Amaç: Dünyada beslenme ilişkili sağlık sorunları önde gelen problemler arasında yer almaktadır. Çalışmamızın amacı birinci basamak sağlık hizmet birimi olan sağlıklı hayat merkezi diyabet ve obezite biriminde verilen diyetisyenlik hizmetlerinin obezitenin kontrolündeki etkinliğini araştırmaktır. Gereç ve Yöntemler: Bu çalışma 01/01/2017–30/06/2018 tarihleri arasında İstanbul’un bir ilçesinde son yıllarda popülerleşen sağlıklı hayat merkezi diyabet ve obezite danışma biriminde çalışan diyetisyene başvuran kişilerin verileri üzerinden yapılmıştır. Başvuru esnasında diyetisyen tarafından kişilerin demografik bilgileri, aile öyküsü, beslenme takviyesi alma durumları, hastalık ve ilaç bilgileri kaydedilmiştir. Ayrıca kişilerin vücut ağırlığı, boy uzunluğu, vücut yağ ölçümü yapılmış ve vücut-kitle indeksi (VKİ) hesaplanarak veri tabanına girilmiştir. Ölçümler her başvuru sırasında tekrarlanmış ve kaydedilmiştir. Araştırma evrenini, kilo vermek amacıyla birime başvuran, en az bir kontrolüne gelmiş, VKİ normal düzeyin üzerinde olan yetişkin bireyler oluşturmaktadır. Bulgular: Diyetisyen hizmetini kullanan 904 danışandan, 310’u (%34,3) kontrol randevularına gelmemiştir. Araştırmada değerlendirilen 446 danışandan 422’si (%94,6) kadındır. Birinci derece akrabada obezite olma durumu %75,8’dir. Danışanların ilk durumları VKİ’lerine göre sınıflandırıldığında; %31,4’ü kilolu, %58,7’si obez ve %9,9’u morbid obezdir. Kronik hastalık durumları sorgulandığında 244 kişinin (%54,7) eşlik eden kronik hastalığı olduğu bilgisi edinilmiştir. Ortalama yağ kaybı 2,6 (±4,0) ve ortalama kilo kaybı 3,1 (±3,6)’dir. Sonuç: Diyabet ve obezite danışma birimlerinden kadınlar daha yüksek oranla yararlanmaktadır. Literatür incelendiğinde koruyucu sağlık hizmetlerinin kullanımında kadınların ön plana çıktığı görülmüştür. Danışanların bir kısmının tanılı olup, ilaç kullanmadıkları anlaşılmaktadır. Bu durumla ilgili diyetisyenlerin danışanlarını uyarmaları ve hatırlatmaları yönünde telkine tabi tutulmaları yerinde olacaktır. Danışanların yaşı büyüdükçe, kilo verme başarılarının anlamlı derecede artmış olduğu tespit edilmiştir. Kilolu bireylerin aile hekimleri takiplerinde diyetisyenlere yönlendirilmesi periyodik olarak hekimlere hatırlatılmalıdır. Herhangi bir kronik hastalık tanısı almış bireyin muhakkak diyetisyene yönlendirilmesi, uzman hekim tarafından kontrollerde ilaç uyumunun ve diğer sorgulanan konuların yanında muhakkak diyet ve egzersiz uyumlarının da sorgulanması önem arz etmektedir. Sunulan sağlık hizmeti, kilo verdirme açısından başarılı bulunmuştur.

Background and Objectives: Tobacco use and exposure to tobacco products remain a major public health challenge, even among athletes. This study aimed to evaluate tobacco use and second-hand smoke exposure in athletes through urinary cotinine levels and exhaled air carbon monoxide (CO) measurements. Materials and Methods: This cross-sectional study included licensed athletes who visited the sports medicine outpatient clinic of a tertiary hospital. Participants completed an electronic questionnaire on smoking habits and second-hand smoke exposure. Urine samples were analysed for cotinine levels, while CO levels were measured in exhaled breath. Results: A total of 421 athletes participated (57.8% male, median age: 18 years). Tobacco use was reported by 29.9% (n = 126) of participants. Median urinary cotinine levels were 22.9 ng/mL among daily tobacco users and 17.4 ng/mL among athletes exposed daily to second-hand smoke, with a statistically significant difference between exposure levels (p < 0.05). The optimal cut-off value for detecting second-hand smoke exposure was identified as 12.5 ng/mL. Median exhaled air CO levels were 5 ppm in daily tobacco users. Conclusions: This study demonstrates that tobacco use prevalence among athletes mirrors Türkiye’s national rates. Despite legal measures to curb tobacco use, direct use and second-hand smoke exposure remain pressing issues among athletes.

Introduction: Youth smoking and passive exposure is a serious public health problem. This study examined the prevalence of tobacco use and passive exposure to smoke among adolescent athletes. Methods: This cross-sectional study was conducted in Ankara, Türkiye, in 2023. It was based on the...

To evaluate the cost-effectiveness of introducing Human Papillomavirus (HPV) vaccination into Türkiye’s National Immunization Program. The analysis employed the WHO-endorsed PRIME model in Microsoft Excel. Two vaccination strategies were simulated for 12-year-old girls: Scenario 1 (bivalent or quadrivalent vaccine) and Scenario 2 (nonavalent vaccine). Each scenario was assessed from both the Social Security Institution (SGK) and societal perspectives. Incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted life year (DALY) averted, with sensitivity analyses conducted to test model robustness. Scenario 1 yielded an ICER of USD 2,231 per DALY averted, while Scenario 2 produced an ICER of USD 2,342. The incremental ICER of Scenario 2 versus Scenario 1 was USD 2,592. According to WHO cost-effectiveness thresholds, both scenarios were classified as “very cost-effective.” Sensitivity analyses identified the discount rate as the most influential factor, followed by vaccine efficacy, HPV subtype distribution, and vaccine price. The annual program cost to SGK was estimated at USD 15.7 million for Scenario 1 and USD 23.6 million for Scenario 2. Vaccination remained highly cost-effective at prices up to USD 54 (Scenario 1) and USD 78 (Scenario 2), but not cost-effective above USD 167 and USD 242, respectively. HPV vaccination is highly cost-effective in Türkiye, with both strategies offering substantial health gains and favorable ICERs well below national GDP per capita. Adoption of a national HPV vaccination program would likely reduce cervical cancer morbidity and mortality while representing an efficient use of healthcare resources.

Aim: The aim of this study was to adapt and validate the Cryptoglandular Anal Fistula Quality of Life (AF-QoL) scale for Turkish-speaking patients, providing a disease-specific, patient-reported outcome measure (PROM) to assess quality of life (QoL) in cryptoglandular anal fistula. Methods: A prospective, multicenter, cross-sectional study was conducted across seven tertiary centers in Türkiye. The 22-item AF-QoL scale, originally validated in English, was translated and culturally adapted into Turkish following Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, including expert consensus and a pilot study ( n = 10). A total of 220 Turkish-speaking adults with cryptoglandular anal fistula completed the scale. Structural validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed using Cronbach’s alpha, and item–total correlations. Test–retest reliability was evaluated in a clinically stable subgroup of patients. Results: EFA confirmed a six-domain structure, comprising psychological impact, everyday activities, unpredictability/disease control, seton-related issues, social limitations, and discharge/discomfort, explaining 69.2% of the total variance. CFA demonstrated an acceptable overall model fit ( χ ² / df = 1.94, root mean square error of approximation [RMSEA] = 0.048, Comparative Fit Index [CFI] = 0.945, standardized root mean square residual [SRMR] = 0.035). The Turkish AF-QoL demonstrated high internal consistency (Cronbach’s α = 0.828), satisfactory item–total correlations ( r = 0.32–0.76), and good test–retest reliability (intraclass correlation coefficient = 0.74), indicating temporal stability. Conclusions: The Turkish version of the AF-QoL demonstrates satisfactory reliability and structural validity for use in Turkish patients with cryptoglandular anal fistula. This cross-cultural validation provides a disease-specific PROM suitable for clinical and research applications. Further studies assessing additional measurement properties, including structural validity, measurement error, and responsiveness, are warranted. Clinical trial registration: This study was not a clinical trial and thus was not registered in a clinical trial registry.