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Challenging Situations (challenging + situation)
Selected AbstractsEvaluating the impact of a cancer supportive care project in the community: patient and professional configurations of needHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2007Kristian Pollock PhD MA PGCHE Abstract Advances in cancer care and treatment have created a new and somewhat anomalous category of patients with a diagnosis of non-curative disease who still have a considerable period of life remaining. During much of this time they may remain relatively well, without manifest need for clinical care. The responses of patients to this challenging situation are largely unknown. However, it has been assumed that because they confront a difficult experience they will need, or can benefit from, professional intervention. The implementation of pre-emptive support measures is anticipated to improve patients' resilience in coping with their illness and approaching death. This study aimed to investigate the impact of the keyworker role in a 3-year cancer supportive community care project to identify and provide for the needs of patients with a diagnosis of non-curative cancer. It was a qualitative study incorporating face-to-face interviews and focus groups with 19 healthcare professionals and 25 patients and carers from an urban East Midlands locality and a thematic analysis of qualitative interview and focus group transcripts. The project was positively evaluated by patients, carers and professionals. However, the findings raised questions about the different configuration of ,need' within the lay and professional perspectives and how this should most appropriately be addressed. In contrast to widespread professional assumptions about patients' need for counselling, many patients preferred to turn to their friends and families for support, and to adopt a stance of emotional and personal self-reliance as a strategy for coping with their predicament. The study highlights the continuing orientation of services around professional, rather than patient, agendas and the momentum towards increasing specialisation of professional roles and the medicalisation of everyday life that flows from this. [source] The Usefulness of Chronic Heart Failure Treatments in Chronic Cardiac Graft FailureCARDIOVASCULAR THERAPEUTICS, Issue 1 2010Osman Najam Following cardiac transplantation, registry data has demonstrated a gradual improvement in survival over the last several decades, which is testament to continual improvement in aftercare strategy. However, a significant number of patients will eventually develop a new syndrome of chronic heart failure, owing to the multitude of physiological processes that occur after transplantation. This condition, referred to as chronic graft failure (CGF) should be regarded as a unique illness rather than one that is simply analogous with chronic heart failure. In particular, the unique pathophysiological (and pharmacological) environment in the setting of CGF presents a challenging situation to the transplant physician. There is uncertainty over which treatments to offer given a paucity of clinical trial data to support the use of standard heart failure treatments in CGF. In this review, we discuss which chronic heart failure treatments could be considered in the setting of CGF based on their mechanisms of action, benefits within the native heart failure setting, and the relevant issues within the posttransplant environment. [source] Brain mechanisms underlying emotional alterations in the peripartum period in ratsDEPRESSION AND ANXIETY, Issue 3 2003Inga D. Neumann Abstract In the period before and after parturition, i.e., in pregnancy and lactation, a variety of neuroendocrine alterations occur that are accompanied by marked behavioral changes, including emotional responsiveness to external challenging situations. On the one hand, activation of neuroendocrine systems (oxytocin, prolactin) ensures reproduction-related physiological processes, but in a synergistic manner also ensures accompanying behaviors necessary for the survival of the offspring. On the other hand, there is a dramatic reduction in the responsiveness of neuroendocrine systems to stimuli not relevant for reproduction, such as the hypothalamo-pituitary-adrenal (HPA) axis responses to physical or emotional stimuli in both pregnant and lactating rats. With CRH being the main regulator of the HPA axis, downregulation of the brain CRH system may result in various behavioral, in particular emotional, adaptations of the maternal organisms, including changes in anxiety-related behavior. In support of this, the lactating rat becomes less emotionally responsive to novel situations, demonstrating reduced anxiety, and shows a higher degree of aggressive behavior in the test for agonistic behavior as well as in the maternal defense test. These changes in emotionality are independent of the innate (pre-lactation) level of anxiety and are seen in both rats bred for high as well as low levels of anxiety. Both brain oxytocin and prolactin, highly activated at this time, play a significant role in these behavioral and possibly also neuroendocrine adaptations in the peripartum period. Depression and Anxiety 17:111,121, 2003. © 2003 Wiley-Liss, Inc. [source] Estimating species' absence, colonization and local extinction in patchy landscapes: an application of occupancy models with rodentsJOURNAL OF ZOOLOGY, Issue 3 2007A. Mortelliti Abstract Making an inference on the absence of a species in a site is often problematic, due to detection probability being, in most cases, <1. Inference is more complicated if detection probability, together with distribution patterns, vary during the year, since the possibility of inferring a species absence, at reasonable costs, may be possible only in certain periods. Our aim here is to show how such challenging situations can be by tackled by applying some recently developed occupancy models combined with sample size (number of repeated surveys) estimation. We thus analysed the distribution of two rodents Myodes glareolus and Mus musculus domesticus in a fragmented landscape in central Italy pointing out how it is possible to identify true absences, non-detections, extinctions/colonizations and determine seasonal values of detection probability. [source] Functions of remembering and misremembering emotionAPPLIED COGNITIVE PSYCHOLOGY, Issue 8 2009Linda J. Levine Memory for the emotions evoked by past events guides people's ongoing behaviour and future plans. Evidence indicates that emotions are represented in at least two forms in memory with different properties. Explicit memories of emotion can be retrieved deliberately, in a flexible manner, across situations. Implicit memories of emotion are brought to mind automatically by cues resembling the context in which an emotional event occurred. One property they share, however, is that both types of memory are subject to forgetting and bias over time as people's goals and appraisals of past emotional events change. This article reviews the cognitive and motivational mechanisms that underlie stability and change in memory for emotion. We also address functions that remembering and misremembering emotion may serve for individuals and groups. Although memory bias is typically viewed as problematic, changes in representations of emotional experience often promote goal-directed behaviour and facilitate coping with challenging situations. Copyright © 2009 John Wiley & Sons, Ltd. [source] Longitudinal Study of Young Children's Responses to Challenging Achievement SituationsCHILD DEVELOPMENT, Issue 2 2001Dannah I. Ziegert Three studies were conducted to replicate and extend Dweck's findings regarding young children's responses to challenging achievement situations. Dweck's dichotomous helplessness classification system (i.e., task choice, task choice reason) was replicated with kindergartners, n= 235 (50% male), and first graders, n=70 (46% male). To test whether individual differences in young children's responses to challenging situations are stable over time, 1- and 5-year follow-ups of the kindergartners were conducted. On the basis of children's responses on age-appropriate behavioral tasks, a composite of cognitive, behavioral, and affective helplessness indices predicted helplessness at 1 and 5 years later, n= 114 (50% male), above and beyond kindergarten task ability and gender, p < .05. Kindergarten helplessness predicted teacher ratings of children's helplessness 5 years later as well, p < .05. The implications of these findings for early intervention are discussed. 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