Two major ethical issues in health education and promotion: assessing stage of change and cancer screening.

In community health education for behavioral change, valid assessment of stage of change is critical; in health promotion screening for cancer, health insurance coverage is also critical because some communities do not have the freedom to choose to change or to get their cancer treated. Proceeding without valid assessment of stage of change or insurance coverage can cause us harm. Harm comes to the patients when providers label them negatively or cause them anxiety if they cannot afford diagnosis and treatment beyond the screening. Not doing harm, (nonmaleficence) is our most compelling ethics principle. The authors analyze these two issues through the principles of autonomy, justice, and nonmaleficence in both their practice and that of their student with US-Mexico border communities and give recommendations.

TechLab and alexon Giardia enzyme-linked immunosorbent assay kits detect cyst wall protein 1.

A Giardia lamblia antigen detected by the TechLab Giardia Test (TechLab, Inc., Blacksburg, Va.) and the Alexon ProSpecT Giardia microplate assay (Alexon, Inc., Sunnyvale, Calif.) was purified by immunoaffinity chromatography from supernatant fluids of encystment cultures. Two major proteins (Mr 22,000 and 26,000) were observed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Coomassie staining that did not resemble the GSA65 antigen reportedly detected by the Alexon test. These proteins reacted intensely with the monoclonal antibodies used in both commercial enzyme-linked immunosorbent assays (ELISAs). Both proteins had identical N-terminal amino acid sequences and were identified as cyst wall protein 1 (CWP1). The 26-kDa form appeared early during encystment followed by the appearance of the 22-kDa form. Recombinant CWP1 (Mr 26,000) was strongly positive in both commercial tests. CWP1 was stable in human stool specimens, resistant to degradation by proteases and N- and O-glycanases, and unaffected by oxidation with sodium periodate. Two minor proteins with Mrs of 32,000 and 39,000 were detected in CWP1 preparations by using a sensitive fluorescent protein stain. Both were identified as CWP2, and neither reacted with the monoclonal antibodies from the commercial tests. We analyzed 535 stool specimens for CWP1 by using both commercial ELISAs and resolved discrepant results by using routine ova and parasite examination (O&P) and on immunofluorescence antibody assay. The presence of CWP1 correlated well between both ELISAs (98.7% correlation). Our results demonstrate that both commercial ELISAs detect CWP1, which is a useful diagnostic marker because it is highly stable, is secreted in large amounts by encysting trophozoites, and correlates well with O&P.

Role of fitness in mediating stress: a correlational exploration of stress reactivity.

Researchers have investigated the effect of exercise on reducing subjects' responsiveness to stress. Results from the initial studies were positive, yet these studies often did not use objective measures of fitness. This investigation applied more rigorous methodology than past experiments to assess the relationship between fitness and reactivity to stress. Maximal oxygen consumption was measured to indicate the fitness of recreational cyclists who were then exposed to three stressful situations (mental subtraction, speech preparation, and the cold pressor test). Heart rate, frontalis electromyographic (EMG) levels, and self-report of tension were monitored during the stress-inducing tasks. Physical fitness was significantly related to heart rate taken during the subtraction and cold pressor tasks, with EMG during subtraction, and with self-report during all three stressor tasks. These results further support the hypothesized association of physical fitness and reducing response to stress.

Relationship of fitness to depression, state and trait anxiety, internal health locus of control, and self-control.

Aerobic forms of exercise have been suggested as one approach to reducing the costly effects of excessive or chronic stress, yet the results of some studies related to this assumption have been mixed. The purpose of this study was to estimate the correlation between emotional states and fitness level among 8 women and 9 men who were recreational cyclists. Fitness was determined by cycle ergometric testing (VO2 max). Psychometric measures included the short version of the Beck Depression Inventory, the internal portion of the Multidimensional Health Locus of Control Scale, Spielberger's State-Trait Anxiety Inventory, and the Self-control Questionnaire. Significant correlations were observed between fitness and the depression scores, internal locus of control, and self-control measures. These results tend to support previous findings regarding the possible link between physical fitness and improved emotionality.