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Introduction: This study aimed to compare the time spent on episodes seen by primary care emergency departments before (2017) and after (2019) the inclusion of an advanced practice nurse in patient classification., Methods: Records from 3 primary care emergency departments in 2017 (n = 18,663) and 2019 (n = 22,632) were compared using Student t and chi-square tests. Waiting time for classification, classification time, and total time spent in the consultation area were compared for total episodes, levels of priority, reasons for consultation, and previous clinical processes., Results: Mean waiting time decreased in 2019 for all episodes (P < .001), priorities IV (P < .001) and V (P < .001), respiratory (P < .001) and skin and subcutaneous tissue diseases (P = .015), and previous chronic processes (P = .042). Mean classification time increased in 2019 for all episodes (P < .001); priorities III (P < .001), IV (P < .001), and V (P = .045); several reasons for consultation, and previous processes. Mean total time spent in the consultation area decreased in 2019 for all (P = .002), priority V (P < .001), skin and subcutaneous tissue diseases (P = .010), and fever episodes (P = .021)., Discussion: The inclusion of nurses with advanced nursing practice roles reduces the waiting time and length of stay in the emergency department, but increases the classification time, which could be linked to early interventions., (Copyright © 2024 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)

Background: As the population ages, the demand for social and health systems grows, especially due to chronic diseases and dependency. Informal caregivers, particularly women, face significant burdens including physical, emotional, and financial strain. Current caregiving assessment tools focus on those already in caregiving roles or health professionals, with no tools for the general population without prior caregiving experience., Purpose: This study aimed to develop and validate the Spanish COMCAPCARE scale, which assesses the skills and abilities necessary to care for dependent individuals, including those nearing the end of life, among individuals without prior caregiving experience., Methods: A scale validation study was conducted. A Delphi panel of 13 experts developed an 18-item scale, which was administered to 253 participants over the age of 18 who had not previously served as primary caregivers. Main measurements were psychometric analyses, including principal components analysis (PCA) and reliability testing using Cronbach's alpha and intraclass correlation coefficient. Correlation with a single-item self-assessment of caregiving competence was verified through Spearman's rho., Results: A total of 253 participants (73.9% women) with a mean age of 33 years (SD 13.7) participated. The scale identified 3 factors: financial and work situation (4 items), adaptability (8 items), and care and communication (6 items). The total scale demonstrated high reliability (α = 0.84) and significant correlations between the scale's total score and a single-item self-assessment of caregiving competence ( r  = 0.693, P  < .001)., Conclusions: The Spanish COMCAPCARE scale provides a reliable and valid tool for assessing caregiving competencies in the general population without caregiving experience., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

When humans assemble into face-to-face social networks, they create an extended social environment that permits exposure to the microbiome of others, thereby shaping the composition and diversity of the microbiome at individual and population levels 1-6 . Here we use comprehensive social network mapping and detailed microbiome sequencing data in 1,787 adults within 18 isolated villages in Honduras 7 to investigate the relationship between network structure and gut microbiome composition. Using both species-level and strain-level data, we show that microbial sharing occurs between many relationship types, notably including non-familial and non-household connections. Furthermore, strain-sharing extends to second-degree social connections, suggesting the relevance of a person's broader network. We also observe that socially central people are more microbially similar to the overall village than socially peripheral people. Among 301 people whose microbiome was re-measured 2 years later, we observe greater convergence in strain-sharing in connected versus otherwise similar unconnected co-villagers. Clusters of species and strains occur within clusters of people in village social networks, meaning that social networks provide the social niches within which microbiome biology and phenotypic impact are manifested., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)