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People who live in larger bodies have unique experiences which may influence their overall wellbeing. While primary care providers may choose to focus on weight and physical health, there are numerous emotional consequences to being fat, including social stigma and shame. Unfortunately, there are few studies researching the experience of fat people, resulting in a significant gap in knowledge. The present study seeks to provide some preliminary information about the fat experience, which can be utilized in future research and in clinical and interpersonal settings. A convenience sample of young adults (ages 18−30 years) was derived from undergraduate and graduate students at a private Christian college in Oregon. Participants were asked to report demographic information, including t-shirt size and body proportions, and answer questions regarding their emotional experience, life satisfaction, and engagement in meaningful activities. We found that fat participants experienced greater external shame compared to their thin peers. No moderating or mediating relationships among body size, shame, or other variables were found. However, it was clear that shame is related to life dissatisfaction and lack of cheer. Engagement in meaningful activities did not appear to be related to shame, but was related to cheer in that participants who experienced higher levels of cheer did not engage in activities as often as those with lower levels of cheer. Overall, the present study highlighted the importance of considering body size and shame in research and clinical practice and encourages future fat-centered research.

An injury to the spinal cord causes immediate changes and can be overwhelming to the patient and their family. During inpatient rehabilitation, it has been observed that there is a significant difference between the expectations of the patient and the rehabilitation team member. 7, 9 Studies have focused on patient goal setting and how this impacts patient participation, discharge planning, and alignment of patient and therapist goals. Studies have shown that expectations of patient’s are never examined. These support the current study by explaining how important it is for the rehabilitation professional to understand factors that impact patient participation and how goals play a big part in discharge planning. 9, 12 The purpose of the study is for occupational therapists to learn about patients with spinal cord injuries, patient identified meaningful activities, therapist’s goal setting skills, and how the content of goals changes during inpatient rehabilitation. A pre-test/post-test pre-experimental design was used to test the research hypotheses. Eligibility was established by the researcher as the patient was admitted to The Ohio State University Medical Center, Dodd Rehabilitation Hospital. The sample was based on patient admissions from April 2009 through July 2009. The sample consisted of eight individuals who have a spinal cord injury as a result of a traumatic or non-traumatic event. The Flinn Performance Screening Tool (FPST) was used to identify the disability issues of patients with a spinal cord injury. Patient admission and discharge FPST scores were gathered plus the FPST scores of the occupational therapists on admission and discharge. Other information collected included; patient attendance to occupational therapy treatment, patient demographics, and discharge needs. Key personnel were used to administer the FPST and with the patient, were blinded to the anticipated results of the study. The occupational therapist completed the FPST on each patient at admission and at discharge. These scores were blinded to the patient and were entered into a database by the key personnel so that the occupational therapist was blinded to the results. The data analysis included a frequency distribution to identify the commonly reported FPST items. A hit ratio was used to compare the FPST responses between the patient’s and the occupational therapist and between the FPST responses from the patient’s at admission and at discharge. The classification accuracy was established at .375 due to limited preliminary data to compare, the large number of FPST items, and the low risk to the patients involved in the study.The top four categories reported by the patient’s were care for others, bathing/showering and financial management followed by community mobility. The top three categories from the OT’s perspective were bathing, feeding, and meal preparation. The categories with the highest hit ratios were personal devices and feeding. Seventy-two percent of the patient admission FPST scores were in agreement with the occupational therapists admission FPST scores. The categories with the highest hit ratios were personal devices and care for others. Seventy-six percent of the patient admission FPST scores were in agreement with the discharge FPST scores.

This study focuses on the importance of activity as an intervention with persons with dementia. Continuity theory serves as a general guide, along with research on leisure in later life and the theory of personhood in dementia, to explain the importance of engaging persons with dementia in activities. Implementing purposeful activities with persons with dementia has been demonstrated to reduce boredom and agitated behavior and to maximize the functional abilities of the individual. The important role of task analysis and adaptation of the activity to personal needs (motor, psychological, social) and past interests of the individual is central to the study, which utilizes meaningful activities as suggested in the literature from the field of occupational therapy. The current study addresses specific principles of activity for persons with dementia and applies a well-established educational philosophy from the field of child development to this population. Previous research has demonstrated that Montessori activities, modified for use with persons with dementia, can facilitate positive engagement and affect. Montessori-based activities were incorporated in a model of well-being in dementia (Coppola, 1998; Hasselkus, 1998), conducted in small parallel group settings, (i.e., referred to a group of individuals situated together but individually completing the same task), included a verbal approach to facilitating meaning of the activities. The amount and type of engagement and affect were compared during Montessori-based activities and regularly scheduled activities of 10 older adults with dementia at a university-based adult day service. Significantly higher levels of constructive engagement (motor or verbal response to activity) and lower levels of non-engagement (sleeping, staring into space) were exhibited during Montessori-activities compared to regular activities. Principles of activities for persons with dementia along with principles of the Montessori-based program are presented. Methodological modifications are suggested, and implications for research and practice are discussed.