OBJECTIVE:The multifaceted risk associated with war and terrorism challenges professionals in providing care matched to needs. While exposure to war and terrorism situations elevates risks of various mental and physical health issues, risk factors are not uniform across individuals and may vary given less apparent but equally powerful sources of distress. Recognizing this challenge, we adapted the Psychosocial Assessment Tool (PAT), a brief screening tool of psychosocial risk, for individuals exposed to war and terrorism (PAT-WT). METHOD:First, an adaptation of the original PAT for the context of war and terrorism was conducted. Then, the new version (PAT-WT) was implemented in an expedited validation pilot study among N = 112 individuals with various types and levels of exposure to war- and terror-related traumatic events. RESULTS:The PAT-WT was found to be valid and consistent with the original PAT. In addition, it correlated with the General-Health Questionnaire (ρ = 0.54, p < .01), indicating its ability to identify high emotional distress among war-exposed individuals. Larger clinical-risk groups were identified compared to prior PAT versions, highlighting the impacted population's vulnerability. However, community cohesion offered a buffer against posttraumatic stress. CONCLUSIONS:While further validation is needed, the PAT-WT shows promise as a comprehensive tool for assessing psychosocial risk factors that may link to adverse biopsychosocial outcomes following exposure to extreme traumatic events related to war and conflict. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BackgroundDuring wartime, civilians rely on digital media for information, connection, and coping. However, engagement patterns may differ in their associations with stress, resilience, and well-being. ObjectiveThis study aimed to characterize patterns of digital media engagement during wartime and examine their associations with stress, resilience, and well-being in a cross-sectional survey of Israeli adults. MethodsWe conducted a cross-sectional web-based survey in Israel in early January 2024. Participants (N=512; age: range18-65, mean 37.54, SD 12.89 years; 241/512, 47.1% male) were recruited using nonprobability quota sampling. Well-being was measured using the 5-item World Health Organization Well-Being Index, stress using the 21-item Depression Anxiety Stress Scales stress subscale, and resilience using the 10-item Connor-Davidson Resilience Scale. Participants reported the extent to which their use of 10 digital media activities increased since the beginning of the war (5-point Likert scale). Analyses included 2-step cluster analysis, exploratory factor analysis (principal axis factoring with Promax rotation), and structural equation modeling path analysis. ResultsCluster analysis identified 2 engagement profiles: low engagement (126/512, 24.6%) and high engagement (386/512, 75.4%; silhouette coefficient=0.30). The high-engagement profile reported higher stress (median 2.39, 95% CI 2.31-2.47) than the low-engagement profile (median 2.01, 95% CI 1.87-2.15; P<.001). Exploratory factor analysis supported a 3-factor structure (active, passive, and institutional engagement), explaining 61.86% of the variance (Kaiser-Meyer-Olkin=0.77; Bartlett χ236=1007.6; P<.001). Structural equation modeling showed acceptable fit (χ21=1.5; P=.21; Comparative Fit Index=0.999; Tucker-Lewis Index=0.981; standardized root-mean-square residual=0.013; root-mean-square error of approximation=0.033). Resilience was negatively associated with stress (β=−0.24, 95% CI −0.34 to −0.14; P<.001) and positively associated with well-being (β=0.30, 95% CI 0.18-0.42; P<.001). Stress was positively associated with active (β=0.27, 95% CI 0.17-0.37; P<.001), passive (β=0.31, 95% CI 0.21-0.41; P<.001), and institutional engagement (β=0.16, 95% CI 0.06-0.26; P<.001). Active engagement was positively associated with well-being (β=0.12, 95% CI 0.04-0.20; P=.006), passive engagement showed a negative trend (β=−0.08, 95% CI −0.18 to 0.02; P=.08), and institutional engagement was not significantly associated with well-being (β=0.07, 95% CI −0.01 to 0.15; P=.11). The total indirect association between resilience and well-being through stress and engagement was significant (indirect effect=0.09, 95% bootstrap CI 0.05-0.13). ConclusionsWartime digital media engagement clustered into distinct profiles and dimensions, each showing different associations with stress, resilience, and well-being. This study advances the field by empirically distinguishing active, passive, and institutional engagement, with the latter often overlooked in crisis-media research. The findings offer a more detailed framework for understanding how civilians navigate digital environments during an ongoing armed conflict and provide practical implications for psychosocial guidance and crisis communication, encouraging more intentional engagement and reducing excessive passive consumption. Causal inferences are limited by the cross-sectional design.

AIMS:Functional neurological disorder (FND) etiology is multifactorial. This study aimed to examine: (1) generalized joint hypermobility (GJH) prevalence in children diagnosed with FND and (2) the association between GJH and FND severity, activity level, and participation. METHODS:Participated in this study 53 children with FND (mean age 14.2 ± 2.7 years; 73.6% female). GJH was assessed using the Beighton score. FND severity was evaluated with the 24-item Children's Somatic Symptoms Inventory (CSSI-24), number of limbs affected, and pain following the six-minute walk test (6MWT). RESULTS:GJH was identified in 43% (Beighton ≥4) and 24% (Beighton ≥6) of participants. Elbow hyperextension was the most common feature (56.6%). The total Beighton score was independently associated with CSSI-24 (R2=.25, p<.01) and with the number of limbs involved (R2=.15, p<.01). A positive association was observed between Beighton score and pain post-6MWT. CONCLUSION:Regardless of the Beighton cutoff used, GJH prevalence remained high, with at least 1 in 4 participants presenting GJH even at the strictest threshold (≥6). GJH was associated with increased CSSI-24 and motor involvement. These findings suggest that GJH may represent a somatic vulnerability factor within the biopsychosocial model of FND. Routine assessment could help identify meaningful subgroups and guide individualized treatment.

ABSTRACT Background Lifestyle factors have been associated with semen quality and have been implicated in the reported global decline in semen parameters. Moderate physical activity has been linked to improved semen quality; however, the association between occupational physical activity and semen quality is limited. Objective To study the association between male occupational physical activity and semen quality parameters. Methods A cross‐sectional single‐center study, with final study cohort of 280 males (after applying inclusion and exclusion criteria on n = 593) attending routine semen analysis at sperm laboratory, was subject to WHO criteria semen quality analysis (semen volume, sperm concentration, total sperm count, percentage sperm motility/morphology) and self‐filled validated physical activity, lifestyle, and demographic questionnaires. Statistical analyses were done using SPSS Statistics (version 23). Results All occupational physical activity characteristics, except for sitting, were significantly associated with semen parameters. Sweating at work and physical tiredness were significantly and negatively associated with multiple semen parameters. Specifically, sweating at work was negatively associated with sperm concentration, morphology, and motility (Spearman r = −0.14 to −0.18, all p < 0.05). Physical tiredness at work was negatively associated with total sperm count, sperm concentration, morphology, and motility (Spearman r = −0.15 to −0.26, all p < 0.05). In hierarchical multiple regression analyses controlling for potential confounders, occupational physical activity expressed as physical tiredness independently predicted lower sperm concentration and morphology ( β = −0.17 and −0.29, respectively; p < 0.01). Discussion Occupational physical activities are negatively associated with semen quality parameters, suggesting a potential adverse effect of work‐related physical exertion on male reproductive function. Conclusions The negative association between occupational physical activity characteristics and semen quality parameters highlights the importance of considering work‐related physical exertion in the context of male fertility assessment, once evidence‐based thresholds and standardized assessment protocols are established.

Motor-vehicle theft remains a transport-related safety concern with implications extending beyond financial loss into well-being and daily mobility. This study evaluated the effectiveness and economic value of adopting at least two advanced road-vehicle safety technologies (alarm, immobilizer, secure parking, CCTV, or wheel clamp) aming private vehicle urers in Imael. A cross-sectional survey of 1,004 respondents assessed perceived safety, theft-related worry, adoption of protection technologies, and incident-related harms. Utility war operationalized via three health-related quality-of-life (HRQoL) domains linked to anxiety/depression, urual activities, and pain/trauma, and mapped to annual quality-adjusted life-year (QALY)-like outcomes. Costs included preventive expenditures and modeled theft-event costs, including vehicle loss, property danpage, productivity loss, administrative burden, and insurance deductibles. Propensity-score matching and inverse-probability weighting addressed non-random adoption. Cost-effectivenem outcomes, net monetary benefit (NMB), cost-effectiveness plans, and acceptability curves quantified uncertainty. Results showed no statistically significant improvement in QALY-like outcomes (AQALY-like 0.007620) and substantially higher incremental costs in the matched analysis (+3,452.107 Israeli new shekels [ILS]), indicating a dorninated strategy. dost-effectiveness probabilities remained below 19% across evaluated willingness-to-pay thresholds. Additional behavioral analyses showed that adoption was more common among respondents with higher theft-related wory, while prior victimization was associated with a numerically higher but not statistically significant adoption rate. These findings support the interpretation that uptake is shaped, at least in part, by perceived risk salience and selection into protection rather than by objective risk alone. Incorporating health-economic eval uation into transport-safety research may improve understanding of behavioral responses to vehicle-related threats and support more evidence-based prevention policies.

Introduction:Sarcopenic obesity (SO) is increasingly recognized as a major yet often overlooked complication in older adults-particularly those with type 2 diabetes (T2D)-and is linked to adverse events. SO evaluation requires muscle function tests [handgrip strength (HGS), knee extensor strength, chair-stand] and body composition. However, SO prevalence can vary widely depending on the muscle function test used, and these assessments are not routinely implemented in clinical care as they might be time-consuming. Aims:(1) Evaluate differences in the prevalence of altered muscle function using internationally accepted clinical guidelines among community-dwelling older adults with T2D; (2) to develop risk clusters for predicting increased SO probability; and (3) to develop an SO index based on routine clinical measures that differentiates individuals by their likelihood of having SO. Methods:Participants underwent comprehensive assessments of muscle function, including HGS, maximal knee extension strength, and chair stand test. Body composition was evaluated using bioelectrical impedance analysis to determine appendicular lean mass relative to body weight. Clinical data, including waist circumference, body mass index, prescription medications, metabolic markers, sex hormones, physical function tests, dietary intake, and physical activity, were collected using standardized protocols. Prevalence of altered muscle function and SO obesity was calculated using internationally accepted SO criteria. Results:Participated in the study 100 community dwelling older adults diagnosed with T2D (mean age: 69.75 ± 4.64). Altered muscle function prevalence ranged from 1% (HGS) to 92% (chair-stand). SO was present in 72% of the sample. Cluster analysis identified three SO severity groups: severe (N = 37), moderate (N = 32), and mild (N = 31). Significant differences in health, sex hormones, and physical function were noted across clusters. A SO risk index using five routine clinical measures (waist circumference, body mass index, medication count, HbA1c, and chair stand) effectively distinguished SO risk clusters (AUC = 0.87). Conclusion:Among older adults with T2D, SO was prevalent, with substantial impairments in muscle function and body composition. Disease severity was primarily driven by alterations in appendicular lean mass and lower-limb strength, whereas handgrip strength showed limited discriminatory capacity. These findings highlight the importance of comprehensive functional and body composition assessment for older adults with T2D. Clinical trial registration:clinicaltrials.gov, identifier: NCT03560375.

Objective: The goal was to investigate the relationship between methodological adherence and clinical outcomes in Progressive Resistance Training (PRT) for Parkinson’s Disease (PD), specifically identifying why findings of “superiority” over active controls remain inconsistent. Methods: This umbrella review utilized a multi-stage process to identify a sample of the primary literature for methodological analysis. An initial search identified 38 systematic reviews published within the specified timeframe. From the reference lists of these reviews, a subset of 34 primary clinical studies was purposefully selected. Inclusion was prioritized for studies providing comprehensive methodological data on PRT protocols and standardized clinical outcomes. Interventions were evaluated using a three-tiered framework: (1) training protocol with specifications of Frequency, Intensity, Time, Type, Volume, and Progression (FITT-VP) (General Exercise), (2) FITT-VP integrated with the American College of Sports Medicine (ACSM) Supplementary Guidelines (Integrated Guidelines), and (3) principles of progression (mechanistic growth). Studies were categorized by control type (active (e.g., aerobic or balance), n = 26; passive (e.g., standard care or no exercise), n = 8). Results: In trials that compared PRT with an active control group, PRT achieved clinical superiority in 57% (n = 15) of trials and 46% (n = 12) when focusing on trials with an effect on specific functional or balance outcomes. Among these successful interventions, 75% maintained high adherence (≥70%) to the Integrated Guidelines, and 58% maintained high adherence to the principles of progression. In the 53% (n = 14) of studies where PRT was found non-superior (equivalent or inferior in functional or balance outcomes) to an active control, 0% met the high adherence threshold for progression. While general FITT-VP compliance remained high (78%), the failure to implement systematic load, specificity, and variation served as a definitive barrier to competitive superiority. In the 100% of studies where PRT outperformed passive controls, high progression was present in 57% of cases. This may suggest that while a baseline resistance stimulus outperforms inactivity, it is fundamentally insufficient to outperform other active clinical therapies. Conclusions: This umbrella review indicates that adherence to the principles of progression may be an important factor influencing the clinical outcomes of PRT in individuals with PD. The variability observed in the current literature suggests that inconsistent application of established exercise frameworks—rather than the failure of the modality itself—could be a contributing element to the reported “inconclusiveness.” To potentially enhance functional outcomes and the comparative effectiveness of PRT, future research should consider prioritizing structured adherence to FITT-VP, Integrated Guidelines, and progression-based frameworks. Establishing a 70% adherence threshold is proposed as a potential benchmark to improve protocol consistency and support rehabilitation efficacy in this population.

Breast cancer survivorship is frequently accompanied by persistent psychosocial distress and heterogeneous supportive care needs. Although distress screening is widely recommended, limited evidence exists on pragmatic tools to identify survivors most likely to require high-intensity psychosocial engagement. Because breast cancer survivorship is a major women’s health issue, tools that support more equitable and timely identification of women with greater supportive care needs may have direct relevance for women-centered service planning. We aimed to develop and internally validate a risk stratification model for high-intensity psychosocial service use and assess the incremental value of a distress index. We conducted a cross-sectional risk stratification study among 411 women living with or after breast cancer who completed an anonymous online self-report questionnaire disseminated through community-based and professional recruitment channels in Israel. High-intensity service use was defined as the upper tertile of cumulative engagement. A base logistic regression model included demographic and clinical predictors; an expanded model added a composite distress index. Discrimination and calibration were evaluated using stratified 5-fold cross-validation and bootstrap internal validation. The base model showed moderate discrimination (cross-validated AUC = 0.675; bootstrap median AUC = 0.706, 95

Creative crafts may support healthy aging, yet evidence for woodcarving is limited. We evaluated a 12-week woodcarving program (Baobab Studio method) using a quasi-experimental pre-post design in a municipal social care center. 31 older adults (mean age 75; 74% female) attended ≥10/12 sessions and completed WHOQOL-BREF, STAI, GDS-15, and CD-RISC-10. Paired t-tests showed improved quality of life (physical and psychological domains), while social and environmental domains were stable. Anxiety and depressive symptoms decreased, resilience increased, and mood improved within sessions. These pilot findings support woodcarving as a feasible, low-cost, non-pharmacological community intervention; controlled studies are warranted.

Population ageing is increasing the burden of chronic disease and frailty, raising important questions regarding how health systems define and allocate value. While pharmacological treatments dominate clinical care, lifestyle-based interventions may offer broader benefits for healthy ageing. However, integrated clinical and economic evidence in older populations remains limited. We conducted a secondary analysis of the CEV-65 randomized controlled trial (n = 100 older adults aged 65 years and older with type 2 diabetes), comparing a Mediterranean diet (VegMedD), pharmacological treatment (empagliflozin), and exercise (circuit resistance training). Outcomes included changes in glycemic control (HbA1c) and frailty, alongside a composite responder measure. Economic evaluation included trial-based cost-effectiveness analyses (using the composite responder outcome based on improvement in both HbA1c and frailty) and cost–utility analyses using quality-adjusted life years (QALYs) derived from SF-12 data via a validated mapping approach. Adjusted regression models, propensity score weighting, and probabilistic sensitivity analyses were applied. Scenario analyses assessed sensitivity to pharmacological pricing assumptions. All interventions improved glycemic control, with no statistically significant between-group differences. Frailty improvements were modest. Pharmacological treatment achieved the highest responder rate, whereas non-pharmacological interventions were substantially less costly. In cost-effectiveness analysis, lifestyle interventions were associated with lower costs but reduced responder-based effectiveness. In contrast, cost–utility analysis indicated that both dietary and exercise interventions were economically dominant, yielding lower costs and higher QALYs under current pricing conditions. The dietary intervention demonstrated the highest probability of cost-effectiveness across conventional willingness-to-pay thresholds. Scenario analyses showed that responder-based conclusions were sensitive to pharmacological pricing, whereas cost–utility findings remained comparatively robust. Interventions with similar short-term clinical outcomes may differ substantially in their economic and population health value. Within the short-term trial horizon, lifestyle-based strategies were associated with more favorable cost–utility profiles. These findings should be interpreted as exploratory and should not be extrapolated to long-term comparative effectiveness, particularly given the established long-term cardiovascular and renal benefits of SGLT2 inhibitors that could not be captured within the 10-week follow-up period. ClinicalTrials.gov (Identifier: NCT03560375; registered on June 5, 2018) https://clinicaltrials.gov/study/NCT03560375?tab=history. Dietary and exercise-based interventions reduced costs relative to pharmacological treatment. Short-term clinical improvements were modest and broadly similar across groups. The dietary intervention showed the highest probability of cost-effectiveness. Non-pharmacological strategies yielded slightly higher short-term QALYs than pharmacological treatment, with long-term implications remaining uncertain. Findings support preventive, community-based ageing policies and broader value frameworks beyond clinical endpoints alone.

Weight regain is a major long-term challenge in post-bariatric surgery. This study aimed to assess long-term weight regain (> 2 years) using a 25

BACKGROUND AND PURPOSE:Frailty, a multidimensional syndrome, is linked with heightened risk of adverse outcomes. Targeted physical therapy interventions for individuals with frailty have proven beneficial, underscoring the value of routine frailty assessment in both clinical and research settings. This study aimed to: (1) describe development of a simple self-report cumulative deficits frailty scale (Sr-CDFS); (2) establish the criterion validity of Sr-CDFS against the commonly used Fried's frailty scale and Study of Osteoporotic Fracture criteria (SOF); and (3) assess other concurrent validity and internal consistency of the new Sr-CDFS. METHODS:The study included 230 older adults ( M age = 79.27 ± 7.42 years), with 76.5% being women. Outcome measures were: (1) validated frailty scales, including Fried's frailty phenotype, SOF, and Sr-CDFS; and (2) a battery of tests for impairment, activity limitations, and health status. Data analysis involved calculating frailty prevalence using the validated frailty scales. The clinimetric properties of the Sr-CDFS were assessed against validated frailty scales. Convergent and discriminative validity of the Sr-CDFS were examined. Internal consistency and structure were evaluated using Cronbach's alpha and exploratory factor analysis. RESULTS AND DISCUSSION:No differences ( P = .80) in frailty prevalence were found between Fried (26.1%) and SOF (25.2%) methods. The Sr-CDFS exhibited excellent internal consistency (Cronbach's alpha = .92), with reliability of questionnaire components (health, falls, physical, cognitive, socioemotional function) ranging from .73 (falls) to .90 (physical ability). Additionally, the Sr-CDFS demonstrated convergent and discriminative validity, with its total score and various parts correlating significantly with most outcomes ( r = .25-.59, P < .05). Using K1-criterion and a scree plot, we identified a 5-factor solution that had a common variance of 63.9%. CONCLUSION:The newly developed Sr-CDFS exhibits robust clinimetric properties with good-to-excellent reliability and validity. The newly developed Sr-CDFS has the potential to increase the feasibility of assessing frailty in clinical settings or large-scale epidemiological studies.

Background: The Israeli Mamanet Cachibol League (MCL) is a community-oriented athletic program serving mothers through non-competitive recreational sports participation. This study aimed to assess the effects of the MCL on perceived health status, mental health (happiness, depression, social capital), and healthy lifestyle behaviors (physical activity and nutrition). Methods: This is an experimental study with a sample of 231 women (174 in the experimental group and 57 in the control). Participants completed questionnaires in November 2023 (T1) and then in August 2024 (T2). The questionnaire included questions on sociodemographic characteristics, perceived health status, mental health (happiness, depression, social capital), and healthy lifestyle behaviors (physical activity and nutrition). Results: At T1, the MCL participants reported better mental health (higher subjective happiness and social capital and lower depressive symptoms) than the control group. Over time, participation in the MCL led to significant improvements in mental health (reductions in depression and increases in subjective happiness and social capital). The participants showed substantial improvements in healthy lifestyle behaviors, with moderate effect sizes (effects size > 0.5) observed across these areas. Sociodemographic factors influenced the outcomes, with variations in health perception and physical activity linked to marital status and education level. Conclusions: Participation in the MCL program was associated with better mental health at baseline and significantly improved over time compared to the control group. The MCL participants also showed gains in healthy lifestyle behaviors, highlighting the importance of tailored interventions.

For individuals with Duchenne or Becker muscular dystrophy (DMD and BMD, respectively), transitioning to adulthood presents significant challenges. Although considerable attention has been given to facilitating medical transitions due to the complexity of these conditions, less focus has been placed on other aspects of the transition, such as achieving independence. This study assessed the transition needs of people with DMD or BMD, exploring various domains including health, education, employment, living arrangements, transportation, daily activities, and independent personal life. Men with DMD or BMD participated in this cross-sectional study. Transition to adulthood was assessed using Transition Readiness Assessment for Young Adults with DMD. The questionnaire evaluates transitions in health care, education and employment, housing and transportation, activities of daily living, and independent life and autonomy. Factors associated with and predicting transition to adulthood were evaluated using Spearman’s correlations and multiple regression analysis. Forty-two people with DMD or BMD (mean age: 24.3±5.3) participated in this study. The transition domains in which most participants needed help were education and employment (52.5%) and activities of daily living (57.0%). Transition needs that stood out included palliative care (66.6%), employment and education support (76.1%), social worker consultation for housing assistance (76.1%), and assistive device consultation (64.2%). Mobility and breathing function did not correlate with transition level. Number of siblings positively correlated with and predicted most transition domains. Older age predicted only education and employment status. In conclusion, the analysis showed that the most problematic transition domains among people with DMD or BMD were activities of daily living and education and employment. In most transition domains, help needed did not decrease with age and was not affected by function. However, adolescents and adults with more siblings typically reported being more ready to transit to adult life.

Background The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. Objective To identify how to improve surveillance of movement behaviours, from the perspective of experts. Methods This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from 'extremely' to 'not at all' important. Consensus was defined as > 70% rating of 'extremely' or 'very' important. Results We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research. Conclusions This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.

Introduction:Physical activity (PA) is integral to type 2 diabetes (T2D) treatment, yet few national health services incorporate structured PA services as part of T2D treatment. Moreover, healthcare professionals acknowledge their role in integrating PA into the daily routines, but implementation faces notable barriers. Recognizing the pivotal role of healthcare systems and professionals in promoting physical activity-based interventions is crucial to closing the gap between guidelines and their implementation in real-world settings. Methods:The study involved 363 healthcare and physical activity professionals across diverse clinical settings. A questionnaire, developed through a focus group and literature review, assessed participants' attitudes and knowledge on PA and national practices pertaining to PA for people with T2D. The questionnaire's internal reliability was examined using Cronbach's alpha. Chi-squared tests compared participants' attitudes and knowledge prevalence in each healthcare and physical activity professionals' sector. Results:Participants (mean age = 48.00 ± 12.55) overwhelmingly supported PA inclusion in healthcare (97.8%) and reimbursement (77%). Translating PA recommendations into clinical practice remains a significant challenge due to several interrelated barriers. These include time constraints that hinder physicians' ability to provide in-depth counseling during routine visits, and patient-related factors, such as low responsiveness (43.8%) and limited awareness (33.3%). Around 70% of physicians endorsed regular PA recommendations. Exercise physiologists (30%) and physiotherapists (28%) were deemed most qualified to instruct T2D patients, followed by physicians (15.7%). A majority (57%) advocated for a multidisciplinary approach to PA prescription, incorporating aerobic, strength, and stretching training. Conclusion:The study underscores the need for the National healthcare system to prioritize infrastructure development, including multidisciplinary teams, for personalized PA programs vital to individuals with T2D.

Obesity, defined as a body mass index (BMI) of ≥ 30 kg/m2, is a global health crisis with severe physical and mental health implications. While bariatric surgery offers the most effective solution for severe obesity, long-term success depends on sustained behavioral changes and support (non-professional and professional). This study explores the role of support in promoting a healthy lifestyle after surgery. This study surveyed 211 individuals, aged 18–65, who had bariatric surgery more than 2 years ago, using random selection. Data were collected via phone interviews, ensuring anonymity. Questionnaires assessed healthy lifestyle (physical activity and nutrition) as well as professional and non-professional support participants received. Analysis methods encompassed χ2 tests, Pearson correlations, t-tests, and multiple regressions for predicting a healthy lifestyle. Most participants underwent sleeve gastrectomy with varied BMIs (17–47), and only 19.4