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.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the factors that are most correlated with the levels of functional disability in patients with fibromyalgia. METHODS: This is a cross-sectional descriptive study in which 42 patients diagnosed with fibromyalgia according to the criteria of the American College of Rheumatology reported their status using the following questionnaires: the Beck Depression Inventory, the Perceived Stress Scale 14, the Revised Fibromyalgia Impact Questionnaire, the Visual Analog Pain Scale, and the Health Assessment Questionnaire. RESULTS: Moderate to severe levels of depression (Beck Depression Inventory: 22.35±10.39), moderate to severe functional disability (Health Assessment Questionnaire: 1.28±0.58), and high levels of stress (Perceived Stress Scale 14: 31.59±10.02) were found. The correlation adjusted by multiple regression as a function of the Health Assessment Questionnaire indicated a negligible to weak positive correlation with perceived stress (r=0.11), while a moderately strong positive correlation was observed with the Visual Analog Pain Scale (r=0.55). Regarding physical exercise, one of the pillars of the treatment, a moderate negative correlation was found with the Health Assessment Questionnaire (r=-0.4). CONCLUSION: The pain levels were moderately influenced by depression severity. The factors most linked to functional disability are due to the pain levels but not to the perception of stress.

Abstract: Ticks are blood-sucking arthropods that attach to human skin through oral devices causing diverse initial cutaneous manifestations, and may also transmit serious infectious diseases. In certain situations, the Health Teams (and especially dermatologists) may face difficulties in identifying the lesions and associating them to the parasites. To assist them in clinical diagnosis, we suggest a classification of the skin manifestations in primary lesions, which occur by the attachment the tick to the host (for toxicity and the anticoagulant substances in the saliva and/or marked inflammation by the penetration and permanence of the mouthparts) and secondary lesions that are manifestations of infections caused by rickettsia, bacteria, protozoa and fungi inoculated by the ticks.