System In Spain Research Articles

Life cycle assessment of power generation systems in Spain: Exploring a broader view from a consequential perspective

Developing new clean power generation systems is a research priority for the energy sector, and selection should be based on environmental performance over the entire lifetime. Consequential Life Cycle Assessment evaluates the consequences of this selection and provides environmental data to support decision-making. This research uses a consequential approach to assess the environmental impacts of two medium power generation systems. The selected environmental impact assessment methods are IPCC 2013 GWP 100y and ReCiPe 2016. Moreover, the work describes a methodology for finding the marginal mix technologies for electricity and cooling energy production depending on the time horizon. The positive environmental consequences associated with short-term marginal energy mixes (electricity and cooling) progressively disappear when the marginal energy mix varies throughout time. The environmental results strongly depend on the marginal mix of technologies and evidence the necessity to develop methodologies and standards to improve the robustness of environmental assessments. A new line of discussion is opened concerning the temporal variation of environmental impacts of an energy production system, which could also be considered in Attributional Life Cycle Assessments.

The signal of snowmelt in streamflow and stable water isotopes in a high mountain catchment in Central Spain

Study regionPeñalara catchment, in the mountains of the Central System in Spain, Study focusFor the first time, we investigated the streamflow and streamwater isotopes during the snow accumulation and melting periods and over subsequent months in two snow seasons. The aim is to better understand the hydrological processes linked to snowmelt; to describe the temporal evolution and the interannual differences in isotopic streamwater; and to improve the understanding about the hydrological functioning of snowmelt water across the catchment. New hydrological insights for the regionThe isotopic signal of the streamwater progressively became isotopically depleted from the beginning of the melt period until the snow cover depletion of the catchment. Higher snowfall led to depleted isotopic values in the stream compared to a year with low snowfall. The interannual variability of the isotopic signature of streamwater during snowmelt may represent a difficulty to establishing reference values to be used in mixing models for hydrograph separation. The streamflow isotopic values had very limited sub-daily variation and showed slow temporal changes, suggesting a central role for alpine aquifers in explaining the hydrological functioning of the catchment, pointing to piston flow as a key process in streamflow generation.

Carbon footprint of transhumant sheep farms: accounting for natural baseline emissions in Mediterranean systems

Abstract Purpose Transhumance has rarely been analyzed through LCA approaches, and there is little evidence about its emissions level when conducted under different practices (by truck or on foot) or compared to sedentary livestock systems. Moreover, mobile pastoralism is strongly linked to natural resources by its seasonal grazing patterns, thereby occupying the niche of wild herbivores. Considering natural emission baselines in these ecosystems could have relevant effects when estimating their carbon footprint. Materials and methods Inventory data of 20 sheep farms was collected to estimate the carbon footprint (CF) of lamb meat produced. Farms were divided into three sub-groups representing typical management practices in the region: (1) sedentary (SED), (2) transhumance by truck (THT), and (3) transhumance on foot (THF). Livestock GHG emissions were modeled according to herd structure and IPCC guidelines. Off-farm emissions from external feeds and fuels were accounted based on existent LCA databases. A natural baseline of wild herbivores was established from the population of red deer reported in a hunting preserve, previously considered to be a reference for the natural carrying capacity in Mediterranean ecosystems. GHG emissions of wild herbivores were estimated through two methods based on (1) IPCC guidelines and (2) allometric regression equations. Results and discussion Carbon footprint ranged from 16.5 up to 26.9 kgCO2-eq/kg of lamb liveweight (LW). Significant differences were identified among sedentary and transhumant farms, the latter consistently showing lower CF values (SED: 25.1 kg CO2-eq/kg LW, THT: 18.3 kg CO2-eq/kg LW, THF: 18.2 kg CO2-eq/kg LW). Sedentary farms resulted in higher GHG emissions (+ 27%) and higher CO2 and N2O, contributions derived from the consumption of additional feeds. Both methods applied to compute emissions for wild herbivores led to similar results (25.3–26.8 Mg CO2-eq/km2), comparatively lower than estimation for transhumant sheep (47.7 Mg CO2-eq/km2). When considering natural baseline emissions, the CF of transhumant lamb meat is reduced by almost 30%, reaching values quite below those reported for intensive lamb production systems in Spain. Conclusions From our results, mobility of grazing livestock can be considered as a strategy promoting climate change mitigation. This is achieved mainly by reducing the need of external feeds, while maximizing the use of local forage resources that otherwise would be difficult to valorize. Further reductions in the CF result when considering natural baseline emissions. The application of this new GHG accounting perspective could have relevant implications when aiming at climate neutrality of grazing-based ruminant systems.

Disparities between Latinx migrants and Spanish natives in COVID-19 outcome in Madrid

ABSTRACT Previous studies have suggested an increased susceptibility of COVID-19 among certain populations. We analyzed whether COVID-19 presentation and mortality differ between Latinx migrants and Spanish natives. Methods and Materials. COVID-19 patients between 35–64 years old admitted between January 26th-May-5th 2020 were reviewed. Demographics, major comorbidities, symptoms, signs and analytical parameters on admission were recorded. Respiratory failure was defined as PaO2/FiO2 ≤ 200 mmHg, noninvasive or invasive mechanical ventilation requirement at any time during hospitalization. A propensity score (PS) adjustment was created between Latinx and Spanish. A multivariable logistic regression model adjusted by the PS was performed to evaluate the effects of different variables on mortality. Results. 894 patients: 425 (47.5%) Latinx and 469 (52.5%) Spanish natives were included. Latinx were younger (50 vs 55 years p < 0.001) and had less comorbidities (29.4% vs 55.0% p < 0.001) than Spanish natives. More often they exhibited fever (22.1% vs 9.8% p = 0.018) and had higher inflammatory markers (PCR) (11.3 mg/dl vs 7.7 mg/dl p < 0.001). Mortality seemed lower among Latinx (4.7% vs 8.7%, p = 0.017). No association was found between ethnicity and mortality. Respiratory failure [OR = 23.978 (CI 95% 9.4–60.1) p < 0.001], LDH [OR (per unitary increment) = 1.002; CI95% (1.000–1.004;p = 0.036] and PCR [OR (per unitary increment) = 1.044 (CI95% 1.06–1.08); p = 0.02] were independently associated to mortality. Conclusions: We were unable to identify significant ethnic disparities between Latinx and Spanish natives in terms of COVID-19 mortality. Universal access to the health care system in Spain may have contributed to a better outcome of Latinx patients. Differences previously described might be a consequence of socioeconomic disparities.

Personalized Precision Medicine for Health Care Professionals: Development of a Competency Framework

Personalized precision medicine represents a paradigm shift and a new reality for the health care system in Spain, with training being fundamental for its full implementation and application in clinical practice. In this sense, health care professionals face educational challenges related to the acquisition of competencies to perform their professional practice optimally and efficiently in this new environment. The definition of competencies for health care professionals provides a clear guide on the level of knowledge, skills, and attitudes required to adequately carry out their professional practice. In this context, this acquisition of competencies by health care professionals can be defined as a dynamic and longitudinal process by which they use knowledge, skills, attitudes, and good judgment associated with their profession to develop it effectively in all situations corresponding to their field of practice. This report aims to define a proposal of essential knowledge domains and common competencies for all health care professionals, which are necessary to optimally develop their professional practice within the field of personalized precision medicine as a fundamental part of the medicine of the future. Based on a benchmark analysis and the input and expertise provided by a multidisciplinary group of experts through interviews and workshops, a new competency framework that would guarantee the optimal performance of health care professionals was defined. As a basis for the development of this report, the most relevant national and international competency frameworks and training programs were analyzed to identify aspects that are having an impact on the application of personalized precision medicine and will be considered when developing professional competencies in the future. This report defines a framework made up of 58 competencies structured into 5 essential domains: determinants of health, biomedical informatics, practical applications, participatory health, and bioethics, along with a cross-cutting domain that impacts the overall performance of the competencies linked to each of the above domains. Likewise, 6 professional profiles to which this proposal of a competency framework is addressed were identified according to the area where they carry out their professional activity: health care, laboratory, digital health, community health, research, and management and planning. In addition, a classification is proposed by progressive levels of training that would be advisable to acquire for each competency according to the professional profile. This competency framework characterizes the knowledge, skills, and attitudes required by health care professionals for the practice of personalized precision medicine. Additionally, a classification by progressive levels of training is proposed for the 6 professional profiles identified according to their professional roles.

Comparison of the teaching of digital competences between health science faculties in Andalusia and Catalonia

IntroductionCovid-19 brought great restrictions to face-to-face classes throughout the university system in Spain. In the field of health sciences, face-to-face teaching has been transformed into a virtual format. In most cases, teaching activities could not be prepared or planned, leading to unprecedented challenges for students and teachers, making it clear that some teachers have not developed an optimal level of digital skills. Materials and methodsThis descriptive-comparative study aims to analyse the level of digital teaching competence among the university health sciences teaching staff in two Spanish autonomous communities: Andalusia and Catalonia. 561 teachers participated in the study and answered the DigCompEdu check-In questionnaire. ResultsThe results show how, in general, the level of their professed digital skills is basic, without significant differences between the participating communities. Further, technological mastery appears to be greater than pedagogical mastery with respect to one of the classroom technologies. The lack of technological training is highlighted and there is a discussion of the structuring of personalized learning itineraries by competences. ConclusionsWith regard to possible limitations of the research, we could reflect on the different areas for improvement and how comparative studies between future works with similar characteristics should be approached. One of the main weaknesses lies in the types of samples used, since the intentional sampling method indicates that it is not random, therefore, the results found should be considered non-extrapolatable to other areas of knowledge. Incorporating probabilistic samples for each area to be studied in future studies will allow the collection of more representative data that can be extrapolated globally.

Obstacles and Limitations in the Use of Protocols Responding Intimate Partner Violence Against Women from the Health System in Spain.

Intimate partner violence against women (IPVAW) is a public health problem that affects women worldwide. Consequently, victims frequently go to healthcare centers, usually with a cover reason. To address this problem, national and autonomic protocols to respond to IPVAW in health systems have been developed in Spain. In this regard, the role of primary care physicians (PCPs) will be essential for addressing IPVAW, but they could encounter obstacles in doing so. The purpose of this study was to explore how IPVAW is addressed in healthcare centers in Spain. This study synthesized the information available in the protocols to address IPVAW among health care workers in Spain and analyzed it according to World Health Organization (WHO) guidelines. Additionally, PCPs' perspectives on these protocols and the nature of IPVAW attention from healthcare centers were explored through a focus group. The findings displayed that, although the protocols mostly conform to WHO guidelines, they are insufficient to address IPVAW. Generally, PCPs were unaware of the existence of the protocols and referred to the lack of training in IPVAW and protocol use as one of the main obstacles to intervening, along with a lack of time and feelings as well as cultural, educational, and political factors. The adoption of measures to ensure that PCPs apply these protocols correctly and to approach PCPs' obstacles for addressing IPVAW in consultations will be crucial for the care of victims.

Analysis of Profiles of Family Educational Situations during COVID-19 Lockdown in the Valencian Community (Spain)

Due to the pandemic (COVID-19), the education system in Spain was forced to close for three months, creating an unprecedented situation: improvised distance schooling. Family characteristics and their life situations with Information and Communication Technology use would be aspects to be studied as educational conditioning factors. This paper presents the ways in which a representative sample of families in the Valencian Community (Spain) assumed the education of their children during the lockdown. Mixed methods (quantitative -surveys-/qualitative -focus groups-) are used. Multivariate profiles are studied (k-means cluster) that summarise the life circumstances, represented by composite indicators resulting from the families’ responses to specific items describing their way of life and educational performance. Associated variables, such as demographic or life situation characteristics, are analyzed for each profile. Some gaps (described by indicators that synthesize the functioning of the families) are observed due to life circumstances that correspond not only to vulnerable groups but also to upper-middle-level families.

Trends in cardiovascular care in the National Health System in Spain. Data from the RECALCAR project 2011-2020

Introduction and objectivesThe RECALCAR project (Resources and Quality in Cardiology), an initiative of the Spanish Society of Cardiology, aims to standardize information to generate evidence on cardiovascular health outcomes. The objective of this study was to analyze trends in the resources and activity of cardiology units and/or services and to identify the results of cardiovascular care during the last decade in Spain. MethodsThe study was based on the 2 annual data sources of the RECALCAR project: a survey on resources and activity of cardiology units and/or services (2011-2020) and the minimum data set of the National Health System (2011-2019), referring to heart failure (HF), STEMI, and non-STEMI. ResultsThe survey included 70% of cardiology units and/or services in Spain. The number of hospital beds and length of stay decreased, while there was a notable increase in the number of cardiac imaging studies and percutaneous therapeutic procedures performed. Age- and sex-adjusted admissions for HF tended to decrease, despite an increase in mortality and the percentage of readmissions. In contrast, the trend in mortality and readmissions was highly favorable in STEMI; in non-STEMI, although positive, the trend was less marked. ConclusionsThe information provided by the RECALCAR project shows a favorable trend in the last decade in resources, activity and results of certain cardiovascular processes and constitutes an essential source for future improvements and decision-making in health policy.

Frustrated transfers: the attempt to introduce school vouchers system in Spain (1978–1982)

ABSTRACT This paper analyses the origin, development and fall of the ‘school voucher’ system in Spain. It was called the Ley de Financiación de la Enseñanza Obligatoria (Compulsory Education Financing Law) (LFEO), and this reform represented the first attempt at an international level to establish a school voucher model for a whole country. This article attempts to explain the importance of the new ideas that emerged from the Economics of Education and International Organisation to understand the origin of the proposed LFEO. It also focuses on its development and the parliamentary debate of the law. Finally, it explains how other foreign ideas began to compete to establish models of equal opportunities in education different from the one proposed. The paper provides a valuable insight into how educational transfers take place, and the importance of the role that local actors can play in the development and, in this case, the failure of such transfers.

Vertical farming: A trade-off between land area need for crops and for renewable energy production

Indoor vertical farming (VF) may play an important role in tackling future food insecurity as it can reduce the land use requirements for crop land and is not affected by environmental conditions. However, its energy-intensive operation and the associated environmental impacts can be a cause for concern. To alleviate these issues, it is desirable to operate VF with renewable energy. Our aim was to investigate the land use requirements for generating renewable energy for VF and whether the land area saved by growing crops in multiple layers is sufficient for energy production. The land area requirements for wind and solar (photovoltaic, PV) energy were assessed for lettuce, tomato, potato and wheat production in VF systems in Spain and Sweden. In addition to current-technology scenarios, future scenarios for technological advancement in VF systems and renewable energy generation were included. The results showed that with current technologies, the saved land area was sufficient to produce enough energy only in the case of using PV for lettuce production. However, with improved technologies, the saved land area was sufficient to produce electricity with PV for all crops except tomatoes in Sweden. In contrast, wind energy only satisfies lettuce production, even with future technologies. This study serves as a guideline for determining the feasibility of VF operated with renewable energy in relation to land area, electricity requirements and renewable electricity generation potential in various regions of Europe.

Impact of the new measures related to the circular economy on the management of agrochemical packaging in Spanish agriculture and the use of biodegradable plastics

BackgroundWaste disposal is an activity that pollutes the environment. The European Union has developed different legislative measures which are based on the circular economy (CE) to avoid this negative externality. The management of agricultural packaging (fertilizers and phytosanitary products) is carried out through Collective Deposit, Return, and Refund Systems (CDRRS). New regulations on waste tax the consumption of non-recyclable plastic in packaging, but also reward the use of plastic by-products from packaging. The administrations recommend using biodegradable plastic in the means of production, as well as establishing a traceability system (TS) to control the proper management of all the generated waste. The proposed measures can affect producer cost accounts. This work aimed to identify and evaluate the existing agricultural packaging management system in Spain. It also studied the influence of the price of a barrel of oil, crop surface, irrigation regime, and the type of subsectors on CDRRS, and quantified the impact of the latest fiscal measures and initiatives proposed by Spanish administrations.ResultsThe generation of agricultural packaging is influenced by variables including the cultivated area, irrigation regime, and agricultural subsector. The price of a barrel of oil directly influences the current by-product utilization system. Using biodegradable plastic or implementing a TS can increase production costs by up to 9.80%. The current system of subsidies to producers can soften the economic impact caused by the additional cost of biodegradable plastic (4.03%), but no subsidies have been foreseen to encourage the use of environmentally friendly alternatives.ConclusionsFindings indicate that public administrations should be guided by the specific characteristics of the different agricultural systems when defining regulations on agricultural waste management. The fixed rate in the current system of subsidies for using plastic by-products obtained from packaging should be substituted for a variable rate. Transferring powers to autonomous communities to define by-products may lead to heterogeneity in the Spanish territory. New measures derived from the recent environmental agreements to comply with the 2030 Agenda will increase production costs even after considering the current aid scheme. The subsidy coefficient should be increased to 80% of the purchase invoice.

Caroline Gray, Territorial politics and the party system in Spain: Continuity and change since the financial crisis. London: Routledge, 2020

Caroline Gray, Territorial politics and the party system in Spain: Continuity and change since the financial crisis. London: Routledge, 2020

A Raise for Grandma: Pensions and Household Expenditure*

Abstract This paper analyses the causal effect of changes in public pensions on household spending. The identification exploits the introduction of a new welfare system in Spain during the 1980s and 1990s, and uses a novel narrative series of legislated pension changes as an instrument for pension income. Despite public pensions having a limited impact in the aggregate, I find a high, though less than unity, marginal propensity to consume for pensioners due to permanent income shocks at the household level. Moreover, large spending responses for pensioners with the highest income and wealth mean that liquidity considerations can be disregarded as a key source of marginal propensity to consume heterogeneity. Instead, a strong precautionary savings motive can explain the excess smoothness of consumption, and costly adjustments explain the skewed spending response for durables.

Atmospheric carbon removal via industrial biochar systems: A techno-economic-environmental study

It is critical to develop carbon removal projects that are both effective and financially viable. Herein, we investigated the carbon removal potential of an industrial biochar system in Spain. This study is the first to assess the techno-economic-environmental impact of large-scale olive tree pruning residue pyrolysis for atmospheric carbon removal, using an integrated assessment framework that is based on current market dynamics. Production optimization using response surface methodology (RSM) was carried out, aiming to maximize yield, production throughput and stable carbon content while prioritizing stability. It was determined that optimized biochar production was attained at 650 °C and 15 min residence time. Furthermore, a biochar plant with a biomass processing capacity of 6.5 tonnes-per-hour was designed for further analysis. A thermodynamic model was developed using Advanced System for Process Engineering (ASPEN Plus) software, and the process was determined to be self-sufficient with the availability of surplus energy. Moreover, a life cycle assessment (cradle-to-grave) revealed that approximately 2.68 tCO2e are permanently removed from the atmosphere per tonne of biochar produced, after accounting for the carbon footprint of the entire process. This corresponds to a carbon removal capacity of 3.26 tCO2e per hour and the removal of approximately 24,450 tCO2e annually. The economic assessment revealed that the project is profitable; however, profitability is sensitive to pricing of the carbon removal service and biochar. A project internal rate of return (IRR) of 22.35% is achieved at a price combination of EUR 110/tonne CO2e removal and EUR 350/tonne biochar, and a feedstock cost of 45 EUR/tonne (delivered with 20% moisture content), where service and product pricing are both within the lower bound of market pricing. If the project was exclusively designed to offer a carbon removal service, a minimum price of EUR 206/tonne CO2e removal is required to achieve project profitability, based on the same feedstock cost. The findings of this study demonstrate the viability of immediately deploying large-scale biochar-based carbon removal via pyrolytic conversion of olive tree pruning residues to address the climate crisis.

Trends in hospitalization and death rates among patients with head and neck cancer in Spain, 2009 to 2019

ABSTRACT Background Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide, and prevalence is still substantially higher in men than in women. Causative factors include smoking and alcohol use, while human papillomavirus (HPV) infection is causally related to a subset of oropharyngeal cancers. In this retrospective study, we aimed to provide estimates on the clinical and economic burden of HNSCC in Spain. Methods We used the discharge reports from the Spanish Minimum Basic Data Set (MBDS), to retrospectively analyze hospital discharge data in individuals with a diagnosis of HNSCC in any diagnostic position, based on the ICD coding system (ICD-9-CM and ICD10 CM), from 2009 to 2019. Results A total of 175,340 admissions and 14,498 deaths due to laryngeal, pharyngeal and oral cavity cancer were recorded in Spain, of which 85% occurred in men. The most prevalent diagnoses were laryngeal cancer in men (50.9%) and oral cavity cancer in women (49.1%). In general, the hospitalization and death rates for all major head and neck cancer sites decreased in men and increased or remained stable in women during the study period. However, the corresponding rates for tonsil cancer, strongly associated with HPV infection, increased significantly in men. Overall, the economic burden of HNSCC during the study period was estimated at 100 million euros per year on average. Conclusion HNSCC still places an important clinical and economic burden on the health system in Spain. Prevention strategies should be prioritized, and vaccination programs against HPV in both sexes should be reinforced.

La influencia de los factores individuales y contextuales del liderazgo en los alcaldes de larga duración en las capitales de provincia en España

The long-term mayors in the local government system in Spain can be defined as mayors who have remained at least four terms in office; as a result, they constitute agents of special interest for Political Science after four decades of municipal democracy. Based on an analysis of the scientific literature, this research note elaborates a proposal about the individual factors (autonomy, previous experience, female gender and political career) and contextual ones (population size, motion of censure, type of investiture, crisis produced by nationalization of local life and turncoat tendency) that affect the prolongation in time of local leadership. This way, we analyze the influence of these factors upon the temporal continuity of a sample of long-term mayors of elected in province capital cities and autonomous cities between 1979 and 2019. As a result, it is noted that previous professional experience, the local political career, the smaller demographic size and the type of investiture are the factors positively influencing local leaders to consolidate as long-term mayors.

COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain.

BackgroundWith the emergence of SARS‐CoV‐2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals.MethodsUsing a test‐negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID‐19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS‐CoV‐2 variant.ResultsVE was 89% (95% CI: 83–93) against COVID‐19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS‐CoV‐2 variants, although variant‐specific VE was slightly higher against Alpha.ConclusionsThe SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID‐19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID‐19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS‐CoV‐2 variants (Alpha vs. Delta).

CHILD PARTICIPATION IN FAMILY AND CHILD PROTECTION MATTERS IN SPAIN

The paper is part of a collaborative research organized by the International Association of Youth and Family Judges and Magistrates (AIMJF/IAYFJM) on child participation in family and protection matters. The article explains the legal, institutional and procedural aspects of child participation in the Justice System in Spain.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study.

We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.