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Summer camps are widespread in many countries and have a long history. Their contribution to children's and young people's leisure and recreation is widely acknowledged, as is their usefulness as an educational resource. That large numbers of children and young people across Europe attend summer camps is well-known; according to Eurofound (2020), most of the twenty-seven countries analyzed record student attendance at camps, and in twelve countries (including Spain) over 50% of young people take part. However, another study carried out in the member countries of the European Union (Plantenga & Remery, 2017) stated that when the availability, use, and quality of this service was assessed, it was seen that out-of-school services lacked structure and quality. Despite being an especially important and relevant topic in political discourses and international organizations, most countries do not define the service clearly and precisely (OECD, 2011). According to Eurofound (2020), many European states centralize their planning of educational leisure at national level, including the laws and decrees that underpin how these activities are organized. But camps are implemented locally, and municipalities play a significant role in designing and providing this leisure activity, both during the year and during holiday periods. Coinciding with previous publications (Eurofound, 2007), the formula for success was to be found in public-sector support, community involvement, integration between services and spaces, and the inclusion of minorities.

Background and purpose: The purpose was to perform a nationwide epidemiological study of Guillain–Barré syndrome (GBS) in Spain, analysing background incidences and seasonal variation and trying to identify incidence changes during the coronavirus disease 2019 (COVID‐19) years. Methods: This was an observational study collecting all GBS diagnoses from the National Epidemiological Surveillance Network collected by the Ministry of Health. Patients discharged with GBS as the main diagnosis and admitted during 2018–2021 were included. Data on the incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections were obtained from the National Epidemiology Centre. Results: In total, 3147 cases were included, 832 in 2018, 861 in 2019, 670 in 2020 and 784 in 2021. Nationwide hospital incidence was 1.78 in 2018, 1.71 in 2019, 1.41 in 2020 and 1.66 in 2021, with an increased frequency in males, the elderly population and in the winter season. Eleven per cent of GBS patients needed ventilatory support. GBS and SARS‐CoV‐2 incidences did not correlate with one another (r = −0.29, p = 0.36). GBS incidence decreased during 2020 and during the COVID‐19 lockdown period in comparison to the same months of 2018–2019. Conclusions: The incidence of GBS in Spain is similar to that of other countries. Despite prior reports describing a significant increase in COVID‐19‐associated GBS in Spain, a significant drop of GBS incidence during the SARS‐CoV‐2 pandemic was detected, probably due to prevention measures. [ABSTRACT FROM AUTHOR]

Background and purpose: The aim of this study was to describe the frequency and distribution of SOD1 mutations in Spain, and to explore factors contributing to their phenotype and prognosis. Methods: Seventeen centres shared data on amyotrophic lateral sclerosis (ALS) patients carrying pathogenic or likely pathogenic SOD1 variants. Multivariable models were used to explore prognostic modifiers. Results: In 144 patients (from 88 families), 29 mutations (26 missense, 2 deletion/insertion and 1 frameshift) were found in all five exons of SOD1, including seven novel mutations. A total of 2.6% of ALS patients (including 17.7% familial and 1.3% sporadic) were estimated to carry SOD1 mutations. The frequency of this mutation varied considerably among regions, due to founder events. The most frequent mutation was p.Gly38Arg (n = 58), followed by p.Glu22Gly (n = 11), p.Asn140His (n = 10), and the novel p.Leu120Val (n = 10). Most mutations were characterized by a protracted course, and some of them by atypical phenotypes. Older age of onset was independently associated with faster disease progression (exp[Estimate] = 1.03 [0.01, 0.05], p = 0.001) and poorer survival (hazard ratio 1.05 [1.01, 1.08], p = 0.007), regardless of the underlying mutation. Female sex was independently associated with faster disease progression (exp[Estimate] = 2.1 [1.23, 3.65], p = 0.012) in patients carrying the p.Gly38Arg mutation, resulting in shorter survival compared with male carriers (236 vs. 301 months). Conclusions: These data may help to evaluate the efficacy of SOD1 targeted treatments, and to expand the number of patients that might benefit from these treatments. [ABSTRACT FROM AUTHOR]

It is well known that German and Spanish labour markets are quite different from a macro point of view. In this paper, we look at these markets through the lenses of individual unstable spells. These include all forms of atypical employment (such as temporary contracts and mini-jobs) as well as unemployment. This combined unstable state captures a fuller picture of the individual experience of volatile income and uncertain employment status than unemployment alone. We find that the survival rates of unstable spells in the two countries are much more similar than those from unemployment. This suggests that the usual focus on unemployment stocks and durations exaggerates the contrast between the two countries in terms of workers' experience of instability. We place these findings in the context of very similar aggregate shocks in the two countries and different policy choices on labour market reforms. [ABSTRACT FROM AUTHOR]

Scientific and grey literature on invasive alien species (IAS) is conditioned by social, economic and political priorities, editorial preferences and species and ecosystem characteristics. This leads to knowledge gaps and mismatches between scientific research interests and management needs. We reviewed the literature on IAS management in Spain found in Scopus, Web of Science, Google Scholar and Dialnet to identify key deficiencies and priority research areas. The collected literature was classified, employing features describing formal aspects and content. We used bibliometric and keyword co-occurrence network analyses to assess the relationship between features and reveal the existence of additional topics. Most of the compiled documents (n = 388) were focused on terrestrial ecosystems and inland waters, whereas marine and urban ecosystems were under-represented. The literature was largely generic and not species-specific, focusing on raising awareness and proposing changes on current regulation as prominent approaches to prevent further introductions. The compiled authors exhibited many clear publishing preferences (e.g. language or document type), but less regarding target taxa. In addition, there was a strong association between species and the different features considered, especially between the methodological approach (e.g. review, field experiment) and the primary emphasis of study (i.e. basic/theoretical, applied or interdisciplinary). This indicates that research on IAS has had a strong species-specific focus. References about terrestrial species focused mainly on vascular plants, whereas references about inland waters were mostly on fishes and the giant reed (Arundo donax), which has been managed with partial success. Animal culling and plant removal were the most frequent eradication and small-scale control treatments, whereas the documents addressing wider spatial scales were largely theoretical. Consequently, the success of described treatments was largely uncertain. Spanish invasion science research has been occasionally innovative, incorporating novel technologies (e.g. species distribution modelling) and engaging society with citizenscience approaches. However, the ratio between basic/theoretical and applied studies indicates that more applied research/management is needed, especially in inland waters and marine ecosystems. We call for increasing effort in the effective dissemination of experience in IAS management to enhance current practical knowledge, including that of schemes undertaken by public agencies. [ABSTRACT FROM AUTHOR]

Background: Dementia care is associated with physical, emotional, and monetary impact on the informal carers providing unpaid care. Differences in the personal characteristics of caregivers may help explain the variations in the costs of dementia care.Objective: The aim of this study was to analyze the effect of caregivers' sense of coherence (SOC) on direct and indirect costs in dementia care.Methods: A cross-sectional study was conducted in community dwelling caregivers of patients with Alzheimer's disease. Data of healthcare services were obtained from clinical registries, and information was collected from caregivers regarding their use of social care resources and time spent caregiving. The transformation of all costs into Euros was made assigning a fixed cost of 10.29 € /h and 16.24 € /h for assisting in instrumental and basic activities of daily living, respectively. Caregivers' SOC was assessed using the Orientation to Life Questionnaire (OLQ-13). Adjusted regression models were developed, with different types of costs as dependent variables.Results: A sample of 147 caregivers was recruited. The mean OLQ-13 score was 73.3 points (SD = 11.6). The regression models showed a small association between caregivers' SOC and direct costs, mainly linked to the use of social care resources (r2 = 0.429; β= -15.6 € /month), and a greater association between SOC and indirect costs (r2 = 0.562; β= -222.3 € /month).Conclusion: Increasing caregivers' SOC could reduce dementia care costs by decreasing the use of social care resources and caregiving time. [ABSTRACT FROM AUTHOR]

Purpose: Multidisciplinary care has become the preferred model of care for patients with amyotrophic lateral sclerosis (ALS). It is assumed that the sum of interventions associated with this approach has a positive effect on survival. The objective of the study was to evaluate the impact of a multidisciplinary care approach on the survival of patients with ALS. Patients and methods: We performed a retrospective review of prospectively collected data in a tertiary referral center in Spain. Participants were patients with definite or probable ALS managed in a multidisciplinary care program. We compared demographic and survival data of patients with definite or probable ALS treated in a referral center without and with implementation of a multidisciplinary care program. We performed time-dependent multivariate survival analysis of the use of noninvasive mechanical ventilation (NIMV) and gastrostomy. Results: We evaluated 398 consecutive patients, of whom 54 were treated by a general neurologist and 344 were treated in the multidisciplinary care clinic. Patients receiving multidisciplinary care were older (62 vs 58 years), tended to have bulbar onset disease (30% vs 17.7%), and were more likely to receive riluzole (88.7% vs 29.6%, p<0.01), NIMV (48.8% vs 29.6%, p>0.001), and nutrition via gastrostomy (32.3% vs 3.7%, p<0.01). Kaplan–Meier analysis showed a 6-month increase in survival (log-rank, 16.03, p<0.001). Application of the Andersen-Gill model showed that the variables associated with reduced mortality were reduced time to NIMV and gastrostomy and the duration of both, thus reflecting compliance. Conclusions: Multidisciplinary care increased the survival of ALS patients in our study population. Timely use of respiratory support and gastrostomy are fundamental aspects of this benefit. [ABSTRACT FROM AUTHOR]

Biodiversity assessment of marine hard-bottom communities is hindered by the high diversity and size-ranges of the organisms present. We developed a DNA metabarcoding protocol for biodiversity characterization of structurally complex natural marine hard-bottom communities. We used two molecular markers: the “Leray fragment” of mitochondrial cytochrome c oxidase (COI), for which a novel primer set was developed, and the V7 region of the nuclear small subunit ribosomal RNA (18S). Eight different shallow marine littoral communities from two National Parks in Spain (one in the Atlantic Ocean and another in the Mediterranean Sea) were studied. Samples were sieved into three size fractions from where DNA was extracted separately. Bayesian clustering was used for delimiting molecular operational taxonomic units (MOTUs) and custom reference databases were constructed for taxonomic assignment. Despite applying stringent filters, we found high values for MOTU richness (2,510 and 9,679 MOTUs with 18S and COI, respectively), suggesting that these communities host a large amount of yet undescribed eukaryotic biodiversity. Significant gaps are still found in sequence reference databases, which currently prevent the complete taxonomic assignment of the detected sequences. In our dataset, 85% of 18S MOTUs and 64% of COI MOTUs could be identified to phylum or lower taxonomic level. Nevertheless, those unassigned were mostly rare MOTUs with low numbers of reads, and assigned MOTUs comprised over 90% of the total sequence reads. The identification rate might be significantly improved in the future, as reference databases are further completed. Our results show that marine metabarcoding, currently applied mostly to plankton or sediments, can be adapted to structurally complex hard bottom samples. Thus, eukaryotic metabarcoding emerges as a robust, fast, objective and affordable method to comprehensively characterize the diversity of marine benthic communities dominated by macroscopic seaweeds and colonial or modular sessile metazoans. The 18S marker lacks species-level resolution and thus cannot be recommended to assess the detailed taxonomic composition of these communities. Our new universal primers for COI can potentially be used for biodiversity assessment with high taxonomic resolution in a wide array of marine, terrestrial or freshwater eukaryotic communities. [ABSTRACT FROM AUTHOR]

Biodiversity assessment of marine hard-bottom communities is hindered by the high diversity and size-ranges of the organisms present.Wedeveloped aDNAmetabarcoding protocol for biodiversity characterization of structurally complex natural marine hardbottom communities. We used two molecular markers: the ``Leray fragment' of mitochondrial cytochrome c oxidase (COI), for which a novel primer set was developed, and the V7 region of the nuclear small subunit ribosomal RNA (18S). Eight different shallow marine littoral communities from two National Parks in Spain (one in the Atlantic Ocean and another in the Mediterranean Sea) were studied. Samples were sieved into three size fractions from where DNA was extracted separately. Bayesian clustering was used for delimiting molecular operational taxonomic units (MOTUs) and custom reference databases were constructed for taxonomic assignment. Despite applying stringent filters, we found high values for MOTU richness (2,510 and 9,679 MOTUs with 18S and COI, respectively), suggesting that these communities host a large amount of yet undescribed eukaryotic biodiversity. Significant gaps are still found in sequence reference databases, which currently prevent the complete taxonomic assignment of the detected sequences. In our dataset, 85% of 18S MOTUs and 64% of COI MOTUs could be identified to phylum or lower taxonomic level. Nevertheless, those unassigned were mostly rare MOTUs with low numbers of reads, and assigned MOTUs comprised over 90% of the total sequence reads. The identification rate might be significantly improved in the future, as reference databases are further completed. Our results show that marine metabarcoding, currently applied mostly to plankton or sediments, can be adapted to structurally complex hard bottom samples. Thus, eukaryotic metabarcoding emerges as a robust, fast, objective and affordable method to comprehensively characterize the diversity of marine benthic communities dominated by macroscopic seaweeds and colonial or modular sessile metazoans. The 18S marker lacks species-level resolution and thus cannot be recommended to assess the detailed taxonomic composition of these communities. Our new universal primers for COI can potentially be used for biodiversity assessment with high taxonomic resolution in a wide array of marine, terrestrial or freshwater eukaryotic communities. [ABSTRACT FROM AUTHOR]

We analysed with multigene (18S and COI) metabarcoding the effects of the proliferation of invasive seaweeds on rocky littoral communities in two Spanish Marine Protected Areas. The invasive algae studied were Caulerpa cylindracea , Lophocladia lallemandii and Asparagopsis armata . They are canopy-forming, landscape-dominant seaweeds, and we were interested in their effects on the underlying communities of meiobenthos and macrobenthos, separated in two size fractions through sieving. A new semiquantitative treatment of metabarcoding data is introduced. The results for both markers showed that the presence of the invasive seaweed had a significant effect on the understory communities for Lophocladia lallemandii and Asparagopsis armata but not for Caulerpa cylindracea . Likewise, changes in MOTU richness and diversity with invasion status varied in magnitude and direction depending on the alga considered. Our results showed that metabarcoding allows monitoring of the less conspicuous, but not least important, effects of the presence of dominant invasive seaweeds. [ABSTRACT FROM AUTHOR]

We studied the reproductive cycle of the sea urchin Arbacia lixula in a subtidal population from northeast Spain over four years using a gonadosomatic index (GSI) and gonad histology. Our results show that the GSI of A. lixula follows a seasonal cycle which peaks in May–July and attains its lowest values in October–November every year. The time course of the GSI matched closely the photoperiod cycle. We also found a remarkable inter-annual variability in the maximum value of GSI, which correlated with mean water temperature during the gonad growth period (winter and spring). Gonad histology was also in agreement with a single gametogenic cycle per year in this species. We explored the application of circular statistics to present and analyse gonadal development data, which allowed us to adequately handle the high intra-individual variability detected, with several developmental stages commonly found within the same gonad. The picture that emerged is one of a gametogenic timing driven by photoperiod, while the amount of reproductive output is determined by temperature. This is coherent with the tropical origin of the species and lends support to recent warnings about an increase in the abundance of this species in the Mediterranean as a result of global warming, with associated increased impact potential in sublittoral communities. [ABSTRACT FROM AUTHOR]

Objectives To determine the relationship between quality of life ( QOL) and environmental factors of temperature, noise, and lighting in nursing home residents with severe dementia. Design Cross-sectional, observational, analytical. Setting Eight public, long-term care nursing homes in the province of Girona, Spain. Participants Random sample of 160 nursing home residents with severe dementia. Measurements Functional and cognitive impairment, pain, neuropsychiatric disturbances, and QOL were determined using standardized instruments. Temperature, noise, and lighting in bedrooms, dining rooms, and living rooms were measured in the morning and afternoon using a multifunction environment meter in a standardized manner. Results Adjusted multivariate linear regression models demonstrated that environmental measures were independently associated with QOL and related factors. High temperature in the bedroom was associated with lower QOL (standardized β = 0.184), high noise levels in the living room were associated with low behavioral signs of social interactions (β = 0.196), and low lighting levels in the bedroom were associated with number of signs of negative affective mood (β = −0.135). Conclusion The QOL of nursing home residents with severe dementia was related to environmental factors such as temperature, noise, and lighting. The monitoring of these environmental factors may improve these individuals' QOL. [ABSTRACT FROM AUTHOR]

The aim of the study was to develop a cross-cultural adaptation and to evaluate the validity and reliability of a Spanish version of the Quality of Life in Late-Stage Dementia (QUALID) scale. Observational and cross-sectional validation study. The QUALID was translated according to standardised procedures. Internal consistency was assessed using Cronbach’s alpha. The QUALID structure was assessed using a Principal Component Analysis (PCA). Inter-respondent (one rater asking two respondents) and inter-rater (two raters asking one respondent) reliability was assessed using the Intraclass Correlation Coefficient (ICC). The criterion validity (concurrent) was assessed by Spearman’s correlation between the QUALID score and the QoL-Visual Analogue Scale (QoL-VAS) score. The construct validity (convergent) was assessed by Spearman’s correlations between QUALID score and scores on the Pain-Visual Analogue Scale (Pain-VAS), on the Mini-Mental State Examination (MMSE) and on the Neuropsychiatric Inventory-Nursing Home (NPI-NH). A total of 160 elderly residents and 152 respondents at 8 long-term care centres in the province of Girona (Spain) participated in the study. Results showed satisfactory levels of internal consistency (Cronbach’s α coefficients 0.74) and evidenced the multidimensionality of the scale. Three factors were identified (behavioural signs of discomfort, behavioural signs of social interaction and signs of negative affective mood). Acceptable inter-respondent reliability (ICC = 0.74) and high inter-rater reliability (ICC = 0.95) were found. The QUALID score was associated with the QoL-VAS score, suggesting a good concurrent criterion validity, and also with the Pain-VAS, the MMSE and the NPI-NH scores, suggesting good construct validity. Our evaluation of the psychometric properties of the Spanish version of the QUALID indicates that it is a reliable and valid instrument with an adequate capacity to distinguish between different clinical status. [ABSTRACT FROM AUTHOR]

The Besòs River Basin authority is working towards the implementation of integrated river basin management, as required by the Water Framework Directive (WFD), to achieve a good ecological and chemical status of all water bodies by 2015. The studied system is constituted by two communities (La Garriga and Granollers), their corresponding draining catchments, sewer systems and two WWTPs, which discharge treated water at different locations of the same river. Within this context, the realisation of an integrated model of the river stretch and of the two WWTPs with their sewer systems and draining catchments was necessary. Such a model allows to efficiently simulate and analyse the behaviour of the integrated system and to optimize its performance holistically. In this article, a method is presented to generate rules to be implemented in a supervisory system for automatic management of the Integrated Urban Wastewater System (IUWS) in dry and storm weather. This is achieved by identifying, with the help of Monte Carlo simulations, the most performing operational parameters-according to environmental and economic criteria-for the two weather conditions. [ABSTRACT FROM AUTHOR]

In the present study we analyzed prey preferences of the polyclad flatworm Prostheceraeus roseus among three different species of colonial ascidians of the genus Pycnoclavella occurring sympatrically in the Northwestern Mediterranean (Spain). Palatability assays were conducted in laboratory conditions in order to test predator preferences in pairwise tests, and cycles of abundance of the predator and prey were monitored in the field. The results showed a clear preference of the predator for Pycnoclavella communis over Pycnoclavella nana and Pycnoclavella aurilucens. We suggest that chemical variation in defense compounds among species of this secondary metabolite-rich genus can drive the flatworm preferences. The ascidian had seasonal cycles in the area studied, with resting (aestivation) states in the summer months. The flatworm abundance showed no clear seasonal cycle, but it was less abundant in winter. The predator has been seen in the field feeding either on active zooids or on the reserve-laden basal mass of tunic during the aestivation phase of P. communis. [ABSTRACT FROM AUTHOR]

The identification of adequate wastewater treatment for small communities is a complex problem since it demands a combination of data from different sources, such as aspects of the community and landscape, the receiving environment and the available wastewater treatment technologies. The Catalan Water Agency (Agència Catalana de l'Aigua) considered using an EDSS (Environmental Decision Support System) as a tool to help water managers select the most adequate treatment for the urban wastewater of nearly 3,500 small communities in Catalonia (Spain). From that moment, EDSS was applied to all the river basins in Catalonia. In this paper the authors present the results obtained for the 76 small communities located in one of these river basins: the Fluvia River Basin. The characteristics of the community used in the reasoning process of the EDSS, the list of selected wastewater treatment alternatives, the technical environmental justification for the selected treatments and the reasons for discarding, favouring or disadvantaging them are presented. Finally, some results for the Fluvia River Basin are compared with those obtained in other Catalan river basins with different characteristics in order to evaluate which are the significant features in identifying adequate wastewater treatments. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the larval bloom of oviparous sponge Cliona viridis in rocky communities of the Blanes littoral in northeastern Spain. Discussion on sexual reproduction in sponges; Methodology of the study; Results of the study.

Invasive alien species have widespread impacts on native biodiversity and ecosystem services. Since the number of introductions worldwide is continuously rising, it is essential to prevent the entry, establishment and spread of new alien species through a systematic examination of future potential threats. Applying a three-step horizon scanning consensus method, we evaluated non-established alien species that could potentially arrive, establish and cause major ecological impact in Spain within the next 10 years. Overall, we identified 47 species with a very high risk (e.g. Oreochromis niloticus , Popillia japonica , Hemidactylus frenatus , Crassula helmsii or Halophila stipulacea), 61 with high risk, 93 with moderate risk, and 732 species with low risk. Many of the species categorized as very high or high risk to Spanish biodiversity are either already present in Europe and neighbouring countries or have a long invasive history elsewhere. This study provides an updated list of potential invasive alien species useful for prioritizing efforts and resources against their introduction. Compared to previous horizon scanning exercises in Spain, the current study screens potential invaders from a wider range of terrestrial, freshwater, and marine organisms, and can serve as a basis for more comprehensive risk analyses to improve management and increase the efficiency of the early warning and rapid response framework for invasive alien species. We also stress the usefulness of measuring agreement and consistency as two different properties of the reliability of expert scores, in order to more easily elaborate consensus ranked lists of potential invasive alien species. [Display omitted] • Horizon scan is important for prioritizing management efforts • We identified 108 species with high or very high risk of becoming invasive in Spain • Many prioritized species are already present in neighbouring countries • Agreement and consistency statistics inform about the reliability of experts scores [ABSTRACT FROM AUTHOR]

Abstract: The Fleuve Manche (English Channel) palaeoriver represents the largest river system that drained the European continent during Pleistocene lowstands, particularly during the Elsterian (Marine Isotope Stage 12) and Saalian Drenthe (MIS 6) glaciations when extensive ice advances into the North Sea area forced the central European rivers to flow southwards to the Bay of Biscay (NE Atlantic). Numerous long piston cores and high-resolution acoustic data from the northern Bay of Biscay have been correlated using a well-constrained chronostratigraphical framework, and for the first time allow the estimation of the discharge of the Fleuve Manche palaeoriver at the end of the last glacial period (i.e. Weichselian). Our results, discussed in the light of relationships between river loads and drainage area characteristics, strongly suggest that the Bay of Biscay collected sediment-laden meltwater from the Northern European lowlands and the southern part of the Fennoscandian ice sheet at the end of the last glacial period and particularly during the paroxysmal phase of the European deglaciation ca 20–18ka ago. This demonstrates that the Fleuve Manche drainage area at that time was equivalent to those dating from the major Elsterian and Saalian Drenthe glaciations. Based on our data, we propose a revision of the palaeogeographical and palaeoglaciological evolution of the North Sea area while showing that the British and Fennoscandian ice sheets entered the North Sea basin until ca 18ka initiating isostatic adjustment of the basin. This allowed the North Sea fluvial system to flow southwards through the Dover Strait. Finally, we discuss the Fleuve Manche freshwater discharge during the maximum European ice sheet retreat ca 18ka. The estimated discharge at this time appears important and sufficiently sustained to possibly contribute to the profound destabilisation of the thermohaline circulation recognised in the North Atlantic from ca 18 to 16ka. [Copyright &y& Elsevier]

Abstract: The correlation of continental sedimentary records with the marine isotope stratigraphy is a challenge of central importance in Quaternary stratigraphy, particularly in Western Europe where long records of glaciation on land areas are particularly rare. Here we demonstrate for the first time the interrelationship of events during the last 1.2Ma in an ocean-sediment core from the Bay of Biscay (NE Atlantic), SW of the Channel. The identification of discharge variations from tributary river systems to the ‘Fleuve Manche’ palaeoriver during glacio-eustatic sea-level lowstands demonstrates the correlation of the marine sediment stratigraphy to the expansion and recession of the European ice-sheets. The amplitude and chronology of European ice-sheet oscillations since the late Early Pleistocene is discussed and our results demonstrate that the first coalescence of the Fennoscandian and British ice-sheets in the North Sea basin ca 450ka ago caused a profound change in lowstand European drainage alignment. This change caused a rerouting of Fennoscandian and eastern British ice-sheets-derived meltwaters from northwards into the Nordic Seas to southwards into the eastern North Atlantic thereafter. Besides allowing a thorough synchronisation of the European ice-sheet palaeogeography with the well-dated records of palaeoceanographical changes, our results improve the stratigraphy of the English Channel palaeovalleys and will provide important constraints on paleoclimatic scenarios considering the impact that such rerouting and meltwater surges might have on the stability of the oceanic conveyor belt. [Copyright &y& Elsevier]

Abstract: Continuous high-resolution mass accumulation rates (MAR) and X-ray fluorescence (XRF) measurements from marine sediment records in the Bay of Biscay (NE Atlantic) have allowed the determination of the timing and the amplitude of the ‘Fleuve Manche’ (Channel River) discharges during glacial stages MIS 10, MIS 8, MIS 6 and MIS 4–2. These results have yielded detailed insight into the Middle and Late Pleistocene glaciations in Europe and the drainage network of the western and central European rivers over the last 350kyr. This study provides clear evidence that the ‘Fleuve Manche’ connected the southern North Sea basin with the Bay of Biscay during each glacial period and reveals that ‘Fleuve Manche’ activity during the glaciations MIS 10 and MIS 8 was significantly less than during MIS 6 and MIS 2. We correlate the significant ‘Fleuve Manche’ activity, detected during MIS 6 and MIS 2, with the extensive Saalian (Drenthe Substage) and the Weichselian glaciations, respectively, confirming that the major Elsterian glaciation precedes the glacial MIS 10. In detail, massive ‘Fleuve Manche’ discharges occurred at ca 155ka (mid-MIS 6) and during Termination I, while no significant discharges are found during Termination II. It is assumed that a substantial retreat of the European ice sheet at ca 155kyr, followed by the formation of ice-free conditions between the British Isles and Scandinavia until Termination II, allowed meltwater to flow northwards through the North Sea basin during the second part of the MIS 6. We assume that this glacial pattern corresponds to the Warthe Substage glacial maximum, therefore indicating that the data presented here equates to the Drenthe and the Warthe glacial advances at ca 175–160ka and ca 150–140ka, respectively. Finally, the correlation of our records with ODP site 980 reveals that massive ‘Fleuve Manche’ discharges, related to partial or complete melting of the European ice masses, were synchronous with strong decreases in both the rate of deep-water formation and the strength of the Atlantic thermohaline circulation. ‘Fleuve Manche’ discharges over the last 350kyr probably participated, with other meltwater sources, in the collapse of the thermohaline circulation by freshening the northern Atlantic surface water. [Copyright &y& Elsevier]

Introduction: Age- and sex-stratified incidence rates of uncommon dementia subtypes are imprecise and scarce., Methods: We used data from 7357 newly diagnosed individuals aged between 30.6 and 101.0 years from the Registry of Dementia of Girona during 2007-2016 to determine the incidence rates of uncommon dementia subtypes stratified by sex and age groups and to describe their clinical characteristics., Results: Uncommon dementia subtypes were classified according to their etiology. The incidence rate of uncommon dementia subtypes was 27.8 cases per 100,000 person-years for those aged 30 years and older, 3.7 cases per 100,000 person-years for people aged less than 65 years, and 110.9 per 100,000 person-years for those aged 65 years and older. Age, sex, dementia severity, and medical comorbidities were different depending on the dementia subtype., Discussion: There are differences in the incidence rates and the demographic and clinical characteristics among uncommon dementia subtypes for age and sex groups., (Copyright © 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Objective: To estimate the incidence of early-onset dementia (EOD) and to compare the clinical characteristics of EOD vs late-onset dementia (LOD) in a geographically defined area., Methods: We used data from the Registry of Dementia of Girona (ReDeGi), an epidemiologic surveillance system of dementia. The ReDeGi is a standardized clinical registry of new dementia cases diagnosed in the 7 hospitals of the Health Region of Girona (Catalonia, Spain), which encompasses an area of 5,517 km(2) and 690,207 inhabitants. EOD cases were defined as those patients residing in the target area at the time of diagnosis who were diagnosed with dementia with an age at onset of symptoms before 65 years., Results: The ReDeGi registered 2,083 patients between January 1, 2007, and December 31, 2009 (6.9% EOD). The incidence rate of EOD for the age range 30-64 was 13.4 cases per 100,000 person-years (95% confidence interval 11.3-15.8). Alzheimer disease was the most frequent cause of EOD (42.4%), followed by secondary dementia (18.1%), vascular dementia (13.8%), and frontotemporal dementia (9.7%). EOD cases at the time of diagnosis were less impaired on the Mini-Mental State Examination and had a greater score on the Blessed Dementia Rating Scale behavior subscale than LOD cases. The frequency of a personal history of depression was higher in EOD cases., Conclusions: The incidence of EOD was less than 6 cases per 100,000 person-years in the age group 30-49 years; in the age group 50-64 years, the incidence rate was 3-fold higher and doubled with each 5-year increase.

Aim: To perform a descriptive analysis of the outpatient activity in a neurological department in terms of the frequency and type of neurological diseases that were attended., Patients and Methods: A retrospective and cross-sectional study was conducted involving patients referred to the neurology outpatients department. The cases that visited for the first time during the years 2006 and 2007 were recorded consecutively. Medical information was evaluated based on computerised hospital registers and the following data were collected: health referral area, date of visit, age, sex and diagnosis according to the International Classification of Diseases, 9th edition, clinical modification (CIE-9-MC), reconverted into the International Classification of Diseases, 10th edition (CIE-10)., Results: The mean age was 60.6 +/- 20.9 years (range: 4-95 years) and 61.4% were females. The rate of frequency of visits was 4.3 requests/1000 inhabitants for the year 2006 and 3.9 for the year 2007; an increase was observed with age for the neurodegenerative diseases. As far as the CIE-10 is concerned, the diseases were classified as episodic and paroxysmal (25%), degenerative and demyelinating (18.6%), organic mental disorders (14.7%), extrapyramidal syndromes (10.5%), diseases affecting cerebral circulation (3.5%), stress-related disorders and somatomorphs (3.5%) and diseases of the inner ear (3.3%). The remaining pathologies did not reach 3% of the total. Diseases of the central nervous system were observed in 61% of the patients and psychiatric disorders were found in 20.3%. The most common diseases were cognitive disorders (31.5%), headaches (18.6%) and movement disorders (11.7%), followed by psychiatric diseases, epilepsies, cerebrovascular diseases and neuropathies., Conclusions: The frequency of visits increases with age and the order, in terms of frequency, was: episodic and paroxysmal, degenerative and demyelinating, psychotic and behavioural disorders, and extrapyramidal syndromes.

Introduction and Aim: Classic epidemiological studies do not allow to know the dementia patterns of derivation and diagnosis in a defined territory. This information is fundamental for the planning and distribution of the sanitary and social resources to a medium-to-long term. The results of a pilot-registry program for dementia cases based on the population surveillance principles is presented., Materials and Methods: Consecutive and standardized registry of the incident dementia diagnoses of a memory unit during biennium 2004-2005., Results: 670 new cases of dementia, of which 74% corresponded to Alzheimer's disease, were registered. The presenile dementias were 10.3% of the cases. The mean time between the beginning of the symptoms and the clinical diagnosis was of 2.4 years and the severity of the dementia was mild in 60.0%. 90.1% of the cases lived in their homes or in a relative's home. The hypertension, the diabetes mellitus and the antecedents of depressive disease were the more frequent pathological antecedents (> 20%). The diagnostic coverage based on the estimated dementia cases was 75% for the memory unit's reference territorial area. The diagnostic coverage for the health region of Girona was 38%., Conclusions: The registered data show the viability and validity of the proposed registry program for dementia cases. Nowadays the registry program is able to extend the diagnostic coverage all over the health region of Girona.

Introduction: Alzheimer's disease (AD) is characterised by progressive cognitive and functional decline. There is evidence that AD is more prevalent in women. This study aims at identifying the clinical and sociodemographic variables associated with the cognitive functions and the pattern of decline in women with moderate to moderately severe AD., Methods: Cross-sectional observational study of 165 women with dementia of the AD type according to NINCDS-ADRDA criteria. The cognitive functions were assessed using the Cambridge Cognitive Examination (CAMCOG). The sociodemographic and clinical data were collected from the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) interview, and the Neuropsychiatric Inventory (NPI) was administrated to the caregiver., Results: The number of years of schooling and the score on the CAMDEX depression scale were the variables associated with the CAMCOG score. The effect of these variables was not homogenous for all the CAMCOG subtests., Conclusions: The number of years of schooling and the presence of depressive symptomatology influence the results of the neuropsychological exploration, but the effect is moderate and not homogenous for all the CAMCOG subtests. The differences in cognitive profile between moderate and moderately severe are characterised by a greater effect on temporal orientation, calculation and perception.

Introduction and Aims: Dementia with Lewy bodies (DLB) has only relatively recently been acknowledged as an independent neurodegenerative entity. Until now few epidemiological prevalence studies have been carried out that include DLB and there are no studies about its incidence. The aim of this study is to determine the annual clinical incidence of DLB., Patients and Methods: We performed an observational retrospective study of the diagnosis of all the individuals who were attended at the UVAMID (Memory and Dementia Assessment Unit) between 1999 and 2001. The clinical assessment was performed in a standardised manner following the UVAMID protocol, which includes the medical history, obtained by interviewing the patient and a reliable informant, a general medical and neurological check up, neuropsychological exploration and a set of complementary tests., Results: The incidence of DLB in clinical practice was found to be 26/100,000 cases per year. By age groups, a progressive increase in incidence was seen until the 80 84 year old bracket and 63% of the cases of DLB were males., Conclusions: The results of this study show that cases of DLB made up 2% of the total number of new annual cases. The main limitation of this study lies in the fact that, because patients were referred to clinic from primary health care centres, they do not constitute a representative sample that is clinically unbiased, and this imposes restraints on the extrapolation of results.