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Introduction Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists (AEPs) for clients with type 2 diabetes (T2D) in clinical practice. Methods and analysis A non-randomised, opportunistic control, longitudinal design trial will be conducted at ten Exercise Physiology Clinics. Participants will be individuals with T2D attending one of the Exercise Physiology Clinics for routine AEP services (exercise prescription and counselling) (intervention) or individuals with T2D not receiving AEP services (usual care) (control). The experimental period will be 6 months with measurements performed at baseline and at 6 months. Primary outcome measures will be glycosylated haemoglobin (HbA1c), resting brachial blood pressure (BP), body mass index, waist circumference, 6 min walk test, grip strength, 30 s sit to stand, Medical Outcomes Short-Form 36-Item Health Survey and Active Australia Questionnaire. Secondary outcomes will be medication usage, out-of-pocket expenses, incidental, billable and non-billable health professional encounters and work missed through ill health. Healthcare utilisation will be measured for 12 months prior to, during and 12 months after trial participation using linked data from Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data. Ethics and dissemination The study is a multicentre trial comprising: University of Tasmania, University of New South Wales Lifestyle Clinic, University of Canberra, Baker Heart and Diabetes Institute (covered under the ethics approval of University of Tasmania Health and Medical Ethics Committee H0015266), Deakin University (Approval number: 2016-187), Australian Catholic University (2016-304R), Queensland University of Technology (1600000049), University of South

A portable surface modular thermal transfer unit (MTTU) has been built and tested for 2 years at the Stobie mine in Ontario, Canada. Cold air is heated in the winter by spraying mine return water into the air to generate ice which is stored and used for cooling hot air in the summer. It was found that the unit could increase the sub-zero ambient air temperature from below -6 degrees C to zero, but operation of the system in reverse was less successful, with just a 4-5 degree C cooling effect on ambient temperature. The generation of large volumes of ice could not be guaranteed, and keeping it frozen until needed was also difficult. The operational limits led to difficulties in obtaining comprehensive data, and high water spray flows affected the quality of data measurement. Thermodynamics of steady flow was used to evaluate the heat exchange through the MTTU, and the results were verified by heating/cooling powers obtained from psychrometric relationships. The proposed ideal water flow rate methodology provides a guideline for heating sprays in winter operations, or could be used to define the initial water flow in a process control loop., A portable surface modular thermal transfer unit (MTTU) has been built and tested for 2 years at the Stobie mine in Ontario, Canada. Cold air is heated in the winter by spraying mine return water into the air to generate ice which is stored and used for cooling hot air in the summer. It was found that the unit could increase the sub-zero ambient air temperature from below -6 degrees C to zero, but operation of the system in reverse was less successful, with just a 4-5 degree C cooling effect on ambient temperature. The generation of large volumes of ice could not be guaranteed, and keeping it frozen until needed was also difficult. The operational limits led to difficulties in obtaining comprehensive data, and high water spray flows affected the quality of data measurement. Thermodynamics of steady flow was used to evaluate the heat exchange through the MTTU, and the results were verified by heating/cooling powers obtained from psychrometric relationships. The proposed ideal water flow rate methodology provides a guideline for heating sprays in winter operations, or could be used to define the initial water flow in a process control loop.

This article discusses and critiques recent research trends within the study of positive youth development (PYD) through sport in addition to proposing directions for future study. Specifically, it is suggested that future work in PYD through sport delve into its potential application to the study of community development. First this article explores early work providing the theoretical background for PYD followed by a discussion of sport psychology’s adoption of PYD concepts. Recent PYD research is then examined suggesting strong evidence supporting the enhancement of life skills through sport contingent on an appropriate set of contextual factors and coach/leader strategies being in place. Support for the enhancement of the 5Cs through sport is less consistent. Several steps are suggested to help substantiate the connection between PYD and community development through empirical research.

Patients with familial hypercholesterolemia (FH) are at markedly increased risk of coronary artery disease. Regular participation in three self-management behaviors, physical activity, healthy eating, and adherence to medication, can significantly reduce this risk in FH patients. We aimed to predict intentions to engage in these self-management behaviors in FH patients using a multi-theory, integrated model that makes the distinction between beliefs about illness and beliefs about self-management behaviors. Methods: Using a cross-sectional, correlational design, patients (N = 110) diagnosed with FH from a clinic in Perth, Western Australia, self-completed a questionnaire that measured constructs from three health behavior theories: the common sense model of illness representations (serious consequences, timeline, personal control, treatment control, illness coherence, emotional representations); theory of planned behavior (attitudes, subjective norms, perceived behavioral control); and social cognitive theory (self-efficacy). Results: Structural equation models for each self-management behavior revealed consistent and statistically significant effects of attitudes on intentions across the three behaviors. Subjective norms predicted intentions for health eating only and self-efficacy predicted intentions for physical activity only. There were no effects for the perceived behavioral control and common sense model constructs in any model. Conclusions: Attitudes feature prominently in determining intentions to engage in self-management behaviors in FH patients. The prominence of these attitudinal beliefs about self-management behaviors, as opposed to illness beliefs, suggest that addressing these beliefs may be a priority in the management of FH.

Background: Lifestyle factors including inadequate physical activity may contribute to increased risk of developing cardiovascular disease in colorectal cancer survivors. Identification of the barriers to physical activity is important for forming an evidence base of factors to target in future physical activity programs aimed at improving cardiovascular health in this population. Methods: Colorectal cancer survivors (N = 24) from St. John of God Subiaco Hospital participated in semi-structured interviews about their current physical activity behaviors and perceived barriers to physical activity. Results: Inductive thematic analysis of interviews revealed 5 overarching themes relating to barriers to physical activity: psychological barriers, environmental barriers, knowledge of guidelines, lack of practitioner support, and energy/age barriers. Conclusions: Novel findings revealed participants' dependence on practitioner support, including a reliance on practitioners to recommend lifestyle change. Survivors also revealed that regular checkups to monitor cardiovascular risk replaced the need for healthy lifestyle changes. Implications: With survivors holding the advice of clinicians in high regard, an opportunity exists for clinicians to facilitate lifestyle change. Health care professionals such as nurses can implement motivational strategies and provide additional health information during follow-up visits, to ensure long-term adherence. Individuals who reported psychological, motivational, and environmental barriers may benefit from interventions to improve self-regulation, planning, and problem-solving skills.

© 2016 Japan Atherosclerosis Society.Familial hypercholesterolemia (FH) is the most common and serious form of inherited hyperlipidaemia. Dominantly inherited with high penetrance, untreated FH leads to premature death from coronary artery disease due to accelerated atherosclerosis from birth. Despite its importance, there is still a major shortfall in awareness, detection and treatment of FH worldwide. International models of care for FH have recently been published, but their effective implementation requires the garnering of more knowledge about the condition. The “Ten Countries Study” aims to investigate diagnostic, epidemiological and service aspects, as well as physician practices and patient experiences of FH in several countries in the Asia-Pacific Region and the Southern Hemisphere. Five observational studies are being undertaken that will systematically investigate the following aspects of FH: the phenotypic predictors of low-density lipoprotein receptor mutations, the point prevalence in available community populations, current knowledge and clinical practices among primary care physicians, availability and utilisation of services and facilities, and patient perceptions and personal experiences of the condition. The information gathered will inform better clinical practice and will enable the development of country-specific models of care for FH.

Objectives This study examined the modal salient behavioral, normative, and control beliefs within the theory of planned behavior (TPB) in the context of anti-doping in sport. We tested the efficacy of four hypothesized expectancy-value models as predictors of the directly-measured social-cognitive components of the TPB toward doping avoidance: attitude, subjective norm, perceived behavioral control (PBC), and intention. Methods After developing the belief-expectancy and belief-value of modal salient beliefs items based on a pilot belief-elicitation study of young elite athletes (N = 57, mean age = 18.02), 410 young athletes (mean age = 17.70) completed questionnaire items of the modal salient beliefs and direct measures of the social-cognitive components of doping avoidance. Variance-based structural equation modeling was used to examine the four proposed expectancy-value models. Results Belief-expectancies, belief-values, and the expectancy-belief multiplicative composites formed positive associations with their corresponding social cognitive variables. The model in which belief-expectancies were the sole predictors of the social cognitive provided the most parsimonious and reliable model to explain the relationship between modal salient beliefs and directly-measured social-cognitive variables for doping avoidance in sport. Conclusion Belief-expectancies including behavioral belief strength (e.g., “doping avoidance is likely to ease the worry of being caught doping”), normative belief strength (“my coach thinks that I should avoid doping”) and control belief strength (“I expect I have power to ‘say no’ to doping”) are the belief-based components that underpin direct measures of the social-cognitive variables from the TPB with respect to doping avoidance.

Background: Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. Objective: This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. Methods: The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing.Results: The study is expected to take approximately 14 months to complete. Conclusions: The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations.

Elite athletes’ beliefs about, and attitudes toward, taking banned performance enhancing substances were explored in 8 focus-group discussions with 57 athletes from 7 different sports. Discussion was initiated by 3 broad open-ended questions pertaining to 3 important themes likely to affect beliefs and attitudes toward banned performance enhancing substances. Thematic content analysis of interview transcripts revealed 9 lower-order themes emerging under the 3 global themes: personal attitudes (reputation and getting caught, health effects, and financial incentives and rewards), social influences (coaches, parents, and medical staff and sport scientists), and control beliefs (i.e., insufficiency of doping testing, resource availability, and sport level and type). Findings provide insight into the beliefs and attitudes that likely underpin motives and intentions to take banned performance-enhancing substances. Results are generally consistent with, and complement, research adopting quantitative approaches based on social– cognitive models examining the beliefs and attitudes linked to taking banned performance-enhancing substances.

Self-determination theory has been applied to the prediction of a number of health-related behaviors with self-determined or autonomous forms of motivation generally more effective in predicting health behavior than non-self-determined or controlled forms. Research has been confined to examining the motivational predictors in single health behaviors rather than comparing effects across multiple behaviors. The present study addressed this gap in the literature by testing the relative contribution of autonomous and controlling motivation to the prediction of a large number of health-related behaviors, and examining individual differences in self-determined motivation as a moderator of the effects of autonomous and controlling motivation on health behavior. Participants were undergraduate students (N=140) who completed measures of autonomous and controlled motivational regulations and behavioral intention for 20 health-related behaviors at an initial occasion with follow-up behavioral measures taken four weeks later. Path analysis was used to test a process model for each behavior in which motivational regulations predicted behavior mediated by intentions.Some minor idiosyncratic findings aside, between-participants analyses revealed significant effects for autonomous motivational regulations on intentions and behavior across the 20 behaviors. Effects for controlled motivation on intentions and behavior were relatively modest by comparison. Intentions mediated the effect of autonomous motivation on behavior. Within-participants analyses were used to segregate the sample into individuals who based their intentions on autonomous motivation (autonomy-oriented) and controlled motivation (control-oriented). Replicating the between-participants path analyses for the process model in the autonomy- and control-oriented samples did not alter the relative effects of the motivational orientations on intention and behavior. Results provide evidence for consistent effects of autono

UK drinkers regularly consume alcohol in excess of guideline limits. One reason for this may be the high availability of low-cost alcoholic beverages. The introduction of a minimum price per unit of alcohol policy has been proposed as a means to reduce UK alcohol consumption. However, there is little in-depth research investigating public attitudes and beliefs regarding a minimum pricing policy. The aim of the present research was to investigate people's attitudes and beliefs toward the introduction of a minimum price per unit of alcohol policy and their views on how the policy could be made acceptable to the general public.