Is Community Based Tourism viable in the long run? Lessons learnt from the case of Prainha do Canto Verde (Brazil)

Prainha do Canto Verde es un ejemplo paradigmático de Turismo Comunitario (TC). Esta villa costera se ha convertido en un referente nacional para los medios de comunicación de masas y para académicos y miembros de ONG que consideran Prainha un ejemplo exitoso de un turismo comunitario, justo, redistributivo, respetuoso con el medio ambiente y con la cultura local. Sin embargo, se dan en Prainha una serie de conflictos internos que cuestionan la viabilidad futura del proyecto turístico. Como conclusión se sostiene que estos conflictos surgen de la debilidad de las estructuras comunitarias y del desajuste entre una concepción de comunidad corporativa y comunitarista y una población que es en la práctica diversa y que presenta elevadas dosis de individualismo. Asimismo se reflexiona sobre la viabilidad del TC teniendo en cuenta que el turismo desarticula elementos estructurales de las comunidades.Prainha do Canto Verde is a paradigmatic example of Community Based Tourism (CBT). This coastal village has become a national benchmark for mass media, academics and NGO members who consider Prainha a successful example of a redistributive, respectful with the environment and local culture CBT model. However, in Prainha there are a series of internal conflicts that question the future viability of the tourism project. As a conclusion it is argued that these conflicts arise from the weakness of community structures and the mismatch between a concept of community as a corporate and communitarian body which is in the process of been imposed on a population that is actually diverse and that present high levels of individualism. There is also reflection on the viability of the CBT model taking into account that tourism per ser tends to generate and/or accelerate structural transformations within the community.- Grupo de investigación Antropología y Filosofía (SEJ-126). Universidad de Granada. - Área de Antropología Social. Universidad de Jaén. - Laborarorio de Antropología Social y Cultural (HUM-472). Universidad de Almería. - Departamento de Filosofía II. Universidad de Granada

Slowly expanding lesions relate to persisting black-holes and clinical outcomes in relapse-onset multiple sclerosis

Black holes; Chronic active lesions; Volumetric MRIAgujeros negros; Lesiones activas crónicas; Resonancia magnética volumétricaForats negres; Lesions actives cròniques; Ressonància magnètica volumètricaBackground Slowly expanding lesions (SELs) are MRI markers of chronic active lesions in multiple sclerosis (MS). T1-hypointense black holes, and reductions in magnetization transfer ratio (MTR) are pathologically correlated with myelin and axonal loss. While all associated with progressive MS, the relationship between these lesion’s metrics and clinical outcomes in relapse-onset MS has not been widely investigated. Objectives To explore the relationship of SELs with T1-hypointense black holes, and longitudinal T1 intensity contrast ratio and MTR, their correlation to brain volume, and their contribution to MS disability in relapse-onset patients. Methods 135 patients with relapsing-remitting MS (RRMS) were studied with clinical assessments and brain MRI (T2/FLAIR and T1-weighted scans at 1.5/3 T) at baseline and two subsequent follow-ups; a subset of 83 patients also had MTR acquisitions. Early-onset patients were defined when the baseline disease duration was ≤ 5 years (n = 85). SELs were identified using deformation field maps from the manually segmented baseline T2 lesions and differentiated from the non-SELs. Persisting black holes (PBHs) were defined as a subset of T2 lesions with a signal below a patient-specific grey matter T1 intensity in a semi-quantitative manner. SELs, PBH counts, and brain volume were computed, and their associations were assessed through Spearman and Pearson correlation. Clusters of patients according to low (up to 2), intermediate (3 to 10), or high (more than 10) SEL counts were determined with a Gaussian generalised mixture model. Mixed-effects and logistic regression models assessed volumes, T1 and MTR within SELs, and their correlation with Expanded Disability Status Scale (EDSS) and confirmed disability progression (CDP). Results Mean age at study onset was 35.5 years (73% female), disease duration 5.5 years and mean time to last follow-up 6.5 years (range 1 to 12.5); median baseline EDSS 1.5 (range 0 to 5.5) and a mean EDSS change of 0.31 units at final follow-up. Among 4007 T2 lesions, 27% were classified as SELs and 10% as PBHs. Most patients (n = 65) belonged to the cluster with an intermediate SEL count (3 to 10 SELs). The percentage of PBHs was higher in SELs than non-SELs (up to 61% vs 44%, p < 0.001) and within-patient SEL volumes positively correlated with PBH volumes (r = 0.53, p < 0.001). SELs showed a decrease in T1 intensity over time (beta = -0.004, 95%CI −0.005 to −0.003, p < 0.001), accompanied by lower cross-sectional baseline and follow-up MTR. In mixed-effects models, EDSS worsening was predicted by the SEL log-volumes increase over time (beta = 0.11, 95%CI 0.03 to 0.20, p = 0.01), which was confirmed in the sub-cohort of patients with early onset MS (beta = 0.14, 95%CI 0.04 to 0.25, p = 0.008). In logistic regressions, a higher risk for CDP was associated with SEL volumes (OR = 5.15, 95%CI 1.60 to 16.60, p = 0.006). Conclusions SELs are associated with accumulation of more destructive pathology as indicated by an association with PBH volume, longitudinal reduction in T1 intensity and MTR. Higher SEL volumes are associated with clinical progression, while lower ones are associated with stability in relapse-onset MS

Seasonal and interannual variability of dissolved oxygen around the Balearic Islands from hydrographic data

Oceanographic data obtained between 2001 and 2011 by the Spanish Institute of Oceanography (IEO, Spain) have been used to characterise the spatial distribution and the temporal variability of the dissolvedoxygen around the Balearic Islands (Mediterranean Sea). The study area includes most of the Western Mediterranean Sea, from the Alboran Sea to Cape Creus,atthe border between France and Spain. Dissolved Oxygen (DO) at thewatersurface is found to be in a state of equilibrium exchange with the atmosphere. In the spring and summer a subsurface oxygen supersaturation is observed due to the biological activity, above the subsurface fluorescence maximum. Minimum observed values of dissolved oxygen are related to theLevantine Intermediate Waters (LIW). An unusual minimum of dissolved oxygen concentrations were also recorded in the Alboran Sea Oxygen Minimum Zone. The Western Mediterranean Deep Waters (WMDW) and the Western Intermediate Waters (WIW) show higher values of dissolved oxygenthanthe Levantine Intermediate Waters due to their more recent formation. Using these dissolved oxygen concentrations it is possible to showthat the Western Intermediate Waters move southwards across the Ibiza Channel and the deep water circulates around the Balearic Islands. It has also been possible to characterise the seasonal evolution of the different watermassesandtheir dissolved oxygen content in a station in the Algerian sub-basin. Keywords: Ocean circulation, dissolved oxygen, water masses, Western Mediterranean Sea, Balearic SeaPost-print

Differentiating Multiple Sclerosis From AQP4-Neuromyelitis Optica Spectrum Disorder and MOG-Antibody Disease With Imaging

Multiple sclerosis; Neuromyelitis optica; ImagingEsclerosis múltiple; Neuromielitis óptica; ImágenesEsclerosi múltiple; Neuromielitis òptica; ImatgesBackground and Objectives Relapsing-remitting multiple sclerosis (RRMS), aquaporin-4 antibody–positive neuromyelitis optica spectrum disorder (AQP4-NMOSD), and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) may have overlapping clinical features. There is an unmet need for imaging markers that differentiate between them when serologic testing is unavailable or ambiguous. We assessed whether imaging characteristics typical of MS discriminate RRMS from AQP4-NMOSD and MOGAD, alone and in combination. Methods Adult, nonacute patients with RRMS, APQ4-NMOSD, and MOGAD and healthy controls were prospectively recruited at the National Hospital for Neurology and Neurosurgery (London, United Kingdom) and the Walton Centre (Liverpool, United Kingdom) between 2014 and 2019. They underwent conventional and advanced brain, cord, and optic nerve MRI and optical coherence tomography (OCT). Results A total of 91 consecutive patients (31 RRMS, 30 APQ4-NMOSD, and 30 MOGAD) and 34 healthy controls were recruited. The most accurate measures differentiating RRMS from AQP4-NMOSD were the proportion of lesions with the central vein sign (CVS) (84% vs 33%, accuracy/specificity/sensitivity: 91/88/93%, p < 0.001), followed by cortical lesions (median: 2 [range: 1–14] vs 1 [0–1], accuracy/specificity/sensitivity: 84/90/77%, p = 0.002) and white matter lesions (mean: 39.07 [±25.8] vs 9.5 [±14], accuracy/specificity/sensitivity: 78/84/73%, p = 0.001). The combination of higher proportion of CVS, cortical lesions, and optic nerve magnetization transfer ratio reached the highest accuracy in distinguishing RRMS from AQP4-NMOSD (accuracy/specificity/sensitivity: 95/92/97%, p < 0.001). The most accurate measures favoring RRMS over MOGAD were white matter lesions (39.07 [±25.8] vs 1 [±2.3], accuracy/specificity/sensitivity: 94/94/93%, p = 0.006), followed by cortical lesions (2 [1–14] vs 1 [0–1], accuracy/specificity/sensitivity: 84/97/71%, p = 0.004), and retinal nerve fiber layer thickness (RNFL) (mean: 87.54 [±13.83] vs 75.54 [±20.33], accuracy/specificity/sensitivity: 80/79/81%, p = 0.009). Higher cortical lesion number combined with higher RNFL thickness best differentiated RRMS from MOGAD (accuracy/specificity/sensitivity: 84/92/77%, p < 0.001). Discussion Cortical lesions, CVS, and optic nerve markers achieve a high accuracy in distinguishing RRMS from APQ4-NMOSD and MOGAD. This information may be useful in clinical practice, especially outside the acute phase and when serologic testing is ambiguous or not promptly available. Classification of Evidence This study provides Class II evidence that selected conventional and advanced brain, cord, and optic nerve MRI and OCT markers distinguish adult patients with RRMS from AQP4-NMOSD and MOGAD.The study was funded by the UK MS Society (Grant No.: 917-09) and the National Institute for Health and Care Re- search (RP-2017-08-ST2-004)

Community nutrition in Spain: advances and drawbacks

Scientific evidence has placed community nutrition among the front-line strategies in health promotion. Community nutrition in different regions of Spain has developed at an unequal pace. Early initiatives in the mid 1980s provided good-quality population data and established a basis for nutrition surveillance including individual body measurements, dietary intake data, information on physical activity, and biomarkers. The Nutrition and Physical Activity for Obesity Prevention Strategy (NAOS) reinforces community nutrition action in Spain. Presented here is an overview of developments in community nutrition in Spain in recent years as well as potential trends under the scope of the NAOS.Publicad

Intergroup conflict and rational decision making

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict ¿associated with indicators of the activation of negative feelings (negative affect state and heart rate)¿ has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making

Slowly expanding lesions relate to persisting black-holes and clinical outcomes in relapse-onset multiple sclerosis

Background: Slowly expanding lesions (SELs) are MRI markers of chronic active lesions in multiple sclerosis (MS). T1-hypointense black holes, and reductions in magnetization transfer ratio (MTR) are pathologically correlated with myelin and axonal loss. While all associated with progressive MS, the relationship between these lesion's metrics and clinical outcomes in relapse-onset MS has not been widely investigated. Objectives: To explore the relationship of SELs with T1-hypointense black holes, and longitudinal T1 intensity contrast ratio and MTR, their correlation to brain volume, and their contribution to MS disability in relapse-onset patients. Methods: 135 patients with relapsing-remitting MS (RRMS) were studied with clinical assessments and brain MRI (T2/FLAIR and T1-weighted scans at 1.5/3 T) at baseline and two subsequent follow-ups; a subset of 83 patients also had MTR acquisitions. Early-onset patients were defined when the baseline disease duration was &amp; LE; 5 years (n = 85). SELs were identified using deformation field maps from the manually segmented baseline T2 lesions and differentiated from the non-SELs. Persisting black holes (PBHs) were defined as a subset of T2 lesions with a signal below a patient-specific grey matter T1 intensity in a semi-quantitative manner. SELs, PBH counts, and brain volume were computed, and their associations were assessed through Spearman and Pearson correlation. Clusters of patients according to low (up to 2), intermediate (3 to 10), or high (more than 10) SEL counts were determined with a Gaussian generalised mixture model. Mixed-effects and logistic regression models assessed volumes, T1 and MTR within SELs, and their correlation with Expanded Disability Status Scale (EDSS) and confirmed disability progression (CDP). Results: Mean age at study onset was 35.5 years (73% female), disease duration 5.5 years and mean time to last follow-up 6.5 years (range 1 to 12.5); median baseline EDSS 1.5 (range 0 to 5.5) and a mean EDSS change of 0.31 units at final follow-up. Among 4007 T2 lesions, 27% were classified as SELs and 10% as PBHs. Most patients (n = 65) belonged to the cluster with an intermediate SEL count (3 to 10 SELs). The percentage of PBHs was higher in SELs than non-SELs (up to 61% vs 44%, p &lt; 0.001) and within-patient SEL volumes positively correlated with PBH volumes (r = 0.53, p &lt; 0.001). SELs showed a decrease in T1 intensity over time (beta = -0.004, 95%CI -0.005 to -0.003, p &lt; 0.001), accompanied by lower cross-sectional baseline and follow-up MTR. In mixed effects models, EDSS worsening was predicted by the SEL log-volumes increase over time (beta = 0.11, 95% CI 0.03 to 0.20, p = 0.01), which was confirmed in the sub-cohort of patients with early onset MS (beta = 0.14, 95%CI 0.04 to 0.25, p = 0.008). In logistic regressions, a higher risk for CDP was associated with SEL volumes (OR = 5.15, 95%CI 1.60 to 16.60, p = 0.006). Conclusions: SELs are associated with accumulation of more destructive pathology as indicated by an association with PBH volume, longitudinal reduction in T1 intensity , MTR. Higher SEL volumes are associated with clinical progression, while lower ones are associated with stability in relapse-onset MS