Effort distress

Not,/.need necessity, want emergency distress effort. 

The use of BRMs to treat human disease has its origins in the use of bacterial toxins to treat cancer by William B. Coley.73 These early studies resulted in the use of microbi-ally-derived substances such as BCG, Picibanil, carbohydrates from plants or fungi such as Krestin and Lentinan, other products such as Biostim and Broncho-Vaxom, as well as thymic extracts (Table 9.4). However, the lot-to-lot variation in the manufacture of these drugs has dampened enthusiasm. Equally, the focus on MOAs in drug development strategies has also dampened developmental efforts. The particulate nature of some BRMs can also result in pulmonary thrombosis and respiratory distress following i.v. injection. However, BRMs are commonly used to treat bladder cancer and derivatives of natural products are routinely used clinically. 

Obsessive-Compulsive Disorder (OCD). Certainly the name suggests that OCD and OCPD are closely related. This is actually somewhat misleading. With OCD, the obsessions are intrusive and distressful (i.e., ego dystonic) thoughts that lead the patient to develop rituals (i.e., compulsions) to alleviate the resultant anxiety. With OCPD, we use the term obsession in a somewhat different way. The OCPD patient is not necessarily prone to obsessions in the form of intrusive thoughts instead, they display a perfectionistic preoccupation with detail that characterizes their obsessionality. Furthermore, this obsessionality is ego-syntonic. Patients with OCPD purposefully harbor these obsessions in an effort to exert control over themselves and their environment. 

One of the clinician s most important tasks is thus to identify the principal sources of distress and impairment and to prioritize the targets for pharmacological intervention. Although tic reduction may be the first priority in some cases, in other cases it may be a child s ADHD, depression, or compulsions that may have the first claim on the clinician s interventional efforts. Even when the tics are not themselves the initial target of treatment, the TS-related nature of the child s depression, ADHD, or obsessive-compulsive disorder (OCD) may have important implications for the choice of agents, therapeutic response, or possible side effects. 

Cognitive psychotherapeutic techniques have further been developed since their introduction by Beck et al. (1979), who demonstrated their effectiveness in the treatment of depression. Several studies have extended Beck s cognitive therapy to adulthood schizophrenia with encouraging clinical results. The efficacy of cognitive-behavioral approaches could be demonstrated in several key areas in schizophrenia, especially therapy-resistant hallucinations and delusions. Several approaches have also addressed therapeutic efforts in the treatment of associated symptoms such as anxiety and depression. In addition, cognitive-behavioral techniques have been shown to be effective in treatment of chronic schizophrenia, resulting in reduction of distress and disruption due to hallucinations and delusions. In some studies anxiety and depression associated with schizophrenia could also be reduced to some extent. The value of these techniques in children and adolescents has yet to be demonstrated. 

The industrial warfare of the twentieth century has required unprecedented steps toward the total mobilization of the society and the economy. 2 Even quite liberal societies like the United States and Britain became, in the context of war mobilization, directly administered societies. The worldwide depression of the 1930s similarly propelled liberal states into extensive experiments in social and economic planning in an effort to relieve economic distress and to retain popular legitimacy. In the cases of war and depression, the rush toward an administered society has an aspect of force majeure to it. The postwar rebuilding of a war-torn nation may well fall in the same category. 

Conclusions - Efforts toward the synthesis of the anthracycllnes have provided a chemical harvest which Is already bounteous and continues to be reaped. Overall yields for the total synthesis of the Intact, chiral natural products la-3a, as well as and their analogs, are now on the order of 5% In the best cases. Whether total (or partial) synthesis will emerge as the practical solution for the future Is, however, a question whose ultimate answer depends on many as yet Incompletely resolved factors which include the relative economics of fermentative and total synthesis, the potential therapeutic superiority of non-natural anthracycllnes, and future advances in total synthesis. It Is the opinion of the author that at the present time fermentation remains the preparative method of choice, but this verdict Is much less certain than It would have been five years ago. Five years hence such a judgment may be Indefensible. Synthetic chemists would not be distressed. 

Coming as most of them do from the distressed areas of Wales, Northumberland, Durham and Cumberland it was for many of the children the first party they had ever attended, and no effort was spared to see that they had a real good time. The sight of their happy faces and the sound of their excited voices was a fine reward for the two months strenuous work which the organisation of the party entailed. ... 

Lundberg, U. and Frankenhaeuser, M. (1980). Pituitary-adrenal and sympathetic-adrenal correlates of distress and effort. Journal of Psychosomatic Research 24 125-30. 

Frankenhaeuser (1989) and Frankenhaeuser and Lundberg (1985) made the distinction between effort without distress and ort with distress, denoting these different reaction patterns. On the subjective level, the former reaction is characterized by feelings of activation and the latter by feelings of tension or anxiety. 

---