller number of institutional blockholders, a prominent position to their blockholders, and more dedicated institutional blockholder ownership. Moreover, we find that the negative association between institutional blockholder coordination and climate change risk disclosure is more pronounced in firms with corporate general counsels, a non-concentrated customer base, higher asset tangibility, and those that are environmentally sensitive. Our main conclusion still holds after using an alternative measure for climate change risk disclosure as well as a battery of endogeneity tests. Finally, we propose that institutional blockholder coordination lessens climate change risk disclosure through the channel of increased performance-induced CEO dismissal. Collectively, this study provides insightful implications for academics, financial statement users, regulators, and policymakers.

Factors affecting employment status in people with epilepsy

Aim: People with epilepsy often face difficulties finding and keeping a job in India. This study aimed to determine the employment rate of people with epilepsy, compare it with that of people without epilepsy and to assess the various factors affecting theiremployment status. Methods: A comparative cross-sectional study was done by recruiting 140 people with epilepsy and 140 people without epilepsy (relatives of patients) from an epilepsy clinic in New Delhi, India. Demographic and clinical data were collected using questionnaires. Additionally, five items were added to measure self-perceived importance of work, ability to work and family support for working. Psychometric scales were used to measure the psychosocial variables affecting employment. Questionnaires were completed by people with epilepsy. Results: The employment rate of people with epilepsy was 59.3% as compared to 70.0% in those without epilepsy (P=0.045). Gender, younger age, having fewer family members, higher educational attainment, self-perceived importance of being employed for personal and financial reasons, and the ability to work and family support for working were some of the factors associated with employment status in people with epilepsy (P<0.05). Among the psychosocial variables, epilepsy stigma and perceived social support were found to be significantly associated with being employed (P<0.05). None of the clinical variables were found to be associated. Of those in the study, 56 out of 83 people with epilepsy, who had a job, felt they were underemployed. Conclusions: The employment rate of people with epilepsy was lower than the control population. The majority of those with jobs felt they were underemployed. A host of factors affect employment status in people with epilepsy. This suggests the need for vocational training, raised awareness among the general population, and counselling and other services for people with epilepsy.

Assessment Of the Adherence to Perioperative Nutritional Care Protocols in Brazilian Hospitals: The Preop Week Study

ObjectivesThe study (PreopWeek) aimed to assess the perioperative nutritional care for major surgical patients in Brazilian hospitals, focusing on adherence to emerging multimodal protocols like ERAS and ACERTO. Research Methods & ProceduresAn observational cross-sectional study was conducted in Brazilian hospitals enrolled voluntarily from 19 to 23/06/2023 (convenience sample). Data were collected through patient interviews and medical records review. ResultsData from 219 patients up to the 5th postoperative day or postoperative discharge across 24 hospitals were analyzed. Only three hospitals (12.5%) had established institutional perioperative protocols. Most of the patients were female (60.3%) and over 60 years old (81.7%), submitted to gastrointestinal (34.7%) or orthopedic surgeries (33.3%). General and nutritional preoperative counseling were provided to 82.2% and 62.6% of the patients. Only 25.7% of the patients had preoperative fasting for up to 3 hours, and 28.8% received carbohydrate-rich supplements. Immunonutrition was not received by 43.8% at any moment. Although most started postoperative refeeding within 24 hours (81.7%), 39.4% started with a liquid diet, and 70.6% reported postoperative immobilization in the first 24 hours. Notable differences were observed between hospitals with and without protocols. Hospitals with institutional protocols referred significantly more preoperative exercises and nutritional counseling and higher adherence rates to all the perioperative protocols. ConclusionOur study demonstrates a lack of adherence to the multimodal protocols, even in hospitals with institutional protocols. Future educational programs are necessary to improve this result.

Watch those OD numbers!

In a comment entitled “the new math,” Rob Kent, former general counsel for the federal Office of National Drug Control Policy, and before that general counsel for the New York Office of Addiction Services and Supports (OASAS), sent us this.

Vocational Rehabilitation in Times of the Covid-19 Pandemic

The Covid-19 pandemic has posed new challenges to actors in vocational rehabilitation (VR) for people with disabilities. In this study, we were interested in the following: How did actors like service providers and financers of VR (here: German Federal Employment Agency (FEA)) experience the Covid-19 pandemic, which process changes and delays have occurred, and what impact will this possibly have on the future of vocational rehabilitation for people with disabilities? Between July 2020 und July 2021, a total of 29 persons from service providers of VR programs (n=16) and representatives of the FEA (n=8) were asked about their experiences during the Covid-19 pandemic in the course of 24 guided expert interviews. The interviews were recorded, transcribed, coded in MAXQDA; the analyses of the transcribed material are based on a system developed from inductive and deductive categories. VR programs had to be conducted remotely, digital possibilities had to be created. As a result, VR was also forced to evolve technologically, revealing opportunities (in the provision of programs) and limitations (e. g. acquisition of social skills or assessment of mental health). Thus, continuous additional support by the service providers was indispensable to contain psychological crises, to ensure the understanding of the program contents and to avoid dropouts. Just like schools, the employment agencies and job centers closed their doors for a long time and VR and general vocational counseling did not take place nor did assessment procedures carried out at the medical and psychological services of the FEA for determining VR needs. A decline in access to VR had been apparent for some time, but it became increasingly evident, particularly for 2021/22. Individuals from poor households were more likely to be affected because they were more difficult to keep in touch with. Even though VR has experienced a major digital boost, experience from the pandemic has shown that programs in face-to-face formats with social contact are particularly important for young people and people with mental disabilities. Nevertheless, VR must change with the working environment in order to prevent people with disabilities from being left behind even further.

The Effects of Burnout, Team Support, and Perceived Leader Effectiveness on Career Intentions Among JAG Corps Personnel.

Destructive interpersonal relationships at work may result in negative feelings among employees that hinder personal and organizational productivity, which may also result in high levels of job disengagement and subsequent career turnover intentions. Leaders play a key role in creating work environments conducive to optimizing employee performance, organizational culture, and workplace well-being. Social support, which may include support from one's supervisor, colleagues, and loved ones, has been shown to reduce strains and perceived stressors at work. In the Army, the Judge Advocate General's Corps (JAGC) personnel have a unique position as lawyers and legal staff and have been shown to have high rates of burnout. To promote soldier health, well-being, and career longevity, it is important to understand the impact interpersonal relationships have on career intentions. The current study assesses the relationship between perceived leadership effectiveness and career intentions as moderated by burnout measured by job disengagement and team care activities in JAGC personnel. The Walter Reed Army Institute of Research conducted a survey to understand factors affecting the well-being of the JAGC's soldier and civilian personnel as requested by the JAGC. JAGC personnel were administered several questionnaires covering a range of work and mental health topics. Job disengagement, career intentions, team care activities, and general leadership were assessed. A total of 831 JAGC personnel completed the survey, the majority (92%) of which were soldiers. Among soldiers, first lieutenants and captains (∼49%) were the majority. The sample largely consisted of men (∼63%), White individuals (∼76%), married individuals, (70%), and individuals with graduate degrees (∼81%). One in four participants (∼29%) experienced high levels of disengagement, with their work. Over two-thirds of participants agreed that their immediate supervisor is an effective leader. When asked about career intentions, the majority of JAGC participants (54%) indicated that they would probably or definitely stay in the JAGC until retirement. Ordinal logistic regressions were conducted to assess the relationship between perceived leader effectiveness and career intentions, assessing the main effects of job disengagement and team care activities, and the interactions between those variables. No interaction effects were found to be significant, but main effects for perceived leader effectiveness were significant. JAGC personnel reported higher levels of job disengagement for those with career intentions that were undecided or definitely leaving the JAGC after their current obligation. Those who were engaged in more team care activities had lower levels of disengagement. While the majority of the JAGC participants indicated career intentions to stay in the JAGC until retirement, increasing perceived effectiveness of leaders could help increase attrition and career intentions to stay in the JAGC beyond one's current obligation.

Donald N. Bersoff (1939-2024).

This article memorializes Donald N. Bersoff (1939-2024), who provided a foundational influence on the development of American law-psychology and served as the 2013 president of the American Psychological Association (APA). Don had a long and meaningful career as a psychologist and a lawyer. One of Don's greatest interests was in training psychologist-lawyers who would make meaningful contributions to either field. After a decade as APA general counsel, he was recruited to direct the law-psychology program at Hahnemann University and Villanova School of Law. He was elected as the president of the APA in 2013; two of the major themes of his presidency involved encouraging service to military veterans and their families, and promoting diversity within the ranks of psychology to better serve an increasingly diverse population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Legal Mind at the Helm: General Counsel in Top Management and Firm Innovation

Legal Mind at the Helm: General Counsel in Top Management and Firm Innovation

VAT/GST harmonisation challenges for digital assets such as bitcoin and NFTs in the EU following Case C-264/14 (Skatteverket v David Hedqist)

The verdict in the case of Skatteverket v. David Hedqvist (Kokott, Advocate General (2015) Opinion delivered on 16 July 2015, Case C-264/14. ECLI:EU:C:2015:498. Available via TandF Online. https://doi.org/10.1080/20488432.2015.1096631.) is crucial for understanding how the EU treats virtual currencies, such as Bitcoin, in terms of Value-added Tax (VAT). This case involved the Swedish citizen David Hedqist who was seeking clarity from the Swedish Tax Authority Skatteverket on exchanging money for Bitcoins. The case set a precedent exempting such services from VAT under the EU’s VAT Directive (Council Directive 2006/112/EC (2006) On the common system of value added tax. OJ L347. Available via EUR-Lex. https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:32006L0112. Accessed 3 January 2024.). Specifically, Article 135(1)(e) of the EU’s VAT Directive excludes those transactions from VAT that include money-related transactions, that include deals or negotiations about different kinds of money, including cash and coins that are officially legal tender, i.e., used for buying things, except for collectable items like special coins or notes that people collect but do not use as a means of payment. Skatteverket (Kokott, Advocate General (2015) Opinion delivered on 16 July 2015, Case C-264/14. ECLI:EU:C:2015:498. Available via TandF Online. https://doi.org/10.1080/20488432.2015.1096631.) clarified that cash transactions are not subject to VAT, even though they are considered services for VAT purposes.Despite this clarity, the evolving landscape of digital assets’ uniqueness, including Non-Fungible Tokens (Alawadhi KM, Alshamali N (2022) NFTs Emergence in Financial Markets and their Correlation with DeFis and Cryptocurrencies. Applied Economics and Finance 9:108. https://doi.org/10.11114/aef.v9i1.5444. Available at CORE. https://core.ac.uk/download/pdf/524752899.pdf. Accessed 3 January 2024.), continues to challenge VAT frameworks across member states.Using insights from the European Commission’s Working Paper 1060, this article advocates for a unified approach tailored to digital and crypto services, addressing complexities in NFT taxation to reduce uncertainty and foster market cohesion. The findings highlight the importance of legislative changes and increased cross-border collaboration, as well as provide recommendations for policymakers and stakeholders in the digital finance and platform sector (European Commission (2024) Working Paper 1060. Available at: https://ec.europa.eu/info/publications/working-paper-1060_en. Accessed 3 March 2024.). By proposing strategic harmonisation of VAT enforcement, the research helps to improve tax compliance and support long-term growth in the EU’s digital market (Cappai M (2023) The role of private and public regulation in the case study of crypto-assets: The Italian move towards participatory regulation. Computer Law & Security Review 49:105831. Available at: https://www.sciencedirect.com/journal/computer-law-and-security-review/vol/49/suppl/C.; Hasa J (2021) Digitaalisten palvelujen rajat ylittävä kuluttajakauppa ja laajeneva arvonlisäveron erityisjärjestelmä. Licentiate thesis. University of Lapland, Faculty of Law. Available at: https://lauda.ulapland.fi/bitstream/handle/10024/64771/Hasa_Juho.pdf?sequence=1. Accessed 1 March 2024.).

Compatibility of the DAC6 Obligation to Report Cross-Border Arrangements with Fundamental Rights: A Green Light from the Advocate General?

On 29 February 2024, Advocate General Emiliou of the Court of Justice of the European Union gave his Opinion in Belgian Association of Tax Lawyers and Others v. Premier ministre/Eerste Minister (Case C-623/22) on the compatibility of DAC6 with the principles of equality and non-discrimination, legality in criminal matters, legal certainty and the right to respect for private life. This contribution summarizes and criticizes the main elements of the Opinion, which will have major ramifications for the European tax transparency and tax cooperation regime if upheld by the Court of Justice of the European Union in its forthcoming DAC6 decision.

Advocate General’s Opinion in the X BV Case (C-585/22) – Exploring the Potential Interaction between Wholly Artificial Arrangements and the Arm’s Length Principle – Convergency or Divergency?

The proper characterization of the arm’s length principle (ALP) still represents an unresolved issue in the context of EU tax law since it is not clear whether it represents a rule on allocation of income aimed at avoiding economic double taxation or if should be interpreted de iure condendo as a specific provision aimed at determining the minimum level of substance requirement applicable to intercompany transactions. In this article, the authors express their preliminary comments on the Advocate General’s recent opinion in X BV (C-585/22) which concerns the notion of the ALP in the EU context, its departure from Lexel (C-484/19) and the related interplay between the concept of wholly artificial arrangements and the ALP within the EU tax law framework.

Efforts to Prevent Hypertension in The Kaili Tribe Community

Background: Hypertension causes many risks of premature death. The increase in hypertension sufferers in Palu City continues to fluctuate every year, the latest data for 2022 is that the number of hypertension sufferers is 7,848 cases and is in first place on the list of the highest non-communicable diseases. Based on medical record reports from the community health center, most of those suffering from hypertension complications from Kaili ethnic backgrounds are caused by lifestyle. Objective: This study aims to analyze efforts to prevent hypertension in the Kaili tribe community. Method: The type of research is qualitative research with an ethnographic approach. Data collection using independent interviews and observations. The research informants were 12 informants who were determined using the snowball sampling technique. Results: The research results show that the Kaili tribe community accepts health values in preventing hypertension through health activities such as Posbindu PTM and Sehat Friday, involving various parties. The general health protection norm is 5-30 minutes of light to heavy physical activity every day. The culture of consuming local fruit, such as bananas, is still strong with an average of 1-2 fruits per day, but the pattern of vegetable consumption is good even though there is an inappropriate habit of cooking vegetables with coconut milk. Routine health checks are carried out 1-3 times a month, including general examinations, blood pressure, blood sugar, urine and counseling. Conclusion: Suggestions for the Kaili tribe community to actively participate in health programs, so that they are aware, independent and able to avoid hypertension from an early age.

Implementing financial toxicity and health-related social risks screening and referral.

11006 Background: Financial toxicity (FT), or cancer-related economic hardship, is associated with delayed/skipped care, reduced quality of life, and worse mortality. Screening for FT and health-related social risks (HRSR) as part of assessment for social determinates of health is currently being integrated into clinical care, but there is limited research on outcomes after patients screen positive for FT or HRSR. Methods: We conducted FT and HRSR screening for patients receiving treatment for breast, gynecologic, gastrointestinal, or thoracic cancer at an urban comprehensive cancer center. Screening included the 11-item Comprehensive Score for Financial Toxicity (COST) tool (scored 0-44, lower scores = worse FT) and a HRSR checklist to identify food, housing, medicine, and transportation insecurity. A COST score ≤20 or any endorsed HRSR was considered a positive screen, and financial/assistance counseling referral was offered. Multivariable logistic regression assessed associations of accepting referral, after controlling for demographic and clinical characteristics. Data were collected 09/2022-08/2023. Results: 28,606 patients completed screening, of which 32% (n = 9106) screened positive. Median COST was 16.0. Identified HRSR were: 23% food, 25% housing, 21% medicine, and 24% transportation insecurity. Of positive screens, 51% (n = 4683) requested some form of financial counseling. Associations with accepted referral include: higher FT (β = 1.15, 95% CI: 1.13, 1.16), younger age (β = 1.01, 95% CI: 1.008, 1.02), more essential needs (β = 1.19, 95% CI: 1.13, 1.25), non-White race/ethnicity (β = 1.70, 95% CI: 1.49, 1.93), and stage 3 (β = 1.29, 95% CI: 1.08, 1.53) or stage 4 (β = 1.26, 95% CI: 1.07, 1.49) diagnoses (vs. stage 0/1). Needs of patients who requested counseling included concerns relating to out-of-pocket expenses (68%), non-medical expenses (39%), health insurance coverage (23%), and paying for prescription medication (18%; not mutually exclusive). Of financial counseling sessions with available dispositions (n = 2336/4683, 50%), outcomes (not mutually exclusive) included general counseling (29%), referral to specific assistance programs (e.g., copay assistance, reduced cost care program; 15%), and insurance navigation (15%). One-third of patients requesting counseling did not respond to contact attempts; 21% reported no longer being interested in counseling upon contact. Conclusions: Screening for FT and HRSR was feasible, and one-third of patients were identified as at risk for FT or having an unmet essential need. Patients known to have worse FT outcomes (those with later-stage disease, younger age, higher FT, minoritized groups) were more likely to accept financial counseling; however, only one-half of those at risk accepted help. Future work will focus on improving workflows to ensure assistance meets patient needs, including addressing patient stigma around requesting help.

The Use of Spanish Light Verb Constructions in the Advocate General’s Opinions of the Court of Justice of the European Union

Abstract Over the past few decades, increasing attention has been devoted towards the study of formulaic language, both in Lithuania and abroad. It is assumed that stable word combinations, rather than single words, are preferred in speaking and translating processes, which makes this study increasingly relevant. The idea of formulaic language is well reflected by light verb constructions as one of the collocation types, therefore this article aims to describe the use of these constructions in the analytic Spanish language. The article provides a theoretical overview of light verb constructions, their identification using the Sketch Engine computer program, and their usage in a representative-size corpus, compiled from the EUR-Lex database of documents from the original Spanish texts of the Advocate General’s Opinions of the Court of Justice of the European Union. The analysis of the use of Spanish light verb constructions in the analyzed text provided large objective data on their use, revealing the light verb constructions and their patterns typical to administrative Spanish. It has been found that the grammatical meaning of these light verb constructions is mostly represented by the following support verbs: tener, poner, dar, tomar and hacer. In combinations with nouns, these support verbs mark grammatical aspects such as mood, tense, person, and number. The frequent repetition of light verb constructions in the corpus indicates a standardized lexicon within the Spanish administrative language. In general, the high number of light verb constructions in the corpus reveals their importance in analytic Spanish, especially in the administrative legal language of the Advocate General‘s opinions.

Sexual health of women using combined oral contraceptive containing estetrol and drospirenone: A prospective observational study

Aim. To evaluate the effect of a combined oral contraceptive (COC) containing estetrol and drospirenone on the sexual function of women using it. Materials and methods. A total of 251 women aged 21–35 years (mean age, 25.30±2.82 years) referred for contraceptive fitting were included in the study (ICD-10: Z30.0 General contraceptive advice and counseling, Z30.4 Contraceptive drug monitoring). Women in the study cohort used the original formulation containing 15 mg estetrol and 3 mg drospirenone in a 24+4 regimen for contraceptive purposes, according to the current instructions. All female participants (n=251) were assessed for sexual function at baseline, 6 and 12 months using FSFI (The Female Sexual Function Index), FSDS-R (The Female Sexual Distress Scale-Revised) and SQoL-F (The Sexual Quality of Life-Female) scales. Study design. An open, independent, prospective observational study. Results. Women taking COC containing estetrol 15 mg and drospirenone 3 mg maintained a baseline high level of sexual satisfaction (p0.05) throughout the study, as assessed by FSFI, SQoL-F and FSDS-R scales. Conclusion. The results obtained indicate that there is no negative effect of COC containing 15 mg estetrol and 3 mg drospirenonone on the sexual function of women. High contraceptive efficacy of the drug was confirmed.

Gaining consensus on emotional wellbeing themes and preferences for digital intervention type and content to support the mental health of young people with long-term health conditions: A Delphi study.

Young people (YP) with long-term conditions (LTCs) are at greater risk of psychological distress than those without LTCs. Despite this, there is a scarcity of quality digital interventions designed to help improve mental wellbeing in this population. The aim of this study was to determine what YP, parents and health professionals preferred for future interventions. Twenty-six YP with asthma, diabetes and/or epilepsy (the three most common LTCs in YP), 23 parents of YP with LTCs and 10 health professionals mainly in paediatric specialisms (total n = 59) took part in an online Delphi study to gain consensus (set at 75% agreement) on four questions across three rounds. Participants ordered psychological themes that may be experienced by YP with LTCs by importance and ranked digital intervention types and delivery modes by importance or usefulness. The most common results were reported if no consensus was reached by round 3. Participants preferred a mobile phone app (73% agreement) and a mixture of one-on-one and group support for an intervention (75% agreement). The two highest ranked psychological themes were anxiety (44%) and wanting to appear 'normal' (38%), and the top intervention type was 'general counselling' (54% agreement). There was a clear desire for an app to help with the psychological aspects of living with LTCs and for a combination of one-to-one and group intervention elements. Anxiety and wanting to appear 'normal' might be two closely linked psychological challenges that could be addressed by a single intervention. The results will be important to consider for a future intervention, although further consultation will be needed for app development. Two YP with a LTC provided feedback on the study protocol including the aims and procedures of the project. Another six YP with LTCs were consulted on an early draft of the study questionnaire (the four questions), which was subsequently revised. Once the project began, a patient and public involvement group consisting of two YP with LTCs and one parent of a YP with an LTC gave feedback on the research process, lay report of the results and dissemination plan.

Panel II – Bank Resolution and Fundamental Rights

Abstract The second Panel of the SRB’s Legal Conference, moderated by the SRB General Counsel Karl-Philipp Wojcik, focused on the possible interferences between the resolution framework and the protection of fundamental rights as embedded in the EU Charter of Fundamental rights (the Charter) the European Convention on Human Rights (ECHR) and its protocols. The panellists also picked up case law developments regarding those interferences before both the European Court of Justice (ECJ), and the European Court of Human Rights (ECtHR).

'I Can't Get No Satisfaction'… Experience in the treatment, satisfaction, and professional support of young depressed people using SPARX.

Depression in young people is common and can lead to poor long-term outcomes. Digital therapies are a promising means of promoting access to care. Currently, among the digital treatments for depression in adolescents recognized by the NICE guidelines, there is SPARX (Smart, Positive, Active, Realistic, X-factor), based on Cognitive Behavioral Therapy, CBT. This narrative review aimed to evaluate: 1) Who were the depressed young people who used SPARX and what was their experience with the treatment? 2) Were users satisfied with the SPARX treatment? Did the youth's perceived level of satisfaction with using SPARX impact completion rates? 3) What was the role of professionals (researchers, consultants, teachers) in the SPARX studies? Has their support in running SPARX affected completion rates? A narrative review of the English literature was performed. The articles were searched in Pubmed, SCOPUS, and Web of Science databases (from 2012 to 2023) with keywords such as 'SPARX,' depression' and 'young adult'. Of 557 papers, 18 were included in our review. The young people who used SPARX were students or adolescents from special help-seeker populations at risk or with mild to moderate depression. The highest satisfaction levels were present in users of primary health services, such as general practice and counseling services. The support of the school counselor and experts in mental health clinicians was instrumental in impacting user satisfaction and completion rates. The personalization of the game in terms of user culture - symbols, language, norms, values, and artifacts; the customization of the avatar, the gender identity; the narrative structure; the presence of a guide character (virtual therapist); the CBT homework seemed to represent crucial SPARX characteristics related to satisfaction and completion rates. Our narrative review provides an overview of the main results of using SPARX with interesting considerations that may suggest improvements for broader use and diffusion of this digital treatment.