Search Results (171)

Background/Objectives: The obesity epidemic coexists with the phenomenon of “hidden hunger” (Type B malnutrition)—a micronutrient deficiency amidst a caloric excess. Traditional dietary assessment methods often distort the actual picture by ignoring technological losses during cooking, which necessitates the use of digital tools. Methods: A cross-sectional study (N = 3267) was conducted using the digital platform “NIAP”. The analysis was based on valid 3–7-day dietary records with algorithmic accounting for nutrient retention factors during thermal processing. The nutrient profiles of individuals with a normal body mass index (BMI) and obesity (BMI ≥ 30 kg/m²) were compared. Results: The epidemiology of intake shortfalls was highly prevalent and pronounced: 99.9% of the cohort had ≥1 inadequacy (with a mean negative deviation of −77.3% for vitamin D and −59.2% for Omega-3), and 61.5% exhibited ≥10 simultaneous multiple intake shortfalls. These inadequacy rates remained robust in a sensitivity analysis excluding under-reporters. The obesity group consumed significantly more energy, saturated fatty acids, added sugars, cholesterol, and sodium, but demonstrated a lower relative macronutrient intake (g/kg of body weight). Absolute fiber intake did not differ between the groups, indicating a decrease in its density per 1000 kcal in the diet of individuals with obesity; the intake of Omega-3 polyunsaturated fatty acids (PUFAs) showed a downward trend. The Na:K ratio was significantly higher in the obesity group (1.19 vs. 1.04, p < 0.001). Correlation analysis confirmed an inverse relationship between BMI and the overall nutrient density of the diet. Conclusions: A high-energy diet does not compensate for systemic micronutrient inadequacy among the evaluated cohort. Obesity is associated with a dietary imbalance favoring “empty calories” and pro-inflammatory components against a background of severe multiple dietary inadequacies. The integration of algorithmic dietary assessment that accounts for cooking losses is critical for objective diagnosis and personalized nutritional intervention. Full article

The objectives of this study were to evaluate the effects of different dietary omega-6 to omega-3 (n-6:n-3) fatty acid ratios during timed artificial insemination (TAI) on reproductive responses, luteal development, and offspring characteristics in lactating dairy cows. Holstein cows (n = 60) averaging 109 ± 10 days in milk (DIM) were randomly assigned to receive either a greater n-6:n-3 diet or a lower n-6:n-3 diet for 42 days. All cows were synchronized using a modified Ovsynch protocol. Although synchronized ovulation rates and pregnancy outcomes were not significantly affected by treatment, cows fed the lower n-6:n-3 ratio exhibited significantly greater corpus luteum (CL) volume and cross-sectional area on days 11 and 14 post-TAI, indicating enhanced luteal development. Pregnancy rates following the first AI and cumulative AI, as well as the number of services per conception, did not differ between treatments. However, cows fed the lower n-6:n-3 ratio tended to produce a greater proportion of female offspring (66.67% vs. 42.90%; p = 0.09). In addition, calves born to cows receiving the lower n-6:n-3 ratio had greater birth weights than calves born to cows fed the greater n-6:n-3 ratio diet. Additionally, the lower n-6:n-3 diet tended to increase milk yield and significantly increased lactose and solids-not-fat yields. In conclusion, a lower dietary n-6:n-3 ratio during a TAI program enhanced luteal development, tended to increase the proportion of female offspring and increased calf birth weight. These findings suggest that reducing the dietary n-6:n-3 ratio during the breeding period may enhance luteal development and may influence offspring sex ratio and calf birth weight in lactating dairy cows. Full article

Background and Objectives: The Back Beliefs Questionnaire (BBQ) is a patient-reported outcome measure used to assess beliefs about back pain. This study aimed to cross-culturally adapt the BBQ into Serbian and evaluate the psychometric properties of the Serbian version (BBQ-Srb) in patients with chronic low back pain. Materials and Methods: A cross-sectional study involving cross-cultural adaptation and psychometric validation was conducted in 143 patients with chronic low back pain. The adaptation process included forward and backward translation, expert review, and pilot testing. Psychometric evaluation included assessment of floor and ceiling effects, internal consistency, test–retest reliability, measurement error, exploratory and confirmatory factor analyses, and construct validity testing using predefined hypotheses. Construct validity was examined through associations between BBQ-Srb scores and pain intensity, disability, pain catastrophizing, and work absenteeism. Results: The BBQ-Srb showed acceptable internal consistency, with Cronbach’s alpha of 0.728 and McDonald’s omega of 0.735. Total-score analyses were based on the preliminary exploratory 8-item BBQ-Srb version excluding BBQ13, whereas floor and ceiling effects were examined for the original 9-item scored BBQ-Srb version. Test–retest reliability was excellent (ICC = 0.916). Exploratory factor analysis suggested a predominantly one-factor structure, but the explained variance was modest. Confirmatory factor analysis of the 8-item version provided only partial support for unidimensionality, with marginal model fit and a low average variance extracted. The 8-item BBQ-Srb total score showed significant negative correlations with pain intensity, disability, and pain catastrophizing, confirming three of four predefined hypotheses. Conclusions: The BBQ-Srb demonstrated acceptable reliability and preliminary evidence of construct validity as a Serbian patient-reported outcome measure for assessing beliefs about back pain. However, structural validity was only partially supported, and the exploratory 8-item structure requires confirmation in larger, independent, and more diverse Serbian-speaking samples. Full article

Background/Objectives: Adequate micronutrient intake during pregnancy is critical for fetal development, yet whether pregnant women and healthcare professionals share consistent knowledge, beliefs, and supplementation practices remains poorly characterized. Methods: Two parallel cross-sectional surveys using identical core items were conducted at a German tertiary care center between April and November 2024. Pregnant women (n = 132) and healthcare professionals who initiated the survey (n = 105) completed anonymous QR-code-based questionnaires assessing micronutrient-related knowledge, perceived dietary adequacy, and supplementation practices or recommendation patterns. Comparative analyses were restricted to fully completed healthcare professional questionnaires (n = 80). Group differences were analyzed using chi-square or Fisher’s exact tests. Results: Healthcare professionals demonstrated higher knowledge levels across most micronutrients. Knowledge gaps were most pronounced for vitamin B12, with 53.0% of pregnant women unable to identify any fetal effect compared with 20.0% of providers (p < 0.001). Beliefs about dietary sufficiency were broadly aligned for folic acid (p = 0.452) and vitamin D (p > 0.999), but diverged markedly for vitamin B12, where 79.2% of providers considered dietary intake alone adequate compared with 47.3% of pregnant women (p < 0.001). Substantial differences were observed between patient-reported supplementation practices and provider-reported recommendation patterns: Vitamin B12 (70.0% vs. 3.8%), vitamin D (76.2% vs. 41.3%), omega-3 fatty acids (76.2% vs. 47.5%), and folic acid (98.5% vs. 81.3%; all p < 0.001). The internet was the most frequently cited information source among pregnant women (89.4%), while healthcare professionals reported using both scientific literature (75.0%) and internet-based resources (76.3%), the latter primarily for accessing professional and scientific information. Conclusions: Substantial patient–provider differences in micronutrient knowledge, beliefs, and supplementation practices persist even within a highly educated population at a tertiary care center. These findings suggest potential differences between patient-reported supplementation behavior and provider-reported recommendation practices, particularly for vitamin B12 and vitamin D. These findings suggest that more structured communication regarding micronutrient supplementation during pregnancy is needed. Full article

Background/Objective: Low back pain (LBP) is a leading cause of disability worldwide, and patient-reported outcome measures such as the Roland–Morris Disability Questionnaire (RMDQ) are essential for assessing LBP-related disability. While the Modern Standard Arabic version of the RMDQ has demonstrated preliminary reliability, its structural validity has not been thoroughly evaluated. This study aimed to assess the structural validity of the Modern Standard Arabic RMDQ using confirmatory factor analysis (CFA). Methods: A cross-sectional study was conducted for 113 patients with LBP recruited from outpatient physical therapy clinics in Saudi Arabia. Participants completed the Modern Standard Arabic RMDQ, a 24-item instrument scored dichotomously. CFA was performed using the Weighted Least Squares Mean and Variance adjusted estimator to test a unidimensional model. Model fit was assessed using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), Tucker–Lewis Index (TLI), and Comparative Fit Index (CFI). Reliability was evaluated using McDonald’s omega (ω). Results: The initial one-factor CFA model showed close to acceptable fit (RMSEA = 0.044; SRMR = 0.149; TLI = 0.94; CFI = 0.93). After accounting for significant residual correlations between item pairs (items 4 & 21; 13 & 18), model fit improved (Δχ² = 22.33; Δdf = 2; p < 0.001) (RMSEA = 0.038; SRMR = 0.145; TLI = 0.95; CFI = 0.95). Most items had significant loadings on the latent construct, except item 2. McDonald’s ω was 0.91, indicating excellent internal consistency. Conclusions: The findings of this study provide supportive evidence for the structural validity and internal consistency of the Modern Standard Arabic version of the RMDQ and suggest the presence of a dominant unidimensional structure. The Arabic RMDQ may be useful for assessing LBP-related disability in Arabic-speaking patients with LBP, although further validation studies are warranted. Full article

Background: Adequate nutrition during young adulthood is essential for health promotion, optimal physiological function, and the prevention of non-communicable diseases. However, evidence describing both nutrient adequacy and compliance with dietary recommendations in well-characterized samples of young adults remains limited. Therefore, the aim of the present study was to describe macronutrient and micronutrient adequacy and to quantify compliance with current dietary recommendations in young adults using an individualized energy-adjusted nutrient adequacy approach (NARm), and to explore sex differences to identify priority targets to inform tailored health promotion and public health nutrition strategies. Methods: This cross-sectional study included 74 young adults aged 18–45 years participating in the NutAF project. Dietary intake was assessed using a 5-day dietary record, including three weekdays and two weekend days. Modified nutrient adequacy ratios (NARm), adjusted according to individualized total daily energy expenditure, were calculated for macronutrients and micronutrients. The prevalence of compliance with current dietary recommendations was also determined. Differences between men and women were analyzed using independent samples t-tests. Results: Protein and total lipid intake levels exceeded recommended values in most participants, whereas carbohydrate adequacy was below recommendations. Regarding micronutrients, adequate intake was observed for several nutrients; however, low adequacy and low compliance rates were identified for calcium, folate, vitamin D, and omega-3 and omega-6 polyunsaturated fatty acids. No participants met the recommendations for vitamin D. No significant sex differences were observed for most nutrients. Conclusions: Despite intake levels above recommendations for some macronutrients, young adults included in this study exhibited inadequate intake and low compliance with current dietary recommendations for several key nutrients. No relevant sex differences were observed for most nutrients. These findings, obtained using an individualized energy-adjusted nutrient adequacy approach (NARm), underscore the need for targeted nutritional strategies, including nutrition education and micronutrient-focused interventions, aimed at improving dietary adequacy and supporting health promotion in this population. Full article

Background/Objectives: Gestational Diabetes Mellitus (GDM) involves metabolic alterations that may affect breast milk composition. Imbalances in protein and fatty acid (FA) profiles have been reported in mature milk from mothers with GDM. However, evidence for colostrum and transitional milk is limited, despite the key role of ω-3 and ω-6 Polyunsaturated fatty acids (PUFAs) in neonatal neurodevelopment. This study compared ω-3 and ω-6 PUFAs and protein concentrations in colostrum and transitional milk from women with and without GDM. Methods: This cross-sectional study was conducted from January 2023 to December 2024. Women aged ≥ 18 years with GDM and non-GDM pregnancies recruited at Hospital General de México “Dr. Eduardo Liceaga” were included. Colostrum and transitional milk samples were collected at 0–5 and 6–14 days postpartum, respectively. To assess whether postpartum time (hours) and maternal group (non-GDM vs. GDM) affected milk volume, an analysis of covariance (ANCOVA) was performed. Differences in milk composition between the GDM and non-GDM groups were assessed using Student’s t test or the Mann–Whitney U test, according to variable distribution. Results: A total of 71 milk samples were analyzed: 51 colostrum samples (25 from women with GDM and 26 from women with non-GDM) and 20 transitional milk samples (10 from women with GDM and 10 from women with non-GDM). A moderate correlation was observed between milk volume and postpartum time, with no significant differences between the GDM and non-GDM groups. Colostrum from women with GDM had lower protein content compared with milk from women with non-GDM (3.8 ± 0.4 vs. 5.2 ± 0.5 g/dL, p = 0.02) and transitional milk (1.4 ± 0.2 vs. 2.2 ± 0.2 g/dL, p = 0.02). Transitional milk from GDM group showed higher total fat (5.7 ± 1.8 vs. 2.0 ± 0.4 g/100 g, p = 0.05) and fat-to-protein ratio (3.9 ± 1.1 vs. 1.0 ± 0.3, p = 0.02), along with an increased ω-6/ω-3 ratio driven by higher linoleic acid and lower α-linolenic acid concentrations. Conclusions: GDM was associated with variations in breast milk protein and FA profiles with a potential negative impact on the newborn’s neurodevelopment. Full article

Background: Ageism is a global public health concern associated with poorer health outcomes and inequities in care. Culturally adapted instruments are needed to assess ageist attitudes among healthcare professionals in Spain. This study aimed to cross-culturally adapt and evaluate the preliminary psychometric properties of the Spanish version of the Fraboni Scale of Ageism (FSA-SV). Methods: A methodological study was conducted, including translation and back-translation, expert review, and a pilot test. Content validity was assessed using the content validity index (CVI), the modified kappa coefficient, and Aiken’s V. A descriptive cross-sectional pilot study was conducted with 101 healthcare professionals from a single health department in Valencia to evaluate comprehension and reliability. Internal consistency was examined using Cronbach’s alpha and McDonald’s omega. Results: Content validity indices indicated acceptable agreement among experts (S-CVI = 0.745; Aiken’s V = 0.770). All items were retained to preserve conceptual and structural equivalence with the original instrument. The FSA-SV demonstrated high internal consistency (Cronbach’s alpha = 0.903; McDonald’s omega = 0.915). The mean total score was 51.2 (SD = 9.62), with no significant associations observed between ageism and participants’ sociodemographic or professional variables. Conclusions: This pilot study represents a first step in the cross-cultural adaptation and preliminary psychometric evaluation of the FSA-SV for use among healthcare professionals in Spain. The results suggest that the instrument shows promising initial properties for the preliminary assessment of ageism, supporting its potential utility in future research and in evaluating educational and organizational interventions aimed at reducing ageism and improving the quality and safety of care for older adults. Further studies with larger, more diverse samples are required to evaluate additional psychometric properties, including the factorial structure. Full article

Background: The Operating Room Management Attitudes Questionnaire (ORMAQ) is widely used to assess operating room (OR) staff attitudes toward patient safety and teamwork across diverse contexts. However, no validated French version currently exists, limiting its use in francophone settings. This study aimed to translate and culturally adapt the ORMAQ into French and to evaluate its psychometric properties, while also reporting OR professionals’ attitudes explored during the validation process. Methods: A cross-sectional methodological study was conducted among OR professionals, including surgeons, anesthetists, anesthesia nurses, operating room nurses, and residents. The original ORMAQ was translated into French using a standardized forward–backward translation procedure and pretested with 20 OR professionals. Content and concurrent validity were examined. Reliability was assessed through internal consistency, test–retest reproducibility, and dimension-level consistency. Construct validity was examined using both exploratory and confirmatory factor analyses (CFA). Results: The overall response rate to the survey was 76.5% (n = 303). The French ORMAQ demonstrated good internal consistency, as evidenced by both Cronbach’s alpha (α = 0.842) and McDonald’s Omega (ω = 0.98). For the individual dimensions, reliability values ranged from 0.597 to 0.891 for alpha and from 0.75 to 0.89 for Omega. Test–retest analysis showed excellent reproducibility (ICC = 0.96; 95% CI: 0.92–0.98). Factor analyses supported the eight-factor structure, with the CFA confirming good model fit and meaningful item loadings across dimensions, with standardized loadings ranging from 0.40 to 0.83. Conclusions: The French version of the ORMAQ showed satisfactory psychometric properties. It represents a robust tool for assessing safety and teamwork attitudes among OR professionals in francophone countries. Full article

Background/Objectives: Whether habitual dietary omega-3 fatty acid intake is reflected in circulating biomarkers of atrial fibrillation (AF)-related pathways is unclear. We assessed whether usual dietary intake of n-3 fatty acids—considered as total, marine-derived, or non-marine-derived—was associated with the trajectories of five serum markers that reflect AF-related mechanistic pathways [N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), high-sensitivity troponin T (hs-TnT), high-sensitivity C-reactive protein (CRP), the C-terminal propeptide of type-I procollagen (PICP), and 3-nitrotyrosine (3-NT)] over 5 years of follow-up. Methods: In 510 participants of the PREDIMED-Plus trial (older Spanish adults with metabolic syndrome), we measured plasma NT-pro-BNP, hs-TnT, CRP, PICP, and 3-NT at baseline and after 3 and 5 years. Energy-adjusted omega-3 intake was assessed with a validated 143-item food-frequency questionnaire. Cross-sectional and 5-year longitudinal associations according to tertiles of omega-3 fatty acid intake were estimated with linear regression and mixed-effects models. Results: Median total omega-3 intake was 2.0 g/day. Total omega-3 intake was not associated with any biomarker, neither cross-sectionally nor longitudinally. Marine omega-3 was directly associated cross-sectionally with 3-NT (highest vs. lowest tertile +28.4%, 95% CI 5.5 to 56.2; p-trend = 0.014) but not longitudinally. Moderate baseline non-marine omega-3 fatty acid intake was associated with a decrease in PICP after 5 years of follow-up. Conclusions: Overall, habitual total omega-3 fatty acid intake was not associated with circulating AF-related pathways. The sporadic association between marine omega-3 fatty acid intake and 3-NT in the cross-sectional assessment and the isolated non-linear association between baseline non-marine omega-3 fatty acid intake and PICP after 5 years warrant further investigation. Full article

Background/Objectives: Nursing organizational well-being has important implications for nurses, patients, and healthcare organizations. From a nursing-specific perspective, it arises from the balance between nursing demands and nursing resources in the work environment. However, most available instruments are not grounded in explicit nursing theory and do not allow the identification of well-being profiles through person-centered approaches. This study aimed to develop and evaluate the psychometric properties of the Nursing Organizational Well-being Questionnaire (NOW_Q). Methods: Following COSMIN guidelines, a two-phase design was adopted. Phase 1 involved item generation and expert evaluation, resulting in a 28-item instrument rated on a 5-point frequency scale. Phase 2 consisted of a multicenter cross-sectional study. Construct validity was examined through exploratory and confirmatory factor analyses using cross-validation. Reliability was assessed using ordinal omega coefficients, concurrent validity through associations with a global organizational well-being item, and cluster analysis to explore practical utility. Results: Findings (n = 461 nurses; 7 hospitals) supported an eight-dimension structure: workload, emotional demands, work–family conflict, autonomy, available resources, nurse–nurse relationship, nurse–head nurse relationship, and nurse–physician relationship. The confirmatory model showed good fit (RMSEA = 0.051; CFI = 0.938; TLI = 0.927; SRMR = 0.067), and all dimensions demonstrated satisfactory internal consistency (ordinal omega = 0.75–0.87). Significant associations with global organizational well-being were observed. Three distinct profiles emerged (Nurturing, Observed-Detached, and Withstanding), reflecting different configurations of nursing demands and resources. Conclusions: The NOW_Q is a theory-based, nursing-specific instrument with satisfactory psychometric properties and practical utility for identifying organizational well-being profiles and supporting targeted interventions in clinical settings. Full article

Background: HPV16 is the most prevalent high-risk genotype associated with cervical cancer, yet the genetic variability and immune potential of the replication protein E1 are less characterized in asymptomatic infections. We assessed HPV16 E1 diversity and predicted conserved T-cell epitopes. Methods: We conducted a descriptive cross-sectional study of cervical samples from women undergoing HPV screening. HPV was detected with universal primers and then HPV16-specific PCR. Thirty HPV16-positive samples underwent full-length E1 amplification and nanopore amplicon sequencing. Variability and phylogeny were analyzed with Clustal Omega and MEGA (maximum likelihood). MHC class I and II epitopes were predicted with the IEDB using HLA alleles representative of South American populations and evaluated for conservation, toxicity, allergenicity, and population coverage. Results: Mutations were detected in 14/30 samples, while 16 sequences matched the reference (GenBank: NC_001526.3). European lineages (A1–A3) predominated, with one sequence in the Asian-American lineage D. Seven highly conserved MHC I epitopes and 37 conserved MHC II epitopes were identified. Epitopes mapped to multiple regions across the E1 sequence. Predicted global coverage was 94.38% for MHC I, 83.75% for MHC II, and 99.09% combined. Conclusions: HPV16 E1 is highly conserved and contains candidate T-cell targets with broad predicted coverage, supporting evaluation for future vaccine or immunotherapy strategies. Full article

Background/Objectives: Evidence-based nutritional recommendations for obesity management require understanding of sex-specific and age-specific body composition patterns and their associations with metabolic biomarkers, habitual dietary intake and chronic low-grade inflammation. This study aimed to characterize body composition phenotypes in a large clinical cohort of adults with obesity, to evaluate associated metabolic and inflammatory biomarker patterns, to contextualise these patterns against habitual nutrient intake assessed in a dietary subcohort, and to derive age- and sex-specific nutritional recommendations based on the identified patterns. Methods: We performed a cross-sectional analysis of 29,544 adults with obesity (BMI ≥ 30; 21,374 women, 8170 men; age 30–69) who underwent multi-frequency bioelectrical impedance analysis (BIA; InBody 770). Biochemical assessments (fasting glucose, lipid profile, uric acid, HbA1c, insulin) were available for 2019 hospitalized patients from the same population. Habitual dietary intake was quantitatively assessed in a dietary subcohort of 423 patients using the validated Russian software-based questionnaire “Scientific Nutrition Analysis Tool”. Inflammatory biomarkers (high-sensitivity CRP, IL-6) and adipokines (leptin, adiponectin) together with serum 25(OH)D were measured in an inflammation/adipokine subcohort of 116 patients. A body composition phenotype with low relative muscle mass and high visceral fat (VFA ≥ 100 cm²) was defined using FNIH criteria (ALM/BMI < 0.789 men, <0.512 women). Benjamini–Hochberg FDR correction (q < 0.05) was applied for multiple comparisons. Results: The body composition phenotype prevalence increased progressively with age: men 24.6% (30–39) to 42.0% (60–69); women 10.3% (30–39) to 31.8% (60–69). Skeletal muscle mass (SMM) was positively associated with uric acid (r = +0.347, p < 0.001, FDR q < 0.05) and inversely associated with HDL-cholesterol (r = −0.321, p < 0.001, FDR q < 0.05)—both associations with direct nutritional implications. BMI was associated with fasting insulin (r = +0.233, p < 0.001, FDR q < 0.05). Women showed significant age-related metabolic differences between the 30–39 and 60–69 age groups: fasting glucose +12.9%, triglycerides +34.8%, uric acid +15.0% (all p < 0.001); in men, significant differences were observed for fasting glucose (+7.0%) and HbA1c (+5.2%) (both p < 0.001), while lipid parameters did not reach significance. In the dietary subcohort, habitual saturated-fat intake exceeded recommended values in 70–72% of patients of both sexes, dietary fibre intake was below recommended levels in 73–85%, and habitual calcium intake decreased significantly with age in women (1022 → 746 mg/day, p = 0.028). Serum CRP was elevated (median 5.59 mg/L, n = 59). In a separate extended laboratory subcohort, serum oestradiol declined markedly with age in women (55.0 → 16.8 pmol/L between 30–39 and 50–59 years, p < 0.001), consistent with the menopausal transition; serum testosterone in men remained stable across age groups; and 25(OH)D insufficiency (<30 ng/mL) was prevalent in 49.7–55.8% of patients. Conclusions: The identified sex-specific and age-specific body composition patterns provide a rationale, supported by observed dietary and inflammatory patterns, for targeted nutritional intervention: increased dietary protein, omega-3 fatty acids supplementation, low-glycemic-index dietary patterns, and purine restriction with hyperuricemia. Routine BIA-based nutritional screening combined with quantitative dietary assessment should begin at age 30, with preventive monitoring at age 40 and intensification of control at age 50, to guide personalized dietary planning in obesity. Full article

Background/Objectives: Pediatric pain management remains a significant clinical challenge, with contemporary biopsychosocial models increasingly emphasizing humanized care and non-pharmacological strategies. This study aimed to culturally adapt and evaluate the psychometric properties of the Polish version of the HUPEDCARE-Q (Humanisation of Pediatric Care in Pain Management with a Non-Pharmacological Approach) questionnaire among healthcare professionals and students. An additional objective was to explore differences in knowledge, attitudes, and self-reported practices across different age groups and stages of professional development. Methods: An observational, cross-sectional study was conducted. The cross-cultural adaptation process included independent forward translations, reconciliation, back-translation, and an expert panel review. Data were collected using online surveys. Construct validity was evaluated through confirmatory factor analysis (CFA), while internal consistency reliability was assessed using McDonald’s omega coefficient and the Kuder–Richardson Formula 20 (KR-20). Group differences were analyzed utilizing the Mann–Whitney U test. Results: Because the original factor structure exhibited a suboptimal fit to the data, a revised and reduced Polish version was proposed, which demonstrated significantly improved fit indices (CFI = 0.91 for the attitudes and knowledge domains; CFI = 0.99 for the pain management domain). Exploratory bivariate analyses showed higher knowledge and attitudes scores among older participants and working professionals, whereas no statistically significant differences were observed in self-reported pediatric pain management practices. Conclusions: The revised Polish short-form adaptation of the HUPEDCARE-Q showed improved model fit and domain-specific psychometric performance, with strong internal consistency for the pediatric pain management domain, acceptable reliability for the knowledge domain, and moderate reliability for the attitudes domain. Therefore, the instrument should be interpreted as a preliminary screening and assessment tool rather than as a fully established measure with uniformly strong reliability across all domains. The observed discrepancy between higher knowledge and attitude scores and the absence of significant differences in self-reported practices may suggest that knowledge and attitudes alone are not sufficient to explain differences in self-reported pediatric pain management practices. Full article

Objective: To test the factorial structure and reliability of the Brazilian version of the Diabetic Foot Self-Care Questionnaire of the University of Malaga-Spain (DFSQ-UMA-Br). Method: Cross-sectional study for psychometric evaluation of the DFSQ-UMA-Br conducted with 269 people with diabetes who responded to the items of the collection instrument composed of sociodemographic and clinical data and the tested instrument, from February 2024 to February 2025. The internal structure was evaluated using Exploratory and Confirmatory Factor Analysis. Reliability was assessed using Cronbach’s alpha and McDonald’s omega. Results: The factor analysis for the DFSQ-UMA-Br data matrix was adequate (KMO = 0.79 [95% CI] = 0.71–0.82]); Bartlett’s sphericity test = p < 0.001; degree of freedom of 66), indicating that the variables are correlated. Psychometric sensitivity with adequate values of asymmetry (sk = 0.199–3.655) and kurtosis (ku = −0.226–+3.764) proving the normal distribution of data. Conclusions: The DFSQ-UMA-Br is a valid and reliable instrument capable of assessing foot self-care in people with diabetes in the Brazilian population and can be used by nurses and other professionals to promote health in the context of clinical care and research. Full article