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Uber and Lyft are still waiting for a government green light, but that's not stopping other companies from operating in B.C.

Penny Daflos , Reporter, CTV Vancouver

@PennyDaflos

The biggest names in ride-hailing still aren’t operating in Metro Vancouver, but local competitors are opening up shop despite heavy fines and investigations from provincial authorities.

While Uber has been analyzing the market, participating in multi-governmental panels and preparing to launch upon legalization anticipated in the fall, some small upstarts are trying to get the jump on their competition.

Some Chinese language apps have been operating under the radar of provincial regulators and civic officials since last spring, but now an English language operator has quietly begun accepting fares in Metro Vancouver.

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Uber, taxi industry pitch different solutions to cab shortage at all-party meeting
Uber-style services already operating illegally in Metro Vancouver
Province hires consultant, extends timeline on ridesharing legislation

Photos

A ride-hailing app is seen in use in Vancouver in this image from Friday, Jan. 19, 2018.

ReRyde has been soliciting customers on Twitter, Facebook and Instagram since November while trying to recruit drivers on multiple platforms, including Craiglist, where a posting says they’re hiring 150 people for the region.

View this table:
Table 5

Physical activity consideration, precautions, and recommended activities for exercising with health-related complications

Recommendations

Targeted behavior-change strategies should be used to increase physical activity in adults with type 2 diabetes. B

When using step counters, adults with type 2 diabetes should initially set tolerable targets for steps/day before progressing toward higher goals. C

For adults with type 2 diabetes, Internet-delivered interventions for physical activity promotion may be used to improve outcomes. C

Behavior-Change Strategies

Behavioral interventions can significantly increase physical activity in adults with type 2 diabetes ( Dolce amp; Gabbana Woman Floralappliquéd Brocade Top Gray Size 38 Dolce amp; Gabbana Wide Range Of Cheap Price Factory Price Online Sale Online Low Price Sale Outlet 2018 New GyQpStGei
), and A1C reductions produced by such interventions have been sustained to 24 months ( 174 ). Five key techniques have been identified: ) prompt focus on past success, ) barrier identification/problem-solving, ) use of follow-up prompts, ) provision of information on where/when to perform the behavior, and ) prompt review of behavioral goals ( 175 ). However, motivational interviewing is not significantly better than usual care ( Lingerie Womens Bra SALINE Spotted Daniel Hechter Cheap Cost Genuine Sale Online Popular Clearance Footlocker Finishline Cheapest Sale Online 0Jy9uy80I
), and other intervention factors associated with weight loss, such as number and duration of contacts, have been inconsistent or not associated with greater participation ( 177 ).

Step counters/pedometers have been widely studied as a behavior-change tool. Wearing the device may prompt activity, and it provides feedback for self-monitoring. Pedometer use in adults with type 2 diabetes increased their daily steps by 1,822, but did not improve A1C ( Cheap Sale For Cheap Sale With Paypal Sofia Cropped Embroidered Cottonblend Gauze Wrap Top White Rixo London Discount Low Price Fee Shipping WgdqcVZ
). Using a daily steps goal (e.g., 10,000) was predictive of increased participation, even using self-selected step goals ( 178 ). Thus, adults with type 2 diabetes should initially set feasible/achievable targets for steps/day before progressing toward higher goals. Adults should avoid taking <5,000 steps/day ( 179 181 ) and to strive for ≥7,500 steps/day ( 182 ). The positive findings for pedometers are not universal ( 175 ), however, and some individuals may require greater support to realize benefits. Longer-term efficacy and determination of which populations can benefit from pedometers and other wearable activity trackers ( 183 ) require further evaluation.

Technology-Based Strategies

Given that the majority of individuals with type 2 diabetes have access to the Internet, technology-based support is appealing for extending clinical intervention reach. For adults with type 2 diabetes, Internet-delivered physical activity promotion interventions may be more effective than usual care ( 184 ). Effective Internet-based programs included monitoring of physical activity, feedback, goal setting, and support from a coach via phone/e-mail ( 184 ). More evidence is needed regarding social media approaches, given the importance of social and peer support in diabetes self-management ( 185 ).

Conclusions

Physical activity and exercise should be recommended and prescribed to all individuals with diabetes as part of management of glycemic control and overall health. Specific recommendations and precautions will vary by the type of diabetes, age, activity done, and presence of diabetes-related health complications. Recommendations should be tailored to meet the specific needs of each individual. In addition to engaging in regular physical activity, all adults should be encouraged to decrease the total amount of daily sedentary time and to break up sitting time with frequent bouts of activity. Finally, behavior-change strategies can be used to promote the adoption and maintenance of lifetime physical activity.

Article Information

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Footnotes

This position statement was reviewed and approved by the American Diabetes Association Professional Practice Committee in June 2016 and ratified by the American Diabetes Association Board of Directors in September 2016.

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