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ObjectivesTo assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK.MethodsParticipants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked ‘Yes’ or ‘No’, and as achieved if the participant had checked ‘Yes’ to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses.ResultsA total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked ‘Yes’) was 48% (IQR 28%, 64%; range 0–100%) for the total sample with relatively similar medians across three of four countries. Achievement rates on individual QIs showed a large variation ranging from 11% (referral to services for losing weight) to 67% (information about the importance of exercise) with significant differences in achievement rates between the countries.ConclusionsThe results indicated a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing healthcare services, ideas may be generated on how the quality might be improved across nations. Larger studies are needed to confirm and further explore the findings.

Polymeric nanoparticles have revealed very effective in transmucosal delivery of proteins. Polysaccharides are among the most used materials for the production of these carriers, owing to their structural flexibility and propensity to evidence biocompatibility and biodegradability. In parallel, there is a preference for the use of mild methods for their production, in order to prevent protein degradation, ensure lower costs and easier procedures that enable scaling up.In this work we propose the production of pullulan-based nanoparticles by a mild method of polyelectrolyte complexation. As pullulan is a neutral polysaccharide, sulfated and aminated derivatives of the polymer were synthesized to provide pullulan with a charge. These derivatives were then complexed with chitosan and carrageenan, respectively, to produce the nanocarriers. Positively charged nanoparticles of 180-270 nm were obtained, evidencing ability to associate bovine serum albumin, which was selected as model protein. In PBS pH 7.4, pullulan-based nanoparticles were found to have a burst release of 30% of the protein, which maintained up to 24h. Nanoparticle size and zeta potential were preserved upon freeze-drying in the presence of appropriate cryoprotectants. A factorial design was approached to assess the cytotoxicity of raw materials and nanoparticles by the metabolic test MTT. Nanoparticles demonstrated to not cause overt toxicity in a respiratory cell model (Calu-3). Pullulan has, thus, demonstrated to hold potential for the production of nanoparticles with an application in protein delivery.

Non-prescription acquisition, age and gender could be determinants of self-medication with antibiotics among Portuguese people in the Algarve region.

Time series analysis of data for sea surface temperature and upwelling components from the southwest coast of AbstractThis study relates sea surface temperature (SST) to the upwelling conditions off the southwest coast of Portugal using statistical analyses of publically available data.Optimum Interpolation (OI) daily SST data were extracted from the United States (US) National Oceanic and Atmospheric Administration (NOAA) and data for wind speed and direction were from the US National Climatic Data Center. Time series were extracted at a daily frequency for a time horizon of 26 years. Upwelling indices were estimated using westerly (Q x ) and southerly (Q y ) Ekman transport components.In the first part of the study, time series were inspected for trend and seasonality over the whole period. The seasonally adjusted time series revealed an increasing slope for SST (0.15ºC per decade) and decreasing slopes for Q x (-84.01 m 3 .s -1 .km -1 per decade) and Q y (-25.20 m 3 .s -1 .km -1 per decade), over the time horizon. Structural breaks analysis applied to the time series showed that a statistically significant incremental increase in SST was more pronounced during the last decade. Cross-correlation between upwelling indices and SST revealed a time delay of 5 and 2 days between Q x and SST, and between Q y and SST, respectively. A spectral analysis combined with the previous analysis enabled the identification of four oceanographic seasons. Those seasons were later recognised over a restricted time period of 4 years, between 2008 and 2012; when there was an extensive sampling programme for the validation of ocean colour remote sensing imagery. The seasons were defined as: summer, with intense and regular events of upwelling; autumn, indicating relaxation of upwelling conditions; and spring and winter, showing high interannual variability in terms of number and intensity of upwelling events.

Abstract:The European Space Agency has acquired 10 years of data on the temporal and spatial distribution of phytoplankton biomass from the MEdium Resolution Imaging Spectrometer (MERIS) sensor for ocean color. The phytoplankton biomass was estimated with the MERIS product Algal Pigment Index 1 (API 1). Seasonal-Trend decomposition of time series based on Loess (STL) identified the temporal variability of the dynamical features in the MERIS products for water leaving reflectance (ρ w (λ)) and API 1. The advantages of STL is that it can identify seasonal components changing over time, it is responsive to nonlinear trends, and it is robust in the presence of outliers. One of the novelties in this study is the development and the implementation of an automatic procedure, stl.fit(), that searches the best data modeling by varying the values of the smoothing parameters, and by selecting the model with the lowest error measure. This procedure was applied to 10 years of monthly time series from Sagres in the Southwestern Iberian Peninsula at three Stations, 2, 10 and 18 km from the shore. Decomposing the MERIS products into seasonal, trend and irregular components with stl.fit(), the ρ w (λ) indicated dominance of the seasonal and irregular components while API 1 was mainly dominated by the seasonal component, with an increasing effect from inshore to offshore. A comparison of the seasonal components between the ρ w (λ) and the API 1 product, showed that the variations decrease along this time period due to the changes in phytoplankton functional types. Furthermore, inter-annual seasonal variation for API 1 showed the influence of upwelling events and in which month of the year these occur at each of the three Sagres stations. The stl.fit() is a good tool for any remote sensing study of time series, particularly those addressing inter-annual variations. This procedure will be made available in R software.

Chitosan/carrageenan/tripolyphosphate nanoparticles were previously presented as holding potential for an application in transmucosal delivery of macromolecules, with tripolyphosphate demonstrating to contribute for both size reduction and stabilisation of the nanoparticles. This work was aimed at evaluating the capacity of the nanoparticles as protein carriers for pulmonary and nasal transmucosal delivery, further assessing their biocompatibility pattern regarding that application. Nanoparticles demonstrated stability in presence of lysozyme, while freeze-drying was shown to preserve their characteristics when glucose or sucrose were used as cryoprotectants. Bovine serum albumin was associated to the nanoparticles, which were successfully microencapsulated by spray-drying to meet the aerodynamic requirements inherent to pulmonary delivery. Finally, a satisfactory biocompatibility profile was demonstrated upon exposure of two respiratory cell lines (Calu-3 and A549 cells) to the carriers. A negligible effect on cell viability along with no alterations on transepithelial electrical resistance and no induction of inflammatory response were observed.

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