Background: Peer support is a mutual aid system based on the belief that someone who faced/overcome adversity can provide support, encouragement and guidance to those who experience similar situations. Objective: To conduct a systematic review that describes this concept and characterizes peer supporters, its practice and efficacy. Method: Research on ISI Web of Science, EBSCO Psychology and Behavioral Sciences Collection and Medline databases (from 2001 to December 2013) was conducted using as keywords "mental illness", "mental health", "psychiatric disability", "mental health services", combined with "peer support", "mutual support", "self-help groups", "consumers as providers", "peer-run services", "peer-run programs" and "social support". Results: We found 1,566 articles and the application of both the exclusion (studies with children, teenagers and elderly people; disease in comorbidity; peer support associated to physical illnesses or family members/caregivers) and the inclusion criteria (full text scientific papers, peer support or similar groups directed for schizophrenia, depression, bipolar or psychotic disorders) lead to 165 documents, where 22 were excluded due to repetition and 31 to incomplete text. We analyzed 112 documents, identifying as main peer support categories: characterization, peer supporter, practices and efficacy. Discussion: Despite an increasing interest about this topic, there is no consensus, suggesting realizing more studies.
Type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic metabolic diseases of the 21st century. Nevertheless, its prevalence might be attenuated by taking advantage of bioactive compounds commonly found in fruits and vegetables. This work is focused on the recovery of polyphenols and polysaccharide–polyphenol conjugates from grape pomace for T2DM management and prevention. Bioactives were extracted by solid–liquid extraction and by pressurized hot water extraction (PHWE). Polyphenolic fraction recovered by PHWE showed the highest value for total phenolic content (427 μg GAE.mg−1), mainly anthocyanins and proanthocyanidins, and higher antioxidant activity compared to the fraction recovered by solid–liquid extraction. Polysaccharide–polyphenol conjugates comprehended pectic polysaccharides to which approximately 108 μg GAE of phenolic compounds (per mg fraction) were estimated to be bound. Polyphenols and polysaccharide–polyphenol conjugates exhibited distinct antidiabetic effects, depending on the extraction methodologies employed. Extracts were particularly relevant in the inhibition of a-glucosidase activity, with free polyphenols showing an IC50 of 0.47 μg.mL−1 while conjugates showed an IC50 of 2.7, 4.0 and 5.2 μg.mL−1 (solid–liquid extraction, PHWE at 95 and 120 °C, respectively). Antiglycation effect was more pronounced for free polyphenols recovered by PHWE, while the attenuation of glucose uptake by Caco-2 monolayers was more efficient for conjugates obtained by PHWE. The antidiabetic effect of grape pomace bioactives opens new opportunities for the exploitation of these agri-food wastes in food nutrition, the next step towards reaching a circular economy in grape products.
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