Hakan Demirhindi

Although a substantial body of evidence indicates that food insecurity is positively associated with obesity, the underlying mechanisms of this relationship remain unclear. This cross‐sectional study, conducted on 859 individuals, aimed to examine the association between food insecurity and obesity. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS), which was developed by the Food and Nutrition Technical Assistance (FANTA) project under the United States Agency for International Development (USAID). Factors influencing food insecurity and the role of food insecurity in obesity were evaluated. The mean age of the participants was 34.70 ± 13.84 years (range: 18–85). The prevalence of obesity was 4.5% in the mildly food‐insecure group, 12% in the moderately food‐insecure group, and 11.3% in the severely food‐insecure group ( p = 0.013). The odds of obesity were 2.075 times higher among those experiencing severe food insecurity. The odds of severe food insecurity were 1.59 times higher in men and 2.50 times higher in rural residents, but 2.8 times lower in households with an income above the poverty line (Odds Ratio [OR] = 0.356) and 1.87 times lower in those receiving social support (OR = 0.532). Individuals with moderate and severe food insecurity were found to consume less protein‐rich foods and more grain‐based (carbohydrate) and snack products daily ( p < 0.001). Food insecurity was found to be a significant moderator in the relationship between protein intake and body mass index, with a stronger association observed at lower levels of food insecurity and a weaker association at higher levels. Food insecurity was associated with higher obesity prevalence, and this association was moderated by dietary patterns, specifically lower intake of protein‐rich foods and higher consumption of cereals and snack foods. Providing social support to at‐risk groups may help reduce obesity risk.

Obesity is a global health problem where emotional eating, linked to impulsivity, significantly complicates prevention efforts. This study examined the direct effects of emotional eating on body fat percentage and whether emotional eating moderates the relationship between lipid parameters and body fat percentage in women seeking obesity counselling. This cross-sectional study was conducted among 271 women who applied for counselling on obesity and healthy eating. Body fat was measured by the bioelectrical impedance method. Direct and indirect effects of emotional eating behaviour on body fat content were examined. The mean age of 271 women included in our study was 38.2 ± 11.4 years, among them the rate of "emotional" and of "very emotional" eaters was 53.1% and 12.2%. HDL levels were lower; LDL levels were higher in "very emotional" eaters. There was a positive correlation between emotional eating and blood triglyceride or HbA1c values, and a negative correlation with HDL or physical activity level. Emotional eating level was determined as an important moderator in the relationship between blood cholesterol and LDL values or body fat percentage. In multivariate linear regression analysis, it was found that a one-unit increase in cholesterol, and HbA1c, was associated with a 0.057-unit, and 3.158-unit increase in body fat level, respectively, while a one-unit increase in HDL was associated with a 0.128-unit decrease in body fat level. LDL and triglyceride levels were higher in patients with higher levels of emotional eating, which was also determined as an important moderator affecting the relationship between body fat percentage and total cholesterol or LDL blood levels, in a strengthening (increasing) way.

Background/Objectives: This study aimed to evaluate the effect of breast cancer awareness training on screening beliefs and behaviour. Methods: This single-group pre-test/post-test quasi-experimental study included 286 women living in rural areas. The effectiveness of the educational intervention was evaluated via the Breast Cancer Screening Beliefs Scale (BCSBS). Screening behaviours were assessed using self-reported data collected via a structured questionnaire administered before the intervention. Results: The mean age of the participants was 58.3 ± 8.3 years (range 43–69). Post-test results showed a significant increase in the total BCSBS score and all sub-dimensions, including attitudes towards health screenings, breast cancer knowledge and perceptions, and barriers to mammography screening (p < 0.001). The educational intervention had a medium effect on screening beliefs with an effect size (ES) of 0.585, small effects on attitudes towards health screenings (ES = 0.124) and barriers to mammography screening (ES = 0.286), and a large effect on breast cancer knowledge and perceptions (ES = 0.710). Following the educational intervention, the proportion of women with positive screening beliefs increased from 13% to 36% (p < 0.001), positive breast cancer knowledge and perceptions increased from 49% to 69% (p < 0.001), and positive attitudes towards health screenings decreased from 14% to 8% (p = 0.002). Each one-unit increase in breast cancer knowledge and perceptions increased the likelihood of screening by an odds ratio (OR) of 1.02, and each one-unit increase in barriers to mammography screening increased it by an OR of 1.03. Moreover, barriers to mammography screening significantly moderated the relationship between age and breast cancer screening behaviour, strengthening this association. Conclusions: The Turkish Ministry of Health’s education model for breast cancer awareness appears to positively influence beliefs about breast cancer screening. Updating and diversifying educational content to target specific age groups and rural women may enhance its effectiveness.

Background In this study, it was aimed to evaluate the effectiveness of the medical school curriculum in the acquisition of the concept of one health by first and sixth year students of a medical school. Methods This cross-sectional study was conducted by Çukurova University Departments of Public Health and Medical Education and Informatics with 309 first-year students and 315 sixth-year students studying at the Faculty of Medicine in the summer of 2024 and autumn of 2025. Students were reached using the convenience sampling method. The questionnaire consisted of items assessing whether students were familiar with the One Health concept, their definition of the concept, sources of information, issues related to the One Health approach (antimicrobial resistance, zoonotic diseases, vector-borne diseases, foodborne diseases, environmental problems, laboratory-related issues, and other problems), as well as factors that might influence awareness of the concept (such as having a family member working in human health, animal health, or environmental/food safety). In addition, the Global Climate Change Awareness Scale was included. The impact of the medical school curriculum on the One Health approach was also evaluated. Conclusion In our study, it was concluded that the medical faculty curriculum is not sufficient for the acquisition of the concept of one health.

Today, the increasing use of multiple media has led to an increase in the concern of screen addiction. This study aimed to evaluate the direct and indirect dimensions of the relationship between multiple screen addiction and body mass. This cross‐sectional study was conducted on 728 university students. The Multiple Screen Addiction Scale, the Hedonistic Eating Scale, and the International Physical Activity Questionnaire were used to measure screen addiction and its effects. Direct and indirect factors were analyzed to evaluate the relationship between screen addiction and body mass index (BMI). The mean age of the students included in the study was 20.78± 3.94 years (min. 18—max. 54). The prevalence of multiple screen addiction was 13%. It was found that hedonic eating scale scores were higher in people with multiscreen addiction. While there was a weak positive correlation between the multiscreen addiction score and hedonistic eating, no significant correlation was found between BMI and physical activity level. Logistic regression analysis showed that the direct effect of multiscreen addiction on BMI was not significant. Multiscreen addiction was an important moderator in the relationship between hedonistic eating and BMI; increasing the mean of multiscreen addiction by one standard deviation led to an increase of 0.073 units in BMI. The moderator effect of multiscreen addiction was significant at high addiction scores. The direct and moderator effects of physical activity on BMI were not found to be significant. High levels of multiple screen addiction are an important moderator in the relationship between high BMI and hedonistic eating. Elucidating the relationship between screen addiction and hedonia will help solve the problem.

Objectives: Evisceration is a rarely performed surgical procedure, and literature information regarding the characteristics of patients undergoing this surgery is limited. This study aims to evaluate the demographic features and etiological factors of patients who underwent evisceration surgery in a tertiary clinic over 10 years. Methods: This descriptive study comprised the data of 134 patients who underwent evisceration surgery at the Department of Ophthalmology, Faculty of Medicine, Çukurova University, Adana, Türkiye, between 2011 and 2022. Demographic data of all patients, including age, sex, surgical indication, etiology, primary disease location, pathology results, and follow-up periods, were recorded and analyzed. Results: The mean age of the 134 patients included in the study was 56.18 ± 22.71 (min: 8–max: 91), with a male-to-female ratio of 65.2% to 34.8%. Evisceration etiologies included trauma (37%), endophthalmitis (37%), absolute blind eye (12.6%), and spontaneous perforation (11.9%). Endophthalmitis cases were more common in older ages and females, trauma patients in younger ages and males, and spontaneous perforation in older ages and males. Progression to panophthalmitis was observed in 6.6% of all cases, and all were found to originate from endophthalmitis. Culture growth was positive in 18.5% of the cases, with the most commonly grown microorganisms in culture being Pseudomonas aeruginosa, Streptococcus dysgalactiae and Aspergillus fumigatus. Escherichia coli and Staphylococcus epidermidis rates were significantly higher in cases progressing to panophthalmia. Acute inflammation was more prevalent in cases of endophthalmitis and spontaneous perforation, while chronic inflammation was in cases of trauma and absolute blind eyes. Conclusions: Trauma was the main etiology of evisceration in young males and endophthalmitis in older females. Considering trauma prevention measures is important for public health in terms of eyeball saving.

Background/Objectives: Renal cell carcinoma (RCC) accounts for 2–3% of all cancers, with approximately 25% of patients being detected at the metastatic stage. This study aimed to determine the prognostic significance of co-evaluating two risk parameters: one, the HALP score based on haemoglobin, albumin, lymphocyte, and platelet counts, and the other, albumin-to-alkaline phosphatase ratio (AAPR) in patients with metastatic RCC treated with targeted therapy. Methods: This retrospective cohort study included 147 patients with metastatic RCC. The HALP score and AAPR values were calculated from pre-treatment blood test results, and followingly, the cut-off value was determined by using ROC analysis. Patients were categorised into three groups with a low, moderate or high combined risk score based on this cut-off value. The effect of these risk groups on survival was evaluated. Results: The mean age of patients was 64.1 ± 11.9. The median follow-up time was 38.3 months, and the mortality rate was 53.7% in all groups. Kaplan–Meier survival analysis showed a statistically significant difference between the combined scores of the risk groups: the median survival time was 51.6 months in the low-risk group, 20.7 months in the medium-risk group, and 10.4 months in the high-risk group (p < 0.001), with 5-year survival rates being 38.8% in the low-risk group, 30% in the intermediate-risk group, and 19% in the high-risk group. When compared to the low-risk group, Cox regression analysis revealed that the mortality risk, i.e., HR (hazard ratio), was 2.42 times higher in the intermediate-risk group and 3.76 times higher in the high-risk group. A nephrectomy operation decreased the mortality risk (HR = 0.24) by 4.16 times. Conclusions: This new combined risk scoring, obtained from co-evaluating the HALP score and AAPR, was found to be an independent prognostic factor in metastatic RCC patients. This combined risk scoring is expected to help clinicians in treatment decisions.