The oral health impact profile and well-being on mothers and preschool children.

OBJECTIVES: to verify the contribution of mothers' oral health impact profile to their children's oral health profile and the contribution of mothers' well-being and the caries index (dmft) to children's well-being. METHODS: This is a cross-sectional observational study. Mothers and pre-school children enrolled in public schools in the municipality of Araraquara-SP took part. The Oral Health Impact Profile Questionnaire (OHIP-14), Satisfaction with Life Scale (SWLS), Early Childhood Oral Health Impact Scale (ECOHIS) and the Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI) were used. To diagnose caries, a clinical examination was carried out to calculate the dmft index. Path analysis was carried out and the path coefficients were estimated (ß) and evaluated using the z-test (α = 5%). RESULTS: 443 children took part (5.19 ± 0.64 years; 52.4% boys) with an mean dmft of 1.31 ± 2.19. The mean age of the mothers was 33.4 ± 7.01 years. There was a significant impact of dmft and maternal well-being on the child's subjective well-being (s2explained = 43%). The mothers' oral health impact profile and the child's caries experience had a significant influence on both the child (OHIP: ß = 0.22; p < 0.001; dmft: ß = 0.48; p < 0.001) and the family (OHIP: ß = 0.29; p < 0.001; dmft: ß = 0.32; p < 0.001). The child's dmft (ß=-0.10; p = 0.005) and the mothers' subjective well-being (ß=-0.61; p < 0.001) had a significant impact on the child's subjective well-being. CONCLUSION: The mothers' oral health impact profile and the child's caries experience had an impact on both the child and the family. Mothers' subjective well-being and caries experience should be considered when assessing the subjective well-being of Brazilian preschool children.

Handgrip force and bite force in dentulous and edentulous individuals.

BACKGROUND: The literature is unclear about bite force (BF) and handgrip force (HF) in a specific group of different ages and dentate conditions, or even a predictive model for each specific group, using BF and HF as factors. OBJECTIVE: To establish the correlation between HF and BF in female participants with distinct ages and dentate conditions; also create a predictive model of BF as a function of HF. METHODS: Participants were divided into three groups (GI: young natural dentate women, n = 65; GII: adult natural dentate women, n = 67; and GIII: edentulous women users of bimaxillary complete dentures, n = 67) and subjected to an HF measurement test using a digital dynamometer. Subsequently, BF was measured using a digital gnathodynamometer in the molar region. Pearson correlation coefficient (r) and multivariate analysis of variance (α = 0.05) were performed, and simple linear regression was used to obtain a model to predict BF from HF for each group separately (α = 0.05). RESULTS: All groups presented moderate and strong correlations among the variables (GI: r = 0.838; GII: r = 0.714; GIII: r = 0.646). A significant difference in BF was observed (GI > GII > GIII; p < .05). GIII presented a significantly lower HF than the other groups (p < .05). Besides, three equations predicting BF, using HF, were obtained for use in young/adult dentate and edentulous women. CONCLUSION: All groups found a positive and significant correlation between BF, HF and groups. HF can be a simple and efficient method for predicting BF using the predictive models developed for women with good health.

Self-perception of orofacial appearance: Brazil-Finland cross-national study.

OBJECTIVE: (i) To study the measurement invariance of Orofacial Esthetic Scale (OES) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), (ii) to compare the perception of orofacial appearance (OA) and (iii) to study the frequency of individuals who have sought or received aesthetic dental treatment between Brazil and Finland. METHODS: This was a cross-sectional observational study with snowball non-probability sample selection. Students and staff from universities in Finland and Brazil were invited to participate. Data were collected online using a demographic questionnaire, OES and PIDAQ. The samples consisted of 3636 Finns (75.0% female; age: 32.0 years) and 1468 Brazilians (72.6% female; age: 33.2 years). The frequency of receiving aesthetic dental treatment was estimated. If configurational invariance was observed, cross-national measurement invariance was verified by multigroup analysis. When measurement invariance was attested, factor scores were compared using Welch's t-test. RESULTS: OES showed configurational and measurement invariance and no significant difference between the countries. Despite similarity in satisfaction with OA, 71.9% of Brazilians had received aesthetic dental treatment, while 59.4% of Finns had never sought such treatments. PIDAQ did not present configurational invariance between the countries. CONCLUSION: Although there is no difference in satisfaction with OA, seeking and receiving aesthetic dental treatment is significantly greater for Brazilians. Psychosocial impact of OA is perceived differently in the studied countries.

Cross-cultural adaptation and psychometric assessment of the Portuguese language version of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire in Brazilian adults.

PURPOSES: To develop a Brazilian Portuguese version of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire and estimate the psychometric properties of the EADES factorial model for young Brazilian adults and also to assess the association between EADES factors and age, body mass index (BMI), and economic level. METHODS: The cross-cultural adaptation was performed using a standardized protocol. The psychometric properties were assessed separately for each sex. A structural model for each sex was developed to investigate the influence of age, economic level, and BMI on the EADES factors. RESULTS: A total of 1240 participants completed the study [65.8% female, mean age 23.91 (SD = 5.03) years]. The EADES original factorial model did not present good psychometric properties. Then, a factorial model proposed for a Mexican sample was tested and a different model was fitted for each sex. The results showed that younger women have lower self-efficacy and self-confidence and poorer assessment of resources and coping skills. Women with a higher economic level have lower self-efficacy. Higher BMI was associated with lower self-efficacy and self-confidence in both sexes. Younger men have lower self-efficacy and poorer assessment of resources and coping skills. CONCLUSIONS: The Brazilian Portuguese version of the EADES provided valid and reliable data after refinement, and a different model was fitted for each sex. Sex, age, BMI, and economic level were significantly associated with the EADES factors. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

Investigating method effects associated with the wording direction of items of the Social Physique Anxiety Scale.

PURPOSE: The use of psychometric instruments to measure latent concepts is common. The development of these instruments usually involves mechanisms to reduce response bias, such as the inclusion of reversed items. The aim of this study was to investigate method effects related to the wording direction of the Social Physique Anxiety Scale (SPAS) items, a one-dimensional instrument that assesses individual's level of anxiety when others observe their body. METHODS: In total, 152 Brazilian adults (65.8% female) answered 2 formats of the SPAS: the original with 12 items (7 regular and 5 reversed); and a new format with all items written in the same direction (i.e., regular). Both formats were filled out at different times and alternately. Differential item functioning analysis (DIF) and confirmatory factor analysis were conducted. RESULTS: The original SPAS did not fit the data, but after allowing covariances between all reversed items, the fit improved. The wording effect was supported by the DIF, indicating a better fit to the data for the new format with all items worded in the same direction. CONCLUSION: The wording of the SPAS items had effect on the psychometric properties of instrument. When the wording of the reversed items was modified, the factor model fitted the data. Future studies should take these findings into account and evaluate the SPAS with all items worded in the same direction in different contexts. LEVEL OF EVIDENCE: Descriptive (cross-sectional) study, Level V.

Symptoms related to mental disorder in healthcare workers during the COVID-19 pandemic in Brazil.

BACKGROUND: Studies of previous pandemics indicate that healthcare workers have a high risk of developing symptoms related to mental health, especially depression, anxiety, and stress. OBJECTIVE: To identify mental disorder symptoms among Brazilian healthcare workers during the Sars-Cov-2 pandemic and compare findings in different work categories. METHODS: This was an online cross-sectional study. Information related to the pandemic and mental disorder symptoms was collected. The Depression, Anxiety, and Stress Scale and the Impact of Event Scale-revised were used. Associations were estimated by the chi-square test. The mean scores were compared among work categories with ANOVA (α = 5%) and the prevalence of symptoms was estimated. RESULTS: 1,609 healthcare workers participated in the survey [mean age: 36.9 (SD = 11.6) years, women = 83.6%]. There was no association between work category and changes in mental health during the pandemic (p = 0.288) or prevalence of unsafe feeling (p = 0.218). A significant relationship was observed between maintaining work activities during the pandemic and work category (p < 0.001). Physicians had the lowest out-of-work prevalence (9.5%) while dentists had the highest (32.3%). Physicians and nurses showed the highest prevalence of in-person work routine. Psychologists presented the highest prevalence of remote work (64.0%) while dentists had the lowest (20.2%). A high prevalence of depression (D), anxiety (A), and stress (S) symptoms was observed in all professional categories (D: 57.2, 95% CI 48.3-66.1%; A: 46.20%, 95% CI = 37.2-55.2%; S: 55.80%, 95% CI = 46.8-64.8%), with physicians (D = 38.4%, A = 25.80%, S = 37.90%), psychologists (D = 50.2%, A = 39.0%, S = 43.1%), and nurses (D = 50.0%, A = 40.9%, S = 49.0%) having significantly lower scores. Psychologists had the lowest pandemic-related psychological impact (42.70%, 95% CI 36.8-48.6%). CONCLUSION: Extreme changes in the work routine of dentists and psychologists and an overall high prevalence of mental symptoms due to the pandemic were found. Researchers should focus on gathering information that can identify workers at increased risk of mental illness to guide discussions and develop actions to minimize the harm of the pandemic. In addition, we suggest that healthcare and support systems urgently adopt mental health care measures with specialized professionals to protect the psychological well-being of the healthcare community.

Orofacial Esthetic Scale and Psychosocial Impact of Dental Aesthetics Questionnaire: development and psychometric properties of the Finnish version.

OBJECTIVE: To develop the Finnish version of the Orofacial Esthetic Scale (OES-Fi) and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ-Fi) and estimate the psychometric properties of these instruments applied to adult Finns. METHODS: The English versions of the instruments were translated into Finnish and back-translated. Thereafter, OES-Fi and PIDAQ-Fi were established in a pilot study. The factorial validity was estimated using Confirmatory Factor Analysis (CFI, TLI, SRMR) in independent samples (Test and Validation samples). The measurement invariance of the factorial models was tested using multigroup analysis (ΔCFI). Convergent validity [Average Variance Extracted (AVE)] and reliability [Composite Reliability (CR) and α] were estimated. RESULTS: A total of 3636 individuals [mean age = 32.0 (SD = 11.6) years, 75% women] participated in the study. After refinements, the factorial model of the instruments showed an adequate fit to the data (CFI ≥0.94, TLI ≥0.90, SRMR ≤0.07) and showed measurement invariance in two independent samples (|ΔCFI| <0.01). Convergent validity (AVE = 0.54-0.82) and reliability (α = 0.86-0.94) were adequate. CONCLUSION: The data obtained using OES-Fi and PIDAQ-Fi were valid and reliable. Thus, these instruments could be useful for evaluating individual satisfaction with orofacial appearance and the psychosocial impact of dental aesthetics in a clinical or research setting.

Examination of the factorial model of a scale developed to assess body satisfaction in the Brazilian context: a study with people 18 to 40 years old.

PURPOSE: Confirmatory factor analysis was employed to investigate an instrument developed to assess body satisfaction of Brazilian women and men and to identify participants' body satisfaction level. METHODS: Brazilian young adults completed the Body Satisfaction Situational Scale and a sociodemographic questionnaire. A total of 1481 individuals (female = 1035; male = 446) aged between 18 and 40 years old participated in the study. Factorial, convergent and discriminant validity and reliability were evaluated. An invariance test was performed across sexes using multi-group analysis. The prevalence of body satisfaction among participants was calculated using the final models of the instrument. RESULTS: The complete model of the scale (23 items and four factors) was invariant across sexes, but it did not fit the samples even after refinement. Therefore, a theoretical investigation of the scale content was performed based on literature. Thus, a reduced model composed of two factors and ten items was found for each sex. These models showed good validity and reliability to independent samples. About prevalence, most of the women were not at all satisfied with body fat and most of the men were slightly satisfied with body musculature. Further, women and men were moderately satisfied with their face, hair, and skin. CONCLUSION: A reduced model of the instrument for women and another for men showed adequate indices of construct validity and reliability to samples. The most participants were not very satisfied with their bodies. The results can be useful to develop protocols aiming to promote body satisfaction. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

Psychometric characteristics of the Three-Factor Eating Questionnaire-18 and eating behavior in undergraduate students.

PURPOSE: To assess the psychometric characteristics of the Three-Factor Eating Questionnaire-18 (TFEQ-18) and to estimate the prevalence of cognitive restraint (CRes), uncontrolled eating (UE), and emotional eating (EE) among Brazilian undergraduate students. METHODS: A total of 775 students completed TFEQ-18 (62.1% females; total mean age = 20.9 years [SD = 2.8]; females mean age: 20.8 years [SD = 2.8]; males mean age: 21.2 years [SD = 2.7]). Total sample was randomly separated in test/validation samples. An assessment of psychometric characteristics was conducted to each subsample with confirmatory factor analysis considering the indices: chi-square per degree of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA). The mean score of each TFEQ-18 factor was estimated. The prevalence of CRes, UE, and EE was calculated with 95% confidence intervals (95%CI) and compared by sex and weight status. RESULTS: The psychometric characteristics of the TFEQ-18 were adequate in both samples (test/validation: χ2/df = 3.58/2.86; CFI = 0.938/0.958; TLI = 0.928/0.951; RMSEA = 0.081/0.069). The prevalence of students with moderate to exacerbated scores of CRes, UE, and EE was 34.4% (95%CI 31.1-37.7%), 35.6% (95%CI 32.2-39.0%), and 43.1% (95%CI 39.6-46.6%), respectively. There were no statistically significant differences in prevalence according to sex or weight status. CONCLUSIONS: The TFEQ-18 presented adequate psychometric characteristics and indicated a high prevalence of CRes, UE, and EE among the students. This research emphasizes the importance of investigating aspects of eating behavior to best direct clinical and educational strategies for reducing the risk of adopting unhealthy eating behaviors among undergraduate students. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

A psychometric investigation of Brazilian Portuguese versions of the Caregiver Eating Messages Scale and Intuitive Eating Scale-2.

The Caregiver Eating Messages Scale (CEMS) was developed to assess perceived restrictive or critical caregiver messages in relation to food intake and pressure to eat, whereas the Intuitive Eating Scale-2 (IES-2) measures one's tendency to follow internal cues of hunger and satiety when making eating-related decisions. Both scales are useful in the arsenal of eating behaviour scholars. Here, we developed Brazilian Portuguese translations of both scales and assessed their psychometric properties in Brazilian adults. A total of 288 participants (men = 52.8%) completed the CEMS, IES-2, Body Appreciation Scale (BAS), and a demographic questionnaire. The results of confirmatory factor analysis indicated that the factor structure of both scales had adequate fit following the elimination of items and addition of covariances. Evidence of adequate factorial, convergent and discriminant validity, as well as reliability was identified. Furthermore, correlations of CEMS and IES-2 with BAS scores and body mass index were obtained. Both instruments' models were found to be invariant across sex, with men having significantly higher scores on three subscales of the IES-2 only. These results provide evidence for the psychometric properties of the CEMS and IES-2 in Brazilian Portuguese-speaking adults.Level of Evidence: V, cross-sectional descriptive study.

Body Image Quality of Life Inventory: cross-national study in college students from four different countries.

PURPOSE: This study was aimed to examine the psychometric proprieties of the Body Image Quality of Life Inventory (BIQLI) among Brazilian, Portuguese, Mozambican, and Italian college students. METHODS: A total of 1630 subjects (Brazilians = 446; Portuguese = 480, Mozambicans = 360, and Italians = 344) completed the Portuguese (Brazilian, Portuguese, and Mozambican students) and the Italian versions (Italian students) of the BIQLI for measuring the effects of body image on one's quality of life. Psychometric testing included confirmatory factor analysis (CFA), discriminant and convergent validity, internal consistency, and composite reliability. The cross-national invariance of the BIQLI was assessed by multi-group analysis using ΔCFI. Moreover, the global score of the BIQLI for all countries was calculated by an algorithm and compared using the Welch's ANOVA and the Games-Howell post-test (α = 5%). RESULTS: CFA showed an inadequate fit of unifactorial model of the BIQLI. Therefore, an alternative model comprising nine first-order factors and one second-order factor was proposed and evaluated. This new model showed adequate fit in all samples, despite some limitations that were found with respect to its convergent and discriminant validity. The alternative BIQLI model was invariant among countries. Global scores for the influence of body image on quality of life were significantly different across countries, with the Italians presenting the lowest scores. CONCLUSIONS: The BIQLI factorial model found in this study represents a reliable and valid alternative to its original structure for the assessment of the effect of body image on college students' perceived quality of life. This model must be further tested in other populations. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Pain perception in orthodontic patients: A model considering psychosocial and behavioural aspects.

OBJECTIVES: To estimate the agreement between orthodontic pain perception, evaluated with the visual analog scale (VAS), and psychosocial and behavioural aspects of pain and to estimate the impact of clinical and demographic characteristics on these aspects. DESIGN: Cross-sectional design using non-probabilistic sampling. SETTING AND SAMPLE POPULATION: Orthodontic patients undergoing treatment at orthodontic clinics (n = 507 [63.3% women], mean age: 26.32 [SD = 11.70] years). MATERIALS AND METHODS: Psychosocial and behavioural aspects of pain were evaluated using the Multidimensional Pain Inventory (MPI-Orthodontic). Agreement between the pain impact level assessed according to different methods was estimated using the linear-weighted Kappa (κp ) statistic. Structural models were elaborated to estimate the impact of clinical and demographic characteristics on the psychosocial and behavioural aspects of pain. The fit of the model was evaluated, and the z test (α = 5%) was used to estimate the significance of the impact (ß). RESULTS: The agreement between VAS and MPI-Orthodontic factors was inadequate (κp  = 0.028-0.584). The fit of the structural models was adequate. Women, younger individuals, and those who reported difficulty/pain with feeding exhibited greater perception of both the psychosocial and behavioural aspects. Individuals in lower socioeconomic strata who were not satisfied with treatment and did not seek treatment voluntarily exhibited greater perception of the psychosocial aspect of pain. CONCLUSIONS: The impact of orthodontic pain on psychosocial and behavioural aspects of patients' lives is a relevant issue. Clinical and demographic characteristics contributed to these aspects; however, pain intensity as a sole measure may be insufficient for an adequate understanding of pain perception.

Psychometric Properties of the Obstacles to Return-to-Work Questionnaire in a Brazilian context.

Purpose To evaluate the psychometric properties of the Obstacles to Return-to-Work Questionnaire (ORTWQ) among Brazilian workers on sick-leave due to musculoskeletal disorders. Methods Confirmatory factor analysis was conducted to evaluate the factor structure validity of the ORTWQ. Model fit indices and salience of factor loadings were assessed. The convergent validity was estimated using the Average Variance Extracted (AVE) and Composite Reliability (CR). The correlational analysis was verified using the Spearman Correlation between the ORTWQ and other specific tools. Discriminant Validity, internal consistency, stability (test-retest) and floor/ceiling effect were also assessed. Results A total of 301 participants completed the ORTWQ with a mean age of 45.0 (9.9) years. After refinement, the factor structure indexes of the oblique model were [χ2/df = 1.8; CFI = 0.9; TLI = 0.9; PGFI = 0.7; PCFI = 0.8; RMSEA = 0.05 (90% CI 0.05-0.06)]. Only Depression, Physical Workload and Perceived Prognosis subscales presented suitable AVE indices: 0.63, 0.51 and 0.52 respectively. The correlations between ORTWQ and the other questionnaires were appropriate for almost all subscales. Reliability evaluation showed adequate estimates for all subscales except for the Worry Due to Sick-Leave (CR = 0.45; α = 0.44; ICC = 0.69). A higher order hierarchical model is suggested, in order to estimate an overall score to ORTWQ in a Brazilian population. Conclusions The psychometric properties of the Brazilian version of the ORTWQ were evaluated and after refinement, the validity, reliability and floor/ceiling effects indexes were suitable when applied to a sample of Brazilian workers on sick-leave due to musculoskeletal disorders. However, the factor structure presented some issues regarding convergent and discriminant validity.

Male body dissatisfaction scale (MBDS): proposal for a reduced model.

AIMS: To evaluate the psychometric properties of the male body dissatisfaction scale (MBDS) in Brazilian and Portuguese university students; to present a reduced model of the scale; to compare two methods of computing global scores for participants' body dissatisfaction; and to estimate the prevalence of participants' body dissatisfaction. METHODS: A total of 932 male students participated in this study. A confirmatory factor analysis (CFA) was used to assess the scale's psychometric properties. Multi-group analysis was used to test transnational invariance and invariance in independent samples. The body dissatisfaction score was calculated using two methods (mean and matrix of weights in the CFA), which were compared. Finally, individuals were classified according to level of body dissatisfaction, using the best method. RESULTS: The MBDS model did not show adequate fit for the sample and was, therefore, refined. Thirteen items were excluded and two factors were combined. A reduced model of 12 items and 2 factors was proposed and shown to have adequate psychometric properties. There was a significant difference (p < 0.001) between the methods for calculating the score for body dissatisfaction, since the mean overestimated the scores. Among student participants, the prevalence of body dissatisfaction with musculature and general appearance was 11.2 and 5.3%, respectively. CONCLUSIONS: The reduced bi-factorial model of the MBDS showed adequate validity, reliability, and transnational invariance and invariance in independent samples for Brazilian and Portuguese students. The new proposal for calculating the global score was able to more accurately show their body dissatisfaction. No level of evidence Basic Science.

The Disabilities of the Arm, Shoulder and Hand scale in the evaluation of disability - A literature review.

Work-related musculoskeletal disorders (WRMDs) interfere with workers' productivity and quality of life. Thus, early detection of disabilities caused by WRMDs is vital for preventing the aggravation of symptoms. Early detection aids and is aided by educational and preventive programs. WRMDs can be detected using the Disabilities of the Arm, Shoulder and Hand (DASH) Scale. OBJECTIVES: The present study aimed to review the literature on the application of the DASH Scale through a consideration of the cultural adaptation process and an evaluation of the scale's psychometric properties. METHODS: The literature review was conducted using the terms "disabilities", "musculoskeletal disorders", "DASH" "questionnaire" and "upper limbs". RESULTS: Forty-eight articles were collected, and these included only articles available in English which contained the full version of the DASH Scale and which focused on the evaluation of its psychometric properties (n=25). CONCLUSION: Most of the studies partially evaluated the psychometric properties of the DASH instrument; however, these properties were typically evaluated using only a correlation analysis involving other instruments.

Psychometric characteristics of the Functional Assessment of Cancer Therapy-General when applied to Brazilian cancer patients: a cross-cultural adaptation and validation.

BACKGROUND: The psychometric properties of an instrument should be evaluated routinely when using different samples. This study evaluated the psychometric properties of the Functional Assessment of Cancer Therapy-General (FACT-G) when applied to a sample of Brazilian cancer patients. METHODS: The face, content, and construct (factorial, convergent, and discriminant) validities of the FACT-G were estimated. Confirmatory factor analysis (CFA) was conducted the ratio chi-square by degrees of freedom (χ (2)/df), the comparative fit index (CFI), the Tucker-Lewis index (TLI), and the root mean square error of approximation (RMSEA) as indices. The invariance of the best model was assessed with multi-group analysis using the difference of chi-squares method (Δχ(2)). Convergent validity was assessed using Average Variance Extracted (AVE) and discriminant validity was determined via correlational analysis. Internal consistency was assessed using the Cronbach's alpha (α) coefficient, and the Composite Reliability (CR) was estimated. RESULTS: A total of 975 cancer patients participated in the study, with a mean age of 53.3 (SD = 13.0) years. Of these participants, 61.5 % were women. In CFA, five correlations between errors were included to fit the FACT-G to the sample (χ (2)/df = 8.611, CFI = .913, TLI = .902, RMSEA = .088). The model did not indicate invariant independent samples (Δχ(2): µ: p < .001, i: p < .958, Cov: p < .001, Res: p < .001). While there was adequate convergent validity for the physical well-being (AVE = .54) and social and family Well-being factors (AVE = .55), there was low convergent validity for the other factors. Reliability was adequate (CR = .76-.89 and α = .71-.82). Functional well-being, emotional well-being, and physical well-being were the factors that demonstrated a strong contribution to patients' health-related quality of life (ß = -.99, .88, and .64, respectively). CONCLUSION: The FACT-G was found to be a valid and reliable assessment of health-related quality of life in a Brazilian sample of patients with cancer.

Impact of oral health on health-related quality of life: a cross-sectional study.

BACKGROUND: Despite the consensus regarding the existence of a relationship between "impacts on oral health" and "health-related quality of life", this relationship, considering the latent nature of these variables, is still poorly investigated. Thus, we performed this study in order to determine the magnitude of the impacts of oral health, demographic and symptom/clinical variables on the health-related quality of life in a Brazilian sample of dental patients. METHODS: A total of 1,007 adult subjects enrolled in the School of Dentistry of São Paulo State University (UNESP) - Araraquara Campus for dentistry care between September/2012 and April/2013, participated. 72.4 % were female. The mean age was 45.7 (SD = 12.5) years. The Oral Health Impact Profile (OHIP-14) and the Short Form Health Survey (SF-36) were used. The demographic and symptom/clinical variables collected were gender, age, economic status, presence of pain and chronic disease. The impact of studied variables on health-related quality of life were evaluated with a structural equation model, considering the factor "Health" as the central construct. The fit of the model was first analyzed by the evaluation of the goodness of fit indices (χ(2)/df ≤ 2.0, CFI and TLI ≥ 0.90 and RMSEA < 0.10) and the evaluation of the variables' impact over health-related quality of life was based on the statistical significance of causal paths (ß), evaluated by z tests, for a significance level of 5 %. RESULTS: We observed adequate fit of the model to the data (χ(2)/df = 3.55; CFI = 0.95; TLI = 0.94; RMSEA = 0.05). The impacts on oral health explained 28.0 % of the variability of the health-related quality of life construct, while the total variance explained of the model was 39.0 %. For the demographic and symptom/clinical variables, only age, presence of pain and chronic disease showed significant impacts (p < 0.05). CONCLUSION: The oral health, age, presence of pain and chronic disease of individuals had significant influence on health-related quality of life.

Work-related activities that may contribute to musculoskeletal symptoms among dental students: validation study.

BACKGROUND: Dentists are exposed to occupational hazards, such as musculoskeletal disorders, in which symptoms can manifest early in clinical practice. OBJECTIVES: To estimate the reliability and validity of the Portuguese version of the "Questionnaire on work-related activities that may contribute to musculoskeletal symptoms" when applied to dental students. METHODS: 553 Brazilian students participated in the study. The one-factor structure originally proposed was tested through confirmatory factor analysis (CFA) using the indexes c2/df, CFI, GFI, and RMSEA. After observing an inadequate good fit (c2/df=7.140, CFI=0.791, GFI=0.778, RMSEA=0.129), the sample was subdivided into 3 groups and an exploratory factor analysis was conducted (EFA) (n=255). A CFA was then conducted using a subsample (n=113). To test the invariance of the obtained factorial solution, a multi-group analysis was performed using a third sample, independent from the others (n=185). The convergent (AVE) and discriminant (r2) validity were assessed. The composite reliability (CR), Cronbach's alpha coefficient (a), and intra-class correlation coefficient (r) were calculated. RESULTS: In the EFA, 3 factors were extracted: "Repetitiveness," "Working posture," and "External factors" (c2=21895.154; p<0.001; KMO=0.905; l1=6.683; l2=1.464; l3=1.277) that explained 62.82% of the total variance. The three-factor model presented an adequate good fit (n=113 and n=185) (c2/df=2.259; CFI=0.885; GFI=0.833; RMSEA=0.066). The convergent validity was compromised only for "Repetitiveness" (AVE=0.412-0.653). The discriminant validity (r2=0.333-0.428), composite reliability, internal consistency, and reproducibility were adequate for all factors (CR=0.736-0.883; a=0.747-0.876; r=0.729-0.940). CONCLUSION: The questionnaire proved to be reliable and valid for the sample of dentistry students if the three-factor model is used.

Roughness and morphology of composites: influence of type of material, fluoride solution, and time.

This study evaluated the effect of fluoride solutions on surface roughness and morphology of composites in the short and long term. Specimens were randomly assigned to experimental groups (n=5) according to type of composite (nanofilled, microhybrid, microfilled) and immersion media (artificial saliva, 0.05% sodium fluoride solution, Fluordent Reach, Oral-B, and Fluorgard). Roughness was evaluated at time intervals: T 0 after 24 h in artificial saliva (baseline); T 60 after being in assigned immersion media for 1 min daily over 60 days; and T final after artificial aging (20,000 thermal cycles, 1,200,000 mechanical loading cycles, and continuous immersion for 1,825 min). Surface morphology was qualitatively analyzed by scanning electron microscopy (SEM) at T 60 and T final. Roughness data were submitted to analysis of variance for mixed repeated measures, Sidak, and Tukey tests at α=0.05. Micro-filled resin showed the highest roughness values. Fluoride solutions had no influence on roughness. Higher roughness values were observed after artificial aging. In SEM observations after the artificial aging, the specimens showed surface degradation, irrespective of immersion medium or type of composite. Nano-filled resin showed higher loss of resin matrix and protrusion of filler particles. Roughness was not influenced by fluoride solutions; however, it is material dependent and increases over time.

Effects of immersion media and repolishing on color stability and superficial morphology of nanofilled composite resin.

This study evaluated the influence of fluoride mouth rinses and repolishing on the superficial morphology and color stability of nanofilled resin. About 150 specimens were prepared and polished using aluminum oxide discs for 15 s with a pressure of 2 kg. The experimental groups were divided according to the immersion medium (artificial saliva, 0.5% sodium fluoride, Fluordent Reach, Oral B, Fluorgard) and repolishing procedure (without and with). The specimens were continuously immersed for 1 week. Thereafter, half of each sample was repolished. A color reading was performed after 24 h of immersion in the artificial saliva baseline, after continuous immersion, and after repolishing. The superficial morphology was examined using scanning electron microscopy (SEM) in a qualitative way. Color change (∆E) data were submitted to a mixed analysis of variance using a Shapiro-Wilk test (p>0.05 for the different immersion media) and Sidak's test (p<0.05 for the differences between groups). In the interaction between the repolishing and the immersion media, Fluorgard showed a statistical difference between the ∆E values with and without repolishing (p<0.0001). On the SEM observations, both Fluordent Reach and Fluorgard caused degradation of the superficial resinous matrix of the composite after continuous immersion. This matrix was removed after repolishing.