Exploration of grape pomace peels and amaranth flours as functional ingredients in the elaboration of breads: phenolic composition, bioaccessibility, and antioxidant activity.

This study evaluated the incorporation of two ingredients as a source of bioactive compounds: amaranth flour (AF) and grape pomace peels flour (GP) to improve the nutritional qualities and functional properties of a wheat bread, emphasising the revalorisation of agricultural residues from grape winemaking as an ethical and economically viable source of bioactive compounds. Specifically, wheat flour (WF) substitutions were carried out for the individual ingredients, replacing 20% WF (A20 bread) or 5% GP (GP5 bread) and a mixture of both ingredients 20% WF and 5% GP (A20GP5 bread), and the antioxidant potential of the breads was analysed. The effect of simulated gastrointestinal digestion (SGID) on the phenolic profile and antioxidant activity of the fortified breads was also investigated. The substitution of WF by AF or GP introduced several phenolic compounds, digestion increased the bioaccessibility of phenolic compounds and reshaped their phenolic composition profiles. The combined presence of AF and GP in the breads modified the phenolic compounds composition and improved their antioxidant activity after SGID. Interactions between the phenolic compounds and other AF components (possibly proteins) were observed, which could protect the phenols from degradation during SGID, allowing them to be released after SGID.

Chemical and cell antioxidant activity of amaranth flour and beverage after simulated gastrointestinal digestion. Role of peptides.

The potential of peptides generated by simulated gastrointestinal digestion (SGID) of two products derived from Amaranthus manteggazianus seeds, flour (F) and beverage (B), to exert peroxyl scavenging activity (ORAC) and antioxidant action on intestinal cells was studied. B was prepared by solubilisation of seed proteins, with the addition of gums and the application of a pasteurization treatment. The gastrointestinal digests FD and BD showed some differences in the peptide/polypeptide composition. The SGID produced increased ORAC activity for both samples, with some differences in the ORAC of the whole digests BD and FD and of some gel filtration fractions. Bioaccessible fractions (FDdbs and BDdbs) were obtained after treatment with cholestyramine resin to remove bile salts due to their cytotoxicity and oxidative effect. BDdbs presented a greater ORAC potency (IC50: 0.05 ± 0.01 and 0.008 ± 0.004 mg protein/ml for FDdbs and BDdbs, respectively). These fractions showed low cytotoxicity values (measured by LDH release) and produced high intracellular ROS inhibition (around 80 %), increased the SOD activity and the GSH content, with no effect on GPx activity in Caco2-TC7 cells exposed to H2O2. Several fractions with MM < 2.2 kDa presented also these cellular actions; fractions from FD induced higher increases in GSH concentration. Amaranth flour and a processed matrix like the beverage are shown as sources of bioactive peptides with potential cell antioxidant activity.

"The Name of This is Fourth Trimester. A Lot of People Don't Know About it": A Qualitative Analysis to Inform the Development of a Web-Based Tool.

OBJECTIVE: The purpose of this qualitative study is to understand the pregnant and postpartum experiences of Black women in the United States to inform the development of a web-based mobile tool. METHODS: Participants were recruited through Facebook Groups. There were a total of 19 women that participated in one of five focus group discussions. Participants ranged from being in their 3rd trimester of pregnancy through 6 months postpartum. Thematic content analysis was performed to identify emerging themes. RESULTS: Four themes emerged from the focus group discussions: beliefs about postpartum motherhood, experiences during pregnancy, experiences of the postpartum period, and tool recommendations. Key results from these themes demonstrated the difficulties that women faced in having their concerns resolved by healthcare professionals, receiving adequate educational and social support during the COVID-19 pandemic, and having adequate information to help breastfeed and cope with changes they experienced throughout the postpartum period. CONCLUSION: The results highlight the difficulties that Black women experienced throughout pregnancy and the postpartum period. The main findings show that women lacked support in receiving information about the postpartum period, had their concerns dismissed by healthcare professionals, and received inadequate support. These findings can inform the practice of healthcare professionals and inform the development of other non-clinical, digital resources to fill in these gaps. Future research in this area is planned to further develop and pilot the tool among a broader population of women.

The Power and Promise of Postpartum Self Care: Evaluation of a Web-Based Tool for Underserved Women.

OBJECTIVES: Joyuus is a culturally diverse, comprehensive online tool designed to address the self-care needs of underserved postpartum women. The tool provides actionable self-care information, knowledge, and skills to improve postpartum health and identifies red flags for when self-care shifts to seeking care. METHODS: We employed a mixed-methods multiphase design to evaluate the Joyuus prototype, including a pre-post evaluation (N = 87) to assess behavioral health outcomes before and after using the tool for a one-month period. 91% completed the post-test (N = 79). The analysis focused on estimation of treatment effect (via 95% confidence intervals) and fitness of instruments in this population. RESULTS: Participants were between 6 months pregnant and one year postpartum, a mean age of 30 years, 100% female, 99% Black, with nearly equal distribution of married (55%) and not married (44%), and above (47%) and below (46%) annual income of $60 K. Key measures saw significant improvement from pre- (mean = 26.44, SD = 5.39) to post (mean = 28.29, SD = 5.26) on the Connor-Davidson Resilience Scale (p < 0.001) Trends toward improvement (not statistically significant) were noted for Depression (EPDS) (p = 0.624) and Anxiety (STAI) (p = 0.286), and no meaningful change on MOS Social Support or COVID-19 Mental Health Impacts Measures. CONCLUSIONS FOR PRACTICE: This pilot study demonstrates that a self-care mobile tool has the potential to address significant health outcomes related to maternal morbidity and mortality. By providing a continuously available companion addressing physical, mental, and real-life questions, it creates value during postpartum for mothers who can often feel overwhelmed or isolated.

Nivel de conocimientos sobre bioseguridad en estudiantes de Enfermería durante la pesquisa de COVID-19 / Level of knowledge about biosafety in Nursing students during the COVID-19 screening

Fundamento: la bioseguridad es considerada como una norma preventiva universal para reducir factores de riesgo, está orientada en el ámbito de la salud al fomento de la seguridad, y la protección de profesionales y estudiantes en contextos de riesgo. Objetivo: valorar el nivel de conocimientos en estudiantes de Enfermería sobre las medidas de bioseguridad durante la pesquisa de COVID-19. Métodos: se realizó un estudio descriptivo de corte transversal en el período comprendido de febrero a octubre 2021, en Camagüey, Cuba. Se aplicaron métodos teóricos para la fundamentación de la investigación, y empíricos: la observación participante y encuesta confeccionada por los autores. Se establecieron como variables: área de salud, cifra de estudiantes contagiados, posibles causas de contagio y nivel de conocimientos sobre bioseguridad. Resultados: hubo mayor representación de estudiantes del municipio Santa Cruz (15 %). El área de salud con más contagios fue Previsora con un 6,25 %. Las posibles causas de contagio identificadas se refieren a la conducta higiénico-sanitaria durante la pesquisa: dificultades en el uso de la mascarilla, la distancia física entre estudiantes y con la población objeto de pesquisa, y uso de desinfectante 91,25 %, 87,50 % y 82,50 % respectivamente. Conclusiones: se valoró que el nivel de conocimientos en estudiantes de Enfermería sobre las medidas de bioseguridad durante la pesquisa de COVID-19 fue bajo, a pesar de haber recibido un curso de capacitación previo a la actividad, y su presencia en los programas de estudio.

Background: biosafety is considered a universal preventive norm to reduce risk factors, it is oriented in the field of health to promote safety, and the protection of professionals and students in risk contexts. Objective: to assess the level of knowledge in Nursing students about biosafety measures during COVID-19 screening. Methods: a descriptive cross-sectional study was carried out in the period from February to October 2021, in Camagüey, Cuba. Theoretical methods were applied for the foundation of the research, and empirical ones: participant observation and survey made by the authors. The following variables were established: health area, number of infected students, possible causes of infection, and level of knowledge about biosafety. Results: there was a greater representation of students from the Santa Cruz municipality (15%). The health area with the most infections was Previsora ​​with 6.25%. The possible causes of contagion identified refer to hygienic-sanitary behavior during the investigation: difficulties in the use of the mask, the physical distance between students and with the population under investigation, and the use of disinfectant 91.25%, 87, 50% and 82.50% respectively. Conclusions: it was assessed that the level of knowledge in Nursing students about biosafety measures during the COVID-19 screening was low, despite having received a training course prior to the activity, and their presence in the study programs.

Curcumin Sensitizes 4T1 Murine Breast Cancer Cells to Cisplatin Through PAR4 Secretion.

BACKGROUND/AIM: Prostate apoptosis response 4 (PAR4), a tumour-suppressor protein, selectively induces apoptosis of cancer cells without affecting normal cells. Its soluble form is induced by secretagogues (e.g., chloroquine), and it induces apoptosis by interacting with the receptor of glucose-regulated protein 78, which is overexpressed in cancer cells. In this study, curcumin was analyzed as an inducer of PAR4 expression in 4T1 murine breast cancer cell. and its ability to induce PAR4 secretion in Balb/c mice. In addition, the cisplatin sensitizing effect of soluble PAR4 was analyzed. MATERIAL AND METHODS: The 4T1 cell line was treated in vitro using different concentrations of curcumin; cell viability was analyzed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and PAR4 expression by western blotting. The expression of soluble PAR4 in the serum of mice treated with intraperitoneal curcumin was analyzed using the dot-blot method. Moreover, MTT assay was used to analyze the effects of serum from curcumin-treated mice on cell viability. Tumor size was analyzed in mice treated with curcumin alone and in combination with cisplatin. RESULTS: Curcumin showed a dose- and time-dependent effects on cell viability on 4T1 cells, as well as increasing PAR4 expression. Compared with the control group (phosphate-buffered saline), mice treated with curcumin showed an increase in plasma PAR4. In the Balb/C tumor model, mice treated with curcumin and cisplatin showed greater tumor shrinkage than the control group. CONCLUSION: These results indicate that curcumin induces expression of soluble PAR4 and sensitizes tumor cells to cisplatin.

A systematic review of the qualitative literature on barriers to high-quality prenatal and postpartum care among low-income women.

OBJECTIVE: To examine the qualitative literature on low-income women's perspectives on the barriers to high-quality prenatal and postpartum care. DATA SOURCES AND STUDY SETTING: We performed searches in PubMed, Web of Science, Embase, SocIndex, and CINAHL for peer-reviewed studies published between 1990 and 2021. STUDY DESIGN: A systematic review of qualitative studies with participants who were currently pregnant or had delivered within the past 2 years and identified as low-income at delivery. DATA COLLECTION/EXTRACTION METHODS: Two reviewers independently assessed studies for inclusion, evaluated study quality, and extracted information on study design and themes. PRINCIPAL FINDINGS: We identified 34 studies that met inclusion criteria, including 23 focused on prenatal care, 6 on postpartum care, and 5 on both. The most frequently mentioned barriers to prenatal and postpartum care were structural. These included delays in gaining pregnancy-related Medicaid coverage, challenges finding providers who would accept Medicaid, lack of provider continuity, transportation and childcare hurdles, and legal system concerns. Individual-level factors, such as lack of awareness of pregnancy, denial of pregnancy, limited support, conflicting priorities, and indifference to pregnancy, also interfered with the timely use of prenatal and postpartum care. For those who accessed care, experiences of dismissal, discrimination, and disrespect related to race, insurance status, age, substance use, and language were common. CONCLUSIONS: Over a period of 30 years, qualitative studies have identified consistent structural and individual barriers to high-quality prenatal and postpartum care. Medicaid policy changes, including expanding presumptive eligibility, increased reimbursement rates for pregnancy services, payment for birth doula support, and extension of postpartum coverage, may help overcome these challenges.

From effectiveness to sustainability: understanding the impact of CARE's Community Score Card© social accountability approach in Ntcheu, Malawi.

We evaluated the sustainability of CARE's Community Score Card© (CSC) social accountability approach in Ntcheu, Malawi, approximately 2.5 years after the end of formal intervention activities. Using a cross-sectional, exploratory design, we conducted 41 focus groups with members of Community Health Advisory Groups (CHAGs) and youth groups and 19 semi-structured interviews with local and district government officials, project staff, and national stakeholders to understand how and in what form CSC activities are continuing. Focus groups and interviews were audio-recorded, transcribed and translated into English. Thematic coding was done using Dedoose software. Most groups were continuing to meet and implement the CSC, although some made modifications. CHAGs, youth and local government officials all attributed their continued implementation to the value that they saw in the process that allows marginalized groups within the community, including women and youth, a safe space for sharing their ideas and issues and the initial results this generated. However, lack of access to resources for implementation and challenges in convening and facilitating the interface meeting phase created barriers to continued sustainability. The CSC is sustainable by communities 2.5 years after the end of formal intervention activities. For future interventions, health systems and non-governmental organizations should plan for a transition phase with periodic refresher trainings and a small fund to support implementation, such as refreshments and transportation, to increase the likelihood of community-driven sustainability.

The Inflammatory Process Modulates the Expression and Localization of WT1 in Podocytes Leading to Kidney Damage.

BACKGROUND/AIM: Wilms' tumor 1 (WT1) is involved in the development of the urogenital system and is expressed in podocytes throughout life. Inflammation of renal glomeruli causes renal damage-induced nephrotic syndrome and steroid-resistant nephrotic syndrome have mutations in the WT1 gene. The aim of this work was to determine if the inflammatory process modulates the expression and localization of WT1 in podocytes that cause kidney damage using lipopolysaccharide (LPS)-treated mice as a sepsis model. MATERIALS AND METHODS: In investigation of renal damage, proteinuria and histology were analyzed. WT1 modulation was analyzed by indirect immunofluorescence, immunohistochemistry and western blot assays, and proinflammatory cytokines were analyzed by quantitative polymerase chain reaction assay. RESULTS: WT1 expression decreased most at 24 and 36 h after the induction of inflammation and phosphorylated WT1 was mainly localized in the cytoplasm, reduced nephrin mRNA expression and increased mRNA expression of tumor necrosis factor α and interleukin 1ß. CONCLUSION: These results indicate that the immune system plays an important role in the modulation of WT1, leading to kidney damage.

Evaluating Young People's Ability to Sustain an Evidence-Based Social Accountability Approach to Improve Adolescent Sexual and Reproductive Health in Ntcheu, Malawi.

The Community Score Card© (CSC), a social accountability approach, brings together community members, service providers, and local government officials to identify issues, prioritize, and plan actions to improve local health services. In addition, young people in Ntcheu, Malawi have been using the CSC approach to mobilize their communities to bring change across varying issues of importance to them. An earlier cluster randomized trial in Ntcheu showed the CSC effectively increased reproductive health behaviors, improved satisfaction with services, and enhanced the coverage and quality of services. Building upon this evidence of effectiveness, this study aims to evaluate if and how young people were able to sustain implementation of the CSC, and the improvements it brings, approximately 2.5 years after the randomized trial ended. As part of a larger evaluation of CSC sustainability in Ntcheu, we conducted 8 focus groups across 5 health catchment areas with 109 members of mixed-gender youth groups (58 females and 51 males, ages 14-29 years) who continued to engage with the CSC. Audio recordings were transcribed, translated into English, and coded in Dedoose using an a priori codebook augmented with emergent codes and a constant comparative approach. Although the 8 youth groups were still actively using the CSC, they had made some adaptations. While the CSC in Ntcheu initially focused on maternal health, young people adopted the approach for broader sexual and reproductive topics important to them such as child marriages and girls' education. To enable sustainability, young people trained each other in the CSC process; they also requested more formal facilitation training. Young people from Ntcheu recommended nationwide scale-up of the CSC. Young people organically adopted the CSC, which enabled them to highlight issues within their communities that were a priority to them. This diffusion among young people enabled them to elevate their voice and facilitate a process where they hold local government officials, village leaders, and services providers accountable for actions and the quality of healthcare services. Young people organized and sustained the CSC as a social accountability approach to improve adolescent sexual and reproductive health in their communities more than 2.5 years after the initial effectiveness trial ended.

Antioxidant effect of amaranth flour or protein isolate incorporated in high-fat diets fed to Wistar rats. Influence of dose and administration duration.

This study evaluated the effect on Wistar rat's oxidative status of incorporating amaranth flour (AF) and protein isolate (AI) in increased-fat diets. Five of the groups were fed for 4 weeks with either BD (basal diet), Chol+F (2% cholesterol, 10% porcine fat), Chol+F+E (0.005% α-tocopherol), Chol+F+AF1 or Chol+F+AI1 (25% of protein replacement) diets. The other two groups were fed for 4 weeks with Chol+F and then 1 week with Chol+F+AF2 or Chol+F+AI2 diet (50% of protein replacement). Various effects on the oxidative stress biomarkers in tissues (intestine and liver) were observed. These effects were dependent on the ingredients, dose, and administration time. In the intestinal cells, Chol+F+AF1 and Chol+F+AI2 produced an increment in the reduced glutathione (GSH) content (56% and 39%, respectively), while Chol+F+AF2 induced an increment in the superoxide dismutase (SOD) (25%) and glutathione peroxidase (GPx) (46%) activities. The presence of certain components in flour (e.g., fiber, polyphenols, squalene) could explain the higher activity recorded for AF. In the liver, Chol+F+AF2 produced a decrease in SOD (19%) and GSH (36%), as well as an increase in GPx (255%); Chol+F+AI1 and Chol+F+AI2 also produced a decrease in GSH (36% and 24%, respectively) and important increments in GPx activity (273% for Chol+F+AI1 and 2,900% for Chol+F+AI2 ). These effects were dependent on the AI dose and were probably produced by absorbed peptides. PRACTICAL APPLICATIONS: It is known that redox imbalances are involved in the genesis of many chronic diseases. Therefore, it is possible to prevent them or limit their severity by improving the body's antioxidant defense mechanisms through dietary incorporation of antioxidant substances. The results suggest that amaranth protein isolate and amaranth flour have the potential for regulating intestinal and liver cells redox balance; effects were more evident when they contributed 50% of the diet's protein content and were administered for 1 week. Both amaranth ingredients could be used as ingredients in the development of functional foods with beneficial antioxidant properties.

Inclusión sociolaboral de personas usuarias del servicio de salud mental del hospital piñero en el contexto de pandemia por COVID 19 / Socio-labour inclusion of users of the mental health service of the piñero hospital in the context of the COVID 19 pandemic

INTRODUCCIÓN Las personas con padecimiento mental han tenido históricamente mayores restricciones para el acceso a sus derechos, incluido el derecho al trabajo. La pandemia y la crisis económica aumentaron las desigualdades sociales, pero se desconoce en específico, cuál fue el impacto en las condiciones de inclusión/exclusión sociolaboral de las personas con padecimiento mental en CABA. Objetivo Describir la situación sociolaboral de personas adultas que reciben asistencia en el Servicio de Salud Mental del Hospital Piñero, e identificar el efecto de la pandemia considerando las particularidades según género, grupo etario, país de nacimiento y condición frente a la discapacidad. MÉTODOS Estudio cuantitativo, descriptivo, observacional, transversal y prospectivo en el que participaron voluntariamente 286 usuaries adultes a quienes se entrevistó entre noviembre/21 y agosto/22. Los ejes de indagación fueron aspectos sociodemográficos y situación laboral previa a la pandemia y actual. RESULTADOS En la población estudiada la tasa de desocupación pasó del 14,3% al 29,6%; la de empleo, del 60,8% al 46,5%; la de inactividad del 29% al 33,9% y la de subocupación del 35,5% al 42,9%. El 8,4% de la muestra refirió participar de algún plan, programa o dispositivo para favorecer la inclusión sociolaboral. El análisis estratificado permitió identificar el modo en que la discapacidad, la migración, el género y la edad actúan en los procesos de precarización laboral y en el acceso a políticas públicas de empleo. DISCUSIÓN Se evidencia un empeoramiento de la situación laboral de la población estudiada aumento de la desocupación, subocupación, informalidad, cuentapropismo (especialmente de "subsistencia"), inconformidad con los salarios, etc. Las condiciones de exclusión y precarización laboral son notablemente superiores a las de la población general de la CABA. La incompleta implementación de la normativa y el bajo alcance de las políticas públicas sostienen esta desigualdad.

Comparación del estilo personal del terapeuta y dimensiones de personalidad antes y después de las prácticas clínicas pre-profesionales en estudiantes de psicología / Comparison of Therapist Personal Style and Personality Dimensions before and after pre-professional clinical practice in psychology students

En los últimos años, se ha formado un cuerpo creciente de investigación sobre el estilo personal del terapeuta, entendido como un modo propio y personal de ejercer en la clínica (Fernández-Álvarez & García, 1998). Su profundización ha permitido conocer cómo se asocia con el ámbito de trabajo, la línea teórica y la personalidad. No obstante, pocos son los estudios que han investigado este constructo en estudiantes. Por tanto, se pretende evaluar si existen modificaciones en el estilo y en la personalidad tras el entrenamiento clínico en la carrera de grado, y analizar las relaciones entre ambos aspectos. Se trabajó con 77 estudiantes del último año de psicología, que fueron evaluados antes y después de sus prácticas pre-profesionales clínicas con el Cuestionario de Estilo Personal del Terapeuta (Fernández-Álvarez et al., 2003) y el Big Five Inventory (John, 1990). Los resultados apuntan a un aumento de la cercanía emocional y una menor rigidez en el encuadre terapéutico, así como un incremento de la sociabilidad y de la estabilidad emocional luego de las prácticas. El modo en que se relacionan estos factores presenta variaciones respecto estudios con terapeutas en ejercicio, lo que da cuenta de que existen importantes diferencias entre ambos grupos

In recent years, a growing body of research has been conducted on the personal style of the therapist, understood as a personal way of practising in the clinic (Fernández-Álvarez & García, 1998). Its deepening has allowed us to know how it is associated with the field of work, the theoretical line and personality. However, few studies have investigated this construct in students. Therefore, the aim was to assess whether there are modifications in style and personality after undergraduate clinical training and to analyse the relationships between both aspects. We worked with 77 final-year psychology students assessed before and after their pre-professional clinical practice with the Therapist Personal Style Questionnaire (Fernández-Álvarez et al., 2003) and the Big Five Inventory (John, 1990). The results point to an increase in emotional closeness and less rigidity in the therapeutic setting and an increase in sociability and emotional stability after the internship. The relations among these factors show variations regarding studies with practising therapists, which shows that there are essential differences between the two groups

Entramados entre lo común y el Estado como clave para revisitar la participación en salud / Networks between the common and the State as a key to revisit participation in health

Resumen Este artículo revisita las nociones nodales del campo de la salud de participación y comunidad, que precisan ser revaloradas y comprendidas a la luz de las tramas entre políticas públicas modernas y procesos de producción de lo común. Las prácticas colectivas en los territorios construyen, en la vida cotidiana, procesos de salud-enfermedad-atención-cuidados en las reproducciones de la vida y en las resistencias que allí se construyen a modelos hegemónicos tanto de abordaje como de los modos de vida. Esas vivencias y saberes son ejes para otras prácticas en salud que acompañen procesos de autonomía de los territorios. Guiados por ellos, las/los profesionales pueden construir otras prácticas por fuera de los diseños de atención estancos e instituidos.

Abstract The article revisits nodal notions in the health field such as participation and community. These categories need to be revalued and understood in the light of modern public policies and the processes of construction of "the common". In the territories daily life collective practices construct health-illness-assistance-care processes in social reproduction and also in the resistances to the social general hegemonic models, as well as those related to the health care services. These experiences and knowledge are axes for health practices focussed on territorial autonomy processes. Guided by those, professionals can turn to develop other practices outside of the classic, hegemonic and rigid care designs.

Simulated gastrointestinal digestion of amaranth flour and protein isolate: Comparison of methodologies and release of antioxidant peptides.

The effect of both the simulated gastrointestinal digestion conditions and the matrix over protein hydrolysis and antioxidant peptides generation was evaluated by comparing an in-house method with COST INFOGEST-based SGD protocols. The in-house protocol was used to digest amaranth protein isolate I (Id1), while the standardized method and a modified version (similar enzyme/substrate ratio than in our lab) were used to digest I and amaranth flour F (Id3 and Fd3, Id2 and Fd2). Protein hydrolysis degree (TNBS method) was similar for the three I digested (about 60%), but lower for F digested (45 and 34% for Fd2 and Fd3, respectively). The five digested obtained presented comparable protein solubility and only small differences in the polypeptide/peptide composition (SDS-PAGE, tricine-SDS-PAGE, gel filtration FPLC), similar antioxidant activity by the ORAC assay (IC50 values between 0.023 and 0.034 mg.mL-1) and some mild differences by the HORAC assay (IC50 values between 1.13 and 1.30 mg.mL-1 for Id1, Fd2, and Fd3; 1.50 mg.mL-1 for Id2; 1.61 mg.mL-1 for Id3). All the FPLC fractions presented high ORAC activity, while only fractions between 0.43 and 3.5 kDa showed HORAC activity (due to peptide concentration). Differences in activity and potency among fractions were registered, especially for F digested. The modification of digestion conditions produced only small differences in the molecular composition but did not affect the proteolysis degree and the antioxidant activity in the case of digested from protein isolate. The presence of other components and changes in the digestion method had an impact on proteolysis, composition and antioxidant activity of flour digested.

Polyphenols in amaranth (A. manteggazianus) flour and protein isolate: Interaction with other components and effect of the gastrointestinal digestion.

In this work, there were analysed the interaction between phenolics present in amaranth flour (F) and amaranth protein isolate (I) with other components, as well as the effect of the gastrointestinal digestion on them (Fd and Id). Extractions were performed under different conditions (temperature, acid, organic solvent, alkali). Methanol/water extracts (25 °C and 80 °C) from F showed the presence of isoquercetin/rutin, quercetin, kaempferol and two unidentified peaks (II and III). In the presence of acid (much more evident at 80 °C), the extraction of some components increased: catechin, 4-hydroxibenzoic acid, isoquercetin/rutin, II, III. When methanol/acetone/water extraction was performed, p-coumaric acid and a new unidentified peak (IV) were observed. About 15% of the total phenol -namely; p-coumaric, rutin/isoquercetin, and kaempferol- were linked to the protein fraction. After the proteins were isolated (I), the amount of some of the compounds which were originally present in a soluble form (e. g. catechin) and in the protein-bound fraction were decreased. Simulated gastrointestinal digestion of flour released some phenolics (catechin, phenolic acids) that were ligated to proteins, and they significantly incremented the ORAC and ABTS activity of most of the extracts. Isoquercetin/rutin, quercetin and kaempferol remained after digestion. Extracts from the digested protein isolate presented differences in the composition and lower ORAC and/or ABTS activities for some of them. The study of the effect of the simulated gastrointestinal digestion process on bioaccessibility and on antioxidant activity (an aspect that, to our knowledge, has not been previously studied on amaranth polyphenols) yielded promising results, which suggest that amaranth flour is a potential antioxidant functional ingredient.

Respectful and evidence-based birth care in Mexico (or lack thereof): An observational study.

PROBLEM: In Mexico, women are often disrespected and abused during birth, evidence-based practices are seldom used, while outdated and dangerous procedures linger. BACKGROUND: Disrespectful and abusive practices in Mexico have been reported but are not necessarily well-documented; none of the reports so far have relied on direct observation of births. AIM: To describe birth practices and factors associated with respectful and evidence-based care at 15 referral hospitals in Mexico. METHODS: We observed 401 births from 2010-2016. We analysed woman, provider, and hospital characteristics and their association with the performance of 14 evidence-based and 15 respectful birth practices via descriptive statistics and multiple logistic regression models. FINDINGS: Only in four births were all the analysed evidence-based and respectful-birth practices performed. Essential interventions like uterine massage was only given to 46.1% of women and the administration of a uterotonic soon after birth only occurred in 58.3% of births. Professionals who were trained in respectful birth care were more likely to address women by their name (Odds Ratio=3.34, p<0.05), allow consumption of liquids during labour (Odds Ratio=31.6, p<0.05), encourage skin-to-skin contact (Odds Ratio=31.82, p<0.05), and examine the placenta after birth (Odds Ratio=16.55, p<0.01); they were less likely to perform episiotomies (Odds Ratio=0.27, p<0.05). DISCUSSION: This study reveals low rates of evidence-based practices and respectful maternity care but shows training in the topic can have a considerable positive impact. Our results call for further efforts to improve the quality of maternal healthcare, a universal right.

[Interconsultation on palliative care for patients with cancer in a general hospital. Features and opportunity]. / Interconsultas de cuidados paliativos para pacientes con cáncer en un hospital general. Características y oportunidad.

The international recommendations point to the early integration of palliative care (PC) in cancer through simultaneous care and training of primary teams. The PC Unit of the Hospital General de Agudos E. Tornú conducts interconsultations for hospitalized patients in the hospital and provides training to the treatment teams. The profile of the interconsultations carried out could provide important information about the characteristics of the PC intervention within the institution. The objective of this study was to retrospectively analyze the first-time interconsultations of cancer patients carried out over 2 years, focusing on temporality, identification of problems by the treating team and the PC interconsultation team, the promptness of response and the prognostic capacity of the latter. In the period, 168 interconsultations were carried out. Most patients had advanced disease, poor performance status, no possibility of oncological treatment and recent diagnosis. In approximately 25% of the cases, evidence of early intervention and participation of the pc team in decision making was found. The opportunity of PC intervention is discussed and areas needing improvement are indicated, such as the identification of non-physical symptoms and prognosis, to be considered in future care and educational activities.

Las recomendaciones internacionales apuntan a la integración temprana de cuidados paliativos (CP) en cáncer a través de la atención simultánea y del entrenamiento de los equipos primarios. La Unidad de CP del Hospital General de Agudos E. Tornú realiza interconsultas para pacientes internados en el hospital y brinda capacitación a los equipos tratantes. El perfil de las interconsultas realizadas podría brindar información importante sobre las características de la intervención de CP dentro de la institución. El objetivo de este estudio fue analizar retrospectivamente las interconsultas de primera vez de pacientes con cáncer realizadas a lo largo de 2 años, con foco en la temporalidad, la identificación de problemas por parte del equipo tratante y del equipo de interconsulta de CP, y la prontitud de respuesta y capacidad pronóstica de este último. La población atendida en interconsulta (168 casos) estuvo constituida principalmente por pacientes con enfermedad avanzada, deterioro del estado general, sin posibilidad de tratamiento oncológico y diagnóstico reciente. En aproximadamente 25% de los casos se encontraron indicios de intervención temprana y participación del equipo de CP en la toma de decisiones. Se discute la oportunidad de la intervención de CP y se señalan áreas con necesidad de mejora, como la identificación de síntomas no físicos y el pronóstico, a ser tenidas cuenta en las futuras actividades asistenciales y educativas.

Interconsultas de cuidados paliativos para pacientes con cáncer en un hospital general: Características y oportunidad / Interconsultation on palliative care for patients with cancer in a general hospital. Features and opportunity

Las recomendaciones internacionales apuntan a la integración temprana de cuidados paliativos (CP) en cáncer a través de la atención simultánea y del entrenamiento de los equipos primarios. La Unidad de CP del Hospital General de Agudos E. Tornú realiza interconsultas para pacientes internados en el hospital y brinda capacitación a los equipos tratantes. El perfil de las interconsultas realizadas podría brindar información importante sobre las características de la intervención de CP dentro de la institución. El objetivo de este estudio fue analizar retrospectivamente las interconsultas de primera vez de pacientes con cáncer realizadas a lo largo de 2 años, con foco en la temporalidad, la identificación de problemas por parte del equipo tratante y del equipo de interconsulta de CP, y la prontitud de respuesta y capacidad pronóstica de este último. La población atendida en interconsulta (168 casos) estuvo constituida principalmente por pacientes con enfermedad avanzada, deterioro del estado general, sin posibilidad de tratamiento oncológico y diagnóstico reciente. En aproximadamente 25% de los casos se encontraron indicios de intervención temprana y participación del equipo de CP en la toma de decisiones. Se discute la oportunidad de la intervención de CP y se señalan áreas con necesidad de mejora, como la identificación de síntomas no físicos y el pronóstico, a ser tenidas cuenta en las futuras actividades asistenciales y educativas.

The international recommendations point to the early integration of palliative care (PC) in cancer through simultaneous care and training of primary teams. The PC Unit of the Hospital General de Agudos E. Tornú conducts interconsultations for hospitalized patients in the hospital and provides training to the treatment teams. The profile of the interconsultations carried out could provide important information about the characteristics of the PC intervention within the institution. The objective of this study was to retrospectively analyze the first-time interconsultations of cancer patients carried out over 2 years, focusing on temporality, identification of problems by the treating team and the PC interconsultation team, the promptness of response and the prognostic capacity of the latter. In the period, 168 interconsultations were carried out. Most patients had advanced disease, poor performance status, no possibility of oncological treatment and recent diagnosis. In approximately 25% of the cases, evidence of early intervention and participation of the pc team in decision making was found. The opportunity of PC intervention is discussed and areas needing improvement are indicated, such as the identification of non-physical symptoms and prognosis, to be considered in future care and educational activities.