José Hernández-Ascanio

Background/Objectives: Loneliness is a relevant social determinant of health in older age and has been associated with adverse physical, psychological and social outcomes. This study aimed to estimate the prevalence of severe loneliness and to identify its epidemiological and clinical correlates among community-dwelling older adults at risk of falls in Andalusia, Spain. Methods: A cross-sectional analytical study was conducted with 237 adults aged 65 years and older living in private households. Loneliness was assessed using the 10-item version of the UCLA Loneliness Scale, which showed excellent internal consistency in this sample (Cronbach’s alpha = 0.900). After reviewing the scoring direction of the instrument, severe loneliness was operationally defined using the corrected UCLA total score, with higher scores indicating greater loneliness. Sociodemographic and clinical variables included age, sex, living arrangements, economic level, family relationships, pain, sleep quality, depression history, physical exercise, outings from home, polymedication and analgesic use. Bivariate analyses were performed to compare participants with and without severe loneliness, and logistic regression was used to examine independent correlates of severe loneliness. Results: Severe loneliness was identified in 51 participants, corresponding to 21.5% of the analytical sample. The corrected UCLA-10 loneliness burden score ranged from 0 to 30, with higher scores indicating greater loneliness. Participants with severe loneliness were more likely to report poorer sleep quality and severe pain. In the adjusted logistic regression model including age, sex, sleep quality and severe pain, better sleep quality was associated with lower odds of severe loneliness (OR = 0.46, 95% CI: 0.30–0.72, p = 0.001), while severe pain was associated with higher odds of severe loneliness (OR = 3.15, 95% CI: 1.56–6.35, p = 0.001). Age (OR = 1.03, 95% CI: 0.99–1.07, p = 0.184) and female sex (OR = 2.00, 95% CI: 0.83–4.81, p = 0.124) were not statistically significant in the fully adjusted model. Conclusions: Severe loneliness affected a clinically relevant proportion of community-dwelling older adults at risk of falls in Andalusia. The findings should be interpreted as cross-sectional associations and not as evidence of causal pathways. Sleep quality and severe pain emerged as the main independent clinical correlates of severe loneliness in the adjusted model, supporting the relevance of multidimensional assessment in frail older adults.

Background: Burnout is a relevant occupational health concern in Emergency Medical Services (EMSs), with potential implications for workforce well-being, occupational health, and the sustainability of prehospital care. Although burnout has been widely studied among healthcare professionals, evidence concerning Emergency Medical Technician (EMT) students remains limited. This exploratory study aimed to estimate high burnout prevalence among EMT students and practising EMT professionals in Madrid, Spain, describe burnout dimensions in both groups, and examine sociodemographic correlates of high burnout status. Methods: A cross-sectional comparative study was conducted between March and June 2024 using a convenience sample of 85 participants: 43 EMT students and 42 practising EMT professionals. Burnout was assessed using validated Spanish versions of the Maslach Burnout Inventory: the MBI-SS for students and the MBI-HSS for professionals. Because these instruments are population-specific and rely on different norms and thresholds, between-group comparisons of raw scores were interpreted as exploratory. Descriptive analyses, between-group comparisons with effect sizes, correlation analyses, and an exploratory binary logistic regression model were performed. Results: High burnout was identified in 22 EMT students (51.2%) and 23 practising EMT professionals (54.8%), with no statistically significant between-group difference detected (p = 0.73; Cramer’s V = 0.04). Between-group comparisons of burnout dimensions showed small effect sizes for Emotional Exhaustion (Cohen’s d = 0.17), Depersonalisation (Cohen’s d = 0.24), and Personal Accomplishment (Cohen’s d = −0.26). Age was positively associated with Emotional Exhaustion (r = 0.29, p = 0.008) and Depersonalisation (r = 0.24, p = 0.028), and negatively associated with Personal Accomplishment (r = −0.26, p = 0.019). In the exploratory adjusted logistic regression model, age was associated with high burnout status (OR = 1.05; 95% CI 1.01–1.10; p = 0.017), whereas group and sex were not significant correlates. Conclusions: High burnout levels were observed in both EMT students and practising EMT professionals in this regional exploratory sample. However, the findings should be interpreted cautiously due to the cross-sectional design, convenience sampling, modest sample size, limited statistical power, and use of population-specific burnout instruments. These results suggest that burnout-related distress may be relevant across the EMT training-to-practice pathway and support the need for larger longitudinal and multicentre studies incorporating occupational, educational, and organisational variables.

La formación investigadora en el pregrado constituye un desafío central para las universidades contemporáneas, especialmente en las Ciencias de la Salud, donde la toma de decisiones requiere pensamiento crítico y fundamentación científica. Frente a la limitada participación estudiantil en actividades investigativas, los semilleros de investigación emergen como una estrategia efectiva para desarrollar competencias metodológicas, promover la creatividad y fortalecer la cultura académica. Este ensayo analiza la experiencia en desarrollo del Programa Semilleros de Investigación Loyola Salud de la Universidad Loyola Andalucía, integrando un enfoque conceptual y formativo que destaca el valor de estos espacios en la formación profesional. Se describen los fundamentos teóricos de los semilleros, su alineación con la pedagogía ignaciana y la estructura metodológica implementada en Loyola, organizada en fases de convocatoria, conformación de grupos, tutorías y socialización de resultados. La experiencia evidencia que los semilleros potencian la autonomía, la motivación y la capacidad investigadora del estudiantado, contribuyendo a su desarrollo integral y al fortalecimiento de una comunidad académica comprometida con la excelencia, la reflexión crítica y el servicio.

La formación investigadora en el pregrado constituye un desafío central para las universidades contemporáneas, especialmente en las Ciencias de la Salud, donde la toma de decisiones requiere pensamiento crítico y fundamentación científica. Frente a la limitada participación estudiantil en actividades investigativas, los semilleros de investigación emergen como una estrategia efectiva para desarrollar competencias metodológicas, promover la creatividad y fortalecer la cultura académica. Este ensayo analiza la experiencia en desarrollo del Programa Semilleros de Investigación Loyola Salud de la Universidad Loyola Andalucía, integrando un enfoque conceptual y formativo que destaca el valor de estos espacios en la formación profesional. Se describen los fundamentos teóricos de los semilleros, su alineación con la pedagogía ignaciana y la estructura metodológica implementada en Loyola, organizada en fases de convocatoria, conformación de grupos, tutorías y socialización de resultados. La experiencia evidencia que los semilleros potencian la autonomía, la motivación y la capacidad investigadora del estudiantado, contribuyendo a su desarrollo integral y al fortalecimiento de una comunidad académica comprometida con la excelencia, la reflexión crítica y el servicio.

El objetivo de la investigación es analizar las motivaciones e incentivos que influyen en que las personas jóvenes se sientan atraídos por la carrera militar. Utilizamos el Modelo General de Incentivos (GIM). La metodología parte del análisis de los datos ofrecidos por las doce encuestas sobre Defensa Nacional y las Fuerzas Armadas/Ejercito, realizadas en España por el Centro de Investigaciones Sociológicas (CIS) entre 1997 y 2017. Los resultados muestran que los incentivos altruistas, los incentivos de proceso, relacionados exclusivamente con la profesión militar, y los incentivos afectivos, relacionados con el prestigio, son los más influyentes en el interés por la profesión militar. También constatamos el potencial del Modelo General de Incentivos para analizar las motivaciones en la inserción laboral, especialmente en profesionales con una fuerte especificidad.

El presente trabajo es un ejercicio de síntesis y de articulación de los principales elementos teóricos relativos a la definición de la innovación social, las fases a partir de las cuales se desarrolla y los intentos de modelización más significativos que se han llevado a cabo hasta el momento, utilizando como estrategia de análisis el establecimiento de una taxonomía y una discusión de la teoría del cambio subyacente a las propuestas identificadas.

The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative–phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra’s EU taxonomy. The analysis followed Ricoeur’s considerations, using the Nvivo software. In the NCM’s EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system’s limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care.

Aims: To assess the effect of a multicomponent intervention on reducing social isolation and loneliness and improving the quality of life in community-dwelling older adults. Design: A cluster-randomized controlled clinical trial. Methods: A total of 56 older adults participated in the control group and 63 older adults in the experimental group. The intervention consisted of 6 home-based face-to-face sessions, intercalated with 5 telephone calls and was conducted by nursing students and volunteer staff with experience in the subject. The study was conducted between April 2018 and December 2019. In terms of statistical analysis, several procedures were carried out: a statistical analysis per protocol and intention to treat, considering isolation, loneliness and quality of life as endpoints; a comparison of paired means, to analyse the behaviour of the outcome variables at baseline and the end of the study; and finally, a binary logistic regression analysis, considering social support as a dependent variable. Results: The study results do not show the effectiveness of the modified CARELINK programme, analysed as a whole, on the decrease in social isolation or loneliness or the improvement in HRQL. However, a detailed analysis of the behaviour of some of the variables during the study indicates some results that deserve to be commented on. Comparing the mean confidential support scores between the experimental and control group at the initial and final stages shows significant differences in the analysis by protocol, and close to statistical significance in the analysis by intention to treat. Comparing the paired means obtained in the experimental group, an improvement in emotional loneliness scores was found. Finally, the variables associated with the social support of the subjects at the end of the follow-up period were as follows: having people who help them arid mobility. Conclusion: Although the results obtained do not allow us to affirm that the intervention programme is effective, these same results point to improved confidential support and emotional loneliness in older adults participating in the intervention. Having people to help them and a greater degree of mobility are factors favouring the decrease in social isolation. Impact: This study suggested that modified CARELINK, a multicomponent intervention performed by trained volunteers, could improve confidential support in community-dwelling older adults. It also reports the importance of considering the level of mobility and support networks as determinants of the improvement caused by the intervention.