Word count = 4820 28 2 ABSTRACT 1 2 Background The prime focus of research on sports injury has been on physical factors. This is despite 3

This prospective study explored whether extending the Theory of Planned Behaviour (TPB) with additional variables (descriptive norm, moral norm, anticipated affective reaction, self-identity and past behaviour) would account for additional variance in physical activity intentions and behaviour. Four interactions with past behaviour were also investigated. UK college employees participated in this study (n = 200, Time 1; n = 146, Time 2). Moral norm, self-identity and past behaviour each explained additional variance in intentions, over and above the TPB variables. Past behaviour moderated the impact of descriptive norm on intentions. Intentions, self-identity and past behaviour were significant predictors of behaviour, as measured by a self-report physical activity questionnaire. To increase physical activity, interventions might target moral norm and self-identity for physical activity. Focusing on positive descriptive norms might benefit sedentary individuals. The significant role of past behaviour is less useful in directing interventions.

This paper reports findings from a qualitative investigation into the relationship between physical activity and mental health from the experiences of participants on exercise referral schemes. A grounded theory methodology was adopted which used focus groups and semi-structured interviews with participants from three exercise referral schemes in England. Schemes were representative of different types within the UK, and included a local authority leisure centre, a private health club and a local authority leisure centre scheme with organized countryside hikes. Pre- and post-exercise referral intervention focus groups, and interviews with purposively sampled individuals, were undertaken. Eighteen people participated and interviews were audio-taped, transcribed and analyzed. A conceptual framework emerged, and provides a psycho-social explanation for the physical activity and mental health relationship from the perspectives of the participants' who experienced it. The explanation of the relationship from this perspective identifies the core category 'self-acceptance', and the importance and interrelationship of context-related factors (such as social support and the physical environment), for the elicitation of positive experiences for people on exercise referral schemes. Investigating participant's experiences within the social contexts of exercise referral schemes provides an understanding about whether schemes have the potential to influence the mental health of referred patients.

The aim of this systematic review is to summarise the results of cohort studies that examined the incidence of SCD in marathons and to assess the quality of the methods used. A search of the PROSPERO international database revealed no prospective or published systematic reviews investigating SCD in marathons. The review was conducted using studies that reported and characterised the incidence of SCD in people participating in marathons. Studies were identified via electronic database searches (Medline, CINAHL, SPORTDiscus and Google Scholar) from January 1, 1966 to October 1, 2014 and through manual literature searches. 7 studies met the inclusion criteria and were included in this review. 6 of the studies were conducted in the USA and 1 in the UK. These studies covered a 34-year period involving between 215,413 and 3,949,000 runners. The SCD of between 4 and 28 people are recorded in the papers and the reported estimates of the incidence of SCD in marathons ranged widely from 0.6 to 1.9 per 100,000 runners. The proportion of those suffering SCD who were male ranged from 57.1% to 100% and the mean age reported in the papers, ranged from 37 to 48. This review raises 4 methodological concerns over i) collating reports of SCD in marathons; ii) time of death in relation to the marathon; iii) the use of registrants rather than runners in the estimates of sample size and iv) limited detail on runners exercise history.These four concerns all threaten the reliability and interpretation of any estimate of SCD incidence rates in marathons. This review recommends that the methods used to collect data on SCD in marathons be improved and that a central reporting system be established.3

PurposeThis paper responds to the question, is exercise medicine? It does so using a qualitative case study that proposes that exercise is recreation. The study (1) describes and reflects upon an exercise is recreation metaphor, (2) establishes the principles and processes used to develop a sport park within which exercise is recreation, and (3) presents a comparative analysis of the exercise is recreation approach with a UK quality framework for “exercise referrals”.MethodsFour years of documentation were collated and placed into 14 categories: (1) university strategies, (2) plans of the site, (3) policy documents, (4) minutes of a steering group, (5) contemporary documents, (6) organisational charts, (7) responses to local government policies on sport, (8) consultation documents, (9) operational procedures, (10) facility specifications, (11) partnership agreements, (12) material relating to the university's work on events, (13) notes on the universities sport department, and (14) timetables. These data were analysed through a 4-stage process which used recreation as the analytical theme for a comparative analysis.ResultsThe characteristics of the exercise is recreation metaphor in this case are (1) a focus on the experience of the user, (2) the promotion of well-being, (3) the importance of community, (4) embracing inclusivity, (5) sport, (6) aesthetics, and (7) leisure time. The principles and processes used to develop the sport park were (1) custodianship, (2) partnerships, (3) values, (4) inter-professional working, (5) local heritage, (6) change, (7) the natural park environment, and (8) “riding the bike as you build it”. The comparative analysis with a UK quality framework for “exercise referrals” clearly shows a difference from an exercise is recreation approach.ConclusionExercise is recreation and may enable individuals and communities to reach a state of well-being.