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Background Currently, in the scientific literature there is a great interest on the study of strategies to implement patient-centered care. One of the main tools for this is the therapeutic relationship. Some studies suggest that the perception of the environment in which the treatment takes place can influence the perception of its quality, but this is not explored in physical therapy. For all these reasons, the aim of this study was to understand the influence of the environment in which physical therapy treatment takes place on the patients’ perception of the quality of the patient-centered therapeutic relationship in public health centers in Spain. Methods A qualitative study analysed thematically using a modified grounded theory approach. Data collection used semistructured interviewing during focus groups. Results We conducted four focus groups. The size of the focus groups ranged from six to nine participants. In total, 31 patients participated in these focus groups. Participants described a series of specific experiences and perceptions relating to the environment, which they felt were influential in the establishment of therapeutic patient-centered relationships, including six physical factors (Architectural barriers, Furniture, Use of the computer, Physical space, Ambiet conditions, and Privacy) and six organizational factors (Patient-physical therapist ratio, Treatment interruptions, Social factors, Continuity with the professional, Lack of professional autonomy, and Coordination or communication among team members). Conclusion The results of this study highlight environmental factors that affect the quality of the therapeutic patient-centered relationship in physical therapy from the patient’s point of view, and emphasize the need for physical therapists and administrators to underline the need to review these factors and take them into account in their service delivery.

Background Proteus syndrome (PS) is a complex genetic disorder, characterized by the sporadic appearance of hamartomatous lesions that follow a mosaic pattern and have a progressive evolution. It affects most of the mesodermal origin tissues, including the bones. Scoliosis is a common manifestation, with great variability and specific peculiarities, but little about it has been published. Case Description Presentation of 2 clinical cases of patients with PS that underwent scoliosis surgery and literature review. Two patients aged 17 years, a girl (patient 1) and a boy (patient 2), both diagnosed with PS, were being followed-up for scoliosis. Patient 1 had a right thoracic curve with a Cobb angle of 69.1°, whereas patient 2 also had a right thoracic curve of 106.8°. In both patients a posterior fusion was performed, associating rib and ponte osteotomies at the level of the apex in patient 2. A minimum 2-year follow-up was done. Both patients had a satisfactory evolution without neurologic or other complications, with a high degree of correction of their curves (Cobb angle 29.2° and 55.6°, respectively). Their total SRS-22 (Scoliosis Research Society Outcomes Questionnaire) score at the last visit was 4.77 and 4.64, respectively. Conclusions Both PS and scoliosis are conditions associated with deformities and physical limitations that decrease the health-related quality of life of these patients. Because of the severity of the spinal deformities and their risk of progression, early diagnosis and prompt treatment is recommended. Despite being highly complex, scoliosis surgery allows a satisfactory deformity correction and consequently improves the health-related quality of life of patients with PS.

BACKGROUND: Spinal tuberculosis (TB), or Pott’s disease, is the most common form of osteoarticular TB. Early diagnosis and anti-TB drug therapy are the mainstays of treatment. However, in advanced stages, surgery is essential to correct spinal deformities and avoid neurological damage. Very few cases in young children requiring surgical treatment have been described. We present 2 cases of surgically treated thoracic spinal TB in patients under 2 years of age and review the literature on this entity in young children. CASE DESCRIPTION: Two male toddlers, aged 21 (patient 1) and 23 (patient 2) months, were admitted due to insidious systemic deterioration associated with neck stiffness and nonspecific abdominal pain in patient 1 and limping in patient 2. The findings of laboratory tests were unremarkable despite an increase in acute-phase reactants. After an extensive workup, results of a magnetic resonance imaging were consistent with spinal TB in both patients. Patient 1 underwent costotransversectomy of the left third and fourth ribs, debridement, T3-T4 corpectomy, and T2-T6 posterior fusion, to which an anterior rib autograft was added. Patient 2 had a right-sided thoracotomy performed at the apex in addition to debridement and T8 corpectomy; the resected rib was used as anterior structural autograft. Several samples of purulent, caseous material were sent for study. On follow-up, progression of proximal junctional kyphosis was evidenced in patient 1, requiring revision surgery to restore sagittal alignment; the patient was asymptomatic at 2-year follow-up. Patient 2 evolved satisfactorily without neurological sequelae and was asymptomatic at 4-year follow-up. CONCLUSIONS: Spinal TB in young children requires appropriate surgical treatment when presenting at advanced stages or having severe deformity or neurological compromise. Despite the challenges associated with young age and ongoing growth, surgery can be performed safely provided proper surgical expertise. After extensive debridement and decompression, priority should be given to restoring sagittal alignment and balance with stable and durable spinal reconstructions. LEVEL OF EVIDENCE: 3.

Resumen: España es el país europeo donde se realizan más técnicas de reproducción asistida (TRA), alcanzando el 9% de los nacidos. El objetivo de este artículo es introducir el marco legal y analizar algunos aspectos éticos, no exentos de controversia, en relación con el anonimato de los donantes de gametos y la ocultación del origen mediante TRA a los hijos. La legislación española establece el anonimato relativo de los donantes: tanto las receptoras de gametos como los hijos nacidos tienen derecho a obtener información general de los mismos siempre que no incluya su identidad, pero ante situaciones de riesgo para la vida y la salud de los hijos permite su quiebra. Asimismo, se determina un inequívoco derecho a la intimidad y confidencialidad del sometimiento a las TRA. El movimiento tendente a introducir en nuestro país una modificación legislativa que acabe con el anonimato de los donantes de gametos se basa en el derecho de los nacidos a conocer su filiación biológica. Junto con los cambios jurídicos, la actitud de padres y profesionales debe ir modificándose hacia una comunicación más transparente y responsable, en función de las experiencias de los adultos concebidos por estas técnicas, y de los adoptados. Construir valores como la confianza y la verdad en el ámbito de las relaciones familiares desde la responsabilidad requiere colocar a los hijos, grandes olvidados y parte más vulnerable, en el centro del debate. Abstract: Spain is the European country where more assisted reproduction techniques (ART) are performed, reaching 9% of newborns. The objective of this article is to introduce the legal framework and to analyze some ethical questions, not without controversy, in relation to the anonymity of gamete donors and the concealment of origin by ART from their children. Spanish legislation establishes the relative anonymity of donors: both gamete recipients and born children have the right to obtain general information about them as long as their identity is not included, but in situations of risk to the life and health of the children allows your bankruptcy. Likewise, an unequivocal right to privacy and confidentiality of submission to the ART is established. The movement aimed at introducing in our country a legislative amendment that ends the anonymity of gamete donors is based on the right of those children to know their biological origin. Along with legal changes, the attitude of parents and professionals must gradually change towards more transparent and responsible communication, based on the experiences of adults conceived by these techniques, and those adopted. Building values such as trust and truth in the family relationships from responsibility requires placing the children, largely forgotten and the most vulnerable part, at the center of the debate.

Spain is the European country where more assisted reproduction techniques (ART) are performed, reaching 9% of newborns. The objective of this article is to introduce the legal framework and to analyze some ethical questions, not without controversy, in relation to the anonymity of gamete donors and the concealment of origin by ART from their children. Spanish legislation establishes the relative anonymity of donors: both gamete recipients and born children have the right to obtain general information about them as long as their identity is not included, but in situations of risk to the life and health of the children allows your bankruptcy. Likewise, an unequivocal right to privacy and confidentiality of submission to the TRA is established. The movement aimed at introducing in our country a legislative amendment that ends the anonymity of gamete donors is based on the right of those children to know their biological origin. Along with legal changes, the attitude of parents and professionals must gradually change towards more transparent and responsible communication, based on the experiences of adults conceived by these techniques, and those adopted. Building values such as trust and truth in the family relationships from responsibility requires placing the children, largely forgotten and the most vulnerable part, at the center of the debate. Resumen: España es el país europeo donde se realizan más técnicas de reproducción asistida (TRA), alcanzando el 9% de los nacidos. El objetivo de este artículo es introducir el marco legal y analizar algunos aspectos éticos, no exentos de controversia, en relación con el anonimato de los donantes de gametos y la ocultación del origen mediante TRA a los hijos. La legislación española establece el anonimato relativo de los donantes: tanto las receptoras de gametos como los hijos nacidos tienen derecho a obtener información general de los mismos siempre que no incluya su identidad, pero ante situaciones de riesgo para la vida y la salud de los hijos permite su quiebra. Asimismo, se determina un inequívoco derecho a la intimidad y confidencialidad del sometimiento a las TRA. El movimiento tendente a introducir en nuestro país una modificación legislativa que acabe con el anonimato de los donantes de gametos, se basa en el derecho de los nacidos a conocer su filiación biológica. Junto a los cambios jurídicos, la actitud de padres y profesionales debe ir modificándose hacia una comunicación más transparente y responsable, en función de las experiencias de los adultos concebidos por estas técnicas, y de los adoptados. Construir valores como la confianza y la verdad en el ámbito de las relaciones familiares desde la responsabilidad, requiere colocar a los hijos, grandes olvidados y parte más vulnerable, en el centro del debate.

Resumen Objetivo Evidenciar la eficacia de la acupuntura en la ansiedad ante los examenes, en alumnos universitarios. Diseno Estudio experimental sin asignacion aleatoria. Emplazamiento Universidad CEU Cardenal Herrera, Elche, Alicante. Participantes Estudiantes universitario sanos de edad ≥ 18 anos: 23 sujetos en el grupo de intervencion y 21 en el grupo control. Intervenciones El estudio consistio en 10 sesiones de acupuntura (2 por semana) de 30 min cada una, durante las 5 semanas anteriores a los examenes. Al grupo control se le paso el Inventario de Ansiedad de Beck (BAI, Beck Anxiety Inventory) en los mismos tiempos (T1, T2 y T3) en que se realizo las sesiones al grupo de intervencion. Mediciones principales Para la evaluacion de la ansiedad se ha utilizado el BAI, que evalua sobre todo sintomas fisiologicos: 14 de sus 21 items se refieren a sintomas fisiologicos, 4 evaluan aspectos cognitivos y 3 aspectos afectivos. El cuestionario consta de 21 preguntas, con un rango de puntuacion entre 0 y 63. Los puntos de corte son: ansiedad muy baja (0-21), ansiedad moderada (22-35) y ansiedad grave (> 35). Si la puntuacion del BAI es igual o mayor de 22 puntos, la ansiedad es probable. Resultados Tras 5 sesiones de tratamiento se confirma que los niveles de ansiedad disminuyen respecto a la puntuacion obtenida en el BAI antes de comenzar el tratamiento. Despues de 10 sesiones, el grupo de intervencion mantiene los niveles de ansiedad y en el grupo control sin tratamiento se disparan los niveles de ansiedad de forma significativa. Conclusiones La acupuntura ha demostrado ser efectiva para reducir los niveles de ansiedad antes de los examenes en estudiantes de fisioterapia.

BACKGROUND: Over recent years there has been a paradigm shift towards a patient-centred biopsychosocial care model in physical therapy. This new paradigm features a growing interest in understanding the contextual factors that influence the patient's experience of disease, pain and recovery. This includes generalized consensus regarding the importance of establishing a therapeutic relationship that is centred on the patient. OBJECTIVE: To explore physical therapists’ perceptions and experiences regarding barriers and facilitators of therapeutic patient-centred relationships in outpatient rehabilitation settings. METHODS: This is a qualitative study with four focus groups including twenty-one physical therapists. Two researchers conducted the focus groups, using a topic guide with predetermined questions. The focus group discussions were audiotaped and videotaped, transcribed verbatim and analysed thematically using a modified grounded theory approach. RESULTS: Physical therapists perceived that the therapeutic patient-centred relationship not only depends on the personal qualities of the professional, but also on the patient's attitudes and the characteristics of the context, including the organization and team coordination. CONCLUSIONS: Although being more linked towards the patients’ contextual factors and needs than towards the practice of the profession, a therapeutic relationship is worth considering by physical therapists. Furthermore this study highlights the need for physical therapists and administrators to rethink the situation and propose strategies for improvement.

Strawberries have a thin epidermis and a high respiration rate. The use of edible coatings containing chitosan nanoparticles (CSNPs) and propolis (P) has been effective in preserving the shelf life and antioxidant capacity of various fruit and vegetable products. The present research evaluated the effect of coatings with CSNPs and P on the quality, antioxidant compounds, and antioxidant capacity of strawberries. The specific coatings that were evaluated were chitosan (CS), CS+CSNPs33%, CS + CSNPs + P10%, CS + CSNPs + P20%, CS + CSNPs + P30%, and a control with no coating. The variables were weight loss, firmness, total soluble solids (TSS), color, phenols, total flavonoids, antioxidant capacity, and sensory characteristics. An ANOVA and a Tukey test (p &le, 0.05) were used to analyze the data. Strawberries covered with CS + CSNPs + P10% showed the lowest weight loss (9.77%), while those covered with CS + CSNPs + P20% had the greatest firmness (4.96 N). CS + CSNPs + P coatings at 10%, 20%, and 30% concentrations maintained the antioxidant compounds and antioxidant capacity in the evaluated fruit (28.49 mg GAE g&minus, 1, 554.61 &mu, g quercetin g&minus, 1, and 92.48% DPPH, respectively). The application of nanostructured coatings did not modify the sensory characteristics of the fruit. Coatings with CSNPs and/or P could therefore be a viable alternative for preserving the quality and antioxidant capacity of strawberries.

Resumen: Los conflictos que se plantean al negarse el menor de edad o sus representantes a recibir un tratamiento considerado necesario por el pediatra suponen un importante problema ético y conllevan fuerte impacto emocional. Para afrontar el rechazo al tratamiento es necesario explorar y comprender las razones que aducen los implicados, considerar los factores contextuales de cada caso y conocer la conducta a seguir teniendo en cuenta consideraciones bioéticas y el fundamento legal. Abstract: The conflicts that arise when minors or their legal representatives refuse to receive medical treatment considered necessary by the paediatrician pose a serious ethical dilemma and also have a considerable emotional impact. In order to adequately tackle this rejection of medical treatment, there is to identify and attempt to understand the arguments of the people involved, to consider the context in each individual case and be conversant with the procedure to follow in life-threatening scenarios, taking into account bioethical considerations and the legal framework.

Resumen: La profesionalidad apenas se enseña formalmente. Se aprende por ósmosis a través del currículum oculto: conjunto de actitudes que cada uno de nosotros transmite de forma inconsciente a estudiantes, residentes y compañeros. Todos somos modelo o contramodelo de profesionalidad a través de una serie de valores que han constituido los pilares de nuestra profesión desde Hipócrates. Valores que parecen soportar mal el paso del tiempo.Existen factores propios del siglo XXI como la crisis económica, el excesivo tecnicismo, la burocratización o la banalización del acto médico que pueden explicar, pero nunca justificar, el declive de los valores de nuestra profesión: la empatía, la integridad, la solidaridad, el altruismo o la confidencialidad.Por eso, desde el Comité de Bioética de la Asociación Española de Pediatría planteamos la necesidad de reanimar la profesionalidad. Construir y mantener los valores de nuestra profesión formando pediatras científicamente competentes, pero también excelentes desde el punto de vista ético, es parte de nuestra responsabilidad. Abstract: Professionalism is rarely taught formally. It is learned by osmosis through the hidden curriculum: a set of attitudes that each one of us transmits unconsciously to students, medical residents, and colleagues. All of us are a model or counter-model of professionalism through a series of values that have been the pillars of our profession since Hippocrates. Values that do not seem to be strong enough to pass our time.There are specific factors of the 21st century such as the financial crisis, the highly technical nature of medicine, bureaucratisation or trivialisation of the medical process that could explain, but not justify, the decline in the values of our profession: Empathy, integrity, solidarity, the altruism, or confidentiality.That is why, from the Bioethics Committee of the Spanish Paediatrics Association we establish the need to revive professionalism. Building and maintaining the values of our profession by training scientifically competent paediatricians, as well as being excellent from an ethical point of view, is part of our responsibility.

The aim of this study was to evaluate the physicochemical properties and antimicrobial activity of edible propolis-chitosan nanoparticle films. Five formulations containing chitosan (C1), chitosan nanoparticles (C2) and ethanolic extract of propolis (EEP) at different concentrations (C3 = 10%, C4 = 20% and C5 = 30%) were prepared. From the results, a particle size of 28.42 ± 7.43 nm was observed from transmission electron microscopy (TEM) micrographs for chitosan nanoparticles (CSNPs). Contact angle measurements showed a more hydrophilic (0°) behavior for C1 and C4. On the other hand, the most hydrophobic behavior was observed for C3 and C5, with values of 21.38° and 21.17°, respectively. Optical micrographs of coated strawberries showed good adhesion with thickness values between 146.15 and 341.88 μm. No significant differences were found for moisture content, hardness and X-ray diffraction (XRD) (p

El objetivo de este estudio fue analizar las propiedades psicométricas del Cuestionario Centrado en Solucio-nes (ccs) en una muestra española, replicando el estudio original de Grant et al. (2012). El CCS está diseñado para evaluar los pensamientos centrados en las soluciones, compuesta de tres subescalas: distanciamiento del problema, orientación a la meta y activación de recursos. Fue traducido y adaptado al castellano, posteriormente se realizaron dos estudios para examinar sus propiedades psicométricas. El primer estudio confirmó la estructura del instrumento y obtuvo una buena consistencia interna. El segundo estudio confirmó su validez convergente; el CCS correlacionó positivamente con el bienestar, resiliencia, satisfacción con la vida y toma de perspectiva, y negativamente con una medida de psicopatología. El segundo estudio confirmó la estabilidad, a lo largo del tiempo. Estos dos estudios confirman que el CCS es una medida que evalúa pensamientos centrados en las soluciones y puede ser utilizado para población española. The aim of this study was to examine the psychometric properties of the solution-Focused inventory (sFi) in a spanish population, replicating the original validation study of grant et al. (2012). the SFi, designed to evaluate solution-focused thinking, is a 12-item scale with three subscales: problem disengagement, goal orientation and resource activation. The instrument was adapted and translated into spanish, then two studies were carried out to examine its psychometric properties. The first study confirmed the instrument ́s structure, and its good internal consistency. The second study confirmed its convergent validity; SFI was positively correlated with measures of well-being, resilience, satisfaction with life and perspective taking, and negatively correlated with psychopathology. This second study confirmed the stability of the SFI scores across time. in sum, these two studies provide additional support for the reliability and validity of the sFi as a measure of solution-focused thinking, and open its use to spanish-speaking populations. The aim of this study was to examine the psychometric properties of the Solution-Focused Inventory (SFI) in a Spanish population, replicating the original validation study of Grant et al. (2012). The SFI, designed to evaluate solution-focused thinking, is a 12-item scale with three subscales: Problem Disengagement, Goal Orientation and Resource Activation. The instrument was adapted and translated into Spanish, then two studies were carried out to examine its psychometric properties. The first study confirmed the instrument´s structure, and its good internal consistency. The second study confirmed its convergent validity; SFI was positively correlated with measures of well-being, resilience, satisfaction with life and perspective taking, and negatively correlated with psychopathology. This second study confirmed the stability of the SFI scores across time. In sum, these two studies provide additional support for the reliability and validity of the SFI as a measure of solution-focused thinking, and open its use to Spanish-speaking populations.

The conflicts that arise when minors or their legal representatives refuse to receive medical treatment considered necessary by the paediatrician pose a serious ethical dilemma and also have a considerable emotional impact. In order to adequately tackle this rejection of medical treatment, there is to identify and attempt to understand the arguments of the people involved, to consider the context in each individual case and be conversant with the procedure to follow in life-threatening scenarios, taking into account bioethical considerations and the legal framework. Resumen: Los conflictos que se plantean al negarse el menor de edad o sus representantes a recibir un tratamiento considerado necesario por el pediatra suponen un importante problema ético y conllevan fuerte impacto emocional. Para afrontar el rechazo al tratamiento es necesario explorar y comprender las razones que aducen los implicados, considerar los factores contextuales de cada caso y conocer la conducta a seguir teniendo en cuenta consideraciones bioéticas y el fundamento legal.

Professionalism is rarely taught formally. It is learned by osmosis through the hidden curriculum: a set of attitudes that each one of us transmits unconsciously to students, medical residents, and colleagues. All of us are a model or counter-model of professionalism through a series of values that have been the pillars of our profession since Hippocrates. Values that do not seem to be strong enough to pass our time. There are specific factors of the 21st century such as the financial crisis, the highly technical nature of medicine, bureaucratisation or trivialisation of the medical process that could explain, but not justify, the decline in the values of our profession: Empathy, integrity, solidarity, the altruism, or confidentiality. That is why, from the Bioethics Committee of the Spanish Paediatrics Association we establish the need to revive professionalism. Building and maintaining the values of our profession by training scientifically competent paediatricians, as well as being excellent from an ethical point of view, is part of our responsibility.

Resumen : Durante las conversaciones que mantienen los profesionales de la salud con sus pacientes, las preguntas pueden ser consideradas como intervenciones es si mismas. Objetivo: evaluar si existen diferencias entre dos grupos, Preguntas Centradas en el Problema (CP) vs. Preguntas Centradas en la Solucion (CS) en las variables de afecto positivo, afecto negativo y autoeficacia. Metodologia: Diseno experimental con dos grupos y pretest-postest, en el que 107 estudiantes de enfermeria describieron un problema real de su vida que querian resolver, despues fueron asignados, aleatoriamente, a dos grupos: a uno de ellos se les haria preguntas centradas en el problema; y al otro grupo se les haria preguntas centradas en la solucion. Antes y despues de responder a las preguntas, completaron el cuestionario PANAS, que evaluaban el afecto positivo y negativo, y tres preguntas que median la autoeficacia. Resultados: Los ANOVA muestran diferencias estadisticamente significativas en las medias de afecto y autoeficacia entre los dos momentos temporales en ambos grupos, siendo mas favorables para el grupo CS. Conclusion: los resultados, muestran que las preguntas centradas en las soluciones como herramientas para manejar los problemas, pueden ser efectivas para mejorar estados emocionales y aumentar las creencias de autoeficacia de las personas. Palabras clave : Preguntas centradas en la solucion, Preguntas centradas en el problema, Emociones, Autoeficacia, Estudiantes de Enfermeria, Estudio preliminar de replica Abstract : In conversations between health professional and patients, questions can be considered as interventions in their own right. Objective: evaluate the differences between two groups, Problem-Focused questions vs Solution-Focused questions in the positive and negative affect and self-efficacy variables. Method: experimental design with two groups pretest-postest, in which 107 nursing students described a real problem in their life that wanted to solve. Then, they were assigned randomly to two groups: one of them they would be asked questions focused on the problem and the other group would be asked questions focused on the solution. Results: The ANOVA showed statistically significant differences in affect and self-efficacy between the two time points in both groups, being more favourable to the solution-focused questions group. Conclusion: These results show that solution-focused questions, as tools to cope with problems, can be effective in improving emotional states and increase people’s self-efficacy beliefs. Keywords : Solution-focused questions, Problem-focused questions, Emotions, Self efficacy, Nursing students, Preliminary replication study doi: http://dx.doi.org/10.20318/recs.2016.3166

In therapeutic conversations, questions can be considered as interventions in their own right. This study is a cross-cultural replication of Grant (Journal of Systemic Therapies, 2012, 31, 2, 21) study on the effects of different types of questions on various clinically relevant variables. A total of 204 students of a Spanish university described a real-life problem that they wanted to solve and were then randomly assigned to either a solution-focused or a problem-focused questions condition. Before and after answering the questions, they completed a set of measures that assessed positive and negative affect, self-efficacy, and goal attainment. Solution-focused questions produced a significantly greater increase in self-efficacy, goal approach, and action steps than problem-focused questions, and a significantly greater decrease in negative affect, providing further empirical support to solution-focused practices.

Theoretical Framework: In the follow-up stage, breast cancer patients (BCP) have previous control experiences, which determine the subsequent attribution and expectations of control beliefs. Aim: To determine the best profile of specific and more general control beliefs and assess their impact on emotional status and psychosocial adaptation over time. Method: One-hundred-thirty-one BCP were interviewed attending a standard follow-up protocol in the oncology outpatient unit. Results: Clusters having higher general control beliefs were associated with better emotional status and psychosocial adaptation than the cluster with lower general control beliefs and higher specific control beliefs. Moreover, two general control beliefs and one specific control belief were the best predictors of adaptation to illness over time. Conclusion: Our results suggest that overall perceptions of control are related to good emotional status and adaptation.

Professionalism is rarely taught formally. It is learned by osmosis through the hidden curriculum: a set of attitudes that each one of us transmits unconsciously to students, medical residents, and colleagues. All of us are a model or counter-model of professionalism through a series of values that have been the pillars of our profession since Hippocrates. Values that do not seem to be strong enough to pass our time.There are specific factors of the 21st century such as the financial crisis, the highly technical nature of medicine, bureaucratisation or trivialisation of the medical process that could explain, but not justify, the decline in the values of our profession: Empathy, integrity, solidarity, the altruism, or confidentiality.That is why, from the Bioethics Committee of the Spanish Paediatrics Association we establish the need to revive professionalism. Building and maintaining the values of our profession by training scientifically competent paediatricians, as well as being excellent from an ethical point of view, is part of our responsibility. Resumen: La profesionalidad apenas se enseña formalmente. Se aprende por ósmosis a través del currículum oculto: conjunto de actitudes que cada uno de nosotros transmite de forma inconsciente a estudiantes, residentes y compañeros. Todos somos modelo o contramodelo de profesionalidad a través de una serie de valores que han constituido los pilares de nuestra profesión desde Hipócrates. Valores que parecen soportar mal el paso del tiempo.Existen factores propios del siglo XXI como la crisis económica, el excesivo tecnicismo, la burocratización o la banalización del acto médico que pueden explicar, pero nunca justificar, el declive de los valores de nuestra profesión: la empatía, la integridad, la solidaridad, el altruismo o la confidencialidad.Por eso, desde el Comité de Bioética de la Asociación Española de Pediatría planteamos la necesidad de reanimar la profesionalidad. Construir y mantener los valores de nuestra profesión formando pediatras científicamente competentes, pero también excelentes desde el punto de vista ético, es parte de nuestra responsabilidad.

After accidental sport traumatisms, radiological exploration of the injured zone can show infrequent accidental findings. We present the case of a 15-year-old girl, with no significant medical history, who on investigating a wrist traumatism revealed multiple sclerotic areas in the carpal bones in X-rays with no associated symptoms. This is a rare case of osteopoikilosis.

El rapido y descontrolado proceso de industrializacion y desindustrializacion en la ciudad de Sao Paulo ha dejado marcas, problemas y desafios, en su urbanismo contemporaneo. Esta condicion particular de la capital del estado de Sao Paulo se une a su condicion de mega-ciudad, insertada en un complejoentorno “macropolitano” que, junto a un rapido proceso de tercerizacion o especializacion de la ciudaden servicios terciarios, condiciona de manera particular a la ciudad global que es, hoy, Sao Paulo. Esta nueva caracteristica y posicion de la ciudad parece emerger entre dos caracteristicas: por un lado una baja calidad en algunos servicios, y por otro lado, una condicion de servicios de primer orden, atrayendo empresas e inversiones internacionales, y que han colocado la ciudad en la red de vectores de la economia global. Este estudio parte de este contexto y tiene como objetivo el analisis critico de estos conceptos basicos que den base a un planeamiento creativo e innovador para la ciudad de Sao Paulo. Para ello se estudiaran otros planes estrategicos a largo plazo como el de Paris, junto con la propuesta de Plano Sao Paulo 2040, bajo la hipotesis de que los ultimos proyectos urbanos desarrollado en la ciudad, no siempre buscan la cohesion social, una de las directrices principales en todos los planos alargo plazo, y si el enriquecimiento, valoracion y “gentrificacion” de las areas urbanas.

The principle objective of a diagnosis is not to categorise symptoms, or group a combination of signs or clinical symptoms in a coherent way, but to cure a patient or improve their quality of life. Diagnoses that are technically correct, but do not seek this objective may become unnecessary labels which convert healthy people, or those who do not consider themselves to be sick, into patients. We propose a limitation of the diagnostic effort in order to reduce the iatrogenic consequences of these unnecessary labels or diagnoses, a new imperative which, in Kantian terms, can be expressed as: examine and treat your patients in such a way that, at the very least, the effects of your actions always improve the quality of their lives.

Este trabajo trata de establecer paralelismos entre determinados parámetros obtenidos a través del test de Rorschach y diversos tests de aptitud de uso muy extendido. A un grupo de 46 individuos varones, con edades comprendidas entre los 23 y los 40 años, se les aplicó el test de Rorschach y las baterías aptitudinales seleccionadas. La explotación estadística se hizo mediante una estrategia de análisis factorial y constató la ausencia de estructura covariamente común entre ambos tipos de medida. Tal resultado es interpretado como coherente con las divergencias conceptuales sobre la inteligencia existentes entre los teóricos del Rorschach y las teorías en que se basan las baterías psicométricas de aptitud.

This work deals withi the establishment of parallelism among parameters obtained with the Rorschach and different ability tests. We used these tests wiht 46 men between 23 and 40 years old. A factor analysis was applied and we didn't find any common covariant structure. This result agrees with the conceptual divergentes about the intelligence that de theorists of Rorschach and the theories based on the ability psychometric battery support.

Este trabajo está basado en la replicación de una investigación llevada a cabo por Mallinson y Crumrine (1952) con objeto de estudiar la estabilidad de los intereses en la adolescencia. Mediante un diseño con datos apareados en el marco de un estudio longitudinal con dos ejes transversales fijados a los 13/14 y 16/17 años respectivamente, se realizó un estudio sobre la estabilidad posicional intercursos de los campos de interés. Para ello utilizamos el Occupational Interest Znventory (OII) de Lee B Thorpe, revisión de 1956. Los resultados obtenidos confirman una estabilidad entre los cursos de octavo de E.G.B. y tercero de B.U.P., para los campos elegidos en los primeros lugares, tanto de aceptación como de rechazo. This work is based on the replica of an investigation carried out by Mallinson and Crumrine (1952) in order to study the stability of the interests in adolescence. By means of a design with paired data inside a longitudinal study with two fixed crossed axes in the 13/14, 16/17 age-groups respectively, a study of the positional inter-course stability of the fields of interests was accomplished. For that purpose we used the Occupational Interest Inventory (011) 1956 review by Lee & Thorpe. The results obtained confirm a stability between the 8th E. G. B. and the 3rd B. U. P. grades for first selected fields, as regards bolth acceptance and rejection.