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Grenache (GN) and Cabernet Sauvignon (CS) are two traditional red grape varieties widely cultivated in the Mediterranean area and both late-ripening cultivars, which makes them less sensitive to global warming conditions and more stable to harvest timing. Although different studies have evaluated the final antioxidant properties of grapes and pomaces, few studies have explored the effect of sun exposure and harvest on the nutritional and antioxidant properties of these products. This study investigates the control of sunlight and ripening as tools to tailor nutritional and antioxidant properties of grape juices (GJ) and their byproducts (pomace GP). The compositional analysis showed no significant (p ≥ 0.05) differences associated to either harvesting timing or exposure to sunlight for either of the two studied varieties. However, differences (p ≤ 0.05) were observed between varieties of protein and total dietary fibre (TDF). CS protein content ranged from 0.52 to 3.88 (g 100 g−1) in GJ and from 1.0 to 1.32 (g 100 g−1) in GP; meanwhile, GN had higher protein values in GJ (from 2.11 to 4.77 g 100 g−1) and GP (from 5.11 to 6.75 g 100 g−1). The opposite behaviour was observed in TDF; CS grape had higher values for juice (from 11.43 to 19.53 g 100 g−1) and pomace (from 42.20 to 65.80 g 100 g−1) than GN (from 11.43 to 17.22 g 100 g−1 in juice and from 25.90 to 54.0 g 100 g−1 in pomace). The total phenolic content (TP) in GP was 100 times higher than in the juices and showed a much less pronounced evolution compared to the GJ during the harvesting time. GN TP values ranged from 5835 to 8772 mg GAE 100 g−1; meanwhile, CS values ranged from 7637 to 9040 mg GAE 100 g−1. A significant (p ≤ 0.05) correlation between the TP total antioxidant capacity (TAC) results was observed, reg

Gas chromatography-mass spectrometry (GC-MS), physicochemical and microbiological analyses, sensory descriptive evaluation, and multivariate analyses were applied to evaluate the efficiencies of microfiltration and pasteurization processes during the shelf life of beer. Samples of microfiltered and pasteurised beer were divided into fresh and aged groups. A forced ageing process, which consisted of storing fresh samples at 55 degrees C for 6 days in an incubator and then keeping them under ambient conditions prior to analysis, was applied. Physicochemical analysis showed that both microfiltered and pasteurised samples had a slight variation in apparent extract, pH, and bitterness. The samples that underwent heat treatment had lower colour values compared with those that were microfiltered. Chromatographic peak areas of vicinal diketones increased in both fresh and aged samples. The results of the microbiological analysis revealed spoilage lactic acid bacteria (Lactobacillus) and yeasts (Saccharomyces and non-Saccharomyces) in fresh microfiltered samples. In the GC-MS analysis, furfural, considered by many authors as a heat indicator, was detected only in samples that underwent forced ageing and not in samples that were subjected to thermal pasteurisation. Finally, sensory analysis found differences in the organoleptic properties of fresh microfiltered samples compared with the rest of the samples.

One of the problems that most seriously affects oenology today is enzymatic browning, especially when grapes are infected by grey rot. We studied the capacity of glutathione (GSH) and a specific inactivated dry yeast rich in glutathione (IDY-GSH) to protect white grape must from browning compared to that of sulphur dioxide (SO2). The results indicate that SO2 drastically reduces the oxygen consumption rate (by around 72%), protects hydroxycinnamic acids from oxidation and prevents grape must against browning even in the presence of laccase. Specifically, the presence of SO2 reduced the colour's blue-yellow component (b*) by around 91% in control conditions and around 76% in the presence of laccase. GSH, pure or in the form of IDY-GSH, also reduces the oxygen consumption rate (by 23% and 36%, respectively) but to a lesser extent than SO2. GSH also favours the formation of grape reaction product (GRP) from hydroxycinnamic acids and effectively protects grape must against browning in healthy grape conditions. Specifically, the presence of GSH reduced b* by around 81% in control conditions. Nevertheless, in the presence of laccase, it was not effective enough, reducing b* by around 39% in the case of pure GSH and 24% in the case of IDY-GSH. Therefore, both forms of GSH can be considered as interesting alternative tools to SO2 for preventing browning in white grape must, but only when the grapes are healthy.

One of the problems that most seriously affects oenology today is enzymatic browning, especially when grapes are infected by grey rot. We studied the capacity of glutathione (GSH) and a specific inactivated dry yeast rich in glutathione (IDY-GSH) to protect white grape must from browning compared to that of sulphur dioxide (SO2). The results indicate that SO2 drastically reduces the oxygen consumption rate (by around 72%), protects hydroxycinnamic acids from oxidation and prevents grape must against browning even in the presence of laccase. Specifically, the presence of SO2 reduced the colour’s blue–yellow component (b*) by around 91% in control conditions and around 76% in the presence of laccase. GSH, pure or in the form of IDY-GSH, also reduces the oxygen consumption rate (by 23% and 36%, respectively) but to a lesser extent than SO2. GSH also favours the formation of grape reaction product (GRP) from hydroxycinnamic acids and effectively protects grape must against browning in healthy grape conditions. Specifically, the presence of GSH reduced b* by around 81% in control conditions. Nevertheless, in the presence of laccase, it was not effective enough, reducing b* by around 39% in the case of pure GSH and 24% in the case of IDY-GSH. Therefore, both forms of GSH can be considered as interesting alternative tools to SO2 for preventing browning in white grape must, but only when the grapes are healthy.

Alcohol content, proanthocyanins and anthocyanins influence wine quality. The composition of wine depends on the type of cultivar, location, environmental conditions, and management practices. Phenolic compounds have attracted considerable research interest due to their antioxidant properties and potential beneficial effects on human health. However, the low bioavailability of anthocyanins creates a major bottleneck in their ability to exert beneficial effects. Despite extensive research on the effects of wine on human health, no clear evidence has been obtained on the benefits of wine quality or geographic area of production on health conditions, such as metabolic syndrome. Five climatically and geologically distinct wines were evaluated. Based on recent studies, meta-analyses, and pooled analyses of wine composition, along with the predicted low bioavailability of polyphenol compounds, we estimated the efficacy of five geographically distinct wines according to gastrointestinal absorption and the effects of alcohol intake on both men and women, with a view to ascertaining whether geographical origin influences the antioxidant serum composition of wine. Data on the estimated consumption of wine suggest that the polyphenol contents are similar regardless of choice of wine/area, while different alcohol compositions affect the level of alcohol and calorie intake. Thus, moderate wine drinkers should be advised to control the habit, but without exceeding the dose considered a healthy threshold (up to 30–40 g of alcohol/day in men and 10–20 g of alcohol/day in women), given no medical contraindications are present. These results will add value to the framework of the last reform of the Common Agricultural Policy (CAP) adopted in December 2021, where the European Parliament a

Gas chromatography–mass spectrometry (GC–MS), physicochemical and microbiological analyses, sensory descriptive evaluation, and multivariate analyses were applied to evaluate the efficiencies of microfiltration and pasteurization processes during the shelf life of beer. Samples of microfiltered and pasteurised beer were divided into fresh and aged groups. A forced ageing process, which consisted of storing fresh samples at 55° C for 6 days in an incubator and then keeping them under ambient conditions prior to analysis, was applied. Physicochemical analysis showed that both microfiltered and pasteurised samples had a slight variation in apparent extract, pH, and bitterness. The samples that underwent heat treatment had lower colour values compared with those that were microfiltered. Chromatographic peak areas of vicinal diketones increased in both fresh and aged samples. The results of the microbiological analysis revealed spoilage lactic acid bacteria (Lactobacillus) and yeasts (Saccharomyces and non-Saccharomyces) in fresh microfiltered samples. In the GC–MS analysis, furfural, considered by many authors as a heat indicator, was detected only in samples that underwent forced ageing and not in samples that were subjected to thermal pasteurisation. Finally, sensory analysis found differences in the organoleptic properties of fresh microfiltered samples compared with the rest of the samples.

Fermented beverages, particularly wines, exhibit variable concentrations of organic and phenolic acids, posing challenges in their accurate determination. Traditionally, enzymatic methods or chromatographic analyses, mainly high-performance liquid chromatography (HPLC), have been employed to quantify these compounds individually in the grape must or wine. However, chromatographic analyses face limitations due to the high sugar content in the grape must. Meanwhile, phenolic acids, found in higher quantities in red wines than in white wines, are typically analyzed using HPLC. This study presents a novel method for the quantification of organic acids (OAs), glycerol, and phenolic acids in grape musts and wines. The approach involves liquid-liquid extraction with ethyl acetate, followed by sample derivatization and analysis using gas chromatography-mass spectrometry (GC-MS) in selected ion monitoring (SIM) detection mode. The results indicated successful detection and quantification of all analyzed compounds without the need for sample dilution. However, our results showed that the method of adding external standards was more suitable for quantifying wine compounds, owing to the matrix effect. Furthermore, this method is promising for quantifying other metabolites present in wines, depending on their extractability with ethyl acetate. Fermented beverages, particularly wines, exhibit variable concentrations of organic and phenolic acids, posing challenges in their accurate determination. Traditionally, enzymatic methods or chromatographic analyses, mainly high-performance liquid chromatography (HPLC), have been employed to quantify these compounds individually in the grape must or wine. The approach of this proposed method involves (i) methoximation of wine compounds in a ba

IntroductionThe problem of LGBQIA-phobia has been extendedly reported as a problem that threatens the quality of life and well-being, particularly for trans and intersex individuals. Scientific evidence points at the high presence of this form of violence and discrimination during adolescence and youth, negatively affecting the prospects of the victims. At the same time, there is a lack of evidence on the role and potential impact of Youth Worker Networks involved in analysing gender-based violence and finding strategies to improve the situation of LGBTQIA+ youth.MethodsThis study has focussed on the reality of a network of youth workers through a mixed method approach belonging to a transnational project funded by the Rights, Equality and Citizenship Program (REC) of the European Commission. The implementation of 160 questionnaires and 5 semi-structured interviews in 2022 with the training participants provides evidence on the social impact that networking and evidence-based training may have in tackling LGBTQIA-phobia in youth environments.ResultsThe findings of the current study show how the implementation of Youth Worker Networks can provide relevant results to achieve more respectful youth spaces toward diversity. The presence of traditional dominant masculinities together with the lack of quality training seem to be an important barrier for youth workers to fight against gender and sexual discrimination. In contrast, the professionals' motivation and the group potential and support of the network appear to be a significant strength in overcoming forms of violence and discrimination on the grounds of sexual orientation, gender identity, or gender expression in youth contexts.ConclusionsThe results indicate that the role of youth workers, the quality of the training

Introducción: el uso constante de material punzocortante e instrumental rotatorio y la flora bacteriana de la cavidad oral del paciente representan un peligro latente de contagio en los estudiantes de odontología. El objetivo del estudio fue determinar la asociación entre los conocimientos y las actitudes sobre accidentes ocupacionales en prácticas clínicas de alumnos de odontología de una clínica universitaria de Lima (Perú). Materiales y métodos: estudio observacional, analítico de asociación y transversal. El universo incluyó 156 alumnos. Los conocimientos y las actitudes se evaluaron mediante una encuesta adaptada de 24 preguntas, previa validación interna por juicio de expertos. Se calcularon proporciones para las variables cualitativas y medidas de tendencia central (mediana) para la variable edad. De la misma manera, se usaron la prueba de chi-cuadrado para comparar las variables cualitativas y la prueba U de Mann-Whitney para comparar las variables cualitativas con la variable cuantitativa edad. Se aceptó una significancia de 0.05. Resultados: el 78.2 % de los participantes tuvo un conocimiento alto frente al manejo de accidentes ocupacionales; de la misma manera, el 72.4 % manifestó una actitud positiva. No se encontró asociación estadísticamente significativa (p > 0.05) entre las variables conocimientos y actitud. Por otro lado, el 69.1 % de los estudiantes sufrió al menos un accidente ocupacional durante sus prácticas clínicas, en su mayoría causado por el explorador (65.1 %). Conclusiones: no se encontró asociación significativa entre las variables conocimiento y actitud; sin embargo, una gran cantidad de estudiantes sufrieron al menos un accidente ocupacional., Revisión por pares

This study explains attitude towards vaccination against COVID-19. It evaluates four cognitive, affective and normative (CAN) factors: fear of COVID-19 (FCOVID), fear of the vaccine (FVACC), efficacy (EFFICACY), and social influence (SOCINF) and three sociodemographic variables: gender, age, and income level. Ordered logistic regression showed a significant positive influence of FCOVID, EFFICACY and SOCINF and a negative impact of FVACC and income level (INCOME). Configurational analysis allowed observing that all evaluated factors are relevant for explaining the attitude towards vaccination and that the sign of the relationship in configurations between CAN factors and attitude is positive for FCOVID, EFFICACY and SOCINF and negative for FVACC. These variables symmetrically impact on willingness and unwillingness to use the vaccine. INCOME and regarding gender (GENDER) impact asymmetrically to induce acceptance and resistance to vaccination. The results in our paper have clear practical implications. Correlational analysis discovers the average strength of assessed factors on vaccine acceptation and so identifying the most relevant variables. On the other hand, configurational analysis identifies how factors combine to shape profiles of persons with willingness and unwillingness to get vaccinated. These last profiles are of special concern for health policy-makers since their resistance diminishes the effectivity of collective vaccination.

The Roma is the most excluded non-migrant ethnic minority in Europe, facing prejudice, intolerance, discrimination, and social exclusion in their daily lives. This has led to a huge gap in several social domains between the Roma and non-Roma created for centuries. The COVID-19 pandemic has only increased the social and health inequalities that the Roma faced. In this context, it is important to identify actions that have been successful in mitigating the effects that the COVID-19 has had in increasing such inequalities. This paper presents the findings of a mixed-method study carried out in Catalonia (Spain) with the participation of more than 500 Roma, who reported their experience. The study results confirm the significant vulnerability and the negative impact of the COVID-19 pandemic on the Roma communities. Our research also highlights several successful actions developed by the Integrated Plan for the Roma of the Catalan Government, such as health literacy and adult education, as having a positive impact on the quality of life of many Roma during the health and social crisis generated by the COVID-19 pandemic. This paper suggests that the lessons learned from Catalonia could be transferred to other contexts across Europe and guide decision makers to promote the social inclusion and quality of life of the Roma, protecting Roma communities during current and future pandemics.© 2023. The Author(s).

The health consequences of gender violence, a global health and social problem, are increasingly studied. Among its roots, research has identified a coercive dominant discourse imposing the idea that masculinities and relationships marked by abuse and domination are more attractive than egalitarian ones. To prevent the health consequences of gender violence, it is necessary to understand the factors that lead many adolescents to fall into it. This study aims to identify the specific mechanisms by which the coercive dominant discourse manifests in the peer group and its consequences for adolescents. Forty-one 15- and 16-year-old female adolescents from three high schools in Barcelona participated in the study. Eight communicative discussion groups were conducted to deepen on participants’ perceptions regarding how peer interactions promote the learning of attraction to violence in sexual-affective relationships. The results show that the participants perceived and experienced different types of coercion to have violent relationships in their peer group interactions. Those interactions fostered the reproduction of the association between sexual-affective attraction and males with aggressive attitudes and behaviors. Many peers coerce others to have disdainful hookups which have very negative health consequences for the victims, including suicidal ideation and committing suicide. Some peer groups become a risk developmental context for female adolescents as far as they foster the coercive dominant discourse, push some young women to engage in violent sporadic relationships, and even harass some others afterwards. This clarifies the importance of peer group-level interventions when addressing the health consequences of gender violence in adolescence.

Food insecurity can be understood as a manifestation of health inequality and thus a deprivation of the right to health. This paper explores the strategies followed in primary health care centers in Spain to care for people struggling to regularly access healthy, safe, and sufficient food. Ethnographically based, our study analyzes, on the one hand, the resources available to primary health care teams to assess the social determinants of health and, on the other, the importance that professionals give to food in the diagnosis, treatment, and prevention of diseases related to inequality. Given that our study was carried out during the recent economic and health crises, the results show the difficulties faced by these centers in responding to constantly changing social needs. Budget cuts, a lack of specific or structural actions, and the invisibilization of particular expressions of inequality have proven challenging to the aim of providing integrated care capable of recognizing the environmental factors that condition patient health. In the case of food insecurity, our study found that there are no instruments in primary care centers to identify and therefore address this insecurity. We explore whether this is due mainly to the growing lack of means or more to the fact that the relationship between material living conditions, food, and health has been downplayed-and the responsibility of the health system in guaranteeing the right to food correspondingly diluted.

The current state of knowledge indicates that regular sports practice helps prevent and treat non-communicable diseases. The promotion of sport is, therefore, an important community health intervention for maintaining and improving the health of individuals and populations. Culture is identified as being associated with sports practice and sedentary behaviour of ethnic and national minorities. This study aims qualitatively to analyse the potential for culture as a basis for the promotion of sport among immigrants in four regions of Mediterranean Europe. Ten focus groups (n = 62) were conducted with immigrants-adults and young people over the age of 11-and people involved in promoting sport. Thematic content analysis was conducted. The results enabled identifying two major issues: sport as a vehicle for cultural expression and synergies between sport and culture. Accordingly, sport serves to express global, local and non-ethno-national cultural belonging. Regarding synergies, culture and sport feed each other positively and contribute to immigrants' health and cultural well-being. Culture as a strategy for promoting sports practice requires an interdisciplinary approach that involves collaboration between healthcare practitioners and social sciences professionals. There is also a need to use the various axes of cultural definition-global, local and non-ethno-national-of those involved, and for them to take part themselves in designing sports activities. Moreover, promoting sport through non-ethno-national axes of cultural definition may help with immigrants' social inclusion, as intercultural relations between migrants and newcomers are promoted.

In most Mediterranean countries, people diagnosed with severe mental disorders (SMDs) are typically cared for by the mother, causing a significant burden on people in this family role. Based on a broader mental health participatory action and qualitative research carried out in Catalonia (Spain) of 12 in-depth interviews and 3 focus groups, this article analyses the mother-caregivers' experience in the domestic space. The results show that patients and caregivers are engaged in a relationship of "nested dependencies", which create social isolation. This produces the conditions of "reactionary care", practices that limit the autonomy of those affected and that reproduce forms of disciplinary psychiatric institutions. We conclude that both institutional violence derived from economic rationality and that which stems from the gender mandate feed off each other into the domestic sphere. This research argues for placing care at the center of clinical practice and shows the need to consider the structural forces shaping it.© 2022. The Author(s).

The storage of olives in large hoppers is a widespread practice in oil mills, but these large volumes and their unloading can cause a physical deterioration of the olives that will affect the quality of the oil obtained. This research deals with the effect of hopper charge on the formation of alkyl alcohols in olive fruits and its relationship with the sensory quality losses of ‘Arbequina’ virgin olive oil. The contents of ethanol, methanol, and acetaldehyde were measured in olive samples loaded and stored for a short time in a large hopper and analyzed at three different hopper-discharging times, which are related to three different positions inside the hopper. The corresponding oil from each sampling was obtained by using ABENCOR and was evaluated by a trained tasting panel. Results showed that the ethanol content in olives increased during their storage in the hopper, while methanol and acetaldehyde contents did not show significant differences. Regarding their position in the hopper, fruits located at the bottom or on the lateral sides showed a greater deterioration. The sensory analyses showed an inverse relationship between the positive attributes of olive oils and their content of alcohols.

Introduction: Cannabis social clubs (CSC) are community-based non-profit organisations that aim to minimise cannabis-related harm for their members. This contribution seeks to: (i) compare the cost of cannabis flower and resin in CSCs to the national average retail price on the illegal market; and (ii) identify possible quantity discounts for cannabis flower and resin distributed to members of CSCs. Methods: Routine data from four CSCs located in Barcelona, Spain, contained information on n = 220,465 collections of cannabis resin and flower (0.01–39 g per collection). The costs for 1 g of cannabis flower and resin per collection were determined. The mean national prices on illicit cannabis were obtained from Spanish police reports. Results: On average, members paid 6.19€ for 1 g flower (median: 6€; interquartile range: 6–7€) and 8.54€ for 1 g resin (median: 7€; interquartile range: 6–9€), with less variations for flower than for resin. Compared to the national average, prices appeared to be higher for cannabis products distributed in CSCs, but comparisons were limited by a lack of data on the variation of national prices. For resin, doubling the quantity was associated with a 20.7% (95% confidence interval 20.4–21.2%; p < 0.001) fee discount. Discussion and conclusions: Cannabis in CSCs may be more costly than the estimated national average for the illicit market. No meaningful price discount could be observed for flower but for resin. Pricing policies pursued by CSCs may help to disincentivise consumption of larger amounts but may also bar socioeconomically disadvantaged users from accessing safer alternatives than the illegal market.

The variability in grape ripening is associated with the fact that each grape berry undergoes its own biochemical processes. Traditional viticulture manages this by averaging the physicochemical values of hundreds of grapes to make decisions. However, to obtain accurate results it is necessary to evaluate the different sources of variability, so exhaustive sampling is essential. In this article, the factors “grape maturity over time” and “position of the grape” (both in the grapevine and in the bunch/cluster) were considered and studied by analyzing the grapes with a portable ATR-FTIR instrument and evaluating the spectra obtained with ANOVA–simultaneous component analysis (ASCA). Ripeness over time was the main factor affecting the characteristics of the grapes. Position in the vine and in the bunch (in that order) were also significantly important, and their effect on the grapes evolves over time. In addition, it was also possible to predict basic oenological parameters (TSS and pH with errors of 0.3 °Brix and 0.7, respectively). Finally, a quality control chart was built based on the spectra obtained in the optimal state of ripening, which could be used to decide which grapes are suitable for harvest.

The tick Ixodes ricinus is widely distributed across Europe and is responsible for the transmission of several pathogens to humans and animals. In this study, we used a knowledge-based method to map variations in habitat suitability for I. ricinus ticks throughout continental France and Corsica. The multi-criteria decision analysis (MCDA) integrated four major biotic and abiotic factors known to influence tick populations: climate, land cover, altitude and the density of wild ungulates. For each factor, habitat suitability index (HSI) values were attributed to different locations based on knowledge regarding its impact on tick populations. For the MCDA, two methods of factor combination were tested, additive and multiplicative, both which were evaluated at the spatial scales of departments and local municipalities. The resulting habitat suitability maps (resolution=100x100 m) revealed that conditions are suitable for I. ricinus over most of France and Corsica. Particularly suitable habitats were located in central, north-eastern and south-western France, while less-suitable habitats were found in the Mediterranean and mountainous regions. To validate the approach, the HSI scores were compared to field data of I. ricinus nymph abundance. Regardless of scale, the correlation between abundance indicator and HSI score was stronger for the additive than for the multiplicative approach. Overall, this study demonstrates the value of MCDA for estimating habitat suitability maps for I. ricinus abundance, which could be especially useful in highlighting areas of the tick’s distribution where preventive measures should be prioritised.

This scoping review aims to give a narrative account of existing realist evaluation practices in health promotion. Realist evaluations of health promotion interventions published between 2010 and 2021 were identified by searching five academic databases: Embase, Pubmed, PsycINFO, ScienceDirect and Scopus. A data-charting form was created based on the characteristics of realist evaluation and four core features of an approach appropriate for evaluating health promotion interventions. Seventeen articles met the inclusion criteria. These were classified into two types of studies: those aiming to build an initial program theory and those aiming to test an initial program theory. Our results revealed a great variety of realist evaluation practices and uncovered a growing interest in realist evaluation over the years. Our searches identified a lack of participative practice and capacity-building intention. Our examination of the data collection and analysis methods points to some common practices in using multi-methods. Perspectives on realist evaluation practices and on assessing the effectiveness of health promotion have been identified.

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Bringing together medical and linguistic anthropology, I examine the provision of hearing technology, such as cochlear implants, to deaf Jordanian children, a project animated by an imperative to make deaf children speak. Drawing upon ethnographic fieldwork at a cochlear implantation initiative and an audiology department in Amman, I argue that this imperative must be understood in relation to anxieties about the status of Arabic in Jordan and the historical value of orality in the Middle East. This case shows that more attention must be paid to the role of language ideologies in co-constituting medical encounters between clinicians, parents, and patients.

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

In this article we present the concept of autonomy applied to the field of mental health drawing on experiences of the implementation of the "Autonomous Medication Management Guide" in two different contexts: Brazil and Spain. Autonomous medication management proposes an understanding of autonomy that moves away from an individualistic view towards a social and collective perspective. This article highlights potential shifts and tensions and the possible effects of "autonomization" in the context of mental health care. In the Brazilian experience, we observed how this shift is produced from the place of power-knowledge typical of professional practice, while the Spanish experience shows how the adaptation of the tool derives from the necessary involvement of professionals, service users, families and social networks through a joint process of collective working and care.

Insects have been a food source for humans for millennia, and they are actively consumed in various parts of the world. This paper aims to ascertain the feasibility of portable near-infrared (NIR) spectroscopy as a reliable and fast candidate for the classification of insect powder samples and the prediction of their major components. Commercially-available insect powder samples were analyzed using two miniaturized NIR instruments. The samples were analyzed as they are and after grinding, to study the effect of the granulometry on the spectroscopic analyses. A homemade sample holder was designed and optimized for making reliable spectroscopic measurements. Classification was then performed using three classification strategies, and partial least squares (PLS) regression was used to predict the macronutrients. The results obtained confirmed that both spectroscopic sensors were able to classify insect powder samples and predict macronutrients with an adequate detection limit.

The present study examined the influence of inulin on fecal microbiota, cardiometabolic risk factors, eicosanoids, and oxidative stress in rats on a high-fat (HF) diet. Thirty-six male Wistar–Kyoto rats were divided into three dietary groups: standard diet, HF diet, and HF diet + Inulin diet. After 10 weeks, the HF + Inulin diet promoted high dominance of a few bacterial genera including Blautia and Olsenella in feces while reducing richness, diversity, and rarity compared to the HF diet. These changes in fecal microbiota were accompanied by an increased amount of propionic acid in feces. The HF + Inulin diet decreased cardiometabolic risk factors, decreased the amount of the eicosanoids 11(12)-EET and 15-HETrE in the liver, and decreased oxidative stress in blood compared to the HF diet. In conclusion, increasing consumption of inulin may be a useful nutritional strategy to protect against the onset of obesity and its associated metabolic abnormalities by means of modulation of gut microbiota.

The inherent conflict between economic and clinical considerations, between professionalism and managerialism, and between being a manager or being a clinician is widely acknowledged in the sociology of professions. The original article by Waitzberg and colleagues focused on how hospital professionals reconcile these conflicting demands. In this commentary, we argue that their assumption that the considered hospital professionals (managers, CFOs, chief physicians and practising physicians) are dual agents moves on from the unproductive debates of inherent conflicts to envisage possibilities of reconciling economic and clinical considerations. We conclude that the instrumental use of the term dual agent to include "the other" (the manager or the clinician) in a superlative and inclusive category can be considered a reframing strategy to solve inherent interprofessional conflicts and to implement more collaborative models in healthcare.

The Global Mental Health (GMH) movement aims to provide urgently needed treatment to those with mental illness, especially in low- and middle-income countries. Due to the complexity of providing mental health services to people from various cultures, there is much debate among GMH advocates regarding the best way to proceed. While biomedical interventions offer some degree of help, complementary approaches should focus on the social/community aspects. Many cultures conduct traditional rituals involving the communal use of psychoactive plants. We propose that these practices should be respected, protected, and promoted as valuable tools with regard to mental health care at the community level. The traditional use of psychoactive plants promotes community engagement and participation, and they are relatively affordable. Furthermore, the worldviews and meaning-making systems of local population are respected. The medical systems surrounding the use of psychoactive plants can be explained in biomedical terms, and many recently published clinical trials have demonstrated their therapeutic potential. Psychoactive plants and associated rituals offer potential benefits as complementary aspects of mental health services. They should be considered as such by international practitioners and advocates of the GMH movement.

Achieving beer quality and stability remains the main challenge for the brewing industry. Despite all the technologies available, to obtain a high-quality product, it is important to know and control every step of the beer production process. Since the process has an impact on the quality and stability of the final product, it is important to create mechanisms that help manage and monitor the beer production and aging processes. Multivariate statistical techniques (chemometrics) can be a very useful tool for this purpose, as they facilitate the extraction and interpretation of information from brewing datasets by managing the connections between different types of data with multiple variables. In addition, chemometrics could help to better understand the process and the quality of the product during its shelf life. This review discusses the basis of beer quality and stability and focuses on how chemometrics can be used to monitor and manage the beer quality parameters during the beer production and aging processes.

This article explores the local forms that global controversies around autism and ADHD have taken in France and Brazil. Inquiring into the social and historical features of the two contexts makes the abstract, globally circulating ideas meaningful in particular forms, and helps to transcend dichotomies (global/local, biological/relational, mental suffering/disability) through their pragmatic negotiations and integration into the everyday experience of those affected by the conditions. Our research is based on policy reports and regulations, interviews with policy makers, care and school professionals, families, and observations in mental health-care services. We first present inflamed debates in both countries: while autism wars caused the legitimacy of psychoanalysis to be challenged, debates around ADHD focused on the medicalization of social problems. Both controversies impacted policy orientations, the organization of mental health care, and professional knowledge and practices. We discuss the similarities and differences in these transformations in the two countries. We then examine how these controversies unfolded in local configurations of actors and resources. Finally, we call for reflection on how processes of globalization in mental health and local contexts mutually shape each other.

Background: The Syrian conflict has dramatically changed the public health landscape of Syria since its onset in March of 2011. Depleted resources, fractured health systems, and increased security risks have disrupted many routine services, including vaccinations, across several regions in Syria. Improving our understanding of infectious disease transmission in conflict-affected communities is imperative, particularly in the Syrian conflict. We utilize surveillance data from the Early Warning Alert and Response Network (EWARN) database managed by the Assistance Coordination Unit (ACU) to explore trends in the incidence of measles in conflict-affected northern Syria and analyze two consecutive epidemics in 2017 and 2018. Methods: We conducted a retrospective time-series analysis of the incidence of clinically suspected cases of measles using EWARN data between January 2015 and June 2019. We compared regional and temporal trends to assess differences between geographic areas and across time. Results: Between January 2015 and June 2019, there were 30,241 clinically suspected cases of measles reported, compared to 3193 cases reported across the whole country in the decade leading up to the conflict. There were 960 regional events that met the measles outbreak threshold and significant differences in the medians of measles incidence across all years (p-value < 0.001) and in each pairwise comparison of years as well as across all geographic regions (p-value < 0.001). Although most governorates faced an elevated burden of cases in every year of the study, the measles epidemics of 2017 and 2018 in the governorates of Ar-Raqqa, Deir-Ez-Zor, and Idlib accounted for over 71% of the total suspected cases over the entire study period. Conclusions: The 2017 and 2018 measles epidemics were the largest since Syria eliminated the disease in 1999. The regions most affected by these outbreaks were areas of intense conflict and displacement between 2014 and 2018, including districts in

We aimed to assess the effects of the antioxidant-rich Mediterranean diet (MedDiet) on white blood cell count. Our study population included participants in the PREvención con DIeta MEDiterránea study (average age 67 years old, 58% women, high cardiovascular risk). We assessed whether a MedDiet intervention enriched in extra-virgin olive oil or nuts, versus a low-fat control diet, modified the incidence of leukocytosis (>11 × 109 leukocytes/L), mild leukopenia (<4.5 × 109 leukocytes/L), or severe leukopenia (<3.5 × 109 leukocytes/L) in individuals without the condition at baseline (n = 3190, n = 2925, and n = 3190, respectively). We also examined whether MedDiet modified the association between leukocyte count alterations and all-cause mortality. Both MedDiet interventions were associated with a lower risk of developing leukopenia (incidence rates: 5.06% in control diet, 3.29% in MedDiet groups combined; hazard ratio [95% confidence interval]: 0.54 [0.36-0.80]) and severe leukopenia (incidence rates: 1.26% in control diet, 0.46% in MedDiet groups combined; hazard ratio: 0.25 [0.10-0.60]). High cumulative adherence to a MedDiet was linked to lower risk of leukocytosis (incidence rates: 2.08% in quartile 1, 0.65% in quartile 4; HRQ4-Q1: 0.29 [0.085-0.99]) and attenuated the association between leukopenia and all-cause mortality (Pinteraction = 0.032). In brief, MedDiet decreased the incidence of white blood cell count-related alterations in high cardiovascular risk individuals.

Water-in-oil-in-water (W1/O/W2 ) emulsions are complex delivery systems for polyphe-nols amongst other bio-actives. To stabilize the oil–water interphase, dairy proteins are commonly employed, which are ideally replaced by other, more sustainable sources, such as insect proteins. In this study, lesser mealworm (Alphitobius diaperinus) protein concentrate (LMPC) is assessed and compared to whey protein (WPI) and pea protein (PPI), to stabilize W1/O/W2 emulsions and encapsulate a commercial polyphenol. The results show that LMPC is able to stabilize W1/O/W2 emulsions comparably to whey protein and pea protein when using a low-energy membrane emulsification system. The final droplet size (d4,3) is 7.4 µm and encapsulation efficiency is between 72 and 74%, regardless of the protein used. Under acidic conditions, the LMPC shows a similar performance to whey protein and outperforms pea protein. Under alkaline conditions, the three proteins perform similarly, while the LMPC-stabilized emulsions are less able to withstand osmotic pressure differences. The LMPC stabilized emulsions are also more prone to droplet coalescence after a freeze–thaw cycle than the WPI-stabilized ones, but they are the most stable when exposed to the highest temperatures tested (90?C). The results show LMPC’s ability to stabilize multiple emulsions and encapsulate a polyphenol, which opens the door for application in foods. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

In a preliminary study, commercial insect powders were successfully identified using infrared spectroscopy combined with multivariate analysis. Nonetheless, it is necessary to check if this technology is capable of discriminating, predicting, and quantifying insect species once they are used as an ingredient in food products. The objective of this research was to study the potential of using attenuated total reflection Fourier transform mid-infrared spectroscopy (ATR-FTMIR) combined with multivariate analysis to discriminate doughs and 3D-printed baked snacks, enriched with Alphitobius diaperinus and Locusta migratoria powders. Several doughs were made with a variable amount of insect powder (0-13.9%) replacing the same amount of chickpea flour (46-32%). The spectral data were analyzed using soft independent modeling of class analogy (SIMCA) and partial least squares regression (PLSR) algorithms. SIMCA models successfully discriminated the insect species used to prepare the doughs and snacks. Discrimination was mainly associated with lipids, proteins, and chitin. PLSR models predicted the percentage of insect powder added to the dough and the snacks, with determination coefficients of 0.972, 0.979, and 0.994 and a standard error of prediction of 1.24, 1.08, and 1.90%, respectively. ATR-FTMIR combined with multivariate analysis has a high potential as a new tool in insect product authentication.

There is a pressing need to extend the knowledge on the properties of insect protein fractions to boost their use in the food industry. In this study several techno-functional properties of a black soldier fly (Hermetia illucens) protein concentrate (BSFPC) obtained by solubilization and precipitation at pH 4.0-4.3 were investigated and compared with whey protein isolate (WPI), a conventional dairy protein used to stabilize food emulsions. The extraction method applied resulted in a BSFPC with a protein content of 62.44% (Kp factor 5.36) that exhibited comparable or higher values of emulsifying activity and foamability than WPI for the same concentrations, hence, showing the potential for emulsion and foam stabilization. As for the emulsifying properties, the BSFPC (1% and 2%) showed the capacity to stabilize sunflower and lemon oil-in-water emulsions (20%, 30%, and 40% oil fraction) produced by dynamic membranes of tunable pore size (DMTS). It was proved that BSFPC stabilizes sunflower oil-in-water emulsions similarly to WPI, but with a slightly wider droplet size distribution. As for time stability of the sunflower oil emulsions at 25 degrees C, it was seen that droplet size distribution was maintained for 1% WPI and 2% BSFPC, while for 1% BSFPC there was a slight increase. For lemon oil emulsions, BSFPC showed better emulsifying performance than WPI, which required to be prepared with a pH 7 buffer for lemon oil fractions of 40%, to balance the decrease in the pH caused by the lemon oil water soluble components. The stability of the emulsions was improved when maintained under refrigeration (4 degrees C) for both BSFPC and WPI. The results of this work point out the feasibility of using BSFPC to stabilize O/W emulsions using a low energy system.

Oenococcus oeni is the main agent of malolactic fermentation in wine. This fermentation takes place after alcoholic fermentation, in a low nutrient medium where ethanol and other inhibitor compounds are present. In addition, some yeast-derived compounds such as mannoproteins can be stimulatory for O. oeni. The mannoprotein concentration in wine depends on the fermenting yeasts, and non-Saccharomyces in particular can increase it. As a result of the hydrolytic activity of O. oeni, these macromolecules can be degraded, and the released mannose can be taken up and used as an energy source by the bacterium. Here we look at mannoprotein consumption and the expression of four O. oeni genes related to mannose uptake (manA, manB, ptsI, and ptsH) in a wine-like medium supplemented with mannoproteins and in natural wines fermented with different yeasts. We observe a general gene upregulation in response to wine-like conditions and different consumption patterns in the studied media. O. oeni was able to consume mannoproteins in all the wines. This consumption was notably higher in natural wines, especially in T. delbrueckii and S. cerevisiae 3D wines, which presented the highest mannoprotein levels. Regardless of the general upregulation, it seems that mannoprotein degradation is more closely related to the fermenting medium.

Miniaturised near-infrared (NIR) instruments have been increasingly used in the last few years, and they have become useful tools for many applications on different types of samples. The market already offers a wide variety of these instruments, each one having specific requirements for the correct acquisition of the instrumental signal. This paper presents the development and optimisation of different measuring strategies for two miniaturised NIR instruments in order to find the best measuring conditions for the rapid and low-cost analysis of olive oils. The developed strategies have been applied to the classification of different samples of olive oils, obtaining good results in all cases.

This study aims to learn the meanings for teachers of the Nursing course in Catalonia about the use of medicinal plants as complementary therapy in health care. This is a qualitative, exploratory and descriptive research, conducted through semi-structured interviews, with four professors of the Nursing course at a Spanish University located in the region of Catalonia, in May 2016. For the interpretation of the content analysis proposed by Bardin was used. In the content analysis, two themes emerged: Knowledge and use of complementary therapies and Family culture influencing the use of medicinal plants. In the first category, it was emphasized that, in addition to knowing, teachers also used plants frequently. In the second, it is emphasized how the family influence was present and was important to perpetuate the knowledge and forms of use during the generations. The popularization of complementary therapies became evident and, therefore, the articulation of the practice by health professionals is essential, since the training process, especially in nursing, considering the comprehensive care offered to the user.

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Introduction: Members of the LGBT community suffer discrimination in various areas, and the workplace is no exception. This is why it is important to understand the strategies they adopt to cope so that policy-makers, organizations, companies, and the LGBT community can be informed of the resources that can potentially mitigate or eradicate discrimination in the workplace. Methods: In this article, we use a systematic review of the literature up to and including 2018 in the databases Scopus and Web of Science. Results: We analyzed 52 articles and extracted one model with four different strategies for coping with discrimination in the workplace: internal, external, reactive, and proactive. We also identified strategies used by organizations and companies, and make recommendations that can inform future policies in this area. Conclusion: The model places the members of the LGBT community at the heart of the process of overcoming discrimination. Policy implications. We found that these strategies are not equally available in all contexts. Therefore, there is a need not only for LGBT individual agency, but also for companies, society, and the political system to get involved and expand freedoms and labour rights for the LGBT community.

The objective of this study was to assess resilience levels in a group of children and adolescents whose parents were afflicted with Huntington’s disease and in a control group of children and adolescents at risk of poverty. We used a sample of 63 children and adolescents (65% girls), between 7 and 18 years with an average age of 12.67 (SD = 3.07). The subjects were administered the questionnaire on resilience in children and adolescents, which consists of three factors: internal protective factor, external protective factor and empathy. The results showed that both groups had higher levels of resilience than the theoretical median. However, the control group performed better on the internal protective factor and the general resilience scale. The data suggests that resilience levels in children and adolescents do not increase when they are overexposed to adverse circumstances.

It has been suggested that the current ranking of olive oil by Nutri-Score (C) is not in line with its nutritional quality and could have a negative impact on the sales and consumption of olive oil, especially compared to other added fats with lower nutritional qualities One of the objectives of this study is to investigate consumers’ understanding of Nutri-Score when comparing the nutritional quality of added fats, and to test whether or not Nutri-Score has a negative impact on the image and the choice of olive oil in a sample of Spanish consumers. A cross-sectional study of 486 Spanish adults (mean age ± SD: 45.8 ± 14.0 years; 48.6% women) was conducted. Subjects were recruited through a web panel provider to participate in an online questionnaire. Almost 80% of participants declared that Nutri-Score was useful for recognizing the differences in nutritional quality between the eight added fats presented in the study; 89.1% rightly identified that olive oil was among the added fats with the best nutritional quality (vs. 4.1% for rapeseed oil (Nutri-Score C), and less than 3% for other added fats (Nutri-Score D or E)). When asked about which added fat they would buy more frequently, 86.2% of participants selected olive oil. Then, after being reminded that among added fats, the Nutri-Score C given to olive oil was the best grade, a majority of participants declared that they would keep consuming olive oil as much as before (71.4%). Finally, almost 78% of participants thought that Nutri-Score should be displayed on olive oil. In conclusion, the results of our study suggest that displaying Nutri-Score on olive oil was well accepted and understood by a large majority of participants who appeared to accept the current ranking of the Nutri-Score for olive oil (Nutri-Score C).

The combined supplementation of buckwheat D-fagomine (FG) and fish omega-3 polyunsaturated fatty acids (omega-3 PUFA) attenuates the development of insulin resistance in rats fed a high-fat (HF) diet. This study aimed to examine the effects of combined supplementation with FG and omega-3 PUFA on dyslipidemia, transaminases, interleukin-6, and oxidative stress. Forty-five male Sprague-Dawley rats were fed a standard diet, an HF diet, an HF diet supplemented with FG, an HF diet supplemented with omega-3 PUFA, or an HF diet supplemented with FG and omega-3 PUFA for 21 weeks. Triacylglycerol, cholesterol, aspartate aminotransferase, alanine aminotransferase, and interleukin-6 were measured. The assessment of oxidative stress included plasma antioxidant capacity, antioxidant enzyme activities, glutathione content, lipid peroxidation, and protein carbonylation. The combined supplementation with FG and omega-3 PUFA did not attenuate the slight accumulation of liver cholesterol induced by the HF diet but normalized the plasma alanine aminotransferase activity. Rats fed the HF diet supplemented with the combination showed a lower amount of plasma interleukin-6 than those fed a standard diet. The combination attenuated oxidative damage induced by the HF diet, decreased antioxidant enzyme activities, and enhanced glutathione status. The beneficial effects of the combination of FG and omega-3 PUFA on oxidative stress and related risk factors in pre-obese rats were mainly modulated by omega-3 PUFA.

El proceso de convertirse en madre para una primeriza genera sentimientos encontrados y puede llegar a sentir que no tiene la capacidad de afrontar este nuevo rol materno. El objetivo fue describir la experiencia de una primeriza a los 35 años, identificando cuáles aspectos percibió como favorecedores en el proceso de convertirse en madre. Se utilizó el relato biográfico. La entrevista en profundidad permite describir e interpretar dicha información. Se siguió la metodología propuesta por Amezcua y col. Se identificaron cuatro grandes temas: sentimientos, percepciones, expectativas; cambios en la vida; apoyo y conocimientos. El cuidado de enfermería debe responder a necesidades reales de las personas y una forma de acercarse a esa realidad es el abordaje cualitativo, lo cual sirve de insumo para diseño de intervenciones de enfermería congruentes.

Objetivo: Analizar el Plan de Mejora Individual (PMI), para evaluar las prácticas clínicas en unidades de críticos del grado en enfermería, e identificar los elementos clave de aprendizaje. Método: Diseño cualitativo y descriptivo. Muestreo propositivo de 51 estudiantes matriculados en las prácticas clínicas de cuidados críticos. Se utilizó un análisis de contenido. Resultados: La estructura en seis apartados del PMI: reflexión, acción, evaluación, participación, personal, utilidad y transferencia permite la reflexión para identificar áreas de mejora. Se extrajeron seis categorías: Humanización, Comunicación, Aprendizaje, Saberes profesionales, Seguridad clínica y Complejidad. Estas conforman los elementos clave de aprendizaje. Conclusiones: El PMI se presenta como un instrumento estructurado, sumativo y evaluativo a partir del concepto de reflexión-en-la-acción, este ofrece la oportunidad de analizar y reflexionar sobre la práctica, evitando una experiencia de su prácticum que podrían devenir rutinaria y mecanizada.

Microbiological strategies are currently being considered as methods for reducing the ethanol content of wine. Fermentations started with a multistarter of three non-Saccharomyces yeasts (Metschnikowia pulcherrima (Mp), Torulaspora delbrueckii (Td) and Zygosaccharomyces bailii (Zb)) at different inoculum concentrations. S. cerevisiae (Sc) was inoculated into fermentations at 0 h (coinoculation), 48 h or 72 h (sequential fermentations). The microbial populations were analyzed by a culture-dependent approach (Wallerstein Laboratory Nutrient (WLN) culture medium) and a culture-independent method (PMA-qPCR). The results showed that among these three non-Saccharomyces yeasts, Td became the dominant non-Saccharomyces yeast in all fermentations, and Mp was the minority yeast. Sc was able to grow in all fermentations where it was involved, being the dominant yeast at the end of fermentation. We obtained a significant ethanol reduction of 0.48 to 0.77% (v/v) in sequential fermentations, with increased concentrations of lactic and acetic acids. The highest reduction was achieved when the inoculum concentration of non-Saccharomyces yeast was 10 times higher (10(7) cells/mL) than that of S. cerevisiae. However, this reduction was lower than that obtained when these strains were used as single non-Saccharomyces species in the starter, indicating that interactions between them affected their performance. Therefore, more combinations of yeast species should be tested to achieve greater ethanol reductions.