Daily Goals Research Articles

Impact of Teleworking Practices on Presenteeism: Insights from a Cross-Sectional Study of Japanese Teleworkers During COVID-19

Few studies have examined the relationship between teleworking practices and presenteeism. This study determined the association between teleworking practices and presenteeism among teleworkers in Japan. A cross-sectional online survey was administered to 2687 teleworkers from five companies in Japan, collecting data on demographic variables, teleworking practices, frequency and duration of teleworking, presenteeism, and various lifestyle- and health-related factors. A logistic regression analysis was performed. Teleworkers with full-time employment and less teleworking experience exhibited higher presenteeism rates. Key practices negatively associated with presenteeism included creating a dedicated workspace, chatting with colleagues, and setting daily work goals. Gender differences were significant: for men, additional practices, such as determining their work hours, were beneficial; while for women, chatting with colleagues was particularly important. A sensitivity analysis indicated that specific teleworking practices can mitigate presenteeism. Certain teleworking practices, such as creating a workspace, chatting with colleagues, and setting work goals, were associated with lower presenteeism among teleworkers. These findings highlight the need for organizations to support telework ergonomics, promote social interaction, and encourage goal setting to enhance teleworker productivity and health. Training for employees and supervisors to raise awareness of their own and their subordinates’ health while teleworking is advised.

Study longer or study effectively? Better study strategies can compensate for less study time and predict goal achievement and lower negative affect.

The hypothesis that study strategies can compensate for less study time in predicting learning outcomes has often been proposed but rarely tested empirically. In the present study, 231 university students reported their daily perceived time spent on self-study, study strategies (planning, monitoring, concentration and procrastination) and goal achievement over a 30 days period. Results showed that both more overall perceived study time and better study strategies (better planning, monitoring, and concentration, less procrastination) predicted higher goal achievement at the end of the day. In addition, perceived study time and study strategies interactively predicted goal achievement. When students reported better planning, monitoring and concentration as well as lower procrastination, less time was needed to achieve a high goal level compared to days on which they studied less strategically. In other words, when students studied less strategically, they had to invest more time to reach a higher goal level. In addition, perceived study time and study strategies were related to students' negative affect. Negative affect was particularly high when students studied for many hours with low concentration, and it was particularly low when students studied for only a few hours and procrastinated less. Taken together, the results suggest a compensatory effect of study time and study strategies on daily goal achievement and affect, highlighting the need to teach students effective study strategies.

THE IMPACT OF USING SMART WATCHES ON STUDENTS’ EFFORT CAPACITY: A COMPARATIVE STUDY

The increasing use of smartwatch technology among university students has raised questions about its potential impact on physical health and effort capacity. This study aims to evaluate the influence of smartwatch usage on the physical performance and effort capacity of students, focusing on those who utilize these devices for monitoring physical activity and health functions. In this comparative study, we employed a questionnaire to assess the adoption and usage patterns of smartwatches among students. The research sample was divided into two groups: a control group and an experimental group. Both groups participated in weekly aerobic gymnastics classes. However, the experimental group, equipped with smartwatches, was tasked with achieving a daily goal of 13,000-15,000 steps or expending 600 kcal. At the conclusion of the experiment, we evaluated the exercise capacity of all students using the Ruffier and Harvard tests. The results revealed significant differences between the two groups, with the experimental group demonstrating notably higher effort capacity. This suggests that the regular use of smartwatches, combined with specific fitness targets, can enhance physical performance and overall health among students. Our findings underscore the potential benefits of integrating wearable technology into student lifestyles, particularly in promoting physical activity and improving exercise capacity. This study contributes to the growing body of literature on the impact of smartwatches on health and fitness, highlighting their role as valuable tools for monitoring and enhancing physical performance in an academic setting. In conclusion, smartwatches can be useful tools for students, but they must be used with discernment. It is important to strike a balance between the benefits and distractions these devices bring. Students' effort capacity may be influenced by how they integrate smartwatches into their daily routine.

The role of resilience in navigating work stress and achieving daily work goals

SummaryOn a daily basis, resilience is critical for employees to cope with difficulties and challenges in achieving work goals. Understanding the dynamic resilience process throughout the workday is crucial for gaining insights into how employees can effectively leverage their resilience to meet their daily work goals. The present study aims to examine this dynamic resilience process in response to work stress while pursuing work goals among employees with different levels of trait resilience. Drawing on resilience literature and the conservation of resources theory, we propose a resilience‐depleting process in response to morning work stress within a short, half‐day timeframe. We further examine whether state resilience impacts subsequent work goal striving at the within‐person level. Additionally, we explore the buffering effect of trait resilience on the resilience‐depleting process after experiencing work stress. To test our hypotheses, we employed the experience sampling methodology with 108 full‐time employees over five consecutive workdays. Multilevel analyses revealed that morning work stress significantly diminished state resilience, indirectly influencing daily work goal progress through work goal activation. Notably, trait resilience buffered the negative impact of work stress on state resilience. These results offer insights into theoretical understanding and practical implications for managing employee state resilience in the face of work stress to achieve daily work goals.

A Remote Behaviorally Designed Intervention to Promote Physical Activity in Patients With Knee Osteoarthritis: Results of a Pilot Randomized Clinical Trial.

We evaluated a behaviorally designed intervention utilizing gamification and social support to improve physical activity and reduce symptoms in patients with osteoarthritis of the knee (KOA). Veterans with KOA, aged 40-80 years, were enrolled in this randomized controlled trial. Participants received a Fitbit and completed a 2- to 4-week baseline period. A Web-based platform administered biweekly surveys after randomization and tracked physical activity. Participants selected a daily step goal that was 33%, 40%, or 50% above their baseline. The intervention arm received game playing aspects and a social support partner to advance weekly step performance while the control arm only received weekly updates. The primary outcome was the change in steps per day averaged over 2-week intervals. We used mixed effects regression, adjusting for baseline step count. Secondary outcomes assessed the change in KOOS (Knee Injury and Osteoarthritis Outcome Score) over 32 weeks. Thirty-one participants were included in the final analysis. Most participants were male (90.3%), Black (70.96%), had a mean (SD) age of 60 (13) years, and body mass index of 33.7 (5.9) kg/m2. Participants that received the intervention walked a total of 1119 (95% confidence interval: -562, 2799) more steps per day (p = 0.19). The effect was greatest in the first 6 months (1491 [-272, 3254], p = 0.10). Compared with controls, those that received the intervention had improvement over time in total KOOS (mean 2-week change +0.62 [0.031, 1.20] vs -0.38 [-1.04, 0.28], p = 0.02) and several subscales. This intervention demonstrated promise for promoting greater physical activity and improving symptoms in patients with KOA.

Smartphone-Based Digital Peer Support for a Walking Intervention Among Public Officers in Kanagawa Prefecture: Single-Arm Pre- and Postintervention Evaluation.

Digital peer support, defined as peer support delivered through technology such as smartphone apps, may be promising to promote activity in the form of step counts. Interactions among users have a positive impact on retention rates, and apps with social elements show significant improvements in daily step count. However, the feasibility of digital peer support in promoting physical activity (PA) is unknown; therefore, its effectiveness on step count and the clinical implications remain unconfirmed. This study aimed to assess the feasibility of digital peer support over a 3-month intervention period using the retention rate as the outcome. Moreover, changes in daily step count and physical measurements were compared between pre- and postintervention. The study design was a 3-month 1-arm intervention with participants from local government offices in Kanagawa, Japan. We used an available smartphone app, Minchalle, as the tool for the group intervention. Participants were required to report their daily step count to a maximum of 5 members composed exclusively of study participants. The primary outcome was the retention rate. Secondary outcomes included daily step count, the rate of achieving daily step goals, physical measurements, and lifestyle characteristics. Descriptive statistics and the Pearson coefficient were used to examine the relationship between goal achievement and step count, as well as changes in step count and various variables including physical measurements. Of the 63 participants, 62 completed the intervention. The retention rate was 98% (62/63). The average daily step count during the intervention was 6993 (SD 2328) steps, an 1182-step increase compared with the count observed 1 week before the intervention began. The rate of achieving the daily step count during the intervention was 53.5% (SD 26.2%). There was a significant correlation (r=0.27, P=.05) between achieving daily step goals and increasing daily step count. Comparative analyses showed that changes in weight (68.56, SD 16.97 kg vs 67.30, SD 16.86 kg; P<.001), BMI (24.82, SD 4.80 kg/m2 vs 24.35, SD 4.73 kg/m2; P<.001), somatic fat rate (28.50%, SD 7.44% vs 26.58%, SD 7.90%; P=.005), systolic blood pressure (130.42, SD 17.92 mm Hg vs 122.00, SD 15.06 mm Hg; P<.001), and diastolic blood pressure (83.24, SD 13.27 mm Hg vs 77.92, SD 11.71 mm Hg; P=.002) were significantly different before and after the intervention. Similarly, the daily amount of PA significantly improved from 5.77 (SD 3.81) metabolic equivalent (MET)-hours per day to 9.85 (SD 7.84) MET-hours per day (P<.001). This study demonstrated that digital peer support is feasible for maintaining a high retention rate and can, therefore, effectively promote PA. It can be a promising tool to improve daily step count, subjective PA, and clinical outcomes, such as weight and somatic fat rate. UMIN Clinical Trials Registry UMIN000042520; https://tinyurl.com/46c4nm8z.

Nutrient Intakes in Prostate Cancer Survivors in the United States: A Nationally Representative Study

There are currently more than 3.3 million prostate cancer (PC) survivors in the United States. Conformance with national dietary guidelines and a good diet quality may lower the risk for Gleason grade progression in PC patients. Assessing the nutritional status of PC survivors is thus of paramount importance from a public health nutrition perspective. We used 24-h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES) to systematically estimate nutrient intakes in n = 360 PC survivors (which may be extrapolated to represent n = 1,841,030 PC survivors) aged 70.69 years on average, and contrasted the results to the daily nutritional goals (DNG) in the 2020–2025 Dietary Guidelines for Americans (DGA). Diet quality in PC survivors was found to be generally poor, and the DNG as specified in the DGA were not met for many micronutrients, including calcium, magnesium and potassium. PC survivors had an insufficient intake of many vitamins (including vitamins A, C, D and E), and did not meet the intake recommendations for dietary fiber. Racial disparities in PC were reflected in the lower overall DQ in Non-Hispanic Black participants. Our results reiterate the need for nutritional assessment and counseling to improve DQ in PC patients.

The effect of early mobilization on constipation after abdominal surgery: A systematic review

Background/Aim: Constipation can occur after abdominal procedures. In this study, we investigated whether early mobilization after abdominal surgery is effective for treating constipation. Methods: We conducted a systematic review of studies implementing early and planned mobilization after abdominal surgical procedures. We extracted studies published from 2012–2022 from six electronic databases: PubMed, Google Scholar, Science Direct, Cochrane, TürkMedline, and Ulakbim. The data were collected by two reviewers following a pre-designed subtraction form. We made use of narrative synthesis when presenting our results. Results: We examined 10 articles that satisfied the inclusion criteria; patients underwent a cesarean section in four studies, bariatric surgery (gastric bypass) in one study, liver resection in one study, radical cystectomy in two studies, cholecystectomy in one study, and a kidney transplant in one study. The studies were characterized by differences in the early mobilization programs applied to patients after abdominal surgery. In two of the studies, the patients were mobilized accordingly to daily step goals; in five studies only early stimulation and walking attempts were utilized. In three of the studies, the patients were mobilized within the scope of mobilization programs prepared in detail after surgery, and the targets were determined in terms of distance walked. All of the studies stipulated that physical activity should gradually increase over time. Conclusion: Early and planned mobilization programs applied after surgery had positive effects on first gas/first stool output time, the severity of abdominal distension, the occurrence of nausea/vomiting, and the onset of oral intake.

Feasibility and usefulness of postoperative mobilization goals in the enhanced recovery after surgery (ERAS®) clinical pathway for elective colorectal surgery

PurposeDespite mobilization is highly recommended in the ERAS® colorectal guideline, studies suggest that more than half of patients don’t reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS®-patients by validated motion data from body sensors.MethodsERAS®-patients with elective bowel resections were eligible. Self-assessments and motion sensors (movisens: ECG-Move 4 and Move 4; Garmin: Vivosmart4) were used to record mobilization parameter from surgery to postoperative day 3 (POD3): Time out of bed, time on feet and step count.Results97 patients were screened and 60 included for study participation. Self-assessment showed a median out of bed duration of 215 min/day (POD1: 135 min, POD2: 225 min, POD3: 225 min). The goal of 360 min was achieved by 16.67% at POD1, 21.28% at POD2 and 20.45% at POD3. Median time on feet objectively measured by Move 4 was 109 min/day. During self-assessment, patients significantly underestimated their “time on feet”-duration with 85 min/day (p = 0.008). Median number of steps was 933/day (Move 4).ConclusionThis study confirmed with objectively supported data, that most patients don’t reach the daily mobilization goal of 360 min despite being treated by an ERAS®-pathway with ERAS®-nurse. Even considering an empirically approximated underestimation, the ERAS®-target isn’t achieved by more than 75% of patients. Therefore, we propose an adjustment of the general ERAS®-goals into more patient-centered, individualized and achievable goals.RegistrationThis study is part of the MINT-ERAS-project and was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is “DRKS00027863”.

Development of a New Tool to Combine the Promotion of Patient Mobility With Safe Patient Handling Equipment: The Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide.

Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury. Using a modified Delphi approach with a diverse group of experts, we created the Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. This diverse group of 10 experts consisted of nurses, nurse leaders, physical and occupational therapists, safe patient handling committee representatives, and a fall prevention committee leader. The application of the tool was then tested in the hospital environment by two physical therapists. Consensus was reached for safe patient handling (SPH) equipment recommendations at each level of the Johns Hopkins Mobility Goal Calculator (JH-Mobility Goal Calculator). Expert SPH equipment recommendations were then added to JH-Mobility Goal Calculator levels to create the JH-Safe Patient Handling Mobility Guide. JH-Safe Patient Handling Mobility Guide equipment suggestions were compared with equipment recommendations from physical therapists revealing strong agreement (n = 125, 88%). The newly created JH-Safe Patient Handling Mobility Guide provides appropriate safe patient-handling equipment recommendations to help accomplish patients' daily mobility goals. The Johns Hopkins Safe Patient Handling Mobility Guide simultaneously facilitates patient mobility and optimizes safety for nursing staff through recommendations for safe patient handling equipment for use with hospitalized patients.

Comparison of treatment trains for indirect potable reuse and use of quantitative microbial risk assessment (QMRA) to evaluate reliability of pathogen removal: Zoo Miami case study

Wastewater and reclaimed water contain various microorganisms such as bacteria, viruses, and protozoa that can cause waterborne diseases in humans and animals. Zoos and animal conservation parks utilize reclaimed water for various purposes which may contain pathogens harmful to human and animal health. The goal of this study was to assess the treatment performance of two treatment trains for indirect potable reuse (IPR) and perform quantitative microbial risk assessment (QMRA) to evaluate the reliability of pathogen removal at a proposed advanced water treatment facility at the Zoo Miami. A review of advanced treatment and disinfection technologies relevant for reclaimed water production and pathogen removal was conducted as a part of this study. DPRisk was used to perform QMRA for four reference pathogens selected as model organisms for two IPR treatment trains (TT1 and TT2). Public health risk estimates for pathogens including Adenovirus, Cryptosporidium, Giardia, and enteric viruses indicated that the risk of infection was below the EPA's target daily threshold of 2.7 × 10−7 and annual risk threshold of 10−4 without failure analysis. With failure analysis, both treatment trains met the daily risk goals for each of the reference pathogens approximately 99 % of the time. Adenovirus demonstrated the highest probability of infection with a mean annual risk of infection for TT1 of 6.65 × 10−9 in the absence of failures but reached a maximum of 7.34 × 10−2 with failure analysis. TT2 resulted in higher risk estimates compared to TT1 with a mean annual risk of infection of 2.10 × 10−8 without failure and a maximum of 8.37 × 10−2 with failure analysis. The results of the failure analysis demonstrate the benefit of treatment redundancy in potable reuse system design and highlight the importance of online process monitoring to rapidly identify off-spec or treatment failure events to protect public health. With this information, stakeholders can better understand treatment requirements and microbiological risks to inform potable reuse planning, design, and risk management.

Applying dynamic structural equation modeling (DSEM) to examine the dynamics of students’ affect and learning goal achievement

Affect is a critical factor impacting students’ goal setting and goal achievement in learning. While existing studies have demonstrated the vital role of affect in learning and goal achievement, the day-to-day fluctuations of affect and their impact on learning have rarely been examined. This study explored the dynamic relationships between positive affect (PA), negative affect (NA), and daily learning goal achievement (LGA) in 72 college students ahead of a high-stakes test, analyzing 32 days of survey responses totaling 2111 observations. We employed dynamic structural equation modeling (DSEM) to assess the stability, variability, and potential reciprocal relationships of PA, NA, and LGA. Additionally, we investigated the effects of depression, age, and the number of semesters studied on these variables. Results indicated that PA, NA, and LGA remained stable over the observation period, with no systematic changes or trajectories, yet exhibited significant fluctuations within and between participants. All autoregressive effects for PA, NA, and LGA were significant. Both PA and NA were significantly related to concurrent measures of LGA, although no significant cross-lagged relationships between PA and NA were found. Variability in PA, NA, and LGA was significantly explained by students’ age, number of semesters studied, and level of depressive symptoms. Further findings and implications of the study are discussed.

Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer.

Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.

Quality improvement collaborative for improving patient care delivery in Argentine public health sector intensive care units

BackgroundThe demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll.ObjectiveThe aim was to achieve adequate personal protective...

Adapting goals and motivational messages on smartphones for motivation to walk

Physical activity is one of the most recognised means of disease prevention. While several studies investigated different techniques for motivating people to walk (e.g. adaptive goal setting), only few studies considered user profiles to personalise interactions. In this article, we propose a new interaction model which adapts walking goals and motivational messages in a static way (using the initial physical activity level) and in a dynamic way (using previous days’ performance). We explain how we implemented this model in a mobile application counting and displaying in real time the number of steps, an adapted daily goal and personalised motivational messages throughout the day. We describe two field studies conducted with 32 and 50 users over four weeks. We compare the impacts of adapted daily goals and personalised motivational messages on users’ step counts and motivation to walk. Participants using the adapted version of the mobile application displayed an increase in their motivation to walk after the intervention and were more physically active than participants using non adapted versions of the mobile application.

Goal change and goal achievement for emerging adults across the pilot FAMS-T1D intervention for type 1 diabetes.

Interventions for emerging adults (EAs) with type 1 diabetes (T1D) focus on goal setting, but little is known about how goal achievement relates to intervention outcomes. We examined how goals change, how goal achievement relates to diabetes outcomes, and identified barriers and facilitators to goal achievement. EAs with T1D (N=29, M age=21.6 years, 57% female) were coached monthly to set a behavioral goal across a 3-month feasibility trial. Coaching notes were qualitatively coded regarding type, complexity, and changes in goals. Goal achievement was measured via daily responses to texts. HbA1c, self-efficacy, diabetes distress, and self-care were assessed pre- and post-intervention. EAs frequently set food goals (79%) in combination with other goals. EAs overwhelmingly changed their goals (90%), with most increasing goal complexity. Goal achievement was high (79% of days) and not affected by goal change or goal complexity. Goal achievement was associated with increases in self-efficacy and self-care across time. Qualitative themes revealed that aspects of self-regulation and social-regulation were important for goal achievement. Meeting daily diabetes goals may enhance self-efficacy and self-care for diabetes. Assisting EAs to reduce self-regulation challenges and enhance social support for goals may lead to better diabetes outcomes.

Global guidelines recommendations for dietary sodium and potassium intake.

Non-communicable diseases (NCDs) cause a significant global health challenge, with unhealthy diets identified as a major risk factor. Sodium and potassium, which are essential minerals for human health, play important roles in various bodily functions, and an imbalance in their intake can have significant health implications, particularly concerning hypertension and cardiovascular diseases. This review compiles dietary sodium and potassium intake recommendations from prominent global health organizations and compares global guidelines to Japan's Dietary Reference Intake (DRI) guidelines. Sodium and potassium intake guidelines from organizations such as the World Health Organization (WHO), American College of Cardiology (ACC) and American Heart Association (AHA), Dietary Guidelines for Americans (DGA), European Food Safety Authority (EFSA), and DRI for Japanese exhibit variations. Compared to other Asian countries, Japan's historically higher sodium goal aligns with Southeast Asia where traditional preserved foods contribute to high sodium intake. Contrarily, Japan's lower potassium goal contrasts with other countries in Asia promoting a diet rich in fruits and vegetables. The ongoing effort by Japan to align with global recommendations reflects a gradation approach considering social habits. While harmonizing international efforts is essential, appreciating regional diversities is paramount through tailoring guidelines to cultural and dietary habit practices. Implementing context-specific guidelines informed by scientific research can contribute to global efforts in promoting healthy diets and reducing the burden of NCDs. Global guidelines that recommended the daily dietary intake goal for sodium and potassium exhibit variations. These disparities are influenced by diverse factors, including cultural dietary habits, socioeconomic status, health priorities, and available scientific research. Each population should follow the recommendations of their region.

Home-based Circuit Training and Community Walking for Intermittent Claudication

ObjectiveSupervised exercise training is recommended for people with peripheral artery disease (PAD), yet it remains underutilised. Home-based exercise programmes are a potential alternative. The aim of this study was to assess the feasibility of conducting a full scale trial of a 12-week home-based exercise programme (HBEP) for people living with symptomatic PAD. MethodsIn a randomised feasibility trial, patients with intermittent claudication (IC) were allocated to either a HBEP or a non-exercise control. The HBEP group were given a Fitbit to use during a 12-week exercise programme comprising of personalised step goals and a resistance-based circuit to be undertaken at home twice weekly. The primary outcome was feasibility, assessed via eligibility, recruitment, attrition, tolerability, and adherence. Acceptability was assessed via semi-structured interviews. Secondary analysis was undertaken to determine the feasibility of collecting clinical outcome data. Results188 people were screened, 133 were eligible (70.7%), 30 were recruited (22.6%) and one withdrew (3.33%). Mean adherence to the daily step goal was 53.5% (range=29.8–90.5%), and 58.6% of prescribed circuits were completed of which 56.4% were at the desired intensity. Six adverse events were recorded, three of which were related to study involvement. No significant differences were observed in exploratory outcomes. Small clinically important differences were seen in walking speed and pain-free treadmill walking distance which should be confirmed or refuted in a larger trial. ConclusionThe HBEP was feasible and well tolerated, with successful recruitment and minimal attrition. The intervention was acceptable, with walking seen as more enjoyable than circuit exercise. The WALKSTRONG programme may be suitable for those who will not, or cannot, take part in supervised exercise outside of the home.

Evaluation of a community-based pharmacy resident-led continuous glucose monitoring program within a family medicine clinic

BackgroundPharmacist-driven continuous glucose monitoring (CGM) is associated with reduced hemoglobin A1c (HbA1c) and achievement of daily glycemic goals. Community-based pharmacists are well-positioned to improve CGM uptake among patients with diabetes due to their accessibility and expertise. However, little data exists evaluating the outcomes of CGM services led by a community-based pharmacist. ObjectiveTo evaluate the impact of a community-based pharmacy resident-driven CGM service on HbA1c, revenue, and patient satisfaction. Practice DescriptionIndependent community pharmacy sharing a clinical services agreement with a primary care clinic for Postgraduate Year One (PGY1) Community-based Pharmacy Residents to provide patient care under general supervision of the physician. Practice innovationPatients were offered CGM services if they were 18+ years with an HbA1c > 7.0% and had insurance coverage for CGM. Enrolled patients engaged in three months of pharmacist-led appointments for CGM application, data interpretation, diabetes education, and lifestyle management. Current Procedural Terminology (CPT) codes 99211, 95250, or 95251 were billed based on each encounter. HbA1c values were collected at program enrollment and conclusion. Patients completed a satisfaction survey at program conclusion. Evaluation methodsDemographics and billed CPT codes were collected from the electronic health record. Descriptive statistics were used to analyze data. ResultsEighteen patients were included. A mean reduction of 1.2% occurred in HbA1c (n = 12; 9.7%−8.5%). Forty CPT codes were billed, generating $3671.40 of revenue. Satisfaction surveys were collected for 50% of participants (n = 9). Most were satisfied with the CGM service and its individual components (n = 8, 89%). Most were willing to continue using CGM devices and receive diabetes education from a pharmacist (n = 8, 89%). ConclusionA community-based pharmacist-led CGM service demonstrated a reduction in HbA1c and generated revenue for the clinic. Patients reported satisfaction and willingness to continue the service.

A Diary Study of Daily Negative Aging Stereotypes and Goal Pursuit in Older Adults.

This study aimed to investigate the association between negative aging stereotypes and goal pursuit in daily life among older adults. We also explored the roles of stereotype threat and stereotype challenge reactions in mediating this association. Additionally, this study investigated whether variations in these associations exist among older adults based on their self-integrity levels. Participants were 100 older adults who completed daily measures assessing negative aging stereotype experiences, threat and challenge reactions, goal pursuit activities, and self-integrity over a week. More daily experiences of negative aging stereotypes were associated with greater avoidance of responsibilities in goal pursuit and less progress toward goals. Increased threat reactions and decreased challenge reactions were mediators of the association between stereotype experiences and avoidance of responsibilities, as well as that between stereotype experiences and progress toward goals, respectively. Moreover, the associations between threat reactions and avoidance of responsibilities as well as between stereotype experiences and challenge reactions were more pronounced in older adults with lower self-integrity levels. This study is pioneering in demonstrating the real-life interplay between aging stereotypes and goal pursuit among older adults. Its findings not only expand upon the literature concerning aging stereotypes, but also offer theoretical insights for the development of interventions aimed at goal pursuit. These insights have significant implications for fostering healthy aging.