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Aim: Children born very preterm require additional specialist care because of the health and developmental risks associated with preterm birth, but information on their health service use is sparse. We sought to describe the use of specialist services by children born very preterm in Europe.Method: We analysed data from the multi-regional, population-based Effective Perinatal Intensive Care in Europe (EPICE) cohort of births before 32 weeks' gestation in 11 European countries. Perinatal data were abstracted from medical records and parents completed a questionnaire at 2 years corrected age (4322 children; 2026 females, 2296 males; median gestational age 29wks, interquartile range [IQR] 27-31wks; median birthweight 1230g, IQR 970-1511g). We compared parent-reported use of specialist services by country, perinatal risk (based on gestational age, small for gestational age, and neonatal morbidities), maternal education, and birthplace.Results: Seventy-six per cent of the children had consulted at least one specialist, ranging across countries from 53.7% to 100%. Ophthalmologists (53.4%) and physiotherapists (48.0%) were most frequently consulted, but individual specialists varied greatly by country. Perinatal risk was associated with specialist use, but the gradient differed across countries. Children with more educated mothers had higher proportions of specialist use in three countries.Interpretation: Large variations in the use of specialist services across Europe were not explained by perinatal risk and raise questions about the strengths and limits of existing models of care.What This Paper Adds: Use of specialist services by children born very preterm varied across Europe. This variation was observed for types and number of specialists consulted. Perinatal risk was associated with specialist care, but did not explain country-level differences. In some countries, mothers' educational level affected use of specialist services. [ABSTRACT FROM AUTHOR]

Aim: To test the hypothesis that higher seizure burden in Dravet syndrome is associated with increased comorbidities and lower quality of life (QoL) in a large cohort of patients with Dravet syndrome and their caregivers in Europe.Method: An extensive survey of caregivers of patients with Dravet syndrome on experiences of diagnosis, seizure burden, management, social and financial impact, and health services use was administered online in 10 languages.Results: The survey received 584 unique responses from caregivers of paediatric (83%) and adult (17%) patients with Dravet syndrome (aged <1-48y). Despite broadly following current treatment guidance, less than 10% of patients were seizure free in the previous 3 months. Nearly all (99.6%) patients aged 5 years or older experienced at least one or more motor, speech, learning, or behavioural impairment. High seizure frequency was related to more reports of emergency treatment, comorbidities, and a lower QoL (as measured by the standardized instrument EQ-5D-5L). If not diagnosed at the first instance, the majority (83%) of adults, but less than 20% of 6- to 11-year-olds were diagnosed after 4 or more years.Interpretation: Patients with Dravet syndrome with the highest current seizure frequency suffer from more comorbidities and have a lower QoL. Therefore, more effective antiepileptic treatments are needed.What This Paper Adds: The survey captured about 15% of all patients with Dravet syndrome in Europe. Less than 10% of patients had current seizure freedom. Patients with a high current seizure burden have more comorbidities and lower quality of life. [ABSTRACT FROM AUTHOR]

Aim One of the main gaps in the assessment of biodiversity is the lack of a unified framework for measuring its taxonomic and functional facets and for unveiling the underlying patterns. Location Europe, 25 large river basins. Methods Here, we develop a decomposition of functional β-diversity, i.e. the dissimilarity in functional composition between communities, into a functional turnover and a functional nestedness-resultant component. Results We found that functional β-diversity was lower than taxonomic β-diversity. This difference was driven by a lower functional turnover compared with taxonomic turnover while the nestedness-resultant component was similar for taxonomic and functional β-diversity. Main conclusions Fish faunas with different species tend to share the same functional attributes. The framework presented in this paper will help to analyse biogeographical patterns as well as to measure the impact of human activities on the functional facets of biodiversity. [ABSTRACT FROM AUTHOR]

In this paper, we compare species description rates to predict the numbers of undescribed species. These data are used to discuss the merits of various attempts to estimate species richness in the oceans. European marine areas. Predictions of how many species may exist on Earth have lacked an inventory of how many have been described, except for a few small taxa. The ocean is a good place to start an inventory because it includes all but one of the phyla and most classes of life on Earth. The European Register of Marine Species (ERMS) was compiled by taxonomic experts, covered all marine taxa, and accounted for synonyms. Reflecting taxonomic history, Europe's species are the best described in the world. ERMS listed 29,713 species of animals, plants and protists, but excluded bacteria and viruses. An estimated 6500 described species were not included. The best prediction of the number of species remaining to be described was 5613. Plots of years when species were first described showed no decrease in the rate of description for any taxa except birds, mammals and krill. If taxonomic effort has increased, whether due to more resources globally or greater efficiencies of productivity, then description rates per unit effort may be declining and the number of undescribed species may be lower than predicted. However, apart from reduced rates of description during the World Wars, there were no changes in description rates that could be easily attributed to such factors. There are about 36,000 species described from European seas, and we predict that 40,000 to 48,000 may exist. This comprises 15% of the estimated 230,000 described marine species. However, this area is well known compared with other seas and the proportion of species yet to be discovered will be higher elsewhere. [ABSTRACT FROM AUTHOR]