A longitudinal qualitative research study was undertaken to provide an understanding of a prolonged experience of advanced cancer, as seen through the eyes of dying individuals. Using a variant of the grounded theory method, the authors theoretically sampled, from outpatient clinics in a large comprehensive cancer treatment center, 27 patients with either advanced lung or gastrointestinal cancer who had an expected survival of up to 2 years. The authors conducted a total of 54 interviews with these patients to learn of their experience of advanced cancer. The authors represent their experience with the core category: striving to grow in the land of the living/dying, symbolizing their sense of finding themselves in a borderland between life and death where their efforts focused on 3 common goals. controlling dying, valuing life in the present, and creating a living legacy. They provide a longitudinal account of how these goals were addressed throughout the illness trajectory and discuss the theoretical and clinical implications of this understanding for the experience of dying from advanced cancer.

Purpose To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers. Methods An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016. Results 1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities. Conclusions These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

Previous research &as shown that human grief reactions to the l o s of a pet are not only very common, but they can also have a serious impact on the owner's physical and emotional well-king (Katcher & Rosenberg, 1979). The adjustment pmeess can be difficult for owners, especially when the owner is faced with the decision of whether or not to have their pet euthanizeà (Cusack, 1988).The purpose of this study was to investigate the variables of the human grief response associated with pet loss in order to incrrax our understanding of the intensity and duration of the grief process. Resuits of the present study suggest muons why some owners may be "at risk" for excessive grief reactions due to the loss of their cornpanion animal. The importance of providing bereaved owners with a source of mentai health couaselhg is discussed, and directions for fbture research are suggested. Acknowledgmtnts

The present study explored the nature of grief and trauma following the loss of a loved one. The concept of complicated grief (CG) was investigated, and the overlapping symptoms of trauma, CG, and grief were explored. Comparisons were made between those who reported CG and/or trauma and those who did not report CG or trauma in relation to search for meaning, death anxiety, and self-regulation. The failure to find meaning in the death of a loved one, impaired self-reference, and death anxiety were found to play a significant role in both trauma and CG.

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Neimeyer (1998) has argued for the application of a "new wave" of grief theory, involving the need for increased attention to the cognitive processes entailed in mourning. Indeed, within the evolving, general conceptualizations of grief, there is growing understanding of the adjustment to bereavement as one of meaning reconstruction or the rebuilding of previously held assumptions (e.g., Janoff-Bulman 6r Berg, 1998). In their consideration of postmodern understandings of grief, Silverman and Klass (1996) further noted that the meaning of the loss is negotiated and renegotiated over time. This represents a significant paradigm shift from the psychoanalytic emphasis on object loss, decathexis, and disengagement to the bereaved revisiting the experience and maintaining a constant, yet ever-changing, connection to the deceased. In effect, moving from a "going on" to an "ongoing" perspective of the loss. In our view, therefore, a therapeutic approach such as cognitive-behavioral therapy (CBT) seems most fitting as therapists assist bereaved individuals in exploring and articulating their ongoing construction of the relationship with the deceased.This chapter begins with a brief overview of the origins and assump-647

While complicated grief has been addressed in part through some recommendations for modifications in the upcoming fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there remain reasons for substantial concern about its scope therein and within clinical practice. The authors issue a call to the field, reiterating that complicated grief is complicated and cannot be confined to just one syndrome or disorder. Continued research is urged, and specific caveats are identified for exploring the complex dimensions of loss and grief. The authors advocate for ongoing dialogue about and investigation of various potential forms of complicated grief.