Search Results (221)

Background: Research has shown that disordered eating behaviors—including binge eating, night eating syndrome, and food addiction—contribute to the heterogeneity of obesity and assist in phenotyping patients for more tailored interventions. The Eating Behavior Assessment for Obesity (EBA-O) is a recently developed 18-item questionnaire that assesses five pathological eating-behavior domains among individuals with obesity (night eating, food addiction, sweet eating, hyperphagia, and binge eating). The present study aimed to translate, culturally adapt, and validate the Persian (Farsi) version of the EBA-O. Methods: The original English EBA-O was translated into Persian following a standardized forward–backward translation procedure, with cultural adaptations implemented to ensure linguistic accuracy and conceptual clarity. A cross-sectional sample of 278 Iranian adults with overweight or obesity (body mass index [BMI] ≥ 25 kg/m²) completed the Persian EBA-O. Confirmatory factor analysis (CFA) was conducted to verify the five-factor model in the Persian sample. Internal consistency was evaluated using Cronbach’s alpha and composite reliability (CR). Convergent validity was assessed using the average variance extracted (AVE), and discriminant validity was examined with the Heterotrait–Monotrait ratio (HTMT). Model fit indices, including the Comparative Fit Index [CFI], Tucker–Lewis Index [TLI], Normed Fit Index [NFI], Goodness-of-Fit Index [GFI], the Standardized Root Mean Square Residual [SRMR] and relative chi-square value [χ²/df] were used to determine the adequacy of the factor structure. Results: The Persian EBA-O demonstrated a clear and stable five-factor structure consistent with the original instrument. CFA indicated good model fit (CFI = 0.95, TLI = 0.94, NFI = 0.91, GFI = 0.92, SRMR = 0.05, χ²/df = 1.94), confirming the presence of the intended domains. Internal consistency was acceptable to high across all subscales (Cronbach’s α = 0.78–0.86; CR > 0.70), and the total scale showed strong reliability. Three of the five factors demonstrated acceptable convergent validity (AVE = 0.54–0.68), while Food Addiction (AVE = 0.46) and Night Eating (AVE = 0.43) fell slightly below the 0.50 threshold; however, their adequate CR and α values indicate that these constructs remain coherent and psychometrically sound. All inter-factor correlations satisfied discriminant validity criteria (HTMT < 0.90), with the highest association observed between the Binge Eating and Hyperphagia factors. Overall, the psychometric properties of the Persian EBA-O were comparable to those reported in the original validation and subsequent translations. Conclusions: The Persian version of the EBA-O is a valid and reliable instrument for assessing pathological eating behaviors among individuals with obesity. It preserves the original questionnaire’s five-factor structure and demonstrates acceptable internal consistency and construct validity in a Persian-speaking population. This validated tool will support both clinical assessment and research on eating-behavior phenotypes and may contribute to the development of more personalized and effective obesity-management strategies among Persian-speaking individuals. Full article

Background: Teamwork and effective communication are widely recognized as essential pillars for the safety and quality of healthcare. However, in Portugal, no validated instrument had previously been available to assess healthcare professionals’ attitudes toward teamwork. This study aimed to translate, culturally adapt, and validate the TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) for the Portuguese context, resulting in the Portuguese version of the instrument. Methods: A methodological study with a quantitative approach was developed. The translation and cultural adaptation process followed internationally recognized guidelines. The sample consisted of 162 healthcare professionals (136 nurses and 26 physicians) from a hospital in Lisbon. Exploratory and confirmatory factor analysis techniques were used to assess construct validity. The internal consistency of the scale was analyzed using Cronbach’s alpha coefficient. Results: The Portuguese version comprises 30 items distributed across five dimensions: Effective Leadership Support, Team Functional Performance, Teamwork Coordination, Willingness to Engage in Teamwork, and Team Functioning Supervision. The scale demonstrated a total explained variance of 53.9% and an overall internal consistency coefficient (α) of 0.86, indicating good reliability. Confirmatory factor analysis supported the five-factor structure of the scale (χ²/df = 1.461; CFI = 0.900; GFI = 0.821; RMSEA = 0.054; MECVI = 4.731). Conclusions: The T-TAQ-PT proved to be a valid, reliable, and robust instrument for assessing healthcare professionals’ individual attitudes toward teamwork, contributing to the development of research and clinical practice in the Portuguese context. Full article

Background/Objective: This study aimed to translate the Fullerton Advanced Balance Scale (FAB) into Arabic and assess the instrument’s reliability and validity. Methods: The study was carried out in two distinct stages: (i) the translation and adaptation process utilizing the ‘forward-back’ translation method and (ii) the psychometric evaluation of the Arabic version of the FAB-A among a sample of 68 older persons residing in the community. Results: The internal consistency of the FAB-A was excellent (Cronbach’s alpha = 0.86). The Intraclass Correlation Coefficient (ICC) for the inter-rater tests (ICC = 0.96, p ≤ 0.001) and the intra-rater tests (ICC = 0.95, p ≤ 0.001) were excellent and significant. The scale showed a strong correlation with the Berg Balance Scale (r = 0.75). The sampling adequacy for factor analysis was proven by a Kaiser–Meyer–Olkin value of 0.84. The goodness of fit (GFI) statistics for the model were in the acceptable range (Chi-square/Degree of freedom (CMIN/DF) = 1.38, Goodness-of-Fit Index (GFI) = 0.88, Comparative Fit Index (CFI) = 0.95, Root Mean Square Error of Approximation (RMSEA) = 0.07). Conclusions: The FAB-A has demonstrated excellent psychometric qualities for measuring balance in older adults. Full article

Background/Objectives: Current studies have shown that caregiving anxiety is associated with an individual’s dysfunctional thoughts. The aim of this study was to assess the mediating effect of caregivers’ forgiveness (benevolence, lack of avoidance and lack of revenge) on the relationship between dysfunctional thoughts and anxiety in the informal caregivers of dependent older adults. Methods: Participants were 222 family caregivers. We conducted path analysis to test the hypothesized model. Results: We found a model that showed a good fit (χ² = 3.410; χ²/gL = 5; p = 0.63; GFI = 0.994; CFI = 0.999; RMSEA = 0.001). It showed a direct and negative association between dysfunctional thoughts and lack of revenge, and this variable was related positively with both benevolence and lack of avoidance. In turn, benevolence was associated with lower levels of anxiety. The associations between dysfunctional thoughts and anxiety were mediated by caregiver forgiveness. Conclusions: Our research suggests the importance of health workers seeking to understand how individuals judge their avoidance, revenge and lack of benevolence, which affect individuals’ anxiety, for change. This study demonstrates the relevance of forgiving strategies in developing and testing informal caregiving assessments. It is necessary to detect and reduce avoidance and revenge related to caregivers. It is also necessary to detect and improve benevolence. Full article

Background/Objective: This study aimed to adapt the Mental Fatigue Scale (MFs) to evaluate the psychometric properties in adult and adolescent athletes. Methods: A total of 491 adolescent and adult athletes (n = 491) consisting of 204 adults (men = 115; female = 90; age = 24.38 ± 3.18 year) and 287 adolescents (men = 178; female = 109; age = 14.97 ± 1.55 year) who actively participated in various sports branches voluntarily participated in this study. The MFs consists of fifteen (15) items and a single-factor structure and is a measurement tool used to measure the general mental fatigue level of athletes. Two experts used a four-point Likert scale to assess the content validity of each of the fifteen MFs items, which were aligned with the provided definition of mental fatigue in a sports context. Drawing on these findings, a confirmatory factor analysis was conducted on the survey data collected to assess the construct validity of this measure. Results: The outcomes of the confirmatory factor analysis provided acceptable support for factorial validity (χ²/sd = 1.52; p < 0.01, SRMR = 0.05, RMSEA = 0.08, GFI = 0.94, CFI = 0.89, NNFI = 0.87). Additionally, multi-group confirmatory factor analysis supported measurement invariance, indicating that the scale functions equivalently across adolescent and adult athletes. Furthermore, the analysis demonstrated favorable internal consistency (α = 0.88), confirming the reliability of the MFs. Test–retest after two weeks revealed an intra-class correlation of 0.90. Conclusions: Collectively, these results suggest that the MFs is a dependable and valid instrument that is particularly valuable for gauging overall mental fatigue in athletes. Coaches and sports scientists can use this assessment tool to evaluate athletes’ general mental fatigue effectively. Full article

Flood hazards in arid oil-producing regions result from both natural hydrological processes and terrain changes due to land subsidence. In the Yibal field in northern Oman, long-term hydrocarbon extraction has caused measurable ground deformation, altering surface gradients and drainage patterns. This study presents a deformation-adjusted flood hazard assessment by integrating a 2013 photogrammetric DEM with a 2023 subsidence-corrected DEM derived from multi-temporal PS-InSAR observations (RADARSAT-2 and TerraSAR-X). Key hydrological indicators—including slope, drainage networks, Height Above Nearest Drainage (HAND), floodplain depth, Curve Number, and extreme precipitation from the wettest monthly rainfall in a 10-year archive—were recalculated for both years. Flood hazard maps for 2013 and 2023 were generated using an AHP-based multi-criteria framework across five hydrologically motivated scenarios. Results indicate that while the total area of high- and very-high-hazard zones changed only slightly in most scenarios (within ±6%), these zones shifted into subsidence-affected depressions, reflecting deformation-driven redistribution of flood-prone areas. Low-hazard zones grew most significantly, especially in Scenarios S2–S4, with increases of 160–320% compared to 2013, while moderate-hazard areas showed smaller but consistent growth. Floodplain-dominated conditions (S5) produced the most pronounced nonlinear response, with a substantial increase in very low hazard and localized concentration of very high hazard in areas of deepest subsidence. Geomorphic analysis using the Geomorphic Flood Index (GFI) shows deepening of flow pathways and expansion of geomorphic depressions between 2013 and 2023, supporting the modeled redistribution of hazards. These findings demonstrate that even moderate subsidence can significantly alter hydrological susceptibility and underscore the importance of incorporating deformation-adjusted terrain modeling into flood hazard assessments in petroleum fields and other subsidence-prone areas. Full article

Background and Objectives: In clinical practice and research, it is necessary to use a standardized measurement tool to accurately determine dietary adherence in adults with celiac disease. The aim of this study is to validate the Celiac Dietary Adherence Test (CDAT) in the Turkish patients with celiac disease. Methods: The CDAT was translated using forward-backward translation method, reviewed by experts, and tested for comprehensibility. The final revised version of the CDAT was completed by 97 adults diagnosed with celiac disease and following a gluten-free diet. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was evaluated via internal consistency (Cronbach’s alpha) and test–retest reliability (Pearson correlation) after re-administration within 2 weeks. Results: Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) value of 0.69, with Bartlett’s test of sphericity being significant (p < 0.001). EFA indicated a single-factor structure, explaining 55% of the total variance. CFA showed acceptable fit indices for the model (χ²/df = 1.45, CFI = 0.93, TLI = 0.90, RMSEA = 0.07, GFI = 0.94, AGFI = 0.88). Reliability analyses indicated Cronbach’s alpha of 0.70, and a test–retest correlation of 0.92. Items 5 and 6 were removed from the Turkish version of the CDAT because their factor loadings were below 0.40. Conclusions: The Turkish CDAT is valid and reliable for rapid, standardized assessment of adherence to a gluten-free diet in adults with celiac disease. Full article

Based on the Theory of Planned Behavior (TPB), this is the first study that integrates Entrepreneurial Policy (EPL) and Entrepreneurial Network Relations (ENR) to examine the direct and indirect effects on entrepreneurial intention (INT) in Thailand. The quantitative method employs a structural equation model (SEM) to analyze 420 valid samples from eight universities. Model fix with χ2 = 183.31, df = 224 p = 0.98 GFI = 0.97 AGFI = 0.95 RMR = 0.031 RMSEA = 0.000. The results showed EPL has the most direct influence on (INT) β = 0.38, like ENR, which indirectly shapes (INT) through attitude and self-efficacy. The model’s R² of 0.69 highlights the significance of policy support and social networks in (INT). The findings provide theoretical contributions and practical implications. Theoretically, expanding TPB by incorporating policy and social network dimensions offers a comprehensive understanding of entrepreneurial behavior. Universities integrate entrepreneurship education and innovation into engineering curricula and implement these concepts in other faculties or institutions. Government agencies support startup policy funds, tax incentives, and innovation hubs. Industries can establish a mentorship network to promote entrepreneurial intention and reduce graduate unemployment. Support both the ecosystem and innovative commercialization. Full article

Background: Nutrition literacy (NL) plays a crucial role in shaping long-term health behaviors among college students, particularly during the transformative final phase of their school education. This study investigated the level of NL among college students in Beijing and examined its association with these behaviors. Methods: A cross-sectional online survey was conducted among 765 students from 12 universities in Beijing. The questionnaire comprised three sections: demographic characteristics, lifestyle factors, and a nutrition literacy scale (Cronbach’s α = 0.893; χ²/DF = 4.750; RMSEA = 0.048; GFI = 0.891; AGFI = 0.876). The NL scale was divided into two domains: cognition and skills. Descriptive statistics were used to summarize NL scores and their distributions across dimensions and subgroups. Group differences for categorical variables were examined using chi-square or Fisher’s exact tests. Logistic regression analyses was employed to identify factors associated with NL. Mediation effects were tested using the Baron and Kenny approach. Results: The mean NL score was 67.74 ± 9.07, with only 7.6% of participants achieving an excellent NL level. Several lifestyle factors were significantly associated with excellent NL. Students with monthly living expenses of 2000–3000 CNY (OR = 2.35, p = 0.019) and >3000 CNY (OR = 3.22, p = 0.023) had higher odds of excellent NL compared to those spending <2000 CNY. Occasional exercise (OR = 2.36, p = 0.026) and daily breakfast consumption (OR = 2.76, p = 0.027) were also positively associated with excellent NL. In contrast, frequent midnight snacking significantly reduced the likelihood of excellent NL (OR = 0.20, p = 0.031). Better self-rated health status was strongly correlated with higher NL (OR = 2.82, p = 0.012). Moreover, NL mediated the relationship between lifestyle factors and healthy eating behaviors, underscoring a gap between nutritional knowledge and practical food skills. Conclusions: Current findings indicated suboptimal nutrition literacy among college students in Beijing, particularly in food selection skills. Excellent NL rates were associated with demographic and lifestyle factors, with NL serving as a mediator between lifestyle and health-related behaviors. These results emphasize the need for targeted nutrition education programs to enhance both knowledge and practical skills among university students. Full article

Contemporary transformations in the world of work, together with the growing emotional and physical demands in nursing, have led to the emergence of new labor phenomena such as quiet quitting, which reflects changes in professional engagement and in the management of nurses’ well-being. Objective: To translate, culturally adapt, and validate the Quiet Quitting Scale for European Portuguese, evaluating its psychometric properties among the nursing population. Methods: A cross-sectional validation study was conducted following COSMIN guidelines. The process included forward and back translation, expert panel review, and pretesting with 30 nurses. The psychometric evaluation was carried out with 347 nurses from Northern Portugal. Data were analyzed using descriptive and inferential statistics, internal consistency measures (Cronbach’s α and McDonald’s ω), and confirmatory factor analysis (CFA) with maximum likelihood estimation to assess construct validity. Results: The Portuguese version (QQS-PT) maintained the original three-factor structure (Detachment/Disinterest, Lack of Initiative, and Lack of Motivation). The model showed satisfactory fit indices (CFI = 0.936; GFI = 0.901; AGFI = 0.814; TLI = 0.905; RMSEA = 0.133). The overall internal consistency was excellent (α = 0.918; ω = 0.922), with subscale α ranging from 0.788 to 0.924. Composite reliability (CR) ranged from 0.815 to 0.924, and average variance extracted (AVE) from 0.606 to 0.859, confirming convergent and discriminant validity. Conclusions: The QQS-PT demonstrated a stable factorial structure, strong reliability, and solid validity evidence. It is a brief and psychometrically sound instrument for assessing quiet quitting among nurses, providing valuable insights for research and management of professional engagement and well-being in healthcare contexts. Full article

Background/Objectives: Adjustment to aging is a key indicator of positive aging and psychological maturity, influenced by cultural and social contexts. This study aimed to translate and evaluate the psychometric properties of the Adjustment to Aging Scale (AtAS) among Iranian older adults. Material and methods: This cross-sectional study was conducted in Tehran, 2024. Following translation and cross-cultural adaptation, face validity, content validity, and reliability of the questionnaire were assessed. The WHO-5 well-being index was used to assess concurrent validity. A total of 328 older adults aged 60 years and above completed the study instruments. Data were analyzed using Confirmatory Factor Analysis (CFA), Cronbach’s alpha, Pearson correlation, independent t-tests, and ANOVA via SPSS version 22 and AMOS 24. The significance level was set at p ≤ 0.05. Results: The mean (SD) age of the participants was 69.42 (6.8) years. Face and content validity were confirmed by fourteen experts (CVI = 0.94). CFA supported the five-factor structure of the questionnaire (χ²/df = 2.06, GFI = 0.90, PCLOSE = 0.07, RMSEA = 0.05), indicating a good model fit. The total questionnaire showed acceptable internal consistency (Cronbach’s alpha = 0.80) and excellent test–retest reliability (ICC = 0.98). Pearson’s correlation revealed a significant positive relationship between the WHO-5 Well-Being Index and AtAS scores (r = 0.56, p < 0.05), supporting criterion validity. Conclusions: The Persian AtAS showed strong psychometric properties, supporting its use in both research and clinical settings, although further studies are recommended to strengthen evidence for its clinical application. Full article

This research investigates the synergistic relationships between Green Supply Chain Management (GSCM) practices and product innovation in marketing performance and organizational sustainability within Thailand’s processed food industry. Building upon Resource-Based View theory and Stakeholder Theory, this study addresses a critical gap in understanding how environmental practices interact with innovation strategies to create sustainable competitive advantages in emerging markets. The research employs a comprehensive mixed-methods approach, integrating qualitative insights from industry expert interviews with quantitative analysis through Structural Equation Modeling (SEM). Primary data were systematically collected from 300 strategically selected enterprises representing small (≤50 employees), medium (51–200 employees), and large-scale (>200 employees) operations across diverse product categories within Thailand’s processed food sector. The analytical framework examines three core GSCM dimensions—green purchasing, green production, and green distribution—alongside three innovation aspects—quality innovation, safety innovation, and sustainability innovation. Eleven hypothesized relationships were rigorously tested to examine direct and indirect effects on marketing performance indicators (sales growth, market share expansion, brand enhancement, customer satisfaction, and cost optimization) and organizational sustainability metrics (environmental impact reduction, regulatory compliance, competitive positioning, and resource efficiency). SEM results revealed that Green Production practices significantly enhance marketing performance (β = 0.16, p < 0.01), demonstrating the strategic value of environmentally responsible production processes in achieving market success. Conversely, Green Distribution exhibited negative effects on both marketing performance (β = −0.106, p < 0.10) and organizational sustainability (β = −0.152, p < 0.05), indicating potential operational trade-offs and infrastructure limitations that require strategic optimization. The model demonstrated excellent fit indices (GFI = 0.929, CFI = 1.000, TLI = 1.000, RMSEA = 0.000, RMR = 0.034), validating the theoretical framework’s robustness. However, modest explanatory power (R² MP = 0.050, R² OS = 0.029) suggests that additional contextual factors, firm-specific capabilities, and market dynamics significantly influence these outcomes, warranting future investigation of mediating and moderating variables. Full article

Background: (1) Objective: This study aimed to develop and evaluate a structural model of life satisfaction in older adults, integrating the World Health Organization’s biopsychosocial determinants and the theory of gerotranscendence to provide a more holistic understanding of the aging experience. (2) Methods: A cross-sectional study was conducted with 600 older adults (≥60 years) residing in Tehran, selected through proportional random sampling. Data was collected via validated instruments assessing demographic factors, physical and mental health, social support, environmental condition quality, and gerotranscendence. Structural Equation Modeling (SEM) using AMOS 24 and hierarchical regression were employed for data analysis. (3) Results: The findings revealed that physical health, mental health, social support, environmental conditions, and gerotranscendence were all significantly associated with life satisfaction (p < 0.01). Hierarchical regression analysis showed that gerotranscendence remained an independent and significant predictor of life satisfaction, even after accounting for other variables. The final model explained approximately 39% of the variance in life satisfaction and demonstrated good fit indices (RMSEA = 0.051, CMIN/DF = 2.545, PCLOSE = 0.272, GFI = 0.815). (4) Conclusion: The proposed model offers a comprehensive framework for understanding life satisfaction in older adults, highlighting the unique contribution of gerotranscendence. These findings highlight the importance of integrated interventions that enhance physical and mental health, promote social and environmental well-being, and foster spiritual growth. Future research should consider longitudinal and mixed-method designs to further explore causal relationships and cultural contexts. Full article

Background: The aim of this study was to compare four recently introduced LLMs (ChatGPT-5, Grok 4, Gemini 2.5 Flash, and Claude Sonnet-4). Experienced endodontists evaluated the accuracy, completeness, and readability of the responses given to open-ended questions about iatrogenic events in endodontics. Methods: Twenty-five open-ended questions related to iatrogenic events in endodontics were prepared. The responses of the four LLMs were evaluated by two specialist endodontists using a Likert scale for accuracy and completeness, and the Flesch Reading Ease Score (FRES), Flesch–Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simplified Measure of Gobbledygook (SMOG), and Coleman–Liau Index (CLI) for readability. Results: The accuracy score of ChatGPT-5’s responses to open-ended questions (4.56 ± 0.65) was found to be significantly higher than those of Gemini 2.5 Flash (3.64 ± 0.95) and Claude Sonnet-4 (3.44 ± 1.19) (p = 0.009, and p = 0.002, respectively). Similarly, the completeness score of ChatGPT-5 (2.88 ± 0.33) was higher than those of Claude Sonnet-4, Gemini 2.5 Flash, and Grok 4 (p < 0.001, p = 0.002, and p = 0.007, respectively). In terms of readability measures, ChatGPT-5 and Gemini 2.5 Flash achieved better FRESs than Claude Sonnet-4 (p = 0.003, and p < 0.001, respectively). Conversely, FKGL scores were higher for Claude Sonnet-4 and Grok 4 compared to ChatGPT-5 (p < 0.001, and p = 0.008, respectively). Correlation analyses revealed a strong positive association (r_s = 0.77; p < 0.001) between accuracy and completeness, a weak negative correlation (r_s = −0.19; p = 0.047) between completeness and FKGL, and a strong negative correlation between (r_s = −0.88; p < 0.001) FKGL and FRES. Additionally, ChatGPT-5 demonstrated lower GFI and CLI scores than the other models, while its SMOG scores were lower than those of Gemini 2.5 Flash and Grok 4 (p = 0.001, and p < 0.001, respectively). Conclusions: Although differences were observed between the LLMs in terms of the accuracy and completeness of the responses, ChatGPT-5 showed the best performance. Even with high scores of accuracy (excellent) and completeness (comprehensive), it must not be forgotten that incorrect information can lead to serious outcomes in healthcare services. Therefore, the readability of responses is of critical importance, and when selecting a model, readability should be evaluated together with content quality. Full article

Background/Objectives: In Japan, the human papillomavirus (HPV) vaccine introduction process is unique, and no HPV knowledge scale with established reliability and validity currently exists. This study aimed to develop a new HPV knowledge scale and evaluate its reliability and validity for practical use. Methods: With permission from the original authors of the HPV Knowledge Scale (Jo Waller et al.), we created a Japanese version incorporating the original two subscales and adding new items. The translation process involved multiple researchers, back-translation by a professional agency, and expert review to ensure linguistic and contextual accuracy. The study was approved by the Clinical Research Ethics Review Board of the researchers’ affiliated universities and conducted between April and August 2024. Results: Reliability and validity were assessed using data from 793 parents of junior high school students, including both boys and girls. Confirmatory factor analysis showed a good model fit (Goodness-of-Fit Index [GFI] = 0.934, Adjusted GFI [AGFI] = 0.907, Comparative Fit Index [CFI] = 0.928, Root Mean Square Error of Approximation [RMSEA] = 0.063). Cronbach’s alpha ranged from 0.688 to 0.845 and item-total correlations ranged from 0.393 to 0.584. Test–retest reliability, assessed with Spearman’s rank correlation, was r = 0.791 (p < 0.001). The final scale, named the Japan HPV Knowledge Scale (J-HPV-KS), includes 17 items across five factors. Conclusions: The J-HPV-KS covers HPV-related diseases, transmission routes, natural history, and vaccines. It demonstrated sufficient reliability and validity for use in Japan and is a useful tool for assessing HPV-related knowledge among Japanese parents and guardians. Full article