Cross-Cultural Validation of the Brazilian Portuguese Version of the Pain Vigilance and Awareness Questionnaire.

AIMS: To cross-culturally adapt the Pain Vigilance and Awareness Questionnaire (PVAQ) to the Brazilian Portuguese language, to evaluate its psychometric properties when applied to Brazilian pain-free adults and to adults with different pain profiles, and to compare the PVAQ factor scores of different groups using a new method for calculating the overall scores for vigilance, attention to pain, and awareness of changes in pain. METHODS: A total of 1,143 adults (79% women; mean ± standard deviation [SD] age of 38.56 ± 10.73 years) participated. Face validity and content validity of the Brazilian Portuguese version of the PVAQ were tested. The fit of four PVAQ models was evaluated with confirmatory factor analysis (CFA), and the invariance of the model with the best fit was estimated across two independent samples (test sample: n = 732; validity sample: n = 411). The overall scores of the factors pain vigilance, attention to pain, and awareness of changes in pain were calculated by using the regression weight matrix obtained in the CFA. The overall scores between the four pain groups (no pain, n = 334; pain < 3 months, n = 386; recurrent pain ≥ 3 months, n = 244; continuous pain ≥ 3 months, n = 179) were compared. RESULTS: The refined two-factor model of the PVAQ fit best to the sample (χ²/degrees of freedom = 6.095; comparative fit index = 0.926; goodness of fit index = 0.928; root mean square error of approximation = 0.083; average variance extracted > 0.45; composite reliability and Cronbach's alpha > 0.85) and presented strong invariance in independent samples. Individuals with pain presented higher scores on PVAQ factors, and the highest scores were found among individuals with continuous pain. CONCLUSION: The Brazilian Portuguese version of the PVAQ was found to be adequate and reliable when applied to the sample. The methodologic considerations presented could improve research on pain vigilance and help clinicians assess PVAQ factors among patients.

Psychometric Properties of the Multidimensional Pain Inventory Applied to Brazilian Patients with Orofacial Pain.

AIMS: To evaluate the psychometric properties of the Multidimensional Pain Inventory (MPI) in a Brazilian sample of patients with orofacial pain. METHODS: A total of 1,925 adult patients, who sought dental care in the School of Dentistry of São Paulo State University's Araraquara campus, were invited to participate; 62.5% (n=1,203) agreed to participate. Of these, 436 presented with orofacial pain and were included. The mean age was 39.9 (SD=13.6) years and 74.5% were female. Confirmatory factor analysis was conducted using χ²/df, comparative fit index, goodness of fit index, and root mean square error of approximation as indices of goodness of fit. Convergent validity was estimated by the average variance extracted and composite reliability, and internal consistency by Cronbach's alpha standardized coefficient (α). The stability of the models was tested in independent samples (test and validation; dental pain and orofacial pain). The factorial invariance was estimated by multigroup analysis (Δχ²). RESULTS: Factorial, convergent validity, and internal consistency were adequate in all three parts of the MPI. To achieve this adequate fit for Part 1, item 15 needed to be deleted (λ=0.13). Discriminant validity was compromised between the factors "activities outside the home" and "social activities" of Part 3 of the MPI in the total sample, validation sample, and in patients with dental pain and with orofacial pain. A strong invariance between different subsamples from the three parts of the MPI was detected. CONCLUSION: The MPI produced valid, reliable, and stable data for pain assessment among Brazilian patients with orofacial pain.

Pharmacology and biochemistry undergraduate students' concern for a healthy diet and nutrition knowledge.

OBJECTIVE: To estimate the concern for a healthy diet and the nutrition knowledge of undergraduate students of a pharmacology and biochemistry program and their associations with the variables of interest. METHODS: This cross-sectional study administered the Nutrition Knowledge Scale and the How is your diet? questionnaire to 381 students. The associations between concern for a healthy diet and nutrition knowledge and between these two factors and the demographic variables were measured by the chi-square test (χ2) or Fisher's exact test. The significance level was set at 5%. RESULTS: The mean age of the students was 20.6 (standard deviation [SD] = 2.7) years; 78.2% were female students; their mean body mass index was 22.6 (SD = 3.7) kg/m²; and 73.5% had an appropriate body mass index-related nutritional status. Most students fell within the category "pay attention to your diet" (77.1%) and "moderate nutrition knowledge" (79.7%). Concern for a healthy diet was significantly associated with program year (p = 0.024), socioeconomic class (p = 0.012), and physical activity (p <0.001). Nutrition knowledge was associated only with program year (p < 0.001). Concern for a healthy diet was not associated with nutrition knowledge (p = 0.808). CONCLUSION: Physically inactive, first-year students from socioeconomic class B (US$ 1,046 - 1,872) were less concerned with a healthy diet. Such concern was not related to the students' nutrition knowledge.

Objetivo: Estimar la preocupación por una alimentación sana y el conocimiento de la nutrición de los estudiantes de un título de grado en Farmacia y Bioquímica y su asociación con variables de interés. Métodos: Este estudio transversal. Participaron 381 estudiantes. Fue utilizado como instrumentos de medición a "Escala El conocimiento nutricional" y "¿Cómo está la comida?". Se realizó un estúdio asociación entre la preocupación por una alimentación sana y el conocimiento nutricional y aquellos con las variables demográficas mediante el uso de la prueba de chi-cuadrado (2) o Fisher. Hemos adoptado un nivel de significación del 5%. Resultados: La edad promedio de los estudiantes fue de 20,6 (SD = 2,7) años, el 78,2% eran varones femenina. El índice de masa corporal (IMC) fue de 22,6 (SD = 3,7) kg/m2 y 73,5% se presentaron con un estado nutricional adecuado para este indicador. La mayoría de los alumnos evaluados fueron categorizados como "estad atentos con la comida" (77,1%) y "el conocimiento nutricional moderado" (79,7%). Se han observado asociaciones significativas entre la preocupación por una alimentación sana y año del curso (p = 0,024), la classe económica (p = 0,012) y la actividad física (p < 0,001). El conocimientos nutricionales sólo se asoció con el año del curso (p < 0,001). No se encontró asociación significativa entre la preocupación por una alimentación saludable y conocimientos sobre nutrición (p = 0,808). Conclusión: Los estudiantes de primer año por supuesto, pertenecen a la clase económica B y no físicamente activos mostraron una menor preocupación por una alimentación saludable. Esta preocupación no se estaba relacionado con el conocimiento nutricional presentado por los estudiantes.

Three-dimensional sonographic assessment of placental volume and vascularization in pregnancies complicated by hypertensive disorders.

OBJECTIVES: The purpose of this study was to evaluate the association between placental volumes, placental vascularity, and hypertensive disorders in pregnancy. METHODS: A prospective case-control study was conducted between April 2011 and July 2012. Placental volumes and vascularity were evaluated by 3-dimensional sonographic, 3-dimensional power Doppler histographic, and 2-dimensional color Doppler studies. Pregnant women were classified as normotensive or hypertensive and stratified by the nature of their hypertensive disorders. The following variables were evaluated: observed-to-expected placental volume ratio, placental volume-to-estimated fetal weight ratio, placental vascular indices, and pulsatility indices of the right and left uterine and umbilical arteries. RESULTS: Sixty-six healthy pregnant women and 62 pregnant women with hypertensive disorders were evaluated (matched by maternal age, gestational age at sonography, and parity). Placental volumes were not reduced in pregnancy in women with hypertensive disorders (P > .05). Conversely, reduced placental vascularization indices (vascularization index and vascularization-flow index) were observed in pregnancies complicated by hypertensive disorders (P < .01; P < .01), especially in patients with superimposed preeclampsia (P = .04; P = .02). A weak correlation was observed between placental volumes, placental vascular indices, and Doppler studies of the uterine and umbilical arteries. CONCLUSIONS: Pregnancies complicated by hypertensive disorders are associated with reduced placental vascularity but not with reduced placental volumes. These findings are independent of changes in uterine artery Doppler studies. Future studies of the prediction of preeclampsia may focus on placental vascularity in combination with results of Doppler studies of the uterine arteries.