Background and Objectives: Environmental pollution in regions like the Sarno River Basin in southern Italy significantly affects physical and psychological health. This study aimed to validate three novel psychometric tools—REST, HEAL-BDLC, and PEACE—for assessing fatigue, mood disturbances, and sleep quality in environmentally exposed populations. While correlations with heavy metal exposure will be addressed in a separate manuscript, this study focuses solely on psychometric validation. Materials and Methods: The PREVES-STOP Initiative recruited 88 participants aged 30–65 years from the Sarno River Basin. Participants completed psychometric questionnaires tailored to measure fatigue (REST), symptoms of depression and anxiety (HEAL-BDLC), and sleep quality (PEACE). Internal consistency, construct validity, and reliability were analyzed using Cronbach’s alpha, correlation analyses, and principal component analysis (PCA). A subgroup received a nutraceutical intervention for us to explore their responsiveness to change over a two-week period. Results: REST (α = 0.969), HEAL-BDLC (α = 0.962), and PEACE (α = 0.736) demonstrated strong reliability. PCA confirmed the unidimensional structure of REST and the two-component structure of HEAL-BDLC (depression and anxiety dimensions) and PEACE (insomnia and sleep quality). Correlations with established measures, such as the WHO Well-Being Index, supported construct validity. Among the intervention participants, significant improvements were observed in fatigue (−12.5 REST median score), mood (−13.0 HEAL-BDLC median score), sleep (+1.5 PEACE median score), and overall well-being (+4.0 WHO-5 median score). Conclusions: REST, HEAL-BDLC, and PEACE are reliable and valid instruments for assessing nuanced health outcomes in environmentally exposed populations. They hold potential for guiding public health interventions and evaluating environmental remediation impacts. These findings lay the groundwork for future studies linking psychometric outcomes with heavy metal exposure.

Background: Fatigue is a prevalent and complex condition with significant impacts on well-being. Existing fatigue assessments often lack comprehensiveness or practicality for general population studies. Methods: This study validated the REST Questionnaire, a novel fatigue assessment tool, in a sample of 268 adults. Psychometric properties, including internal consistency and construct validity, were evaluated. REST scores were correlated with WHO-5 well-being, BMI, self-rated health, and chronic conditions. Exploratory factor analysis identified underlying dimensions of fatigue. Results: The REST Questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.918) and construct validity. Higher fatigue scores were associated with lower well-being, female gender, and the presence of certain chronic conditions (cancer, kidney stones, gastric ulcers). Two distinct fatigue dimensions, “physical fatigue and functional impacts” and “emotional and social consequences”, were identified. Conclusions: The REST Questionnaire is a reliable and valid tool for assessing fatigue in the general population. Its multidimensional framework and sensitivity to comorbidities offer valuable insights for research and public health applications, with the potential to inform targeted interventions aimed at improving well-being.

Evidence on modifiable post-diagnosis factors influencing outcomes after intravesical Bacillus Calmette–Guérin (BCG) therapy for high-risk non-muscle-invasive bladder cancer (NMIBC) is limited. In this exploratory, feasibility-focused prospective multicenter cohort (March 2023–November 2024), BCG-naïve patients completed repeated interviewer-administered 24 h dietary recalls; prespecified food groups, selected foods, and nutrients were screened for associations with 1-year intravesical recurrence using Firth’s penalized logistic regression adjusted a priori for age, sex, and total energy intake, with false discovery rate control within each exposure family. Forty-six patients were enrolled; 41 had evaluable recurrence status, including 8 recurrences (19.5%). Participants were predominantly overweight (mean body mass index (BMI) 28.4 kg/m²) and had low adherence to a Mediterranean dietary pattern (median Mediterranean Adequacy Index 2.25). No dietary exposure met the within-family false discovery rate threshold; the smallest q-value was 0.361. Nominal inverse associations were observed for leafy green vegetables (OR per 1 SD 0.385; 95% CI 0.101–0.972) and for energy-adjusted zinc (OR 0.280; 95% CI 0.069–0.802) and magnesium intakes (OR 0.260; 95% CI 0.045–0.872), but these did not remain significant after FDR adjustment. These exploratory signals warrant replication in larger, biomarker-informed cohorts incorporating dietary biomarkers and immune profiling during BCG. Given the limited sample size and low number of recurrence events, these findings are strictly hypothesis-generating and should not be interpreted as evidence of definitive protective or risk dietary factors.

Background and Objectives: Poor sleep is common in community and primary-care settings, yet very brief sleep measures suitable for routine use remain limited. We developed and evaluated the five-item Promoting Evaluation and Awareness of Comfort in Sleep (PEACE) scale and examined its associations with well-being and fatigue. Materials and Methods: In a cross-sectional, clinician-mediated online survey, 312 community-dwelling adults in Italy who were not receiving active treatment for major diseases completed PEACE, the World Health Organization-Five Well-Being Index (WHO-5), and a short fatigue questionnaire. The sample was stratified and split into exploratory and confirmatory subsamples for factor analyses. Results: Factor analyses supported the use of a single total score and showed acceptable reliability. Results were broadly similar in women and men, with no evidence of item-level bias, although some model-comparison indices were mixed. Higher PEACE scores were associated with better well-being and lower fatigue. Adding PEACE to a model predicting well-being from body mass index and sex increased explained variance from 4.0% to 11.5%. Conclusions: PEACE is a brief sleep-quality measure with promising initial psychometric properties. In this sample, it was associated with well-being and fatigue and may add information beyond body mass index and sex in community and primary-care settings.