An Integrative Behavioral Couple Therapy (IBCT)-Based Conflict Prevention Program: A Pre-Pilot Study with Non-Clinical Couples.

Integrative Behavioral Couple Therapy (IBCT) has demonstrated its efficacy treating severe couple conflict. Nevertheless, its capacity to prevent such conflicts before they appear has not been analyzed. The following empirical study examines the effectiveness of a conflict prevention program based on IBCT's main therapeutic strategies (empathic joining, unified detachment). A sample of 12 individuals (six couples) from the Community of Madrid completed the DAS (Spanier, 1976; Martín-Lanas et al., 2017), IBCTQ (Barraca et al., 2017), and ASPA-A (Carrasco, 1996) pre-treatment, posttreatment, and at a three-year follow up. Three of these couples were randomly assigned to the experimental group, in which they received five, 120-minute sessions of an IBCT-based conflict prevention program. The three remaining couples were assigned to a control group and received no treatment. Results indicated that the experimental couples grew in their acceptance of differences and significantly improved their level of empathic joining and unified detachment; they also manifested greater satisfaction in their total DAS score. At the three-year follow up, neither group showed significant changes with regard to their posttreatment scores. Although the data are based on a small number of couples and should be replicated, the results suggest that a program based on IBCT strategies can help prevent couple conflict up to three years after its application.

[Home Care and COVID-19. Before, in and after the state of alarm]. / Atención domiciliaria y COVID-19. Antes, durante y después del estado de alarma.

In Spain, Home Care as a fundamental tool of Primary Health Care, has had uneven development both before and during the COVID-19 pandemic, although it initially played a relevant role in the control and monitoring of infected people and their families. However, at no time it was used the desirable community perspective and community participation throughout the process as it has been successfully done in other settings. Subsequently, with the closure of health centers, it ceased to be provided in some autonomous communities, when all the attention was transferred to the hospital setting. This exacerbated hospital-centrism, to the detriment of PHC and Home Care, is showing a high contagion in healthcare professionals. The circulation of professionals in the hospitals, where the main focus of infection is concentrated, and from these to their homes is a clear risk factor. In addition, we must not forget that Home Care is of special importance for the care of people with terminal illnesses or very advanced chronic diseases (dementia, COPD...), although always taking into account recommendations tending to extreme precautions for infection for professionals, family and caregivers. This can be adapted to the pandemic situation by using tools that digital health offers (telephone care, video calls...). Finally, it would be very interesting that, once the crisis was over, research was carried out that allowed the incorporation of people who have been treated by the health service during the pandemic, through the technique called public participation in research projects.

Atención domiciliaria y COVID-19. Antes, durante y después del estado de alarma / Home care and covid-19. before, in and after the state of alarm

En España, la Atención Domiciliaria como herramienta fundamental de la Atención Primaria de Salud, ha tenido desigual desarrollo tanto antes como durante la pandemia del COVID-19, aunque inicialmente jugó un papel relevante en el control y seguimiento de las personas infectadas y sus familias. Sin embargo, en ningún momento se contempló la deseable perspectiva comunitaria y la participación comunitaria a lo largo del proceso tal como se ha realizado en otros entornos exitosamente. Posteriormente, con el cierre de centros de salud, dejó de prestarse en algunas comunidades autónomas, al pasar toda la atención al ámbito hospitalario. Este hospital centrismo exacerbado, en detrimento de la APS y la Atención Domiciliaria, está demostrando un elevado contagio de profesionales sanitarios. La circulación de profesionales en los hospitales, donde se concentra el mayor foco de contagio, y desde estos a sus domicilios suponen un claro factor de riesgo. Además, no debemos olvidar que la Atención Domiciliaria es de especial importancia para la atención a personas con enfermedades terminales o enfermedades crónicas muy avanzadas (demencias, EPOC...), aunque siempre teniendo en cuenta recomendaciones tendentes a extremas las precauciones de contagio para profesionales, familia y cuidadoras. Esta puede adaptarse a la situación de pandemia mediante la utilización de herramientas que ofrece la salud digital (atención telefónica, video-llamadas...). Finalmente, sería muy interesante que, una vez superada la crisis, se llevasen a cabo investigaciones que permitiesen la incorporación a la misma de personas que han sido atendidas por el servicio de salud durante la pandemia, a través de la técnica denominada participación pública en proyectos de investigación

In Spain, Home Care as a fundamental tool of Primary Health Care, has had uneven development both before and during the COVID-19 pandemic, although it initially played a relevant role in the control and monitoring of infected people and their families. However, at no time it was used the desirable community perspective and community participation throughout the process as it has been successfully done in other settings. Subsequently, with the closure of health centers, it ceased to be provided in some autonomous communities, when all the attention was transferred to the hospital setting. This exacerbated hospital-centrism, to the detriment of PHC and Home Care, is showing a high contagion in healthcare professionals. The circulation of professionals in the hospitals, where the main focus of infection is concentrated, and from these to their homes is a clear risk factor. In addition, we must not forget that Home Care is of special importance for the care of people with terminal illnesses or very advanced chronic diseases (dementia, COPD ...), although always taking into account recommendations tending to extreme precautions for infection for professionals, family and caregivers. This can be adapted to the pandemic situation by using tools that digital health offers (telephone care, video calls ...). Finally, it would be very interesting that, once the crisis was over, research was carried out that allowed the incorporation of people who have been treated by the health service during the pandemic, through the technique called public participation in research projects

La formación de especialistas en Enfermería Familiar y Comunitaria según las responsables de las unidades docentes / The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units

OBJETIVO: Analizar la situación actual de la formación de especialistas en Enfermería Familiar y Comunitaria desde la perspectiva de las enfermeras responsables de las unidades docentes. MÉTODOS: Análisis exploratorio mediante técnica de grupo nominal de las aportaciones realizadas por representantes de 19 unidades docentes multiprofesionales de atención familiar y comunitaria de 11 comunidades autónomas. Se categorizan y ponderan dichas aportaciones. RESULTADOS: Las categorías emergentes sobre las dificultades y fortalezas encontradas han estado en relación con las tutoras, al entorno donde se realiza la formación, con la propia estructura de la unidad docente, con la organización de la docencia y el programa oficial de la especialidad, con los apoyos externos y con la formación teórica. CONCLUSIONES: La formación en Enfermería Familiar y Comunitaria es una oportunidad de mejora de la atención primaria de salud para capacitar en competencias novedosas y necesarias aunque complejas de adquirir. Se hace necesario dar apoyo para que la formación sea efectiva y se debe dar a conocer la especialidad y su formación. Las tutoras son una pieza clave en este proceso

OBJETIVO: Analizar la situación actual de la formación de especialistas en Enfermería Familiar y Comunitaria desde la perspectiva de las enfermeras responsables de las unidades docentes. MÉTODOS: Análisis exploratorio mediante técnica de grupo nominal de las aportaciones realizadas por representantes de 19 unidades docentes multiprofesionales de atención familiar y comunitaria de 11 comunidades autónomas. Se categorizan y ponderan dichas aportaciones. RESULTADOS: Las categorías emergentes sobre las dificultades y fortalezas encontradas han estado en relación con las tutoras, al entorno donde se realiza la formación, con la propia estructura de la unidad docente, con la organización de la docencia y el programa oficial de la especialidad, con los apoyos externos y con la formación teórica. CONCLUSIONES: La formación en Enfermería Familiar y Comunitaria es una oportunidad de mejora de la atención primaria de salud para capacitar en competencias novedosas y necesarias aunque complejas de adquirir. Se hace necesario dar apoyo para que la formación sea efectiva y se debe dar a conocer la especialidad y su formación. Las tutoras son una pieza clave en este proceso (AU) - es OBJECTIVE: To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. METHODS: Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. RESULTS: The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. CONCLUSIONS: Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process

The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units. / La formación de especialistas en Enfermería Familiar y Comunitaria según las responsables de las unidades docentes.

OBJECTIVE: To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. METHODS: Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. RESULTS: The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. CONCLUSIONS: Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process.

TRAF6 and Src kinase activity regulates Cot activation by IL-1.

Cot is one of the MAP kinase kinase kinases that regulates the ERK1/ERK2 pathway under physiological conditions. Cot is activated by LPS, by inducing its dissociation from the inactive p105 NFkappaB-Cot complex in macrophages. Here, we show that IL-1 promotes a 10-fold increase in endogenous Cot activity and that Cot is the only MAP kinase kinase kinase that activates ERK1/ERK2 in response to this cytokine. Moreover, in cells where the expression of Cot is blocked, IL-1 fails to induce an increase in IL-8 and MIP-1betamRNA levels. The activation of Cot-MKK1-ERK1/ERK2 signalling pathway by IL-1 is dependent on the activity of the transducer protein TRAF6. Most important, IL-1-induced ERK1/ERK2 activation is inhibited by PP1, a known inhibitor of Src tyrosine kinases, but this tyrosine kinase activity is not required for IL-1 to activate other MAP kinases such as p38 and JNK. This Src kinases inhibitor does not block the dissociation and subsequently degradation of Cot in response to IL-1, indicating that other events besides Cot dissociation are required to activate Cot. All these data highlight the specific requirements for activation of the Cot-MKK1-ERK1/ERK2 pathway and provide evidence that Cot controls the functions of IL-1 that are mediated by ERK1/ERK2.