Streptococcus mutans and Actinomyces naeslundii Interaction in Dual-Species Biofilm.

The study of bacterial interaction between Streptococcus mutans and Actinomyces naeslundii may disclose important features of biofilm interspecies relationships. The aim of this study was to characterize-with an emphasis on biofilm formation and composition and metabolic activity-single- and dual-species biofilms of S. mutans or A. naeslundii, and to use a drip flow reactor (DFR) to evaluate biofilm stress responses to 0.2% chlorhexidine diacetate (CHX). Single- and dual-species biofilms were grown for 24 h. The following factors were evaluated: cell viability, biomass and total proteins in the extracellular matrix, 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide-"XTT"-reduction and lactic acid production. To evaluate stress response, biofilms were grown in DFR. Biofilms were treated with CHX or 0.9% sodium chloride (NaCl; control). Biofilms were plated for viability assessment. Confocal laser-scanning microscopy (CLSM) was also performed. Data analysis was carried out at 5% significance level. S. mutans viability and lactic acid production in dual-species biofilms were significantly reduced. S. mutans showed a higher resistance to CHX in dual-species biofilms. Total protein content, biomass and XTT reduction showed no significant differences between single- and dual-species biofilms. CLSM images showed the formation of large clusters in dual-species biofilms. In conclusion, dual-species biofilms reduced S. mutans viability and lactic acid production and increased S. mutans' resistance to chlorhexidine.

Pain catastrophizing: rumination is a discriminating factor among individuals with different pain characteristic.

The objective of this study was to compare the scores of the Helplessness, Magnification, Rumination, and Catastrophizing factors of the Pain Catastrophizing Scale (PCS) between samples with different pain characteristics. The psychometric properties of the PCS were evaluated in 1,151 Brazilian adults (78.9% female; 38.6 (SD = 10.8) years): 335 had no pain, 390 had been in pain for less than 3 months, 250 had been in recurring pain for more than 3 months, and 176 had been in continuous pain for more than 3 months. Confirmatory factor analysis (CFA) was conducted to verify the fit of the PCS models. Convergent validity and reliability were evaluated. Multi-group analysis was used to estimate the invariance of the factorial model. The global score for the PCS factors was obtained using the regression weight matrix for estimating factor scores from CFA. Analysis of variance was used to compare scores between samples. After excluding three items, the tri-factorial model showed adequate fit. The model parameters were invariant (Δχ2(λ,i,ß,Res); p≥0.05). Individuals experiencing pain showed higher scores for catastrophic thoughts. Individuals with pain for less than 3 months had the highest scores for Rumination (p < 0.001). The PCS showed valid, reliable, and invariant results for the sample of Brazilian adults in no pain or with different pain conditions. The PCS adequately discriminated individuals in pain from those without pain. Among those in pain, Rumination was the only discriminating factor.

Brief Pain Inventory: A proposal to extend its clinical application.

BACKGROUND: This study presents an adaptation of the Brief Pain Inventory (BPI) extending its use in clinical/epidemiological contexts and the evaluation of the properties of BPI (short form) in a sample of Brazilian adults. METHODS: Part of item 1 of this instrument was removed because it prevented the participation of individuals with usual pain. In addition to the reference period of original response "last 24 hr," a new period "last pain experience" was proposed. Individuals responded about the presence/lack and onset of pain. Individuals who reported pain in the last 24 hr before the interview answered the BPI considering both reference periods. Confirmatory factor analysis was performed to check the fit of five theoretical BPI models. RESULTS: A total of 1,176 adults participated (79.0% women; 38.7 (SD = 10.8) years), 29.2% did not report pain in the last 24 hr, 33.6% reported pain <3 months and 37.2% pain ≥3 months. All theoretical BPI models presented adequate fit indices (GFI ≥ 0.9; RMSEA < 0.1; α ≥ 0.7) when both reference periods were used. In conclusion, the adaptations proposed can contribute to extend the use of BPI. CONCLUSIONS: The reference period of responses and the theoretical model used must be chosen according to the needs of the researcher and/or physician. SIGNIFICANCE: This study presents evidence related to the validity of applying the Brief Pain Inventory (BPI) in adults with and without pain considering the present pain or memory of pain, enabling the clinician to collect additional information that may be relevant to the clinical management of pain.

Locus of control among individuals with different pain conditions.

The objective of this study was to evaluate the psychometric properties of the Multidimensional Health Locus of Control - Form C (MHLC-C) scale applied to a sample of adult Brazilian patients with different pain conditions. The scores were then identified and compared on each of the subscales and profiles regarding locus of control. The sample consisted of 1,149 adult individuals (79% women; mean age: 36.6 years) of which 334 reported not feeling pain in the prior 24 hours, 386 reported pain in the prior three months, 250 reported recurring pain for the prior three months or longer, and 179 reported continuous pain for the prior three months or longer. A confirmatory factor analysis was performed. The invariance of the MHLC-C was tested on independent samples. The weighted global score was calculated for each of the factors and tested using ANOVA (α = 5%). Individuals were classified according to the eight health locus of control (HLC) profiles. The factors fit the data adequately after the model was refined. A higher score for the Health Professionals HLC was found among individuals reporting less than three months of pain. The "believer in control" profile was the most prevalent among the groups, while the least prevalent profile was the "pure chance" profile. The MHLC-C was found to be valid and reliable for assessing locus of control among people with different pain conditions. Only the Health Professionals HLC factor exhibited significantly different results for these individuals. The "believer in control" profile was the most prevalent among the pain conditions considered.

Psychometric properties of the World Health Organization Quality of Life Instrument-Abbreviated version in Portuguese-speaking adults from three different countries.

OBJECTIVE: To evaluate the validity, reliability and invariance of the World Health Organization Quality of Life Instrument-Abbreviated version (WHOQOL-Bref) in Portuguese-speaking adults from three different countries. METHODS: A total of 4,020 Brazilian, Portuguese, and Mozambican individuals participated in the study. The total sample was divided into four samples: Brazilian patients (n = 1,120), Brazilian students (n = 1,398), Portuguese students (n = 1,165) and Mozambican students (n = 337). Factorial validity of the WHOQOL-Bref was assessed by confirmatory factor analysis. The convergent and discriminant validities of the instrument were assessed using the average variance extracted (AVE) and the square of Pearson's correlational coefficient (r2), respectively. Composite reliability and ordinal alpha were used as measures of reliability. The metric, scalar, and strict invariance of WHOQOL-Bref was evaluated by multi-group analysis in independent subsamples (within each sample) and only between Brazil and Portugal (transnational invariance), because the configural model of Mozambique was different. RESULTS: The original model of the WHOQOL-Bref did not show a good fit for the samples. Different items were excluded to fit the instrument in each sample (different models for WHOQOL-Bref among Brazilian, Portuguese, and Mozambican samples). AVE and r2 were not adequate; however, the reliability of the WHOQOL-Bref was good, except in the Mozambican sample. Invariance was observed only in independent subsamples. CONCLUSION: The WHOQOL-Bref fitted models showed adequate factorial validity and invariance in independent subsamples. The transnational non-invariance of the WHOQOL-Bref shows the influence of culture on the operationalization of the quality of life construct.

Psychometric properties of the World Health Organization Quality of Life Instrument-Abbreviated version in Portuguese-speaking adults from three different countries / Propriedades psicométricas do Instrumento de Qualidade de Vida da Organização Mundial de Saúde - Versão Abreviada em adultos falantes de língua portuguesa de três países diferentes

Abstract Objective: To evaluate the validity, reliability and invariance of the World Health Organization Quality of Life Instrument-Abbreviated version (WHOQOL-Bref) in Portuguese-speaking adults from three different countries. Methods: A total of 4,020 Brazilian, Portuguese, and Mozambican individuals participated in the study. The total sample was divided into four samples: Brazilian patients (n = 1,120), Brazilian students (n = 1,398), Portuguese students (n = 1,165) and Mozambican students (n = 337). Factorial validity of the WHOQOL-Bref was assessed by confirmatory factor analysis. The convergent and discriminant validities of the instrument were assessed using the average variance extracted (AVE) and the square of Pearson's correlational coefficient (r2), respectively. Composite reliability and ordinal alpha were used as measures of reliability. The metric, scalar, and strict invariance of WHOQOL-Bref was evaluated by multi-group analysis in independent subsamples (within each sample) and only between Brazil and Portugal (transnational invariance), because the configural model of Mozambique was different. Results: The original model of the WHOQOL-Bref did not show a good fit for the samples. Different items were excluded to fit the instrument in each sample (different models for WHOQOL-Bref among Brazilian, Portuguese, and Mozambican samples). AVE and r2 were not adequate; however, the reliability of the WHOQOL-Bref was good, except in the Mozambican sample. Invariance was observed only in independent subsamples. Conclusion: The WHOQOL-Bref fitted models showed adequate factorial validity and invariance in independent subsamples. The transnational non-invariance of the WHOQOL-Bref shows the influence of culture on the operationalization of the quality of life construct.

Resumo Objetivo: Avaliar a validade, a confiabilidade e a invariância do World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) em adultos de três diferentes países de língua portuguesa. Métodos: Um total de 4.020 indivíduos brasileiros, portugueses e moçambicanos participaram do estudo. A amostra total foi dividida em quatro amostras: pacientes brasileiros (n = 1.120), estudantes brasileiros (n = 1.398), estudantes portugueses (n = 1.165) e estudantes moçambicanos (n = 337). A validade fatorial do WHOQOL-Bref foi avaliada por meio de análise fatorial confirmatória. As validades convergente e discriminante do instrumento foram avaliadas utilizando a variância média extraída (VEM) e o quadrado do coeficiente de correlação de Pearson (r2), respectivamente. A confiabilidade composta e o coeficiente alfa ordinal foram utilizados como medidas de confiabilidade. As invariâncias métrica, escalar e estrita do WHOQOL-Bref foram avaliadas por análise multi-grupos em subamostras independentes (dentro de cada amostra) e somente entre Brasil e Portugal (transnacional), porque o modelo configuracional de Moçambique era diferente. Resultados: O modelo original do WHOQOL-Bref não apresentou bom ajustamento para as amostras. Diferentes itens foram excluídos para ajustar o instrumento em cada amostra (modelos diferentes para o WHOQOL-Bref entre amostras brasileiras, portuguesas e moçambicanas). A VEM e o r2 não foram adequados; entretanto, a confiabilidade do WHOQOL-Bref foi boa, exceto na amostra moçambicana. A invariância foi encontrada apenas em subamostras independentes. Conclusão: Os modelos ajustados do WHOQOL-Bref apresentaram adequada validade fatorial e invariância em subamostras independentes. A não invariância transnacional do WHOQOL-Bref revela a influência da cultura na operacionalização do construto qualidade de vida.

Pain self-efficacy questionnaire and its use in samples with different pain duration time / Questionário de autoeficácia relacionado à dor e seu uso em amostra com diferentes durações de ocorrência de dor

ABSTRACT BACKGROUND AND OBJECTIVES: The pain self-efficacy questionnaire has been frequently used in several languages, but its use is limited to chronic pain. This study aimed to i) evaluate the properties of the pain self-efficacy questionnaire among Brazilians with different durations of pain occurrence; ii) present a new proposal for estimation of the overall self-efficacy belief score; and iii) compare such score among different pain duration time. METHODS: A total of 1,155 adults (79.0% women; 38.6±10.8 years) participated, 337 had no pain, 386 reported pain for less than 3 months, 253 reported pain for more than 3 months with a recurrent pattern, and 179 reported continuous pain for more than 3 months. The confirmatory factor analysis was performed to check the pain self-efficacy questionnaire unifactorial model good-fit. The pain self-efficacy questionnaire invariance was tested in independent samples using multigroup analysis. We proposed the calculation of the self-efficacy belief score from the factor score obtained in the confirmatory factor analysis. The score was compared among groups (ANOVA, alpha=5%). RESULTS: After inserting four correlations between errors of items, the pain self-efficacy questionnaire model shows to be fit to the sample (X2/df=7.059; CFI=0.978; GFI=0.964; RMSEA=0.072). The model was invariant between independent samples. Lower self-efficacy belief was found among participants with pain for less than three months (p<0.05). CONCLUSION: There is evidence of a relationship between the self-efficacy belief and the pain characteristics, where the presence of pain and length of time living with pain might be important factors in the study of the concepts involved in the perceptions of pain and self-efficacy.

RESUMO JUSTIFICATIVA E OBJETIVOS: A utilização do questionário de autoeficácia relacionado à dor tem sido frequente, porém, limitada ao contexto da dor crônica. Os objetivos deste estudo foram: i) avaliar as propriedades psicométricas do questionário de autoeficácia relacionado à dor para amostra de indivíduos brasileiros com diferentes durações da ocorrência de dor, ii) apresentar uma nova proposta de estimativa do escore global da crença de autoeficácia e iii) comparar esse escore entre grupos com diferentes durações de dor. MÉTODOS: Participaram 1.155 adultos (79,0% mulheres; 38,6±10,8 anos). Do total, 337 não apresentavam dor, 386 relataram dor há menos de 3 meses, 253 relataram dor recorrente há mais de 3 meses e 179, dor contínua há mais de 3 meses. Realizou-se análise fatorial confirmatória para verificar o ajustamento do modelo do Questionário de Autoeficácia relacionado à Dor. A invariância do questionário de autoeficácia relacionado à dor foi testada utilizando análise multigrupos. Foi proposto cômputo do escore global da crença de autoeficácia a partir da matriz dos pesos de regressão da análise fatorial confirmatória. O escore de autoeficácia foi comparado entre grupos (ANOVA, alfa=5%). RESULTADOS: Após inserção de quatro correlações entre os erros dos itens, o modelo do questionário de autoeficácia relacionado à dor apresentou ajustamento adequado à amostra (X2/gl=7,059; CFI=0,978; GFI=0,964; RMSEA=0,072). O modelo foi invariante entre as amostras independentes. Menor escore de crença de autoeficácia foi encontrado entre os participantes com dor presente há menos de 3 meses (p<0,05). CONCLUSÃO: Há evidências da relação entre a crença de autoeficácia e as características da condição dolorosa, o que permite discussões acerca das conceituações teóricas envolvidas na percepção da dor e autoeficácia dos indivíduos.

Locus of control among individuals with different pain conditions

Abstract: The objective of this study was to evaluate the psychometric properties of the Multidimensional Health Locus of Control - Form C (MHLC-C) scale applied to a sample of adult Brazilian patients with different pain conditions. The scores were then identified and compared on each of the subscales and profiles regarding locus of control. The sample consisted of 1,149 adult individuals (79% women; mean age: 36.6 years) of which 334 reported not feeling pain in the prior 24 hours, 386 reported pain in the prior three months, 250 reported recurring pain for the prior three months or longer, and 179 reported continuous pain for the prior three months or longer. A confirmatory factor analysis was performed. The invariance of the MHLC-C was tested on independent samples. The weighted global score was calculated for each of the factors and tested using ANOVA (α = 5%). Individuals were classified according to the eight health locus of control (HLC) profiles. The factors fit the data adequately after the model was refined. A higher score for the Health Professionals HLC was found among individuals reporting less than three months of pain. The "believer in control" profile was the most prevalent among the groups, while the least prevalent profile was the "pure chance" profile. The MHLC-C was found to be valid and reliable for assessing locus of control among people with different pain conditions. Only the Health Professionals HLC factor exhibited significantly different results for these individuals. The "believer in control" profile was the most prevalent among the pain conditions considered.

Validation and Invariance of the Dental Anxiety Scale in a Brazilian sample.

The aim of this study was to evaluate the properties of the Dental Anxiety Scale (DAS) when applied to Brazilian adults and to test its invariance across independent samples and different sociodemographic groups. Sociodemographic data, reports on previous unpleasant dental experiences and DAS responses were collected through telephone interviews. Metric properties of the one and two-factor models were evaluated using confirmatory factor analysis. The analysis included the chi-square ratio divided by degrees of freedom (χ2/df), the comparative fit index (CFI), the goodness of fit index (GFI) and the root mean square error of approximation (RMSEA). Convergent validity was evaluated using the average variance extracted (AVE). Cronbach's alpha (α) and composite reliability (CR) were calculated. In the two-factor model, discriminant validity was evaluated. The invariance of the models was evaluated using a multigroup analysis of the independent samples (pΔχ2λ, pΔχ2 i and pΔχ2 Res ≥ 0.05). Telephone interviews were held with 350 individuals (74.3% women). Of the participants, 135 (38.6%) had previous unpleasant dental experiences, and 117 (33.4%) knew someone who had had this type of experience. The one- and two-factor model (χ2/df < 2.0; CFI,GFI > 0.90; RMSEA < 0.10; AVE > 0.50; α,CR > 0.70) were adjusted to the data. Discriminant validity was limited (ρ2 = 0.66). Both models presented strong invariance across independent samples, but the invariance was weak (pΔχ2i < 0.05) when samples were defined by socioeconomic variables. In conclusion, both DAS models were valid and reliable when applied to a sample of Brazilian adults. However, the weak invariance of the models suggests that sample characteristics interfered with the measurement of dental anxiety.

Occupational characteristics and Burnout Syndrome in Brazilian correctional staff.

BACKGROUND: In the correctional context, occupational characteristics may contribute to the development of burnout. OBJECTIVE: To compare the scores of Emotional Exhaustion (EE), Cynicism (CY) and Professional Efficacy (PE) of staff members according to occupational variables in two correctional facilities (CF1 and CF2). METHODS: 339 Brazilian employees from two correctional facilities completed a socio-demographic/occupational questionnaire and the Maslach Burnout Inventory-General Survey (MBI-GS). The comparison between the scores obtained on each MBI-GS factor, according to variables of interest vs. correctional facilities, was performed using analysis of variance (ANOVA-two way: p < 0.05). RESULTS: Statistically significant differences were observed between the levels of EE, CY and PE between the correctional facilities (p < 0.001); staff from CF2 presented worse levels. Women (p = 0.014) and individuals with a 10-year tenure or higher (p = 0.041) presented higher levels of EE. Lower scores of professional efficacy were found in CF2 staff members with a 10-year tenure or higher (p = 0.018). The prison escort and surveillance agents presented mean values of EE (p = 0.030) and CY (p = 0.008) that were significantly lower than those of the correctional security officers. CONCLUSIONS: The scores of EE, CY and PE of the staff members suffered a significant influence from the correctional facility, gender, professional category and tenure.

Burnout Syndrome and alcohol consumption in prison employees.

OBJECTIVE: The aims of this study were to estimate the association between an at-risk drinking pattern and sociodemographic variables, and to compare the mean scores of the factors associated with the Burnout Syndrome, according to the alcohol consumption pattern in staff members from two Brazilian prisons. METHODS: A cross-sectional study was developed with 339 participants (response rate = 63.8%). The instruments used were a sociodemographic questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the Maslach Burnout Inventory - General Survey (MBI-GS). RESULTS: The participants' average age was 40.2 (SD = 8.8) years, and 81.0% were male. Among 78.5% of participants (95%CI 74.1 - 82.8) reported consuming alcoholic beverages. The prevalence of at-risk drinking behavior in the sample was 22.4% (95%CI 18.0 - 26.9), and of the Burnout Syndrome was 14.6% (95%CI 10.8 - 18.4). We observed a significant association between at-risk drinking behavior with gender, higher risk for men (OR = 7.32, p < 0.001), smoking, increased risk for smokers (OR = 2.77, p < 0.001), and religious practice, showing lower risks for religion practitioners (OR = 0.364, p < 0.001). We noticed significantly higher mean scores (p < 0.001) of emotional exhaustion and cynicism, and lower scores of professional achievement among individuals who reported consuming alcoholic beverages. CONCLUSION: Men who smoke were more likely to develop an at-risk drinking pattern, while religion is presented as a protective factor. Individuals who consume alcohol were more affected by the different factors of the Burnout Syndrome.

Burnout Syndrome and alcohol consumption in prison employees / Síndrome de Burnout e consumo de álcool em agentes penitenciários

ABSTRACT: Objective: The aims of this study were to estimate the association between an at-risk drinking pattern and sociodemographic variables, and to compare the mean scores of the factors associated with the Burnout Syndrome, according to the alcohol consumption pattern in staff members from two Brazilian prisons. Methods: A cross-sectional study was developed with 339 participants (response rate = 63.8%). The instruments used were a sociodemographic questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the Maslach Burnout Inventory - General Survey (MBI-GS). Results: The participants' average age was 40.2 (SD = 8.8) years, and 81.0% were male. Among 78.5% of participants (95%CI 74.1 - 82.8) reported consuming alcoholic beverages. The prevalence of at-risk drinking behavior in the sample was 22.4% (95%CI 18.0 - 26.9), and of the Burnout Syndrome was 14.6% (95%CI 10.8 - 18.4). We observed a significant association between at-risk drinking behavior with gender, higher risk for men (OR = 7.32, p < 0.001), smoking, increased risk for smokers (OR = 2.77, p < 0.001), and religious practice, showing lower risks for religion practitioners (OR = 0.364, p < 0.001). We noticed significantly higher mean scores (p < 0.001) of emotional exhaustion and cynicism, and lower scores of professional achievement among individuals who reported consuming alcoholic beverages. Conclusion: Men who smoke were more likely to develop an at-risk drinking pattern, while religion is presented as a protective factor. Individuals who consume alcohol were more affected by the different factors of the Burnout Syndrome.

RESUMO: Objetivo: Estimar a associação entre o padrão de beber com risco e as variáveis sociodemográficas, e comparar os escores médios dos fatores relacionados com a Síndrome de Burnout , de acordo com o padrão do consumo de álcool em funcionários de duas prisões brasileiras. Métodos: Trata-se de um estudo transversal, desenvolvido com 339 participantes (taxa de resposta de 63,8%). Os instrumentos utilizados foram um questionário sociodemográfico, o Teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT) e o Inventário de Burnout de Maslach - Forma Geral (MBI-GS). Resultados: A média de idade dos participantes foi de 40,2 (DP = 8,8) anos, e 81,1% eram do sexo masculino. Um total de 78,5% dos participantes (IC95% 74,1 - 82,8) relatou consumir bebidas alcoólicas. A prevalência do comportamento de beber com risco na amostra foi de 22,4% (IC95% 18,0 - 26,9) e a da Síndrome de Burnout foi de 14,6% (IC95% 10,8 - 18,4). Observou-se associação significativa entre o comportamento de beber com risco com o gênero, o maior risco para os homens (OR = 7,32, p < 0,001), o tabagismo, risco aumentado para os fumantes (OR = 2,77, p < 0,001) e a prática religiosa, mostrando menor risco para os praticantes de religião (OR = 0,364, p < 0,001). Notaram-se escores médios (p < 0,001) mais altos de exaustão emocional e cinismo, e menor pontuação de eficácia profissional entre os indivíduos que relataram consumir bebidas alcoólicas. Conclusão: Homens fumantes foram os mais propensos a desenvolverem um padrão de beber com risco, enquanto a religião é apresentada como um fator protetor. Os indivíduos que consomem álcool foram os mais afetados pelos diferentes fatores da Síndrome de Burnout .

Validation and Invariance of the Dental Anxiety Scale in a Brazilian sample

Abstract: The aim of this study was to evaluate the properties of the Dental Anxiety Scale (DAS) when applied to Brazilian adults and to test its invariance across independent samples and different sociodemographic groups. Sociodemographic data, reports on previous unpleasant dental experiences and DAS responses were collected through telephone interviews. Metric properties of the one and two-factor models were evaluated using confirmatory factor analysis. The analysis included the chi-square ratio divided by degrees of freedom (χ2/df), the comparative fit index (CFI), the goodness of fit index (GFI) and the root mean square error of approximation (RMSEA). Convergent validity was evaluated using the average variance extracted (AVE). Cronbach's alpha (α) and composite reliability (CR) were calculated. In the two-factor model, discriminant validity was evaluated. The invariance of the models was evaluated using a multigroup analysis of the independent samples (pΔχ2λ, pΔχ2 i and pΔχ2 Res ≥ 0.05). Telephone interviews were held with 350 individuals (74.3% women). Of the participants, 135 (38.6%) had previous unpleasant dental experiences, and 117 (33.4%) knew someone who had had this type of experience. The one- and two-factor model (χ2/df < 2.0; CFI,GFI > 0.90; RMSEA < 0.10; AVE > 0.50; α,CR > 0.70) were adjusted to the data. Discriminant validity was limited (ρ2 = 0.66). Both models presented strong invariance across independent samples, but the invariance was weak (pΔχ2i < 0.05) when samples were defined by socioeconomic variables. In conclusion, both DAS models were valid and reliable when applied to a sample of Brazilian adults. However, the weak invariance of the models suggests that sample characteristics interfered with the measurement of dental anxiety.

Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index.

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (a).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (c2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (a = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

Epidemiology of severity of temporomandibular disorders in Brazilian women.

AIMS: To evaluate the severity of temporomandibular disorders (TMD) of women in the municipality of Araraquara (Brazil) as well as the contribution of the perception of oral health, mandibular functional limitation, and sociodemographic variables on the severity of TMD. METHODS: The participants were interviewed by telephone. Information regarding age, marital status, economic level, education, and use and type of dental prostheses was surveyed. To evaluate TMD severity, mandibular functional limitation and perception of oral health, Fonseca's Anamnesic Index (IAF), the Mandibular Function Impairment Questionnaire (MFIQ), and the General Oral Health Assessment Index (GOHAI) were used. To evaluate the contribution of these variables on TMD severity, a structural equation model (SEM) was fitted to the data and assessed by usual goodness-of- fit indices. RESULTS: A total of 701 women with a mean age of 44.36 years (SD = 16.31) participated. According to the IAF, 59.6% (95% confidence interval = 56.0%-63.2%) of the women were classified as having TMD, of which 63.9% presented light, 26.8% moderate, and 9.3% severe TMD. Mandibular functional limitation was low in 91.0% of the women, moderate in 7.1%, and severe in 1.9%. Goodness-of-fit for the structural model was adequate. The predictors explained 43% of the variation in the TMD severity, with significant contributions of the variables dental prostheses (ß = -.008; P = .006), perception of oral health (ß = -.43; P < .001), and mandibular functional limitation (ß = .014; P = 014). CONCLUSION: The severity of TMD among Brazilian women was greater in nonusers of dental prostheses and was also associated with greater mandibular functional limitation and poor perception of oral health.

Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

Fatores de risco para a disfunção temporomandibular em adolescentes: estudo caso-controle / Risk factors for temporomandibular disorder in adolescents: case-control study

A prevalência de Disfunção Temporomandibular (DTM) em adolescentes tem sido tão frequente quanto em adultos. O objetivo deste estudo foi avaliar possíveis fatores de risco envolvidos na DTM dolorosa em adolescentes de Araraquara. Participaram 100 adolescentes com média de idade de 13,73±0,72 anos, 48 com DTM dolorosa e 52 sem DTM. Os grupos foram pareados por gênero e idade. Foram coletados dados sociodemográficos, clínicos e comportamentais: DTM (Eixo I do Critério de Diagnóstico para Pesquisa das Disfunções Temporomandibulares - RDC/TMD), sobrepeso/obesidade (IMC-z), dor no corpo (Questionário Nórdico para Sintomas Osteomusculares), hábitos parafuncionais orais, prática de atividade física e autoestima (Escala de Autoestima de Rosenberg - SES). Foi realizada também a validação da SES por meio da Análise Fatorial Confirmatória. Estatística descritiva e o estudo de associação, utilizando o teste qui-quadrado com correção de Yates (X2) e o t-Student, foram realizados adotando-se nível de significância de 5%. Foi elaborado modelo de regressão logística múltipla e calculado a Razão de Chances (OR) com intervalo de 95% de confiança para estimar a probabilidade do indivíduo apresentar DTM dolorosa. Considerando a validação da SES, após a remoção de 5 itens a escala mostrou-se ajustada (X2/gl= 0,545; CFI=1,000; GFI=0,991; RMSEA=0,000). Entre os fatores estudados, o relato de apertamento diurno (OR=4,03(IC95%=2,381-20,191),ß =1,394, p=0,003) e a dor no pescoço (OR=6,93(IC95%=1,620-10,025), ß =1,936, p<0,001) apresentaram contribuição significativa para o desenvolvimento de DTM dolorosa. Portanto, adolescentes que relatam hábito parafuncional de apertar os dentes durante o dia e dor no pescoço possuem maior chance de apresentar DTM dolorosa.

The prevalence of signs and symptoms of Temporomandibular Disorder (TMD) in adolescents has been as frequent as in adults. The aim this study was evaluated potential risk factor enrolled with TMD in adolescents. Participated of this study 100 students with 13.73±0.72 years old, 48 painful TMD patients and 52 without TMD. These groups re matched by gender and age. To characterize the sample sociodemographic, clinical and behavioral information were raised: TMD (Research Diagnostic Criteria for TMD Axis I - RDC/TMD), nutritional status (BMI-z), body pain (Standardized Nordic Questionnaire), parafunctional oral habits, physical activity and self-esteem(Rosenberg Self-Esteem Scale - SES). The validity of the SES was conducted using the Confirmatory Factor Analysis. Descriptive statistics and study of the association using the chi-square (X2) and t-Student tests were carried out, adopting a significance level of 5%. Also it estimated odds ratio (OR) and prepared multiple logistic regression model to estimate the probability of developing painful TMD. After removed 5 items of SES, the scale was adjusted (X2/df= 0.545; CFI=1.000; GFI=0.991; RMSEA=0.000). Among the variables studied, the report of daytime clenching (ß =1.394, p=0.003) and neck pain (ß =1.936, p<0.001) showed significant contribution to the development of painful TMD. Therefore, adolescents who reported parafunctional habit of clenching of teeth during the day and neck pain have a higher chance of present painful TMD than those do not

Burnout in dental students: effectiveness of different methods / Síndrome de Burnout em estudantes de Odontologia: efetividade de diferentes métodos

Objetivo: Este estudo teve por objetivo estimar a efetividade de diferentes métodos de rastreamento da Síndrome de Burnout em estudantes de Odontologia. Material e Método: Utilizou-se o Inventário de Oldenburg (OLBI-SS) e o Inventário de Copenhagen (CBI-SS). Como padrão-ouro utilizou-se o Inventário de Burnout de Maslach (MBI-SS). As qualidades psicométricas dos instrumentos foram estimadas. O modelo hierárquico de segunda ordem foi estimado para cálculo do escore global do OLBI-SS e do CBI-SS. As curvas ROC foram construídas e as áreas estimadas (AUROC). Resultado: Participaram 235 estudantes de um curso de graduação. Os instrumentos apresentaram adequada confiabilidade e validade e para tanto, foi necessário remover três questões do OLBI-SS e uma do CBI-SS. Conclusão: Observou-se boa capacidade discriminante das dimensões Exaustão do OLBI-SS e BP e BRE do CBI-SS. O CBI-SS apresentou capacidade discriminante superior à do OLBI-SS na identificação da Síndrome de Burnout (DAUROC=.172 [.103-.240]; p<.05).

Objective: This study was proposed to estimate the effectiveness of different screening methods of the Burnout Syndrome among dental students. Material and Method: The Burnout Syndrome assessment was performed using the Oldenburg Inventory-Student survey (OLBI-SS) and the Copenhagen Inventory-Student survey (CBI-SS). The Maslach Burnout Inventory-Student survey (MBI-SS) was used as the gold standard. The psychometric properties of the instruments were measured. The second-order hierarchical model was estimated to calculate the overall scores for OLBI-SS and CBI-SS, and ROC curves were constructed and the areas were estimated (AUROC). Result: A total of 235 undergraduate students participated in this study. The instruments showed an adequate reliability and validity; however three questions had to be removed from OLBI-SS and one from CBI-SS. The Exhaustion dimension of OLBI-SS, and Personal Burnout and Study related Burnout of CBI-SS presented a good discriminating capacity. Conclusion: CBI-SS showed higher discriminating capacity, than OLBI-SS, to identify the Burnout Syndrome (DAUROC=.172 [.103-.240]; p<.05).

Burnout syndrome among dental students.

The burnout syndrome is characterized by professional exhaustion and has been reported in college students. The aim of this study was to estimate the prevalence of Burnout Syndrome among dentistry students from a public university, and its relationship to socio-demographic characteristics. All students (n = 300) were invited to participate. We used the Maslach Burnout Inventory-Student Version (MBI-SS). We carried out an analysis of the MBI-SS' psychometric properties. Multivariate Analysis of Variance (MANOVA) was performed, followed by Analysis of Variance (ANOVA) and Tukey's post-hoc tests to compare the mean scores of burnout dimensions. Of the 235 participants, 72.8% were women and the mean age was 21.0 ± 1.8 years. The MBI-SS was reliable and valid. Of the students, 17.0% had Burnout Syndrome. There was a significant relation between Burnout Syndrome and a student's performance during the course (F = 4.433, p < 0.001), medication intake because of studies (F = 7.721, p < 0.001), and the thought of dropping the course (F = 16.168, p < 0.001). The students most affected were those with poor performance, those who took medication because of studies, and those with thoughts of dropping the course. We concluded that the prevalence of the syndrome among dentistry students was high, with a significant relation between the syndrome and a student's academic performance, use of medication because of studies, and thoughts of dropping the course.

Síndrome de Burnout em graduandos de Odontologia / Burnout syndrome among dental students

A Síndrome de Burnout caracteriza-se por esgotamento profissional e tem sido relatada em estudantes universitários. O objetivo desse estudo foi estimar a prevalência da Síndrome de Burnout em estudantes de Odontologia de uma universidade pública e sua relação com características sociodemográficas. Todos os estudantes (n = 300) foram convidados a participar. Utilizou-se o Inventário de Burnout de Maslach - versão estudantes (MBI-SS). Realizou-se análise das propriedades psicométricas do MBI-SS. Para comparação entre os escores médios das dimensões do Burnout realizou-se Análise de Variância Multivariada (MANOVA) seguida de Análise de Variância (ANOVA) e testes post-hoc de Tukey. Dos 235 participantes, 72,8 por cento eram mulheres e a média de idade era de 21,0 ± 1,8 anos. O MBI-SS mostrou-se confiável e válido. Dos estudantes, 17,0 por cento apresentaram a Síndrome de Burnout. Verificou-se relação significativa entre a Síndrome de Burnout e o desempenho do estudante no curso (F = 4,433, p < 0,001), o consumo de medicação devido aos estudos (F = 7,721, p < 0,001) e o pensamento de desistir do curso (F = 16,168, p < 0,001). Foram mais acometidos aqueles com desempenho ruim no curso, que consomem medicações devido aos estudos e que já pensaram em desistir do curso. Conclui-se que a prevalência da Síndrome entre os estudantes de Odontologia foi alta, sendo significativa a relação entre a Síndrome e o desempenho do estudante no curso, o consumo de medicação devido aos estudos e o pensamento de desistir do curso.

The burnout syndrome is characterized by professional exhaustion and has been reported in college students. The aim of this study was to estimate the prevalence of Burnout Syndrome among dentistry students from a public university, and its relationship to socio-demographic characteristics. All students (n = 300) were invited to participate. We used the Maslach Burnout Inventory - Student Version (MBI-SS). We carried out an analysis of the MBI-SS' psychometric properties. Multivariate Analysis of Variance (MANOVA) was performed, followed by Analysis of Variance (ANOVA) and Tukey's post-hoc tests to compare the mean scores of burnout dimensions. Of the 235 participants, 72.8 percent were women and the mean age was 21.0 ± 1.8 years. The MBI-SS was reliable and valid. Of the students, 17.0 percent had Burnout Syndrome. There was a significant relation between Burnout Syndrome and a student's performance during the course (F = 4.433, p < 0.001), medication intake because of studies (F = 7.721, p < 0.001), and the thought of dropping the course (F = 16.168, p < 0.001). The students most affected were those with poor performance, those who took medication because of studies, and those with thoughts of dropping the course. We concluded that the prevalence of the syndrome among dentistry students was high, with a significant relation between the syndrome and a student's academic performance, use of medication because of studies, and thoughts of dropping the course.