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Mandala coloring reduces anxiety and pain in circumcised children: A randomized controlled trial
No full textBackground: Boys often experience significant fear and anxiety before the circumcision procedure, and postoperative pain is linked to increased fear and anxiety in children.
Objectives: The aim of this study was to determine the effect of mandala coloring on fear, anxiety, emotional symptoms and postoperative pain of circumcised children.
Methods: This randomized controlled trial was conducted in the pediatric clinic of a state hospital in eastern Turkey. Children were divided into two groups using a computer program: Group 1 (control) included children with no intervention (n = 40), and Group 2 (mandala coloring) included children who received mandala coloring (n = 38). Statistical analyses were performed using the Kolmogorov-Smirnov test to assess the normality of the data, the chi-squared test to compare categorical variables between groups, the paired samples t-test for within-group comparisons, the independent samples t-test for between-group comparisons, and mixed model repeated measures ANOVA (rANOVA) to evaluate the temporal changes in pain and anxiety scores across groups.
Findings: Children's fear, anxiety, emotional symptom, and postoperative pain scores were similar in all groups before the nursing intervention, and the fear, anxiety, and emotional symptom scores of the mandala painting intervention group were statistically lower than the control group after the nur csing intervention. The pain scores of the children in the mandala coloring group were lower than the control group after surgery.
Conclusion: Mandala coloring intervention can be used to reduce emotional symptoms, fear, anxiety and postoperative pain in children aged 6-12 years undergoing circumcision.4054100
The effect of eHealth-based guided self help interventions for binge eating disorder : a meta-analysis of randomized controlled trials
No full textWith rapid technological advancements, eHealth-based guided self-help interventions have become accessible, flexible, cost-effective, and stigma-reducing treatment options for binge eating disorder (BED). This meta-analysis evaluated the effectiveness of these interventions in individuals diagnosed with BED or showing BED symptoms, based on eight randomized controlled trials with 1,575 participants. Intervention length varied between a single session to four months. Six studies focused solely on web-based guided self-help interventions, one study implemented a hybrid approach combining face-to-face and online components, and another study employed two distinct online guided self-help methods. The interventions included psychoeducational modules, therapist feedback, online behavior monitoring, and self-assessments. eHealth-based guided self-help significantly reduced binge eating psychopathology (SMD: 0.53; 95% CI: 0.20–0.86) and objective binge eating (OBE) days (SMD: 0.49; 95% CI: 0.12–0.85) compared to controls. These interventions offer effective solutions for individuals facing barriers to traditional treatment access. © 2025 Taylor & Francis Group, LLC
Effect of eHealth Interventions on Medication Adherence in Kidney Transplant Recipients: Meta-Analysis of Randomised Controlled Trials
No full textBackground: Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients.
Aim: This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients.
Methods: This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024.
Results: The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06-1.35; p = 0.01. Heterogeneity: Q = 8.69; p = 0.28; I2 = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05-0.29; p = 0.02. Heterogeneity: Q = 0.45; p = 0.93; I2 = 0%) significantly increased in the eHealth intervention group compared with the control group.
Conclusion: The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.4019691
The Protective Effect of Boric Acid Against High Fructose-Induced Liver and Kidney Damage in Rats
No full textThis study aimed to determine the protective role of boric acid (BA) in high fructose (HF)-induced liver and kidney toxicity in a young rat model. High-fructose consumption causes serious damage to liver and kidney tissue in healthy individuals and contributes to the emergence of various metabolic diseases. Thirty-two healthy female Wistar albino rats (250-300 g weight and 3-4 months) were randomly distributed into four equal groups (n = 8): control, high fructose % 20 (HF), boric acid 20 mg/kg (BA), and HF + BA. High fructose was freshly prepared and administered to the rats as 20 g of D-fructose dissolved in 100 mL of tap water daily for a duration of 30 days. Boric acid (20 mg/kg) was administered through gastric gavage throughout the 30-day study period. At the end of study, blood, liver, and kidney were collected from rats. The results indicated that high fructose induced increased glucose, total cholesterol, triglyceride, and urea levels in rat serum. Boric acid administration significantly decreased glucose, total cholesterol, triglyceride, and urea levels in HF + BA groups. The results indicated that high fructose-induced oxidative stress by increasing the level of MDA and by decreasing GSH levels, and CAT activity in the liver and kidney of rats. However, oral BA administration significantly decreased MDA levels and increased GSH levels, and CAT activity (p < 0.05). Furthermore, BA significantly reduced high fructose-induced histopathological and Immunohistochemistry alteration in the liver and kidney tissues. In conclusion, BA may prevent the oxidative imbalance and histopathological and immunohistochemical damage caused by high fructose in liver and kidney tissues in rats.3991299
Self-Regulation of Eating Behaviors Among Young Women Nurses and Nursing Students: Its Relationship With Eating Habits
No full textThe primary aim of this study is to adapt the Self-Regulation of Eating Behavior Questionnaire (SREBQ) to the Turkish culture among young women nurses and nursing students. The secondary aim is to investigate the factors associated with self-regulation of eating behavior in this population. The sample consisted of 773 young women nurses and nursing students who were included in the study between June and July 2024. In accordance with the first aim of the study, the construct validity of the SREBQ instrument was confirmed through EFA. The Cronbach's alpha coefficient for the SREBQ was found to be 0.78. There were very low positive correlations between the SREBQ score and the SRS (r = 0.252) and TREQ-CR (r = 0.136) scores, as well as low negative correlations with the TREQ-EE (r = -0.355) and TREQ-UE (r = -0.406) scores (p < 0.001). The 5-item SREBQ has been found to be a valid and reliable instrument for the population of young women nurses and nursing students in the Turkish language. The results indicate that as self-regulation of eating behavior increases in this population, overall self-regulation skills improve, while disordered eating behaviors decrease.4007001
External Costs of Road Traffic Accidents in Türkiye: The Willingness-to-Pay Method
No full textTraffic accidents remain a major global burden, causing mortality, disability, and socio-economic losses that hinder sustainable development. Beyond human suffering, crashes place long-term pressures on health systems, labor markets, and national economies, disproportionately impacting low- and middle-income countries. Estimating the true societal costs of accidents is therefore essential for designing effective, equitable, and sustainable road safety policies. This study applies the Willingness-to-Pay (WTP) method to evaluate the external costs of traffic-related deaths and injuries in Türkiye between 2008 and 2018. By incorporating material and immaterial losses, the WTP framework captures a broader spectrum of impacts than traditional approaches, offering valuable insights into the scale of welfare losses and the value of risk reduction. The findings reveal that external costs rose substantially over the decade, from 1.63% to 2.72% of national Gross Domestic Product (GDP), underscoring that economic losses from road crashes are growing faster than the economy. These results highlight the need for systematic interventions that integrate road safety into national sustainability agendas, including safer infrastructure, behavioral programs, advanced vehicle technologies, and efficient emergency response systems. The evidence presented strengthens the case for prioritizing traffic safety as a fundamental component of sustainable transport and public health strategies. © 2025 by the authors.2-s2.0-10502152007
Volumetric and microstructural changes in the Hippocampus and cingulum in children with west syndrome
No full textPurpose: We aimed to investigate structural changes in the hippocampus using automated segmentation techniques to evaluate the anatomy and function of the hippocampus in patients with West syndrome (WS).
Methods: The study included 48 participants (24 with WS and 24 healthy controls) aged 0-4 years. Automated segmentation methods were used to measure hippocampal volume and evaluate diffusion tensor imaging (DTI) parameters such as fractional anisotropy (FA) and mean diffusivity (MD). Bonferroni correction was applied for multiple comparisons, setting the adjusted significance threshold at p < 0.0033.
Results: Children with WS exhibited significantly reduced total hippocampal volume and diminished volumes in the CA2-CA3, CA4-dentate gyrus (CA4-DG), and SR-SL-SM regions compared to healthy controls (padj 0.0033). Although initial comparisons between ongoing WS and seizure-controlled WS suggested increased volumes in several hippocampal regions in the seizure-controlled group, these differences did not remain significant after adjustment and must be interpreted with caution. Notably, patients with seizure-controlled WS displayed larger hippocampal volumes, higher FA, and lower MD values, indicating a possible link between seizure activity and structural alterations. Additionally, DTI analysis of the cingulum revealed lower FA and higher MD values in WS patients, suggesting compromised microstructural integrity.
Conclusions: These findings emphasize the potential role of hippocampal alterations in the pathophysiology of WS and suggest that DTI parameters may serve as useful measures for monitoring disease progression and treatment response.4031154
Safety and Nutritional Profile of Traditional Turkish Cheeses: A Comprehensive Study on Their Mineral Content, Heavy Metal Contamination, and Health Risks of Aho, Golot, and Telli
No full textTraditional cheeses from Turkey's Black Sea region, such as Aho, Golot, and Telli, are widely known for their unique flavors and artisanal production methods. However, their microbiological safety, mineral content, and heavy metal contamination remain understudied. In this study, we evaluated 30 cheese samples for essential minerals and toxic heavy metals, alongside conducting a corresponding health risk assessment. The results of our mineral analysis revealed sodium (Na) levels ranging from 9787.79 to 37,902.22 mg/kg, while calcium (Ca) and magnesium (Mg) were present at nutritionally relevant concentrations. Heavy metals such as lead (Pb) and mercury (Hg) were detected, with Golot and Telli cheeses showing elevated levels (Pb: up to 1788.75 μg/kg; Hg: up to 468.71 μg/kg). Furthermore, health risk assessments, including estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI), indicated that 93.3% of samples posed negligible risks (HI < 1), though two outliers (6.7%) exceeded safety thresholds. Taken together, these findings underscore the need for improved production processes in traditional cheese production while affirming their nutritional value and overall safety for consumers.4069260
The relationship between internet and smartphone addiction and body mass index: The mediating role of eating behaviors
No full textThis research was conducted determine the mediating role of eating habits in the effect of internet and smartphone addiction on body mass index. The study group consisted of 604 individuals aged between 18 and 45 years (Mean(Age) = 21.07, SD = 3.00). Data were collected using Young Internet Addiction Scale, Smartphone Addiction Scale Short Form and Three-Factor Eating Questionnaire. Findings show positive correlations between internet addiction and smartphone addiction with uncontrolled eating, cognitive restraint and emotional eating behavior. Internet and smartphone addiction were determined to positively predict emotional eating behavior, uncontrolled eating behavior and cognitive restraint. The direct effect and total effect of internet addiction on body mass index were insignificant. However results show that both smartphone and internet use by individuals affect body mass index mediated by eating behavior. This is the first study showing that smartphone and internet use both affected body mass index mediated by eating behavior. Research results emphasise the threat of addiction on physical health and suggest that educational and cognitive dietary interventions can contribute to healthy eating habits. Additionally, considering the internet may be used as an emotion regulation strategy, intervention programs may focus on developing emotion regulation skills aiming to develop coping ability for negative emotions to reduce emotional or uncontrolled eating. © The Author(s) 2025
Validity and reliability of the Turkish version of the chrono-med diet score (CMDS) for adult participants
No full textBackground: This study aimed to examine the validity and reliability of the Chrono-Med Diet Score (CMDS) to assess adherence to the Mediterranean diet in Turkish adults.
Methods: The methodological research conducted in Gümüşhane and Ordu from January to June 2024, including 592 individuals (62.3% women, 37.7% men, and the mean age 43.4 ± 10.6 years). Data were collected through face‒to‒face interview that contained socio-demographic characteristics, the CMDS, the Mediterranean Diet Adherence Screener (MEDAS), and 24-h dietary recall. Internal consistency reliability was assessed using Cronbach's alpha coefficient, while repeatability was examined using the test-retest method. Construct validity was assessed by the MEDAS, and components of the adapted CMDS obtained from the 24-h dietary recall were analyzed using confirmatory factor analysis. The content validity was assessed by the Paired samples t-test and Wilcoxon test. The Bland-Altman test with 95% limits of agreement was used to evaluate the agreement between sum of CMDS. The results were statistically evaluated at a p < 0.05 significance level.
Results: The content validity index of CMDS was 0.87. The overall Turkish version of CMDS had acceptable internal consistency (Cronbach's α = 0.853), thus indicating that the score was reliable. The Paired samples t test coefficients between each item and the overall questionnaire ranged from 0.234 to 1.000. A higher intake of olive oil and fish obtained from a 24-h dietary recall was associated with a higher CMDS quartile (p < 0.05). The MEDAS score was correlated with a higher CMDS quartile (p < 0.001). A moderate positive correlation was determined between total CMDS and MEDAS (r = 0.467; p < 0.001).
Conclusions: Our assessments of the CMDS, consisting of 13 items, in Türkiye demonstrate that it is a viable and reliable instrument to measure adherence to the Mediterranean diet for the adult population. The CMDS is more accurate than other Mediterranean diet scores as it questions about the amount of physical activity and grain products, which helps determine each participant's eating patterns and general health.4051728