Adaptation to Brazilian Portuguese and Latin-American Spanish and psychometric properties of the Mental Illness Clinicians' Attitudes Scale (MICA v4).

OBJECTIVE: To describe translation to Spanish and Portuguese and adaptation of the Mental Illness Clinicians' Attitudes Scale version 4 (MICA v4). METHODS: The questionnaire was administered to primary care physicians (PCPs) from four Latin-American countries, Brazil, Bolivia, Chile, and Cuba. The validation process included four phases: 1) translation of the questionnaire to Spanish and Portuguese; 2) assessment of face validity; 3) assessment of reliability; and 4) evaluation of construct validity with confirmatory factor analysis (CFA). RESULTS: The study sample comprised 427 PCPs. The mean age of the Spanish-speaking sample (n = 252) was 40.1 (S.D = 9.7) years and the mean age of the Portuguese-speaking sample (n = 150) was 40.2 (S.D = 10.9) years. Both models demonstrated "appropriate" internal reliability. Total omega was 0.91 for the Spanish-speaking sample and 0.89 for the Portuguese-speaking sample. The CFA of both questionnaires showed an appropriate fit for a three-factor model (Portuguese: CFI = 0.927; TLI = 0.913; RMSEA = 0.066; Spanish: CFI = 0.945; TLI = 0.935; RMSEA = 0.068). CONCLUSION: The Latin-American versions of the MICA v4 in Spanish and Brazilian Portuguese have appropriate psychometric properties, good internal consistency, and are applicable to and acceptable in the Latin-American context. The instrument proved its validity for collecting data on stigmatizing attitudes among health professionals in different contexts and cultures.

Adaptation to Brazilian Portuguese and Latin-American Spanish and psychometric properties of the Mental Illness Clinicians' Attitudes Scale (MICA v4)

Abstract Objective To describe translation to Spanish and Portuguese and adaptation of the Mental Illness Clinicians' Attitudes Scale version 4 (MICA v4). Methods The questionnaire was administered to primary care physicians (PCPs) from four Latin-American countries, Brazil, Bolivia, Chile, and Cuba. The validation process included four phases: 1) translation of the questionnaire to Spanish and Portuguese; 2) assessment of face validity; 3) assessment of reliability; and 4) evaluation of construct validity with confirmatory factor analysis (CFA). Results The study sample comprised 427 PCPs. The mean age of the Spanish-speaking sample (n = 252) was 40.1 (S.D = 9.7) years and the mean age of the Portuguese-speaking sample (n = 150) was 40.2 (S.D = 10.9) years. Both models demonstrated "appropriate" internal reliability. Total omega was 0.91 for the Spanish-speaking sample and 0.89 for the Portuguese-speaking sample. The CFA of both questionnaires showed an appropriate fit for a three-factor model (Portuguese: CFI = 0.927; TLI = 0.913; RMSEA = 0.066; Spanish: CFI = 0.945; TLI = 0.935; RMSEA = 0.068). Conclusion The Latin-American versions of the MICA v4 in Spanish and Brazilian Portuguese have appropriate psychometric properties, good internal consistency, and are applicable to and acceptable in the Latin-American context. The instrument proved its validity for collecting data on stigmatizing attitudes among health professionals in different contexts and cultures.

Management of common mental disorders should take place in primary health or specialized care? Clinical decisions of psychiatrists from Latin American countries.

OBJECTIVE: The objective of our study was to explore clinical decisions of psychiatrists regarding the management of common mental disorders in primary care (PC) in four Latin Americans countries, through the application of clinical vignettes. METHODS: Using a cross-sectional design, we conducted a self-administered online questionnaire survey of psychiatrists from Bolivia, Brazil, Cuba, and Chile. The questionnaire covered sociodemographic and professional information. The psychiatrists' clinical decisions were assessed through three clinical vignettes representing typical PC cases of depression, anxiety, and somatization. RESULTS: 230 psychiatrists completed the online survey. Psychiatrists from Brazil were less likely to recognize depression as a mental disorder than those from Cuba (odds ratio (OR) = 0.30, 95% confidence interval (CI), 0.10 to 0.91, p < 0.04). Female gender (OR = 0.19, 95% CI, 0.04 to 0.91, p < 0.02) and older age (OR = 0.92, 95% CI, 0.87 to 0.97, p < 0.01) reduced the likelihood of agreement that depression cases should be treated by a Primary Care Physician (PCP). In the somatoform symptoms vignette, longer training duration increased the likelihood of agreement that treatment should be done by a psychiatrist instead of a PCP (OR = 1.19, 95% CI, 1.04 to 1.37, p < 0.01). In the anxiety vignette, females (OR = 2.38, 95% CI, 1.10 to 5.13, p < 0.01) and participants from Bolivia (compared with Cubans, OR = 4.19, 95% CI, 1.22 to 14.42, p < 0.02) were more likely to consider that these patients should be treated by a psychiatrist instead of a PCP. DISCUSSION: Most psychiatrist respondents agreed that patients with depression should be treated by PCPs and that somatoform and anxiety cases should be treated by psychiatrists. These results show that psychiatrists consider that they, and not PCPs, should treat patients with common mental disorders, regardless of the evidence showing that common mental disorders can be treated by primary care physicians in PC.

Evaluation of JC9450 and Neutral Electrolyzed Water in Controlling Listeria monocytogenes on Fresh Apples and Preventing Cross-Contamination.

Recent multistate outbreaks and recalls of fresh apples due to Listeria monocytogenes contamination have increased consumer concerns regarding fresh and processed apple safety. This study aimed to evaluate the antimicrobial efficacy of two sanitizers, mineral oxychloride (JC9450) and neutral electrolyzed water (NEW), for inactivation of L. monocytogenes on fresh apples. A 2-min treatment of 0.125% (v/v) JC9450 with 100 ppm free available chlorine (FAC) or NEW with 110 ppm FAC caused 0.9-1.2 log10 CFU/apple reduction of L. monocytogenes on both Granny Smith and Fuji apples 24 h post-inoculation. Increasing JC9450 concentration to 0.25 and 0.50% significantly improved its bactericidal effect and reduced L. monocytogenes on Granny Smith apples by ~2.0 and 3.8 log10 CFU/apple, respectively, after a contact time of 2 min. At a shorter contact time of 30 sec, the inactivation efficacy of chlorine and 0.25-0.50% JC9450 against L. monocytogenes on apples was significantly reduced compared with the respective 2-min wash. Furthermore, no L. monocytogenes was recovered in deionized water prepared antimicrobial wash solution or on non-inoculated apples post-NEW with 110 ppm FAC or 0.125-0.5% JC9450 washes, indicating their ability to prevent cross-contamination. In addition, a 2-min exposure to NEW with 110 ppm FAC and 0.50% JC9450 reduced apple native microbiota including total plate count by 0.14 and 0.65 log10 CFU/apple, respectively, and yeast and mold counts by 0.55 and 1.63 log10 CFU/apple, respectively. In summary, L. monocytogenes attached on apples was difficult to eliminate. JC9450 and NEW demonstrated a dose-dependent reduction in L. monocytogenes on apples and successfully prevented cross-contamination, indicating their application potential in post-harvest washes of apples.

Adenocarcinoma de trompa de falopio: presentación de un caso / Fallopian tube adenocarcinoma: presentation of one case

Informar de un caso clínico quirúrgico infrecuente. Descripción del hallazgo de un adenocarcinoma de la trompa de Falopio en una paciente de 75 años, quien consultó por sangrado genital. Estudios pre operatorios sugerían tumor de ovario izquierdo. Hospital "Miguel Pérez Carreño", Servicio de Cirugía II. Durante el acto quirúrgico se encontró un tumor en la trompa izquierda cuya histopatología fue concordante con adenocarcinoma. Hubo de ser reintervenida para estadificación. Los cánceres primarios de las trompas de Falopio son los menos frecuentes del aparato genital femenino y se han relacionado con inflamación tubárica precedente. Generalmente se presentan como masas pélvicas y hemorragia genital en posmenopaúsicas