Task Force Research Articles

Successful Implementation of the AIUM Standardized 4-Year Residency Ultrasound Curriculum in Obstetrics and Gynecology: Lessons Learned and Way Forward.

Significant disparities in sonographic education exist in Obstetrics and Gynecology programs in the United States. To address the lack of standardization in ultrasound teaching, the American Institute of Ultrasound in Medicine (AIUM) assembled a multi-society task force in 2018 that resulted in the publication of a Consensus Report outlining a standardized ultrasound curriculum and competency assessment. The primary objective of the study was to implement the AUIM standardized curriculum within an Obstetrics and Gynecology residency program at a tertiary medical center, and report on the early implementation experience. The secondary objective was to assess current national practices in ultrasound training in Obstetrics and Gynecology residency programs. Study design was an effectiveness-implementation hybrid study of a structured ultrasound educational program based on the 2018 AIUM Consensus Report. The theoretical portion of the curriculum consisted of 26 hours of didactic lectures distributed over 4 years. For the practical component, residents received instruction from faculty and sonographers and independently acquired the required images as part of their regular clinical work. Simulator app access was also provided for additional opportunities to practice and acquire images. Deidentified images for the required competencies were uploaded to a WhatsApp group for review. Theoretical knowledge was assessed with a series of multiple-choice exams. Practical skills were assessed through grading of images submitted through WhatsApp as well as direct observations of resident scans. At the completion of 4 years, the assessment of both theoretical knowledge and practical skills was carried out using the ISUOG Basic Training Examination. National patterns in the area of ultrasound education were assessed with a four-question electronic survey of Obstetrics and Gynecology program directors in the United States. Analysis of both portions of the study was primarily descriptive. Four Obstetrics and Gynecology residents completed the curriculum spanning postgraduate years 1 through 4. The number of competencies completed ranged from 7 to 19 out of 41. All of the residents passed the theoretical and practical components of the ISUOG Basic Training Examination. For the residency program director survey portion of the study, response rate was 20% (59 of 290). Among the respondents, 55.9% reported having a structured curriculum and 34.4% reported implementing the AIUM curriculum. The two most commonly cited obstacles to implementation of structured ultrasound teaching were uncertainty with how to start the process (49.2%) and lack of faculty engagement (49.2%). Implementation of the AIUM Curriculum within the framework of an Obstetrics and Gynecology residency program at a tertiary medical center is feasible. In our experimental group, completion of the curriculum resulted in passing of an internationally recognized validated assessment. Obstacles to implementation in our program included a wide range of engagement and participation among residents, and limited opportunities to obtain some of the required competencies. Identification of obstacles to implementation from the perspective of residency program directors is critical for developing targeted approaches to ensure widespread implementation. Successful standardized validated sonographic training of graduating Obstetrics and Gynecology residents is crucial for this operator-dependent modality that has tremendous implications on patient safety and clinical care.

Triple Burden: The Incorrigible Threat of Tuberculosis, HIV, and COVID-19.

The Coronavirus-19 (COVID-19) hasn't seen the dawn since its emergence, however waxing and waning has resulted in the emergence of deadly variants. The effects of the pandemic have not been limited to its virulence, but have rather conferred multiple collateral effects, especially in developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19, these infections in hidden pockets served as a reservoir for the emergence of the deadly Omicron. Another significant impact of this juxtaposition was on the delivery of healthcare services for TB and HIV. The unanticipated COVID-19 pandemic turned the path of ongoing progress of elimination programs. Direct consequences of the COVID-19 pandemic were pronounced on diagnosis, treatment, and services for patients with TB and HIV. Essential TB services were reallocated to the COVID-19 rapid response task force. However, despite escalating the tribulations, this triple burden has simultaneously taught lessons to escalate the progress of halted programs. The pandemic has catalyzed an unusual level of collaboration among scientists, which can be exploited for TB and HIV. Fast-track diagnostics, digitalization, contact tracing, and vaccine development have enabled the world to envision the same for TB/HIV.

Prevalence of long COVID symptoms in Haryana, India: a cross-sectional follow-up study

Emerging research indicates growing concern over long COVID globally, although there have been limited studies that estimate population burden. We aimed to estimate the burden of long COVID in three districts of Haryana, India, using an opportunity to link a seroprevalence study to follow-up survey of symptoms associated with long COVID. We used a population-based seroprevalence survey for COVID-19 conducted in September 2021 across Haryana, India. Adults from three purposively selected districts (Rohtak, Gurugram, and Jhajjar) were eligible to participate; 2205 of 3213 consented to participate in a survey on health status. Trained investigators administered a structured questionnaire that included demographic characteristics, self-reported symptoms of illness in the last six months before the survey, mental health, and history of COVID-19. Unadjusted regression estimates indicated positive correlations between symptomatic complaints and COVID-19 exposure, suggesting lingering effects of COVID-19 in this population. The overall physical morbidity index was higher among those who tested positive for COVID-19, as was the incidence of new cases. However, both morbidity and incidence became statistically insignificant after adjustment for multiple comparisons. Cough emerged as the only statistically significant individual persistent symptom. Sex-stratified analyses indicated significant estimates only for physical morbidity in women. This study is one of the first from India that uses a large population-based sample to examine longer term repercussions of COVID infections. The burden of long COVID should primarily be addressed in clinical settings, where specialised treatment for individual cases continues to evolve. Our analyses also provide insight into the size and nature of studies required to assess the population-level burden of long COVID. This paper was produced under the auspices of the Lancet COVID 19 Commission India Task Force, which was supported financially by the Reliance Foundation. The Lancet COVID 19 Commission was set up in July 2020 and submitted its final report by October 2022. This report by the India Task Force was prepared during the same period.

Enhancing consumer protection in cryptocurrency transactions: Legal strategies and policy recommendations

Enhancing consumer protection in cryptocurrency transactions presents a critical challenge due to the decentralized and often opaque nature of the cryptocurrency market. This abstract explores the legal frameworks and mechanisms aimed at safeguarding consumers engaging in cryptocurrency transactions, focusing on key issues, challenges, and recommendations for improvement. Consumer protection in cryptocurrency transactions is a pressing concern due to the prevalence of fraud, hacking, and market manipulation. The lack of regulatory oversight and the pseudonymous nature of transactions make it challenging for consumers to seek recourse in cases of fraud or misconduct. To address these challenges, legal frameworks have been developed at both national and international levels. At the national level, some countries have implemented consumer protection laws that apply to cryptocurrency transactions, such as requiring exchanges to comply with anti-money laundering (AML) and know-your-customer (KYC) regulations. However, the effectiveness of these laws is limited by the global nature of the cryptocurrency market and the difficulty in enforcing regulations across borders. Internationally, organizations like the Financial Action Task Force (FATF) have issued guidelines to combat money laundering and terrorist financing in the cryptocurrency sector. These guidelines recommend that countries implement AML and KYC measures for cryptocurrency exchanges and wallet providers. While these recommendations are a step in the right direction, implementation remains a challenge, particularly in countries with limited regulatory capacity or political will. To enhance consumer protection in cryptocurrency transactions, several recommendations can be considered. These include increased collaboration between regulators and industry stakeholders, the development of international standards for consumer protection in cryptocurrencies, and the establishment of a regulatory framework that balances innovation with investor protection. Additionally, consumer education and awareness campaigns can help individuals make informed decisions when engaging in cryptocurrency transactions. In conclusion, enhancing consumer protection in cryptocurrency transactions requires a multi-faceted approach that addresses regulatory gaps, promotes international cooperation, and empowers consumers through education and awareness. By implementing these recommendations, policymakers and industry stakeholders can work together to create a safer and more transparent cryptocurrency market.

International enforcement of cryptocurrency laws: Jurisdictional challenges and collaborative solutions

The rise of cryptocurrencies has presented new challenges for regulators around the world, particularly in terms of enforcement across international borders. This abstract explores the jurisdictional challenges faced by authorities in enforcing cryptocurrency laws and proposes collaborative solutions to address these challenges. Cryptocurrencies operate on a decentralized network, making them difficult to regulate within traditional legal frameworks. Jurisdictional issues arise when a cryptocurrency transaction involves parties in different countries, as it is often unclear which jurisdiction's laws apply. This ambiguity can lead to regulatory gaps and enforcement challenges, allowing illicit activities such as money laundering and terrorism financing to flourish. To address these challenges, collaborative solutions are needed. International cooperation between regulators, law enforcement agencies, and industry stakeholders is essential to ensure effective enforcement of cryptocurrency laws. This cooperation can take various forms, including information sharing, joint investigations, and the development of common regulatory standards. One example of successful collaboration is the Financial Action Task Force (FATF), an intergovernmental organization that sets standards for combating money laundering and terrorism financing. The FATF's guidance on virtual assets and virtual asset service providers has helped to clarify regulatory expectations and promote consistency in enforcement efforts across jurisdictions. Another example is the Joint Chiefs of Global Tax Enforcement (J5), a coalition of tax authorities from five countries that work together to combat international tax evasion. The J5's focus on cryptocurrency-related tax crimes highlights the importance of cross-border cooperation in tackling cryptocurrency-related illicit activities. In conclusion, while jurisdictional challenges remain a significant hurdle in the enforcement of cryptocurrency laws, collaborative solutions offer a path forward. By working together, regulators, law enforcement agencies, and industry stakeholders can address these challenges and ensure that the benefits of cryptocurrencies are realized while mitigating their risks.

Correction to: 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.

Correction to: 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.

STRATEGIES FOR PARTNERSHIP WITH WORLD-CLASS PARTNERS TO ACHIEVE PIONEERS OF EDUCATIONAL EXCELLENCE

Introduction: Universitas Negeri Semarang (UNNES) has a vision of "World Reputable University and Pioneer of Educational Excellence with Conservation Insight". The field of Partnership has an important role in the strategy of realizing the vision and mission of Universitas Negeri Semarang in achieving its strategic goals. Partnership at UNNES in its implementation includes planning, implementation, monitoring and evaluation, and control. Practical implementation of international Partnership by promoting innovative products and services owned by strategic partners through exposure visits to partners, websites, social media, and other media, forming a task force to initiate and promote, as well as assisting the implementation process of Partnership through a partnership implementation and commercialization assistance team to world-renowned partners. Method: This research employs a qualitative approach. A literature review of sources related to the collaborative efforts between universities and partners at the national and international levels serves as the primary data source for the researcher. Results: Internationalization strategies can be implemented by providing international experience and competence in collaborative research and learning. Development towards internationalization with various methods, namely providing international teaching certificates, curriculum, planning, implementation process, and learning assessment. Partnership with reputable partners connects students and alumni with international partners to get experience and work in their fields of education and expertise. Conclusion: Practical implementation of international Partnership by promoting innovative products and services owned by strategic partners through exposure visits to partners, websites, social media, and other media, forming a task force to initiate and promote, as well as assisting the implementation process of Partnership through a partnership implementation and commercialization assistance team to world-renowned partners.

National strategy introduced to address maternal MH, SUD crisis

Observing the need to identify a set of evidence‐based, evidence‐informed and promising practices to address maternal mental health care, a first‐ever national strategy released last week by a federal task force is calling for a seamless integration of perinatal mental health and substance use care across medical, community and social systems that increases equity and access.

Global focus on ESG in the supply chain – insights into supply chain management of Environmental, Social and Governance requirements and trends both locally and globally

In our increasingly interconnected world, responsible business operation has become a normal, critical part of doing business for virtually all industries. Consumers, investors, and other company stakeholders are demanding businesses take responsibility for their current and future impacts on people and the environment. When assessing the role corporations play in a more sustainable future, many turn their focus to Environmental, Social and Governance (ESG) factors that help define and measure sustainable business. Given the wide variety of topics encompassed in ESG, companies often identify which are material, or prioritised by company stakeholders. Quantitative and qualitative information for material ESG topics is often reported using a standard or framework such as the Task Force on Climate-related Financial Disclosures; Taskforce on Nature-related Financial Disclosures; Sustainability Accounting Standards Board; the Global Reporting Initiative and the Carbon Disclosure Project (CDP), along with other region-specific standards. One reporting challenge includes extending ESG strategies and data collection to a company’s value chain. By including ESG-related requirements in service contracts or pre-qualification metrics, expectations can be clearly communicated and data aggregation becomes simpler. Engaging with vendors on the importance of material topics and providing educational tools and opportunities is necessary for accurate data collection. Benchmarking companies against their peers allows organisations to make informed decisions to continue or halt business relationships. Every company’s approach to ESG will look different, but protecting the business’s reputation and customer expectations is critical to continuous operations. Outcomes: understanding different components of ESG. Recognition of the types of reporting disclosure frameworks. Best practices with contractors and suppliers.

Interoperability Working Group: core dataset and information systems for data integration and data exchange in the Medical Informatics Initiative

The interoperability Working Group of the Medical Informatics Initiative (MII) is the platform for the coordination of overarching procedures, data structures, and interfaces between the data integration centers (DIC) of the university hospitals and national and international interoperability committees. The goal is the joint content-related and technical design of adistributed infrastructure for the secondary use of healthcare data that can be used via the Research Data Portal for Health. Important general conditions are data privacy and IT security for the use of health data in biomedical research. To this end, suitable methods are used in dedicated task forces to enable procedural, syntactic, and semantic interoperability for data use projects. The MII core dataset was developed as several modules with corresponding information models and implemented using the HL7® FHIR® standard to enable content-related and technical specifications for the interoperable provision of healthcare data through the DIC. International terminologies and consented metadata are used to describe these data in more detail. The overall architecture, including overarching interfaces, implements the methodological and legal requirements for adistributed data use infrastructure, for example, by providing pseudonymized data or by federated analyses. With these results of the Interoperability Working Group, the MII is presenting afuture-oriented solution for the exchange and use of healthcare data, the applicability of which goes beyond the purpose of research and can play an essential role in the digital transformation of the healthcare system.

Assessing Disparities about Overweight and Obesity in Pakistani Youth Using Local and International Standards for Body Mass Index

Background/Objectives: Obesity is currently considered a public health problem in both developed and developing countries. Gender- and age-specific body mass index (BMI) growth standards or references are particularly effective in monitoring the global obesity pandemic. This study aimed to report disparities in age-, gender- and ethnic-specific statistical estimates of overweight and obesity for 2–18 years aged Pakistani children and adolescents using the World Health Organization (WHO), the Center for Disease Control (CDC) 2000 references, the International Obesity Task Force (IOTF) and Pakistani references for BMI. Methods: The study used secondary data of 10,668 pediatric population, aged 2–18 years. Demographic information like age (years), gender, city and anthropometric examinations, i.e., height (cm) and weight (kg) were used in this study. The recommended age- and gender-specific BMI cut-offs of the WHO, CDC 2000 and the IOTF references were used to classify the children sampled as overweight and obese. For the Pakistani reference, overweight and obesity were defined as BMI-for-age ≥ 85th percentile and BMI-for-age ≥ 95th percentile, respectively. Cohen’s κ statistic was used to assess the agreement between the international references and local study population references in the classification of overweight/obesity. Results: The statistical estimates (%) of the participants for overweight and obesity varied according to the reference used: WHO (7.4% and 2.2%), CDC (4.9% and 2.1%), IOTF (5.2% and 2.0%) and Pakistan (8.8% and 6.0%), respectively; suggesting higher levels of overweight and obesity prevalence when local study references are used. The Kappa statistic shows a moderate to excellent agreement (κ ≥ 0.6) among three international references when classifying child overweight and obesity and poor agreement between local references and the WHO (0.45, 0.52), CDC (0.25, 0.50) and IOTF references (0.16, 0.31), for overweight and obesity, respectively. Conclusions: The results of the study showed a visible difference in the estimates of excess body weight after applying the WHO, CDC, IOTF and local BMI references to the study population. Based on the disparity results and poor agreement between international references and the local study reference, this study recommends using local BMI references in identifying children with overweight and obesity.

Updates from the International League Against Epilepsy Classification of Epilepsy (2017) and Focal Cortical Dysplasias (2022): Imaging Phenotype and Genetic Characterization.

The International League Against Epilepsy (ILAE) is an organization of 120 national chapters providing the most widely accepted and updated guidelines on epilepsy. In 2022, the ILAE Task Force revised the prior (2011) classification of focal cortical dysplasias to incorporate and update clinicopathologic and genetic information, with the aim to provide an objective classification scheme. New molecular-genetic information has led to the concept of "integrated diagnosis" on the same lines as brain tumors, with a multilayered diagnostic model providing a phenotype-genotype integration. Major changes in the new update were made to type II focal cortical dysplasias, apart from identification of new entities, such as mild malformations of cortical development and cortical malformation with oligodendroglial hyperplasia. No major changes were made to type I and III focal cortical dysplasias, given the lack of significant new genetic information. This review provides the latest update on changes to the classification of focal cortical dysplasias with discussion about the new entities. The ILAE in 2017 updated the classification of seizure and epilepsy with 3 levels of diagnosis, including seizure type, epilepsy type, and epilepsy syndrome, which are also briefly discussed here.

Integrating sustainability factors into corporate financial reporting in the modern ESG agenda context. Part 1

Subject. This article discusses innovations and trends in the development of corporate reporting standardization within the framework of the IFRS Foundation project and the initiative of the European Financial Reporting Advisory Group. Objectives. The article aims to reveal the essence of the main innovations and characterize the prospects for improving corporate financial reporting in the context of the development of ESG Standards by the International Sustainability Standards Board of the IFRS Foundation and the Task Force of the European Sustainability Reporting Standards Project. Methods. For the study, I used analysis and synthesis, comparison, and generalization. Results. Based on an analysis of the ESG agenda modern realities, the article identifies prerequisites and trends in the development of corporate reporting standardization in relation to the integration of sustainable development factors into financial reporting, and determines the impact of innovations of the two systems of sustainability reporting standards being developed on the informative and analytical value of corporate reporting. Conclusions and Relevance. The need to overcome the limitations and shortcomings of the GRI standards predetermined the development of two new systems of standards in the context of the ESG agenda modern realities. The International Sustainability Standards Board of the IFRS Foundation is developing standards designed to become a global framework for the disclosure of information on sustainable development, focused on the needs of investors and financial markets. The European Financial Reporting Advisory Group is developing European Sustainability Reporting Standards, which should cover a wide range of topics to meet the information needs of various stakeholders. New systems of ESG reporting standards are aimed at generating complete, coherent, comparable and verifiable information in the field of sustainable development. The research results obtained will contribute to the further promotion of sustainability reporting, improve corporate financial reporting practices by incorporating the impact of sustainability issues on value creation, and enhance stakeholder awareness and decision-making in a comprehensive and ESG-informed manner.

Clinical management of typical and atypical carcinoids/neuroendocrine tumors in ENETS centres of excellence (CoE): Survey from the ENETS lung NET task force.

Lung carcinoid tumours are neuroendocrine neoplasms originating from the bronchopulmonary tract's neuroendocrine cells, accounting for only 1%-3% of all lung cancers but 30% of all neuroendocrine tumours. The incidence of lung carcinoids, both typical and atypical, has been increasing over the years due to improved diagnostic methods and increased awareness among clinicians and pathologists. The most recent WHO classification includes a subgroup of lung carcinoids with atypical morphology and higher mitotic count and/or Ki67 labelling index. Despite appropriate surgery, the 5-year survival rate for atypical carcinoids barely exceeds 50%-70%. The role of adjuvant therapy in lung carcinoids is not well-defined, and clinical decisions are generally based on the presence of high-risk features. Long-term follow-up is essential to monitor for recurrence, although the optimal follow-up protocol remains unclear. To address the lack of consensus in clinical management decisions, the European Neuroendocrine Tumor Society (ENETS) initiated a survey among 20 expert centres. The survey identified varied opinions on approaches to imaging, surgery, use of adjuvant therapy, and follow-up protocols. Notably, the absence of dedicated multidisciplinary lung neuroendocrine tumour boards in some centres was evident. Experts agreed on the need for a prospective adjuvant trial in high-risk patients, emphasizing the feasibility of such a study. In conclusion, the study highlights the need for a more uniform adoption of existing guidelines in the management of lung carcinoid tumours and emphasizes the importance of international collaboration to advance research and patient care. Close collaboration between healthcare providers and patients is vital for effective long-term surveillance and management of these rare tumours.

Updates in the care and management of children and adolescents with systemic lupus erythematosus.

This narrative review offers an update of the most important recent articles published in the previous year of childhood-onset systemic lupus erythematosus (cSLE), focusing on care and management. Age-related disparities may play a significant role in the clinical and laboratory characteristics of cSLE, as well as its performance in distinct classification criteria. Monogenic lupus is associated with higher disease damage scores and mortality rate compared to sporadic cSLE. Adolescent face unique challenges, with comorbid psychiatric diagnosis, low resilience and nonadherence posing relevant challenges. A recent international task force has outlined pivotal principles and points-to-consider for treat-to-target (T2T) in cSLE patients. While the past year did yield new randomized controlled trial for cSLE treatment, publications focused on broader management strategies, including the impact of ultraviolet radiation exposure, immunization, and strict blood pressure control. Additionally, case reports and series have evaluated the efficacy/safety profiles of both available and emerging treatments. Current studies highlighted the various facets of cSLE, epidemiology, clinical, laboratory, classification criteria, adolescent issues, prognosis, surveillance, T2T approach and drug management. Despite notable progress, the scarcity of randomized trials emphasizes the need to delineate safer and more efficacious treatment modalities in cSLE.

The Development of an Opioid Misuse Training Program for Physical Therapists: A Learning Community Approach.

Musculoskeletal pain and opioid misuse frequently co-occur. The US Preventive Services Task Force calls for all health care providers to be trained to screen for misuse and/or opioid use disorder. The purpose of this study was to develop and implement an opioid misuse training program that could be used by physical therapists. Thirteen practicing physical therapists were invited to participate in a curriculum development project. Using the Curriculum Framework, a collaborative learning approach was used to develop an opioid misuse training program and training manual for physical therapists. Four training sessions were provided virtually every 2 weeks. Topics included an introduction to the opioid crisis, screening, assessing, and communicating with patients and with the health care team about opioid misuse. Each didactic session was followed by a participant feedback session where participants provided recommendations on improving the training content and their impressions on the barriers and facilitators to incorporating the training into practice. A companion training manual was created and sent to participants for comment. Participants were asked over email to describe whether and how they incorporated training materials into clinical practice during the training curriculum. All participants attended sessions 1-3. Twelve (92.3%) attended the fourth session. Based on the participants' feedback, training sessions were edited, and a companion training manual was finalized and distributed to each participant. After the fourth session, 9 participants (69.2%) reported using what they learned in the training. During the participant feedback sessions, participants regarded the training as important. Some participants expressed barriers to discussing opioids with patients and concerns about whether the training was within physical therapists' scope of practice. An iteratively developed training program for physical therapists to address opioid misuse was acceptable, feasible, and provided immediate practice change by most participants.

What’s on the Cayman Islands regulatory horizon for trustees?

What’s on the Cayman Islands regulatory horizon for trustees?

EADV Task Force Pruritus White Paper on chronic pruritus and chronic prurigo: Current challenges and future solutions.

Chronic pruritus (CP) is frequent in general medicine and the most common complaint in general dermatology. The prevalence of CP is expected to rise in the future due to the ageing population. The clinical presentation, underlying aetiology and treatment strategy of CP are heterogeneous. Also, individual treatment aims and physical, psychic and economic burdens of patients might vary. Chronic prurigo (CPG) is the most severe disease in the chronic pruritus spectrum, being associated with long-standing scratch-induced skin lesions and a therapy refractory itch-scratch-cycle. It is thus important to raise disease awareness for CP and CPG in the general public and among decision-makers in the health system. Further, there is a need to support a rational clinical framework to optimize both diagnostics and therapeutics. Currently, there is still a shortcoming regarding approved therapies and understanding CP/CPG as severe medical conditions. Therefore, the EADV Task Force Pruritus decided to publish this white paper based on several consensus meetings. The group consented on the following goals: (a) ensure that CP is recognized as a serious condition, (b) increase public awareness and understanding of CP and CPG as chronic and burdensome diseases that can greatly affect a person's quality of life, (c) clarify that in most cases CP and CPG are non-communicable and not caused by a psychiatric disease, (d) improve the support and treatment given to patients with CP to help them manage their disease and (e) publicize existing therapies including current guidelines. We aim to point to necessary improvements in access and quality of care directed to decision-makers in health policy, among payers and administrations as well as in practical care.

Alleged State Aid in Relation to a Deduction/Non-Inclusion Structure in Luxembourg – Opinion Statement ECJ-TF 1/2024 on the Decision of the CJEU of 5 December 2023 in Engie (Joined Cases C-451/21P and C-454/21P)

In this CFE Opinion Statement, submitted to the EU Institutions in February 2024, the CFE ECJ Task Force comments on the CJEU’s decision of 5 December 2023 in Engie (Joined Cases C-451/21P and C-454/21P), which addressed alleged State aid in relation to a deduction/non-inclusion structure in Luxembourg.

Intimate geographies of precarity: Water infrastructure and the normalisation of militarism in humanitarian intervention

The recent increase in Venezuelan migrants and refugees to Brazil has prompted a humanitarian response coordinated by multiple government agencies and inter/national organisations. This coordination effort sits under the umbrella of the Operation Welcome task force, in which the military is heavily involved. Situated in the northern state of Roraima, bordering Venezuela, this article explores one particular site of humanitarian care: a set of Water, Sanitation and Hygiene (WASH) facilities located in the capital city of Boa Vista. Here, I investigate the militaristic design and processes of the shower block, which is available to Venezuelan refugees and migrants who are living without adequate shelter. In doing so, this paper argues that the normalisation of militarism in humanitarian intervention (re)produces exclusion and precarity for those accessing spaces of care. By understanding the water infrastructure of the site as an infrastructure of containment, this research shines light on the everyday, often invisiblised implications of migration governance that occur at the micro-scale. In particular, it highlights the conditions of slow and symbolic violence that are embedded within the military-humanitarian response.