A group of 120 patients with rheumatoid arthritis or osteoarthritis volunteered to be subjects for this study of aerobic versus nonaerobic exercise. Patients were stratified by diagnosis and randomized into an exercise program of aerobic walking, aerobic aquatics, or nonaerobic range of motion (controls). The retention rate for the 12-week program was 83%. Exercise tolerance, disease-related measures, and self-reported health status were assessed. The aquatics and walking exercise groups showed significant improvement over the control group in aerobic capacity, 50-foot walking time, depression, anxiety, and physical activity after the 12-week exercise program. There were no significant betweengroup differences in the change scores for flexibility, number of clinically active joints, duration of morning stiffness, or grip strength. Our findings document the feasibility and efficacy of conditioning exercise for people who have rheumatoid arthritis or osteoarthritis.Physical inactivity is associated with increased risk for developing any of a number of degenerative and chronic conditions, the symptoms and findings of From the Departments of Medicine and Statistics, University of Missouri, Columbia.

To examine the effectiveness of a cognitivebehavioral pain management program for patients with rheumatoid arthritis, three patient groups were studied: a cognitive-behavioral group (CB), an attention-placebo group, and a control group. The CB group received a comprehensive, 12-month pain management program that taught coping strategies such as problem-solving techniques, relaxation training, strategies for attention diversion, and training in family dynamics and communication. Dependent measures included pain, coping strategies, psychological status, functional status, and disease status. Data analysis at 12 months revealed benefits for the CB group in the area of enhanced coping strategies. Specifically, the CB subjects showed significantly greater use of coping strategies and significantly more confidence in their ability to manage pain. The findings are discussed in terms of the importance of enhanced self-efficacy and personal control for patients with rheumatoid arthritis.

Twenty-five dogs with naturally occurring mast cell tumors were treated with daily oral prednisone (1 mg/kg) for 28 days. Five dogs (20%) had reduction in tumor volume and were considered responders. Four of these underwent partial remission and one underwent complete remission. Survival times for the five responders were 3, 5, 6, 7.5, and greater than 28 months, respectively. W e therefore conast cell tumors (MCTs) are common neoplasms M in dogs, accounting for 7% to 2 1 % of all skin and subcutaneous tumors.' The clinical course of the disease varies from benign to highly malignant, and approximately 50% of MCTs are considered clinically malignant.2 The degree of malignancy can be correlated to the neoplasm's histopathologic appearance, which has led to a histopathologic grading ~y s t e m .~,~ Treatment of MCTs may include surgery, radiotherapy, and chemotherapy.',2 Wide surgical excision is the preferred treatment, and radiation therapy is recommended when surgical excision is not possible.',* Radiotherapy can be used either as a single mode of therapy or in conjunction with surgery. Chemotherapy may be indicated when surgery or radiotherapy are not feasible, or as an adjunct to those treatments. Glucocorticoids and L-asparaginase have been shown to have activity against M C T S .~,~ Oral prednisone and intralesional triamcinolone are usually recommended.'X2 Previous reports suggest successful treatment with these agents, but no adequate studies have been performed to document their effectiveness. This multi-institutional prospective study was performed to determine if oral prednisone Materials and MethodsThe initial criteria for inclusion in this study were presence of one or more measurable cutaneous or subcutaneous MCT, histopathology specimen available for review, and no previous treatment with glucocorticoids. Twenty-five clientowned dogs (with 39 tumors) presented to the participating institutions between April 1988 and January 1991 were evaluated. Thirteen dogs had been previously treated by surgical excision of MCTs, but had tumor recurrence at the time of this study. Three dogs were also included that did not meet the above criteria; in those dogs, histopathology specimens were not available for review.Tumor volume was determined before treatment, and the location of the tumors was recorded as trunk, extremities, or head and neck in all dogs. When multiple tumors were present (all tumors were cytologically diagnosed as MCTs), the volumes were added to calculate the total tumor volume, and the largest tumor was biopsied. Pretreatment incisional biopsies were obtained in 23 dogs (dogs 1-23), and 2 dogs (dogs 24 and 25) were treated based upon cytologic evidence of MCTs. Other parameters evaluated (eg, buffy coat and bone marrow cytology, radiographs, and serum biochemical profiles) varied between institutions and were not standardized or analyzed.Treatment consisted of prednisone (1 mg/kg) PO sid for 28 days. With the exception of heartworm prophylaxis, this was the only drug given.Tumor burden was d...

The authors asked 320 psychologists to participate in a nonrandom, exploratory study by providing incidents of nonromantic, nonsexual relationships with former clients. In addition, these psychologists were asked to discuss whether they saw these relationships as ethically problematic. A total of 91 useable incidents (from a final sample size of 63 respondents) were sorted into eight relationships categories. The results of this study highlight several issues: (a) Psychologists are dealing with a variety of nonromantic, nonsexual relationships with former clients, (b) there is little consensus about the ethicality of these contacts, and (c) future revisions of the Ethics Code (American Psychological Association, 1992) may need to consider nonsexual and nonromantic relationships with former clients.Multiple relationships with current clients continue to be discussed (i.e., Sonne, 1994), and, over the last several years, the beliefs and behaviors of psychotherapists regarding multiple role relationships with current clients have been examined in several studies (