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What happens if you innovate You create progress. P stands for progress not just progress in goods, services, and pro t, but also personal progress. We toil each day for the satisfaction when we achieve great things, when we help the team, and when we make others lives better. Progress is, in this way, intimately related to the pursuit of signi cance. We go on TRIPs because we want to accomplish big things. We go on TRIPs because we want to solve real problems and because we want to create lasting value. We also progress when we take risks and succeed. When we struggle through the Valley of C and climb the Hill of A, we know that we have grown as a person, that we are stronger and more capable, and, most important, that we have the strength to set out on the next journey, to an even higher hill, and beyond. And isn t that what the journey is about



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small sample sizes, which were either not representative of the larger diabetes population or were inappropriate in the sense that the participants reported low levels of concern with the factor on which the treatment was focused In addition, Rubin and Peyrot (1992) raise other methodological limitations of previous research, such as the use of poor quality outcomes measures; awed designs (eg, no control groups used, no follow-up period); and comprehensive shotgun interventions that included a variety of medical and psychosocial components, which precluded the identi cation of the effective treatment components Future treatment outcome studies may bene t from increased attention to these points as well as to long-term follow-up of patients, the clinical signi cance of obtained changes (Goodall & Halford, 1991), issues of cost containment and cost effectiveness (Glasgow, Fisher, et al.





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, 1999), and the maintenance of behavior change as a separate construct from initial behavior change (Wing, 2000) In addition to these improvements in intervention methodology, future research should also address more thoroughly individual differences in psychosocial factors and their modi cation Little research exists on the speci c needs of racial and cultural minorities with diabetes This is especially noteworthy given the facts that in racial/ethnic minorities (a) diabetes is more common (CDC, 1998) and (b) metabolic control and complications are worse (see review by Weller et al, 1999) Similarly, the unique management issues relevant to women with diabetes also deserve increased attention Although there has been some research in areas of women s health such as diabetes in pregnancy and weight management, there is a dearth of studies on the effects of diabetes on other aspects of women s reproductive health (eg.

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, fertility, contraception choices), the in uence of hormonal changes (eg, menopause) on diabetes management, eating disorders, female sexual dysfunction, and the course and management of depression in women with diabetes (Butler & Wing, 1995; Ruggiero, 1998) Research into such dimensions of individual differences will ultimately facilitate the identi cation of patients to be targeted for intervention by health psychologists and what intervention techniques may be most helpful for certain patients Diabetes research also needs to be increasingly directed by comprehensive theoretical models of patient outcomes Such models would specify the interrelationships among psychosocial factors and adherence and would detail how such factors both in uence (and are in uenced by) physiological outcomes For example, models would capture the dynamic and complex relationship between such factors as stress and outcomes by specifying how stress may affect BG directly through physiological mechanisms; how stress may affect.

Perri, M G, Shapiro, R M, Ludwig, W W, Twentyman, C T, & McAdoo, W G (1984) Maintenance strategies for the treatment of obesity: An evaluation of relapse prevention training and posttreatment contact by mail and telephone Journal of Consulting and Clinical Psychology, 52, 404 413 Pingitore, R, Dugoni, B L, Tindale, R S, & Spring, B (1994) Bias against overweight job applicants in a simulated employment interview Journal of Applied Psychology, 79, 909 917 Pi-Sunyer, F X (1999) Co-morbidities of overweight and obesity: Current evidence and research issues Medicine and Science in Sports and Exercise, 31(Suppl 11), S602 S608 Poston, W S, & Foreyt, J P (1999) Obesity is an environmental issue Atherosclerosis, 146, 201 209 Pouliot, M C, Despres, J P, Lemieux, S, Moorjani, S, Bouchard, C, Tremblay, A, et al (1994).

Inertial systems are described in 4. Indoor functioning is similar to outdoor, with care needed for speci c sensors, such as magnetometers, which are greatly in uenced by metallic structures. Remarkable achievements have already

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