Search

While Locus of Control is typically operationalized as a single dispositional trait that generalizes across settings, it has also been conceptualized as two weakly related factors; Domain-Specific State Locus of Control and a generalized Trait Locus of Control. Malleability of these two factors was tested for recently widowed older adults in self-help support groups (n = 17) and a waiting-list control condition (n = 6). Domain-Specific State Locus of Control-Desire for Control subscale increased over the course of the three-week six-session intervention for support group participants. These group participants also showed decreased psychological distress from pre to post intervention. The change in Domain-Specific State Locus of Control-Desire for Control did not relate to this reduction in distress. As expected, Trait Locus of Control remained stable with greater Trait Internality related to less psychological symptomatology.

Eighty nine of 104 patients with hairy cell leukemia (HCL), enrolled between 1985 and 1987 in a multicenter prospective study on human lymphoblastoid IFN alpha-n1, were evaluable for long-term follow-up. The induction treatment, 3 MU/mq daily for a median of 5.7 months, produced a response of 93%, complete+partial response (CR+PR) = 80%, minor (MR) = 13%. Neither prior splenectomy nor pre-treatment variables were associated with the rate of response to IFN. However maintenance treatment of 3 MU/mq weekly given randomly had a slightly significant effect on failure free survival (FFS). Of the 43 patients who relapsed, 31/36 (86%) obtained a new response with IFN. No differences in FFS were recorded between first and second response. At the third induction 7/11 patients were treated again with IFN, 4/7 obtaining some response, but the FFS was significantly worse. The overall survival is still 85%. We conclude that (1) IFN should be used as chronic uninterrupted treatment for HCL, (2) reduced dosage is sufficient to prolong the disease free status and (3) continuous lymphoblastoid IFN administration seems not to be associated with the development of resistance to retreatment.

It was recently shown that peptide NTM (RSANFTDNAKTIIVQLNESV), corresponding to residues 280-299 in the second conserved domain of HIV-1 envelope glycoprotein gp120, has spectral and sequence similarity with human vasoactive intestinal peptide, VIP (Veljkovic et al., Biochem. Biophys. Res. Commun., 189, 705-710, 1992). We found that natural autoantibodies cross-reactive with this peptide can be detected in sera from HIV-negative asthma patients and healthy blood donors. The level of these antibodies is significantly higher in asthma patients than in healthy individuals, suggesting that these antibodies can in fact be at least partly identical to natural anti-VIP antibodies previously described (Paul et al., Biochem. Biophys. Res. Commun., 130, 479-483, 1985; Paul et al., Science, 244, 158-1162, 1989). Possible origin and role of these antibodies in AIDS pathogenesis and therapy are discussed.

Predicting the everyday life events of people is a relatively unexplored topic, although several major theoretical approaches deal with related issues. The dispositional approach would assign a causal role to personality, while the situational approach would locate causation in the person's environment. Variations on these two extreme themes invoke an interactionist interpretation. Beyond this, a genuinely transactional approach focuses on the enduring person-environment relationship established as people deal with major and everyday life events. This study investigated a wide range of predictors of daily positive, negative, and ill-health events over time in a sample of 206 older adults. Results showed that personality variables played only a minor role in predicting daily events, although an interaction between extraversion and social network size was significant. Background demographic variables and the major stressors of recent conjugal bereavement and physical disability played a role in daily event occurrences. Overall, the strongest degree of predictability of events came from the events themselves: The high degree of event stability over time indicated the value of a genuinely transactional model in understanding the occurrence of everyday events.

In 8 patients (age 25 +/- 46 years, mean 34.5), 4 with Hodgkin's disease (HD) and 4 with non-Hodgkin's lymphoma (NHL), circulating stem cells (CSC) collected at the time of rapid leukocyte and platelet recovery after intense chemotherapy were employed for autologous hematological reconstitution after very-high-dose chemotherapy (CVB combination). At the time of graft 2 patients were in 1st remission and 2 in 2nd, while the remaining 4 had persistence or progression of disease. Autografted patients received 3.4 +/- 8.3 (mean 5.2) x 10e8/Kg mononuclear cells and 2.1 +/- 40.5 (mean 22.5) x 10e4/Kg CFU-GM. All patients had prompt and sustained engraftment, though in one case platelets never reached normal levels. Recovery time was respectively 10 +/- 17 days (mean 13.2) for granulocytes 0.5 x 10e9/L, and 10 +/- 49 days (mean 20.3) for platelets greater than 50.0 x 10e9/L, with an interval of less than 4 days from greater than 0.5 to greater than 1.0 granulocytes in 7 out of the 8 patients. All patients are currently alive at 57 +/- 645 (median 262) days, and 7 in remission at 61 +/- 645 (median 297) days from autologous blood stem cell transplantation (ABSCT). Our study demonstrates that CSC collected after mobilizing chemotherapy are able to promptly restore and sustain hemopoiesis after marrow ablative chemotherapy in patients with malignant lymphoma. CSC reduce toxicity and hospitalization so impressive, that in malignant lymphomas ABSCT could rapidly be considered for first line strategy.

To answer the question of whether interferon (IFN) should replace splenectomy, we reviewed the Italian HCL Registry: the records of 450 patients with hairy cell leukemia (HCL), seen from 1975 to 1988 were analysed. Of these, 321 were considered for the study: 231 had been splenectomized, 46 of them receiving subsequently IFN and 90 patients had IFN as initial therapy. Patients treated with splenectomy showed different survival according to Jansen and Hermans' staging system, which identified two risk groups: stage 1 and stages 2 and 3, p = 0.0329. On the contrary, patients treated with IFN did not show significantly different survival according to stage. By the comparison of stage 1 patients, either treated with splenectomy or with IFN, no statistical difference in survival was registered. Different survivals emerged for patients stage 2 + 3, which improved when treated with IFN, p = 0.0324. The median failure free survival (FFS) after splenectomy resulted in 89 months versus 33 months after IFN. In conclusion, splenectomy still remains the primary therapy for HCL patients stage 1. For high risk patients, stages 2 and 3, IFN should be adopted as first line therapy, improving substantially the survival. The short duration of response to IFN suggests a sequential combination of the two treatments for this group of patients, IFN reducing tumor mass quite safely and splenectomy assuring long lasting stable disease.

The study analyzed daily event differences between groups experiencing the major stressors of conjugal bereavement and physical disability, and analyzed the association of everyday events with self-reports of mental health for different groups across a 3-month time span. Monthly interviews were conducted with 61 recently conjugally bereaved, 62 recently physically disabled, and 123 matched-comparison older adults between the ages of 60 and 80. The purpose of these interviews was to obtain a comprehensive assessment of the monthly frequencies of everyday life events. Self-reports of mental health were obtained from paper-and-pencil measures filled out after each interview. Causal models were used to analyze the best-fitting structure of event/mental health relationships for the first 3 monthly interviews. Undesirable events showed uniformly adverse effects on mental health. Desirable events benefited the psychological well-being of the disabled the most and had no positive effects on the mental health of the bereaved. The bereaved also evidenced less stability over time than other groups in the frequency of small undesirable events.

Ovarian function has been evaluated in 10 women in fertile age, free of disease, who underwent therapy for Hodgkin's disease. Women were divided into groups according to their age at the time of the diagnosis and therapy used. In the group of 6 women treated with chemotherapy alone or associated with sovradiaphragmatic roentgentherapy, 4 (66%) are regularly menstruating and 2 (33%) have become amenorrheic; while among the 4 women treated with TNI or inverted Y, 3 (75%) have become amenorrheic and 1 (25%) is regularly menstruating. 7 women were younger than 30 at the time of the diagnosis: 5 (72%) are regularly menstruating and 2 (28%) have become amenorrheic; while in the group older than 30 at the time of the diagnosis all 3 (100%) have become amenorrheic. These results show that, at present, it is not possible to predict the preservation or the renewal of the ovarian function after therapy for Hodgkin's disease; only taking in account all elements such as age, ovarian function prior to therapy and kind of treatment is it possible to propose a prognostic hypothesis.

The development of an inventory to assess small events is described. In the construction of the inventory specific criteria were established and existing event inventories were screened for items and new items written to fit these criteria. The event had to denote an observable change in a person's everyday life, have a discrete beginning, be classifiable as either desirable or undesirable, and be scaled as having an average of 250 Life Change Units or less using B. S. Dohrenwend, Krasnoff, Askenasy, Dohrenwend's (1978) magnitude estimation parameters. The inventory was constructed to cover events in major areas of life concern: family, work, leisure, household, financial, health/illness, nonfamily relations, crime/criminal activity, education, religion, and transportation. Two studies are reported that test the utility of the inventory.

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60-80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups.