Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory.

BACKGROUND: Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil. METHODS: A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372). RESULTS: Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns. CONCLUSIONS: IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.

How Brazilian Schoolchildren Identify, Classify, and Label Foods and Beverages-A Card Sorting Methodology.

This study examined how Brazilian schoolchildren identified, classified, and labeled foods and beverages. Semi-structured interviews were conducted with 133 schoolchildren aged 7 to 10 years old from a public school located in southern Brazil in 2015. A set of cards with pictures of 32 food and beverage items from the web-based Food Intake and Physical Activity of Schoolchildren tool (Web-CAAFE) were used. Participants identified each item, formed groups for them based on similarity, and assigned labels for those groups. Student's t-tests and analysis of variance (ANOVA) tests were used to verify the mean difference between the groups of items. K-means cluster analysis was applied to identify similar clusters. Schoolchildren made an average of 9.1 piles of foods and beverages that they thought were similar (±2.4) with 3.0 cards (±1.8) each. Five groups were identified: meats, snacks and pasta, sweets, milk and dairy products, and fruits and vegetables. The most frequently used nomenclature for labeling groups was taxonomic-professional (47.4%), followed by the specific food item name (16.4%), do not know/not sure (13.3%), and evaluative (health perception) (8.8%). The taxonomic-professional category could be applied to promote improvements in the identification process of food and beverage items by children in self-reported computerized dietary questionnaires.

COVID-19 pandemic accelerates the perception of digital transformation on real estate websites.

In early March, the newspapers reported the arrival of the Coronavirus in Brazil. The period of confinement directly affected our routines and transformed our consumption habits. Amidst the fear of contagion and uncertainty, people isolated themselves and postponed changes. Previous studies indicate that digital practices were accelerated after the onset of the COVID-19 pandemic, facilitating communication and improving the performance of various sectors of the economy. Thus, to better understand the behavior of Brazilian real estate market professionals in this period, the objective of this research was to verify whether the COVID-19 pandemic accelerated the process of perception of digitalization in real estate websites. To this end, five experts in the digital real estate market were interviewed, asked what are the main items that a quality real estate website should have to improve user experience. Based on the items selected by the experts, a questionnaire was developed and a question was constructed for each item. The questionnaire was sent online to 2144 realtors, asking about the importance of these items before and after the pandemic started. Using a 5-point Likert scale, and strict criteria for analysis, our survey yielded 423 valid responses. The results indicate that regardless of the groups analyzed, the hypotheses confirm that after the beginning of the COVID-19 pandemic, the perception of the importance of digital technology in Brazilian real estate websites was enhanced, increased. Managers took advantage of the pandemic and the availability of digital technology to offer specialized service to customers, thus creating a new competitive scenario. The tools associated with the visualization of the property and information such as '360°/Video Tour', 'Video Visit Broadcast', 'Chatbots' and 'FAQ List' had the greatest increase in perception.

Internal structure and classification of pelvic floor dysfunction distress by PFDI-20 total score.

PURPOSE: To evaluate the internal structure (structural validity and internal consistency) and propose a classification for the distress caused by the presence of pelvic floor dysfunction (PFD) symptoms based on the total score of the Pelvic Floor Distress Inventory (PFDI-20). METHODS: Cross-sectional study conducted with Brazilian women over 18 years of age. Exploratory and confirmatory factor analysis were performed with Parallel Analysis and to test three models to compare them with the Root Mean Square Error of Approximation (RMSEA) and Comparative Fit Index (CFI). Internal consistency was calculated using Cronbach's alpha. Partial credit model (PCM) was performed to classify the total score of the PFDI-20. RESULTS: Data from 237 women (49.62 ± 16.95 years) were analyzed. The one-dimensional structure had 43.74% of the explained variance with α = 0.929. The one-dimensional model was the most appropriate (CFI = 0.987 and RMSEA = 0.022). The total PFDI-20 score was classified as the absence of symptoms (score zero), symptoms with mild distress (1 to 15 points), symptoms with moderate distress (16 to 34 points), and symptoms with severe distress (35 to 40 points). CONCLUSION: The PFDI-20 has an one-dimensional structure and the distress caused by the presence of PFD symptoms can be classified as mild, moderate and severe. Health professionals and future studies can use our classification to facilitate the understanding of the patient's health status and to obtain other analyses on the severity of the distress of the symptoms of PFD.

There are limitations regarding the meaning of the total score of the Pelvic Floor Distress Inventory (PFDI-20) in clinical practice and scientific research. Thus, the aims of this study were to evaluate the internal structure (structural validity and internal consistency) and propose a classification for the distress caused by the presence of pelvic floor dysfunction (PFD) symptoms from the total score of PFDI-20. Cross-sectional study conducted with Brazilian women over 18 years of age. Data from 237 women (49.62 ± 16.95 years) were analyzed. The PFDI-20 has one-dimensional structure and the distress caused by the presence of PFD symptoms can be classified as mild, moderate and severe.

A new measure of health motivation influencing food choices and its association with food intakes and nutritional biomarkers in European adolescents.

OBJECTIVE: To develop a scale to assess health motivation influencing food choices and to explore its performance in the associations with food intakes and nutritional biomarkers. DESIGN: Psychometric study using cross-sectional self-report questionnaires and nutritional biomarkers. SETTING: Multi-centre investigation conducted in ten European cities. PARTICIPANTS: 2954 adolescents who were included in the HELENA study and completed the Food Choices and Preferences (FCP) questionnaire. RESULTS: Nineteen out of 124 items of the FCP questionnaire were in the same dimension. Sixteen presented adequate parameters for the Scale of evaluatiOn of Food choIcEs (SOFIE). The scores were positively associated with the intakes of cereals, dairy products, meats and eggs, and fish, as well as with blood concentrations of vitamin C, ß-carotene, n-3 fatty acids, cobalamin, holo-transcobalamin and folate; scores were negatively associated with the intake of alcohol. CONCLUSIONS: SOFIE can improve the assessment of motivation influencing food choices based on items with the best performance and is proposed as a new measure to health-related studies.

Shift work and sex are variants across Karolinska Sleep Questionnaire and the application of linking analysis as a step forward using Item Response Theory.

The frequency of sleep disturbances is considerably higher in the night and shift workers and in females than in day workers and males, respectively. However, a subjective sleep scale must be invariant across these groups, independently of the level of their members on the scale. This study is aimed to test the invariance of the Karolinska Sleep Questionnaire's (KSQ) items by shift work and sex. We used the data from a census that covered more than 90% (N = 1648) of the nurses from the main institute of the largest public hospital complex of Brazil. Firstly, we intend to find the KSQ's dimensionality using factorial analysis and Item Response Theory (IRT) performed by Graded Response Model. Differential Item Functioning (DIF) was the technique used to test the invariance of each KSQ's dimensions. In case of variance detection, we applied the linking analysis. Intending to test the KSQ's consistency with external variables, we assessed correlations between KSQ's dimensions with health variables, i.e., self-reported health status and musculoskeletal pain. We have found one scale and two subscales from one general and another bidimensional factor structure of the KSQ, respectively. In these dimensions, the KSQ's items fitted well to the IRT and we have identified DIF by shift work. However, we have found DIF by sex just in one item on the general factor. Linking analysis showed as a possible step forward in the variance issue placing on to the same scale the shift work groups in the items with DIF. All correlations between KSQ's dimensions with health variables were significant. Our findings allow us to argue that KQS's items were variant by shift work and sex in a nursing staff census from the largest public hospital complex of Brazil, but we can go on using linking analysis. This could be used as an evidence for the construct validity should go beyond the traditional dimensionality assessment. The dimensionalities of KSQ fit well for other population but individuals living in Scandinavian countries.

Measuring nutritional knowledge using Item Response Theory and its validity in European adolescents.

OBJECTIVE: To analyse the Nutritional Knowledge Test (NKT) using Item Response Theory (ITR) analysis and to assess the construct validity of the Nutritional Knowledge Scale (NKTS) and its associations with adolescent food group consumption and nutritional biomarkers. DESIGN: Cross-sectional study. SETTING: Multicentre investigation conducted in ten European cities.ParticipantsAdolescents aged 12·5-17·5 years (n 3215) who completed over 75 % of the NKT. RESULTS: Factor analysis indicated that the NKT can be analysed with a one-dimensional model. Eleven out of twenty-three items from the NKT presented adequate parameters and were selected to be included in the NKTS. Nutrition knowledge was positively associated with consumption of fruits, cereals, dairy products, pulses, meat and eggs, and fish, as well as with blood concentrations of vitamin C, ß-carotene, n-3 fatty acids, holo-transcobalamin, cobalamin and folate; nutrition knowledge was negatively associated with intake of olives and avocado, alcohol and savoury snacks. CONCLUSIONS: The NKTS assessed nutritional knowledge adequately and it is proposed as a new tool to investigate this subject in future studies.

Análise de qualidade de objeto virtual de aprendizagem para avaliação da dor em enfermagem / Análisis de calidad de objeto virtual de aprendizaje para la evaluación del dolor en enfermería / Quality Analysis of the Virtual Learning Object for Nursing Pain Assessment

RESUMO Introdução: A dor é um problema se saúde pública mundial, sendo que as lacunas no processo de ensino e aprendizagem sobre a avaliação da dor contribuem para esta situação. O desenvolvimento de estratégias inovadoras para o ensino-aprendizagem, como objetos virtuais de aprendizagem, pode colaborar para melhoraria do cuidado de pacientes com dor, sendo fundamental sua avaliação quanto a qualidade. Objetivo: Analisar a qualidade de um objeto virtual de aprendizagem para avaliação da dor aguda em enfermagem a partir do Learning Object Review Instrument 2.0. Métodos: Pesquisa metodológica com abordagem quantitativa. Participaram 5 enfermeiros especialistas e 62 estudantes de enfermagem, que avaliaram as 9 variáveis do instrumento (1-Pessimo até 5-Excelente). Resultados: Os resultados superaram a média alvo (3-Bom) entre estudantes (4,27) e especialistas (4,31). Destacaram-se entre estudantes: "Conformidade com normas" (4,47±0,88) e "Apresentação do projeto" (4,55±0,74), e entre especialistas: "Qualidade do conteúdo" (4,80±0,45) e a "Reusabilidade" (4,80±0,45). Conclusão: A nova tecnologia possui qualidade para aplicação no processo de ensino-aprendizagem em enfermagem sobre a avaliação da dor aguda. A tecnologia é encarada pelos participantes como um procedimento educacional a ser incorporado na vida acadêmica e profissional, que colabora com o processo de aprender a aprender, de modo flexível e interativo(AU)

RESUMEN Introducción: El dolor es un problema de la salud pública mundial, y las lagunas en el proceso de enseñanza y aprendizaje sobre la evaluación del dolor contribuyen a esta situación. El desarrollo de estrategias innovadoras de enseñanza y aprendizaje, como objetos virtuales de aprendizaje, pueden colaborar para mejorar el cuidado de pacientes con dolor, siendo fundamental su evaluación en cuanto a calidad. Objetivo: Analizar la calidad de objeto virtual de aprendizaje para la evaluación del dolor agudo en enfermería a partir del Learning Object Review Instrument 2.0. Métodos: Investigación metodológica con enfoque cuantitativo. Participaron 5 enfermeros especialistas y 62 estudiantes de enfermería, que evaluaron las 9 variables del instrumento (1-Pésimo hasta 5-Excelente). Resultados: Los resultados superaron el promedio objetivo (3-Bueno) entre estudiantes (4,27) y especialistas (4,31). Se destacaron entre estudiantes: "Conformidad con normas" (4,47±0,88) y "Presentación del proyecto" (4,55±0,74), entre los especialistas "Calidad del contenido" (4,80±0,45) y la "Reusabilidad" (4,80±0,45). Conclusión: La nueva tecnología tiene calidad para aplicación en el proceso de enseñanza y aprendizaje en enfermería sobre la evaluación del dolor agudo. La tecnología es encarada por los participantes como un procedimiento educativo a ser incorporado en la vida académica y profesional, que colabora con el proceso de aprender a aprender, de modo flexible e interactivo(AU)

ABSTRACT Introduction: Pain is a global public health concern, a situation to which gaps in the teaching and learning process of pain assessment contribute. Developing innovative teaching and learning strategies, as virtual learning objects, can help improve the care of patients with pain, being fundamental their quality-based assessment. Objective: To analyze the quality of the virtual learning object for acute pain assessment in nursing based on the Learning Object Review Instrument 2.0. Methods: Methodological research with a quantitative approach. Five specialized nurses and 62 nursing students participated, who evaluated the nine variables of the instrument (1-poor to 5-excellent). Results: The results exceeded the expected average (3-good) between students (4.27) and specialists (4.31). The following stood out among students:conformity to standards (4.47±0.88) and project presentation (4.55±0.74); and the ones that stood out among specialists were content quality (4.80±0.45) and reusability (4.80±0.45). Conclusion: The new technology has the quality to be used in the teaching and learning process in nursing for acute pain assessment. Technology is faced by the participants as an educational procedure to be incorporated into the academic and professional life, which collaborates with the process of learning to learn, in a flexible and interactive way(AU)

Changes in Dietary Patterns from Childhood to Adolescence and Associated Body Adiposity Status.

The aims of this study were to identify cross-sectional dietary patterns (DPs) in a representative sample of 7-10-year-old schoolchildren, to examine how scores for these DPs tracked over a time period of five years (from age 7-10 years to 12-15 years), and to investigate longitudinal associations between changes in DPs scores and changes in BMI (Body Mass Index) z-scores. Children aged 7-10-years were examined in 2007 (n = 1158) and a subset of the sample participated in a follow-up in 2012 (n = 458). Factor analysis (FA) was applied to derive DPs at baseline. The change in DP from childhood to adolescence was analyzed by comparing factor scores using the complete cases, in which factor loadings were the ones evaluated at baseline. Associations of BMI change with DP change were assessed by multivariate linear regression. At baseline, four DP were identified that explained 47.9% of the food intake variance. On average, the factor scores of "DP II" (salty snacks, French fries, fast-food, sugary beverages) decreased in follow-up, while no changes were observed for "DP I" (rice, cooked beans, beef/poultry, leafy vegetables), "DP III" (fruits, cooked and leafy vegetables, fruit juices, pasta, milk, cheese), and "DP IV" (milk, coffee with milk, cheese, breads/biscuits). No significant linear association was shown between changes in BMI z-scores and changes in DP scores from childhood to adolescence. In conclusion, three out of four DP scores identified at baseline tracked slightly in adolescence.

Design and validation of an aircraft seat comfort scale using item response theory.

This article aims to evaluate the psychometric properties of a scale that measures aircraft seat comfort. Factor analysis was used to study data variances. Psychometric quality was checked by using Item Response Theory. The sample consisted of 1500 passengers who completed a questionnaire at a Brazilian airport. Full information factor analysis showed the presence of one dominant factor explaining 34% of data variance. The scale generated covered all levels of comfort data, from 'no comfort' to 'maximum comfort'. The results show that the passengers consider there is comfort, but this is very minimal when these passengers have to perform their desired activities. It tends to increase when aspects of the aircraft seating are improved and positive emotions are elicited. Comfort peaks when pleasure is experienced and passenger expectations are exceeded (maximum comfort). This outcome seems consistent with the literature. Further research is advised to compare the outcome of this questionnaire with other research methods, and to check if the questionnaire is sensitive enough and whether its conclusions are useful in practice.

Interaction levels between comfort and discomfort in aircraft seats.

BACKGROUND: Although comfort and discomfort on seats have been widely investigated, their nature is still not well described by literature and it is not known exactly how the interaction between these two phenomena happens. OBJECTIVE: To investigate the multidimensional nature of comfort and discomfort in aircraft seats as well as their levels of interaction. METHODS: A comfort-discomfort questionnaire has been given to 1500 passengers in Brazil. RESULTS: The results brought evidence that comfort and discomfort are different phenomena with a strong negative correlation. At extreme levels, the presence of comfort implies the absence of discomfort; however at the other levels of comfort (minimum to moderate) there is the presence of discomfort. Estimating the scores given by the passengers has allowed them to be placed at scales of comfort and discomfort with their different levels. However, no passenger has achieved the levels of maximum comfort or of maximum discomfort. CONCLUSIONS: It is possible to infer that comfort, as much as discomfort are multidimensional phenomena and must be evaluated through scales with different levels, since at the extreme levels there is no interaction between the phenomena, but at the intermediate levels the passengers could perceive comfort and discomfort at the same time.

Development and validation of instrument for ergonomic evaluation of tablet arm chairs.

The purpose of this study was to develop and validate an evaluation instrument for tablet arm chairs based on ergonomic requirements, focused on user perceptions and using Item Response Theory (IRT). This exploratory study involved 1,633 participants (university students and professors) in four steps: a pilot study (n=26), semantic validation (n=430), content validation (n=11) and construct validation (n=1,166). Samejima's graded response model was applied to validate the instrument. The results showed that all the steps (theoretical and practical) of the instrument's development and validation processes were successful and that the group of remaining items (n=45) had a high consistency (0.95). This instrument can be used in the furniture industry by engineers and product designers and in the purchasing process of tablet arm chairs for schools, universities and auditoriums.

Changes in total and central adiposity and body fat distribution among 7-10-year-old schoolchildren in Brazil.

OBJECTIVE: To describe changes in total and central adiposity and body fat distribution in children over a 5-year period by investigating variations in BMI, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold thicknesses (SFT). DESIGN: A school-based sample of children from 2nd to 5th grades of elementary schools participated in two cross-sectional studies in 2002 (n 2936) and 2007 (n 1232). SETTING: Public and private schools of Florianopolis, Brazil. SUBJECTS: Schoolchildren aged 7-10 years had their weight, height, WC and SFT measured according to standard procedures. Body fat distribution was assessed by triceps, subscapular, suprailiac and medial calf skinfold measurements. Changes in BMI, WC, WHtR and SFT were analysed, adjusting for type of school and monthly family income. RESULTS: Adjusted mean differences between 2002 and 2007 for BMI and WC were always positive and of similar magnitude between boys and girls. However, a statistically significant increase was observed only for BMI (raw and Z-score values) in boys. WHtR remained stable in both sexes. Adjusted median values for SFT also increased in boys and girls, except for triceps skinfold. BMI, WC and SFT tended to increase across age classes in both sexes. The relative change observed for the median central skinfolds (subscapular and suprailiac) was greater than that of peripheral skinfolds (triceps and medial calf). CONCLUSIONS: The subcutaneous adipose tissue (SFT) appeared to increase at a faster rate than total adiposity (BMI). The increase in central SFT indicates that the relative change is due primarily to a rise in central adiposity.

Implementing DICOM structured reporting in a large-scale telemedicine network.

INTRODUCTION: Large-scale asynchronous telemedicine networks can offer a unique opportunity for the acquisition of detailed epidemiological information if the data are acquired and handled in an appropriate way. In this work, an approach is presented for the integration of medical reports in the Digital Imaging and Communications in Medicine (DICOM) Structured Reporting standard in telemedicine networks using structured vocabularies. MATERIALS AND METHODS: The use of these structured vocabularies is extended beyond radiology, and a case study in telecardiology is presented. The approach was applied in the context of a real-world statewide public telemedicine network; nowadays on average 470 written electrocardiographic structured reports daily are being performed. Cardiologists provided more than 220,000 written structured reports, and these reports are stored into a central database. RESULTS: This study was performed during a 12-month period, and it was possible to examine possible associations between a list of co-morbidities and cardiac risk factors with a diagnosis that indicates the presence of cardiac ischemia, cardiac injury, or possible necrosis by using DICOM Structured Reporting. Our application is responsible for coordinating the process of issuance of reports through various technologies and devices. The system works as a library in an HTTP server, which accesses information from studies in DICOM format from the database and from structured vocabularies. CONCLUSIONS: Results indicate that traceability of morbidity, diagnoses, and patient clinical information can be achieved, resulting in an efficient data mining-friendly framework. A multidevice application for Web-based and smartphone-based platforms showed that it is a viable solution for applying the DICOM Structured Reporting standard in telemedicine networks.

Environmental management performance for Brazilian industrials: measuring with the item response theory.

Growing challenges with respect to preserving the environment have forced changes in company operational structures. Thus, the objective of this article is to measure the evidence of Environmental Management using the Item Response Theory, based on website analysis from Brazilian industrial companies from sectors defined through the scope of the research. This is a qualitative, exploratory, and descriptive study related to an information collection and analysis instrument. The general view of the research problem with respect to the phenomenon under study in based on multi-case studies, with the methodological outline based on the theoretical reference used. Primary data was gathered from 270 company websites from 7 different Brazilian sectors and led to the creation of 26 items approved by environmental specialists. The results were attained with the measuring of Environmental Management evidence via the Item Response Theory, providing a clear order of the items involved based on each item's level of difficulty, quality, and propriety. This permitted the measurement of each item's quality and propriety, as well as that of the respondents, placing them on the same analysis scale. Increasing the number of items and companies involved is suggested fEor future research in order to permit broader sector analysis.

Measuring organizational effectiveness in information and communication technology companies using item response theory.

The aim of this paper is to measure the effectiveness of the organizations Information and Communication Technology (ICT) from the point of view of the manager, using Item Response Theory (IRT). There is a need to verify the effectiveness of these organizations which are normally associated to complex, dynamic, and competitive environments. In academic literature, there is disagreement surrounding the concept of organizational effectiveness and its measurement. A construct was elaborated based on dimensions of effectiveness towards the construction of the items of the questionnaire which submitted to specialists for evaluation. It demonstrated itself to be viable in measuring organizational effectiveness of ICT companies under the point of view of a manager through using Two-Parameter Logistic Model (2PLM) of the IRT. This modeling permits us to evaluate the quality and property of each item placed within a single scale: items and respondents, which is not possible when using other similar tools.

Qualitative analysis of the diet of a probabilistic sample of schoolchildren from Florianópolis, Santa Catarina State, Brazil, using the Previous Day Food Questionnaire.

A qualitative evaluation of the diet of a probabilistic sample of 7-10 year old schoolchildren (n=1,232) from Florianópolis (southern Brazil) was carried out by analyzing compliance with recommendations from the Brazilian Food Guidelines. The strengths and limitations of the Previous Day Food Questionnaire (PDFQ) are also presented. Frequencies of intake were defined as how many times per day the food group was reported on the PDFQ. The percentages of schoolchildren who met the minimum recommendations and who ate foods that were not recommended in the guidelines were compared for boys versus girls, private versus public school and by family income level. Although most of the children complied with the guidelines regarding consumption of meat/fish, dry beans, sweets, and eating three meals and two snacks, only 6.5% of the children met the recommendations for cereals, and 15% for fruit and vegetables. The PDFQ was confirmed as a practical and cost-effective method for the evaluation of compliance with health promotion targets.

Evaluation of sixth grade primary schoolchildren's knowledge about avulsion and dental reimplantation.

Dental trauma, particularly tooth avulsion, is a frequent cause of tooth loss in children, adolescents, and young adults. The avulsed tooth should be immediately reimplanted in its alveolus. This procedure can be performed by anyone at the accident site and not only by dental surgeons. Therefore, the purpose of this study is to evaluate the knowledge of sixth graders of the city of Araçatuba, SP, about dental avulsion and tooth reimplantation through a structured and standardized survey. Our sample consisted of 778 students. The data collected was processed using the program EPIINFO 2000. Most students were around 12 years of age and 94.5% related to practice some kind of sports. Results demonstrated that the possibility of tooth reimplantation after dental avulsion is not acknowledged among these students and dental traumatism was associated to caries, toothache, and use of orthodontic appliances. Only 18.9% of the students associated dental traumatism to an impact trauma; 3.6% would store the tooth in milk, and 3.1% believed the tooth could be reimplanted by anyone present at the accident site. In summary, the results show an overall the lack of knowledge about dental traumatism and highlight the need of special programs designed to educate school-aged students about emergency procedures to handle cases of dental traumatisms.

Statistical methodology for pathogen detection.

The main goal of the present study was to discuss the application of the McNemar test to the comparison of proportions in dependent samples. Data were analyzed from studies conducted to verify the suitability of replacing a conventional method with a new one for identifying the presence of Salmonella. It is shown that, in most situations, the McNemar test does not provide all the elements required by the microbiologist to make a final decision and that appropriate functions of the proportions need to be considered. Sample sizes suitable to guarantee a test with a high power in the detection of significant differences regarding the problem studied are obtained by simulation. Examples of functions that are of great value to the microbiologist are presented.