Loree Pham MS, OTR/L, DipACLM(she/her/hers)

Although occupational therapy (OT) practitioners are well suited to address spirituality within client care, evidence suggests many practitioners feel discomfort or lack of knowledge of this subject. Few studies have delved into OTs’ experiences and encapsulated if and how spirituality has been experienced in practice. This study aimed to gain a deeper and more updated insight into this phenomenon. Utilizing a phenomenological approach with interviews, this study explored OT practitioners’ (n = 15) experiences with spirituality in client care. (a) Losing spirit: the inadequacy of only addressing mind and body, (b) spirituality as a vehicle for reaffirming purpose in both client and therapist, and (c) addressing spirituality through functional and measurable treatments. Although the concept of mind, body, and spirit is not new, occupational therapists often do not consistently address these components simultaneously, leading to missed opportunities in client practice.

Keywords. spirituality, occupational therapy, qualitative research

Background. While short-term blood glucose (BG) levels and variability are thought to underlie diminished function and emotional well-being in people with T1D, these relationships are poorly understood. The Function and Emotion in Everyday Life with T1D (FEEL-T1D) study focuses on investigating these short-term dynamic relationships among BG, function, and emotional well-being in adults with T1D.

Objective. To present the FEEL-T1D study design, methods, and study progress to date, including adaptations necessitated by the COVID-19 pandemic to implement the study fully remotely.

Methods. The FEEL-T1D study will recruit 200 adults 18-75 years old with T1D. Data collection includes a comprehensive survey battery, along with 14 days of intensive longitudinal data using blinded continuous glucose monitoring (CGM), ecological momentary assessments (EMA), ambulatory cognitive tasks, and accelerometers. All study procedures are conducted remotely, through mailing study equipment and using videoconferencing for study visits.

Results. To date, after 12 months of recruitment, 124 participants have enrolled in the FEEL-T1D study. Over 80% have provided concurrent CGM, EMA, and accelerometer data for at least 10 of the 14 days of data collection, and nearly 90% of EMA surveys have been completed, with minimal missing data.

Conclusions. Thus far, our reconfiguration of the FEEL-T1D protocol to be implemented remotely during the COVID-19 pandemic has been a success. The FEEL-T1D study will elucidate the dynamic relationships between blood glucose, emotional well-being, cognitive function and participation in daily activities. In doing so, it will pave the way for innovative just-in-time interventions and produce actionable insights to facilitate tailoring of diabetes treatment to optimize function and well-being among individuals with T1D.

The benefits of engaging in physical activity (PA) on an individual’s metabolic health are well established; however, between and within-person relationships of PA and blood glucose (BG) are not so clear. Drawing data from a larger longitudinal study of BG, function, and well-being in adults with type 1 diabetes (T1D), this study uses accelerometry and continuous glucose monitoring (CGM) to examine the within- and between-subject effects of PA bouts on BG.

Background. Excessive sitting is associated with poor health outcomes and increases the risk for chronic conditions. Sitting in chairs may be particularly harmful; yet, a cultural bias toward chair sitting has limited research on alternatives such as floor sitting, which have the potential to negate many of the adverse health risks.

Methods. A literature search was conducted to systematically identify and evaluate evidence related to sitting and health. PubMed and CINAHL databases were searched using keywords and phrases, controlled vocabulary, and constructed combinations of these terms. Search terms included: sedentary behavior, chronic conditions, physical activity, health, lifestyle, floor sitting, posture, sitting position, squatting, kneeling, cross-legged sitting. Reviewed articles were: peer-reviewed, published 2012 to present, and addressed floor sitting in relation to health. Exclusion articles were: non-English, dissertations, and positions such as squatting when related to fitness exercises instead of sitting postures.

Results. The literature examining floor sitting as related to health is relatively sparse. There was promising but limited research on how alternative seated positions such as floor sitting may positively impact cardiometabolic conditions. Findings also showed that sitting on the floor may not only help promote greater health, but the act of regularly sitting and rising from the floor can help promote the maintenance of coordination, muscle strength, and flexibility, thereby positively impacting life expectancy and longevity. Given the emerging understanding of floor sitting physiology and the health impacts of sedentary behavior, which is greatly influenced by our environment, there is a need for more research to expand public health and lifestyle medicine thinking beyond exercise and physical activity. Floor sitting may be a simple lifestyle change that can be used to address chronic conditions as well as improve health, well-being, and participation in daily life activities.

Conclusions. Floor sitting may be a healthier alternative to chair sitting and may be implemented wherever chairs are used. Increasing the knowledge of floor sitting as an active lifestyle change may reduce the harms of sedentary behavior, but a shift in cultural and social norms and the built environment is needed.