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In this paper, we use Time Scale Calculus (TSC) to formulate and solve pharmacokinetic models exploring multiple dose dynamics. TSC is a mathematical framework that allows the modeling of dynamical systems comprising continuous and discrete processes. This characteristic makes TSC particularly suited for multi-dose pharmacokinetic problems, which inherently feature a blend of continuous processes (such as absorption, metabolization, and elimination) and discrete events (drug intake). We use this toolkit to derive analytical expressions for blood concentration trajectories under various multi-dose regimens across several flagship pharmacokinetic models. We demonstrate that this mathematical framework furnishes an alternative and simplified way to model and retrieve analytical solutions for multi-dose dynamics. For instance, it enables the study of blood concentration responses to arbitrary dose regimens and facilitates the characterization of the long-term behavior of the solutions, such as their steady state.
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Invasive non-native freshwater mollusks are a growing concern in South America, with 16 species already recorded in the region. Among them, Sinotaia quadrata has only been documented in Argentina, for the first time in the Punilla Valley, Córdoba (2009) and La Plata, Buenos Aires (since 2015). In this study, we report the presence of S. quadrata in two additional areas, the Río de la Plata River and a stream (unnamed) in the Paraná River basin, two of the most significant rivers in South America, located in the provinces of Buenos Aires and Entre Ríos, respectively. These new records confirm the invasive nature of this species, which has also been identified in Europe, the United States, and Africa in recent years. The findings of this study highlight the need for continued monitoring and management of invasive species in South America's freshwater ecosystems.
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Gastrópodes , Espécies Introduzidas , Rios , Animais , Argentina , Gastrópodes/classificação , Gastrópodes/anatomia & histologiaRESUMO
Several studies have examined the association of externalizing polygenic scores (PGS) with externalizing symptoms in samples of European ancestry. However, less is known about the associations of externalizing polygenic vulnerability in relation to phenotypic externalizing disorders among individuals of different ancestries, such as Mexican youth. Here, we leveraged the largest genome-wide association study on externalizing behaviors that included over 1 million individuals of European ancestry to examine associations of externalizing PGS with a range of externalizing disorders in Mexican adolescents, and investigated whether adversity exposure in childhood moderated these associations. Participants (N = 1064; age range 12-17 years old; 58.8% female) were adolescents recruited for a general population survey on adolescent mental health in the Mexico City Metropolitan region and were genotyped. Childhood adversity exposure and externalizing disorders, specifically attention-deficit hyperactivity disorder (ADHD), conduct disorder, oppositional defiant disorder, and substance use disorder, were assessed via the computer-assisted World Mental Health Composite International Diagnostic Interview for adolescents. A greater externalizing PGS was associated with a greater odds of any externalizing disorder (OR = 1.29 [1.12, 1.48]; p < 0.01) and ADHD (OR = 1.40 [1.15, 1.70]; p < 0.01) in the whole sample, and in females in particular. There were no main effects of the externalizing PGS on conduct disorder, oppositional defiant disorder, or substance use disorder, nor did adversity exposure moderate these associations. Our results suggest that greater genetic propensity for externalizing disorders is associated with increased odds of any externalizing disorders and ADHD among Mexican adolescents, furthering our understanding of externalizing disorder manifestation in this population.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtorno da Conduta , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adolescente , Feminino , Criança , Masculino , Estudo de Associação Genômica Ampla , México , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/genética , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/genética , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
Astigmatism and myopia are two common ocular refractive errors that can impact daily life, including learning and productivity. Current knowledge suggests that the etiology of these conditions is the result of a complex interplay between genetic and environmental factors. Studies in populations of European ancestry have demonstrated a higher concordance of refractive errors in monozygotic (MZ) twins compared to dizygotic (DZ) twins. However, there is a lack of studies on genetically informative samples of multi-ethnic ancestry. This study aimed to estimate the genetic contribution to astigmatism and myopia in the Mexican population. A sample of 1399 families, including 243 twin pairs and 1156 single twins, completed a medical questionnaire about their own and their co-twin's diagnosis of astigmatism and myopia. Concordance rates for astigmatism and myopia were estimated, and heritability and genetic correlations were determined using a bivariate ACE Cholesky decomposition method, decomposed into A (additive genetic), C (shared environmental) and E (unique environmental) components. The results showed a higher concordance rate for astigmatism and myopia for MZ twins (.74 and .74, respectively) than for DZ twins (.50 and .55). The AE model, instead of the ACE model, best fitted the data. Based on this, heritability estimates were .81 for astigmatism and .81 for myopia, with a cross-trait genetic correlation of rA = .80, nonshared environmental correlation rE = .89, and a phenotypic correlation of rP = .80. These results are consistent with previous findings in other populations, providing evidence for a similar genetic architecture of these conditions in the multi-ethnic Mexican population.
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Introducción: Los trastornos alimentarios en menores de 5 años pueden causar alteraciones en el desarrollo y crecimiento. Pueden asociarse con trastornos de la funcionalidad familiar. Objetivo: Describir los trastornos de alimentación de tipo no orgánico en menores de 5 años y su asociación con la funcionalidad familiar en un hospital de segundo nivel en Puebla. Métodos: Estudio descriptivo y transversal, en el que se incluyeron niños menores de 5 años con trastornos alimentarios no orgánicos. A los padres que previamente firmaron el consentimiento informado se les aplicó la herramienta IMFED para estudio de los trastornos alimenticios, y FACES III para describir la funcionalidad familiar. Se utilizó estadística descriptiva y coeficiente de Spearman. Resultados: Se evaluaron 105 pacientes de los cuales 57 fueron hombres y 48 mujeres. La edad media fue 30,42 mínimo 2, máximo 60, ± 16,68 meses. El grupo etario predominante fue de 12-23 meses. 45,71% de los padres reportaron adaptabilidad familiar caótica y 39,04% cohesión relacionada. El trastorno de alimentación más frecuente fue aversiones sensoriales al alimento. Más del 60% presentaron dos o más trastornos de alimentación. La correlación entre adaptabilidad familiar y trastornos de alimentación fue 0,248 (p=0.011), y entre cohesión familiar y trastornos de alimentación 0,87 (p=0,38). Conclusión: Los trastornos de alimentación más frecuentes fueron aversión sensorial al alimento y anorexia infantil. Se correlacionan levemente con adaptabilidad familiar. Son más frecuentes en familias con adaptabilidad caótica. Los menores de 5 años con dos o más trastornos alimentarios son los más frecuentes.
Introduction: Eating disorders under 5 years old may cause development and grow problems. Disorders in family functionality can be associated. Objective: To describe non-organic eating disorders in children under 5 years of age and their association with family functionality in a second-level hospital in Puebla. Methods: It was a descriptive, cross-sectional study. Children under 5 years old with non-organic eating disorders were included. A questionnaire to study eating disorders (IMFED) and other one to describe family functionality (FACES III) were applied to their parents who previously signed informed consent. Descriptive statistics and Spearman test were used. Results: 105 patients were evaluated, 57 men and 48 women, medium age 3.042, minimum 2, maximum 60, ± 16.68 months old. Children 12-23 months old were more frequent. Parents reported chaotic family adaptability in 45.71%, and 39.04% related cohesion. The most frequent eating disorder was sensorial aversions to food. More than 60% had two or more eating disorders. Family adaptability and eating disorders were correlated in 0.248(p=0.011), and family cohesion and eating disorders 0.87 (p=0.38). Conclusion: Most frequent eating disorders were sensorial aversion to food and infant anorexia. They softly correlate with family adaptability. Children under 5 years old with 2 or more eating disorders are more frequent.
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Resumen Objetivo. Conocer las representaciones sociales sobre la violencia basada en género en contra del hombre en deportistas en formación de un club deportivo de la ciudad de Cali. Método. Se empleó un diseño cualitativo, en el que se utilizó una entrevista semiestructurada a seis adolescentes de 16 y 17 años de edad. El análisis de los datos se realizó desde el método de inducción analítica, y algunos elementos del análisis del discurso se procesaron a través del software Atlas.ti. Resultado. Los hallazgos sugieren que la formación deportiva de los adolescentes promueve un tipo de masculinidad hegemónica que les exige adiestrarse en prácticas de masculinidad y adscribirse a un conjunto de normas para tener éxito en su disciplina deportiva. Por otro lado, los deportistas que no logren adherirse a los lineamientos de la masculinidad hegemónica promovida, se convierten en blanco de subordinación por parte de sus entrenadores y compañeros. Conclusión. El sistema de valores y prácticas promovidas por la institución deportiva, legitima formas soterradas de violencia en contra de sus reproductores, los adolescentes.
Abstract Objective. The main objective of the study was to describe the social representations of gender-based violence against male athletes from a soccer club in Cali, Colombia. Method. A qualitative design and a semi-structured interview with 6 adolescents between 16 and 17 years old was used. The data analysis was carried out with an analytical induction method and some elements of discourse analysis that were processed through the Atlas.ti software. Results. Teen sports training promotes a type of hegemonic masculinity that requires the athletes to train in masculinity practices and adhere to a set of standards in order to be successful in their branch of sports. On the other hand, athletes who fail to adhere to the guidelines of promoted hegemonic masculinity become a target of subordination by their coaches and peers. Conclusion. The system of values and practices promoted by the sports institution, legitimates underground forms of violence against its reproducers, teenagers.
Resumo Escopo. Conhecer as representações sociais sobre a violência baseada no gênero em contra do homem atleta em formação de um clube esportivo da cidade de Cali. Metodologia. Foi empregado um desenho qualitativo, no que foi utilizada uma entrevista semiestruturada a seis adolescentes de 16 e 17 anos de idade. A análise dos dados foi feita desde o método de indução analítica, e alguns elementos da análise do discurso foram processados a través do software Atlas.ti. Resultados. As descobertas sugerem que a formação esportiva dos adolescentes promove um tipo de masculinidade hegemónica que exige o adestramento em práticas de masculinidade e a inscrição a um conjunto de normas para ter sucesso na sua disciplina esportiva. Por outro lado, os atletas que não logram se aderir às diretrizes da masculinidade hegemónica promovida, são convertidos em alvo de subordinação por parte de treinadores e companheiros. Conclusão. O sistema de valores e práticas promovidas pela instituição esportiva, legitima formas encobertas de violência em contra dos seus reprodutores, os adolescentes.
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In 2012, a severe drought struck the southeastern of Brazil compromising the Paraná River Basin reservoirs. Here, we described how this climatic event promoted a massive mortality of the giant freshwater mussel Anodontites trapesialis in Furnas reservoir and reported the consequences of this phenomenon. In November 2012, three quarters of 100 m2 were sampled in this reservoir, where 812 dead shells of A. trapesialis were analyzed and measured (33 Ë« 133 mm). The species showed an aggregated distribution with high density ( X ¯ : 1.0 - 5.5 ind/m2). Despite the massive mortality detected in field, it was possible to find living specimens in a small channel in the studied area, allowing the species to survive the water level fluctuations. Large adult individuals (100 Ë« 124 mm) were more affected by drought than juveniles, accounting for about 90% of the dead mussels analyzed. Two years after the massive mortality event, water level was not reestablished and a terrestrial succession (with elevations in the concentration of organic matter and calcium in sediment) was observed in the studied area. We verified that the damming associated with extreme climatic events affect negatively the populations of A. trapesialis and should be faced as a conservationist problem.
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Bivalves , Secas , Animais , Brasil , RiosRESUMO
An untargeted NMR-based metabonomics approach was used to evaluate the effects of pure resveratrol (RSV, 50 and 250 mg/kg per os) on the urinary and faecal metabolome of normal female Wistar rats. Multivariate data analysis on both the endogenous and xenobiotic metabotype of RSV provided an insight into its metabolic fate and influence on endogenous metabolites. The xenobiotic trajectory shows that RSV is highly metabolized within the first 12 h, the period of the most significant variation of endogenous metabolites. The results reveal alterations in gut microbiota co-metabolites, mainly at the high dose of RSV, such as hippurate, phenylacetyl glycine (PAG), p-cresyl glucuronide (p-CG), p-cresyl sulfate (p-CS) and 3-indoxylsulfate (3IS), as well as in osmolytes (creatine, creatinine, taurine and proline betaine). This metabolic variation could mean that RSV modulates the composition and/or function of the gut microbiota as well as its interaction with the host through the gut-microbiome-liver-kidney axis. For instance, RSV may interact with conjugating enzymes present in the intestine and liver. There were also modifications in metabolites of the tricarboxylic acid (TCA) cycle and energy metabolism (2-oxoglutarate, lactate and alanine), and diet-derived metabolites (pantothenate and trans-aconitate). These effects of RSV are perhaps related to its capacity to control energy homeostasis, provide renal protection, and downregulate some biomarkers of oxidative stress (e.g., glycoproteins). Such changes contribute to reduced oxidative stress and inflammation, which are associated with RSV-induced biological activity to improve various conditions, including metabolic disorders, obesity, and chronic and cardiovascular diseases.
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Espectroscopia de Ressonância Magnética Nuclear de Carbono-13 , Metabolismo Energético/efeitos dos fármacos , Fezes/química , Metaboloma/efeitos dos fármacos , Metabolômica/métodos , Estresse Oxidativo/efeitos dos fármacos , Espectroscopia de Prótons por Ressonância Magnética , Resveratrol/farmacologia , Animais , Biomarcadores/urina , Relação Dose-Resposta a Droga , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Ratos Wistar , Resveratrol/metabolismo , Fatores de TempoRESUMO
BACKGROUND: Among patients with Turner Syndrome (TS), premature ovarian failure is a main feature. Recently published consensus guidelines recommend that transdermal (TD) estradiol is the preferred route for estrogen replacement. Studies related to ultrasound (US) measurements during estrogen replacement in TS patients using estradiol (17ß E2) and correlating uterine growth with estrogen metabolites are limited. OBJECTIVES: To compare uterine morphology and hormonal changes depending on route of administration of 17ß E2 (oral vs. TD) in a small population of girls with TS. SUBJECTS: 11 hypogonadal girls with TS (mean (SE) age 14.5 ± 1.4 years; BMI -0.98 ± -1.0 SDS) who participated in a larger study on the effects of oral versus TD 17ß E2 agreed to do a sub-study on the effect of the form of 17ß E2 treatment on uterine size. METHODS: 17ß E2 was given orally or TD for 12 months, titrated to doses up to 2 mg orally or 100 µg TD to achieve normal estradiol levels. Subjects received monthly progesterone for 1 week for withdrawal bleeding. At baseline, 6 and 12 months, a pelvic ultrasound was performed while on estradiol only. RESULTS: Uterine morphology and endometrial thickness increased comparably in both groups. E2 concentrations were comparable at 12 months between both groups but E1 and E1S were lower in TD group at 12 months. CONCLUSIONS: According to our experience, in a group of TS patients randomized to oral vs TD 17ß E2 and monitored with trans-abdominal US, both groups achieved similar increases in uterine size comparable to normal women. To confirm our observation a larger sample and a longer evaluation period is needed.
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Estradiol/uso terapêutico , Síndrome de Turner , Administração Oral , Terapia de Reposição de Estrogênios , Estrogênios , Feminino , Humanos , Síndrome de Turner/tratamento farmacológicoRESUMO
Bivalves are one of the most representative groups in the Phylum Mollusca, with over 1,100 freshwater species around the world except Antarctica. About 900 of these species belong to the Order Unionida Gray, 1854. In South America, the distributional range of the Unionida includes all countries in the region and extends as far south as the lakes and rivers of Argentinean-Chilean Patagonia. With the aim of generating distribution maps for the different genera of Unionida in Argentina, we consulted the databases of the nation's main official malacological collections. The data were analyzed and georeferenced using the point-radius method. Spatial analyses were performed with the software Q-GIS 2.16.3 Nødebo using vector layers under the 2007 Argentinean Geodesic Positions reference system. A total 1,833 lots were analyzed, of which it was possible to georeference 1,503. The distribution of Unionida in Argentinean territory was analyzed according to political provinces, Surface Drainage Basins and the Argentinean Protected Areas. Species richness was analyzed using the surface drainage basins of Argentina. We generate distribution maps for each genus and discuss the species threat status and conservation degree in the region. Only six (18%) of the Unionida present in Argentina have been classified by the IUCN, four are Least Concern and two are Data Deficient. This pattern is also valid for all of South America. More than 95% of the distributional range of the Unionida has no protected area. Conservation management is necessary for the preservation of Unionida diversity in southern South America.
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Bivalves/classificação , Animais , Argentina , Biodiversidade , Conservação dos Recursos Naturais , Água DoceRESUMO
In 1981, Corbicula fluminea (Müller, 1774) and C. largillierti (Philippi, 1844) were recorded at the Río de la Plata River. During the 1980s, C. largillierti was found on a continuous fringe in the shore of that river, while C. fluminea was only found North of Buenos Aires harbor. Ten years later, C. fluminea spread to Punta Indio, while C. largillierti remained restricted to tributary streams. The density and size frequency distribution of both species were compared with previous data from samples performed in the same area in 1985-1989. The aim of this research was to determine whether the densities of both species decreased; whether C. fluminea is still more abundant than C. largillierti; and whether the size frequency distributions indicate different population structures from those observed in the end of the 1980s. Nine localities from the river shore were sampled, and each individual was identified and measured. The size of C. fluminea varied between 2 and 39 mm, showing the highest frequency of individuals between 20 and 25 mm; furthermore the density decreased 90% in 2015/2016. No specimens of C. largillierti were found. In conclusion, the populations of Corbicula inhabiting the Río de la Plata River are retracting.
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Animais , Corbicula/anatomia & histologia , Espécies Introduzidas , Distribuição Animal , Distribuição TemporalRESUMO
In 1981, Corbicula fluminea (Müller, 1774) and C. largillierti (Philippi, 1844) were recorded at the Río de la Plata River. During the 1980s, C. largillierti was found on a continuous fringe in the shore of that river, while C. fluminea was only found North of Buenos Aires harbor. Ten years later, C. fluminea spread to Punta Indio, while C. largillierti remained restricted to tributary streams. The density and size frequency distribution of both species were compared with previous data from samples performed in the same area in 1985-1989. The aim of this research was to determine whether the densities of both species decreased; whether C. fluminea is still more abundant than C. largillierti; and whether the size frequency distributions indicate different population structures from those observed in the end of the 1980s. Nine localities from the river shore were sampled, and each individual was identified and measured. The size of C. fluminea varied between 2 and 39 mm, showing the highest frequency of individuals between 20 and 25 mm; furthermore the density decreased 90% in 2015/2016. No specimens of C. largillierti were found. In conclusion, the populations of Corbicula inhabiting the Río de la Plata River are retracting.(AU)
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Animais , Corbicula/anatomia & histologia , Espécies Introduzidas , Distribuição Animal , Distribuição TemporalRESUMO
Este trabajo es un fragmento de una investigación mayor, la cual toma los discursos de Asunción de los presidentes del Mercosur desde el año 2000 a la actualidad como su objeto. Las categorías que se analizan son dos, enunciaciones en referencia a la Economía y las Relaciones Internacionales del país. Se trabaja sobre solo dos discursos de asunción de presidentes de la República Argentina, Fernando de la Rúa y Cristina Fernández de Kirchner. Se utiliza el algoritmo David Liberman como metodología de análisis del discurso, específicamente los niveles de actos del habla y redes de palabras. El método se aplica sobre un fragmento, obtenido por el juicio interjueces, los cuales determinan la idea nuclear y las ideas complementarias para cada temática en cada discurso.
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Argentina , Discurso , Fala , Política , Psicanálise , Psicologia , PsicometriaRESUMO
Este trabajo es un fragmento de una investigación mayor, la cual toma los discursos de Asunción de los presidentes del Mercosur desde el año 2000 a la actualidad como su objeto. Las categorías que se analizan son dos, enunciaciones en referencia a la Economía y las Relaciones Internacionales del país. Se trabaja sobre solo dos discursos de asunción de presidentes de la República Argentina, Fernando de la Rúa y Cristina Fernández de Kirchner. Se utiliza el algoritmo David Liberman como metodología de análisis del discurso, específicamente los niveles de actos del habla y redes de palabras. El método se aplica sobre un fragmento, obtenido por el juicio interjueces, los cuales determinan la idea nuclear y las ideas complementarias para cada temática en cada discurso.(AU)
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Psicologia , Psicanálise , Política , Discurso , Psicometria , Fala , ArgentinaRESUMO
Resumen
En las instituciones de salud a nivel nacional existe escasez y una alta rotación de enfermeras, ambas situaciones se atribuyen a la insatisfacción laboral que puede ser causada por el síndrome de Burnout, poco reconocimiento entre pares y de la sociedad, percepción de falta de apoyo para la capacitación y desarrollo profesional, sobrecarga de trabajo en relación a la asignación del número de paciente/enfermera; lo anterior provoca mala calidad en la atención, aumento en los eventos adversos, altos costos en salud y por consiguiente, insatisfacción del usurario. Una estrategia para resolver esta problemática son los Hospitales Magnéticos considerados como aquellos que atraen y retienen a los profesionales de enfermería en las instituciones de salud para brindar cuidados de excelencia a través de ocho elementos magnéticos. Es por ello que en este trabajo se vinculan las ocho fuerzas magnéticas con la trilogía de evaluación de la calidad de Donabedian, destacando los beneficios para el paciente, el profesional de enfermería, la institución y la sociedad. Con ello el lector identificará áreas de oportunidad para su práctica diaria.
Summary
Nationwide there is a shortage and high turnover of nurses in health institutions, both are attributed to job dissatisfaction that can be caused by Burnout syndrome, little recognition among peers and society, perceived lack of support for training and professional development, overburden related to the number of patients per nurse; aforesaid can led to poor quality of care, increase of adverse events, high costs in health care and therefore user dissatisfaction. A strategy for solving this problem are Magnet hospitals considered as those that attract and retain nurses in health institutions to provide excellence in care through eight magnetic elements. That is why this paper links the eight magnetic forces to Donabedians trilogy of quality assessment, highlighting the benefits for patient, nursing professionals, the institution and society. With this the reader will identify areas of opportunity in daily practice.
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Humanos , Assistência Hospitalar , Avaliação de Processos e Resultados em Cuidados de Saúde , Desempenho Profissional , Disciplina no Trabalho , Esgotamento Profissional , Mobilidade Ocupacional , Saúde Ocupacional , México , HumanosRESUMO
Introducción: Los registros clínicos de enfermería conforman la evidencia escrita de los cuidados otorgados al paciente, son por excelencia un medio de comunicación y coordinación entre los profesionales de la salud, su realización correcta permite la continuidad de los cuidados y la seguridad del paciente. Objetivo: Construir y validar un instrumento para evaluar la calidad de los registros clínicos de enfermería. Metodología: Partiendo de la variable calidad de los registros clínicos de enfermería se realizó la búsqueda de información con respecto a la temática en diversas bases de datos como Pub Med, medline, Elsevier, Cochraner, se consultó la Ley General de Salud, la Norma Oficial Mexicana del Expediente Clínico (nom-168-SSA-1998), el Código de Ética para Enfermeras y Enfermeros en México. Así como los estándares para la Certificación de Establecimientos de la Atención Médica del Consejo de Salubridad General. Con ello se consideró la normativa para el llenado del formato de los registros clínicos de enfermería, elaborada por la Subdirección de Enfermería perteneciente a una Unidad Médica de Tercer Nivel de Atención del sector público. Se construyó un instrumento que mide la calidad de los registros clínicos de enfermería (carce) en sus tres dimensiones estructura, continuidad de los cuidados y seguridad del paciente. Resultados: Para obtener la confiabilidad se utilizó el coeficiente Kuder-Richardson, alcanzando un índice de .86. Se aplicaron pruebas no paramétricas U de Mann-Whinney y Kruskal Wallis para determinar el poder de discriminación entre las variables obteniendo diferencias estadísticamente significativas p=0.0001. Discusión: Coincidiendo con el Modelo vips un acrónimo para la documentación de enfermería que significa bienestar, integridad, prevención y seguridad vistos como los principales objetivos de los cuidados de enfermería y la perspectiva de Björvell C et al, quienes construyeron instrumentos para evaluar el grado en que los registros describen aspectos importantes del paciente en relación con la atención de enfermería. El instrumento carce aquí propuesto concuerda con los autores mencionados en virtud de que integra la continuidad del cuidado y la seguridad del paciente. Conclusiones: El instrumento reúne los elementos esenciales de confiabilidad y validez así como el poder de discriminación entre las variables intervinientes. Por lo anterior se propone como un instrumento para la evaluación objetiva de los registros clínicos de enfermería en instituciones de salud pública y privada.
Introduction: nursing clinical registers represent written evidence of care given to patients, and a means of communication and coordination between health professionals; therefore, their correct constitution allows continuity in patient care security. Objective: Build and validate an instrument to assess nursing clinical registers quality. Methodology: we started searching in diverse databases including PubMed, MEDLINE, Elsevier, Cochraner, and also consulted the Health General Law, the Mexican Official Standard NOM-168-SSA-1998, the Ethical Code for Mexican Nurses, the standards of the General Health Council of the Medical Attention Sites Certification, and the Public Sector Third Level Attention Medical Units SubDirection. The instrument was named CARCE and it estimates three dimensions of care: structure, continuity, and patient security. Results: we calculated the Kuder Richardson coefficient (.86) and the Mann-Whinney and Kruskal-Wallis coefficients to test variable-discrimination power and obtained statistically significant differences (p = .0001). Discussion: similar to the VIPS model, which tests well-being, integrity, prevention, and security seen as the principal nursing care objectives from the perspective of Bjorvell et al, the CARCE instrument was found to be useful to help integrate patient security and health care continuity. Conclusion: the instrument gathers the essential elements of validity and confidence as well as variable-discrimination power, and because of this, we propose it as an option to assess nursing clinical objectives both in public and in private institutions.