Transformative elements of intercultural education for Japanese nursing students.

There has been little research exploring Japanese nursing students' experiences of having Western instructors in their nursing programs. The purpose of the present study was to describe Japanese nursing students' lived experiences of being taught by foreign faculty. A qualitative design using an interpretive phenomenology approach was used with purposeful sampling. Graduate and undergraduate nursing students (n = 13), who had the experience of being taught by a foreign faculty member for at least one semester, were recruited. Six themes emerged that suggested the participants went through an evolutionary process as they worked to understand and make meaning of these intercultural experiences: struggling with uncertainty, working to understand, discovering differences in teaching styles, opening my eyes to the world, thinking differently now, and wanting to know more. The work students must do to understand foreign teachers influences what they are able to learn, and must be taken into consideration by both faculty and students. To fully realize meaningful teaching outcomes within this intercultural context, it is essential that students have sustained exposure to foreign faculty.

Associations between chronotype and salivary endocrinological stress markers.

OBJECTIVES: To investigate the effect of chronotype on salivary cortisol or salivary α-amylase (sAA). METHODS: From 108 male university students, saliva samples were collected in the afternoon (between 15:00 and 17:00). The salivary cortisol and sAA levels were determined with commercial kits. Chronotype was quantitatively evaluated using the Horne and Östberg Morningness-Eveningness Questionnaire. Subjects were categorized into morning types and evening types. RESULTS: The sAA levels were lower in the morning types than in the evening types. We found no significant difference in salivary cortisol levels between the two groups. CONCLUSIONS: These findings suggest that the sAA levels may be associated with chronotype.

Depressive symptoms among HIV-positive postpartum women in Thailand.

Depressive symptoms have been linked to faster progression to AIDS in HIV-positive individuals. The purpose of this correlational, cross-sectional study was to examine the prevalence and predictors of depressive symptoms among postpartum women in Thailand who are HIV-positive. Data were collected at postpartum outpatient units in four hospitals in Thailand from June 2005 to December 2007. Eighty-five HIV-positive postpartum women completed questionnaires on depressive symptoms, self-esteem, emotional support, physical symptoms, infant health status, and demographics. Results showed that 74.1% of the participants reported depressive symptoms. Self-esteem, infant health status, and education were negatively associated with depressive symptoms. Because of the high rates of depression in our study, all HIV-positive postpartum women in Thailand should be screened for depressive symptoms.

High-throughput screening of brief naturalistic stress-responsive cytokines in university students taking examinations.

This study was designed to prospectively examine the impact of a brief naturalistic stressor (academic examination) on salivary/serum cortisol, measures of anxiety and depressive mood, and 50 circulating immune mediators assessed 7 days before, the first day of, and 2 days after the first term examination period (5 days) among 20 male and 6 female medical students (19.7+/-3.1 years, mean+/-SD). Of 42 serum factors detected, repeated measures ANOVA and Bonferroni post hoc testing indicated that concentrations of macrophage migration inhibitory factor (MIF), monocyte chemoattractant protein (MCP)-3, and beta-nerve growth factor (beta-NGF) were significantly decreased 2 days after finishing examinations, compared with the levels on the first day of examinations (p<0.05) in association with a concomitant post-examination decreases (p<0.05) in anxiety and salivary cortisol levels. In contrast, interleukin (IL)-16 was reciprocally increased between the two time points (p<0.05). However, after correction for multiple comparisons, only changes in MIF were significant (p<0.05/42=0.00119), and MIF levels peaked on the first day of examinations was significantly higher than those measured both 7 days before and 2 days after the examination. The present high-throughput analysis with multiplex cytokine panels reconfirms the impact of brief naturalistic stressors on immune outcomes, and suggests a potential role of MIF in the acute stress response.

Interleukin 10 inhibits interferon gamma- and tumor necrosis factor alpha-stimulated activation of NADPH oxidase 1 in human colonic epithelial cells and the mouse colon.

BACKGROUND: NADPH oxidase 1 (Nox1) is preferentially expressed in the colon, but its functional role is not fully understood. This study was designed to elucidate a potential role of Nox1 in inflammation of the colon. METHODS: Superoxide production by T84 cells was measured by the cytochrome c method. Protein and mRNA levels of Nox1 and Nox organizer 1 (NOXO1) in the cells were measured by real-time reverse transcriptase PCR and Western blotting, respectively. Expression of Nox1, Nox2, dual oxidase 2 (Duox2), NOXO1, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha mRNAs was measured in proximal, middle, and distal portions of colonic mucosas from male wild-type C57BL/6J and interleukin (IL)-10 knockout mice at 6, 10, and 16 weeks of age. Grading of inflammation was done by scoring histological changes. RESULTS: IL-10 significantly inhibited IFN-gamma- or TNF-alpha-induced up-regulation of superoxide-producing activity in T84 cells by suppressing expression of Nox1 mRNA and protein. IL-10 also inhibited TNF-alpha-stimulated induction of NOXO1 and p38 MAPK phosphorylation. Levels of Nox1, but not Nox2 or Duox2 mRNA, was age-dependently increased following a gradient with low levels in the proximal colon and high levels in the distal colon of the wild-type mice. The absence of IL-10 significantly facilitated Nox1 expression in association with increased IFN-gamma mRNA expression before the development of spontaneous colitis and age-dependently accelerated their mRNA expression. CONCLUSIONS: IL-10 may be a possible down-regulator of the Nox1-based oxidase in the colon, suggesting a potential role of reactive oxygen species (ROS) derived from Nox1-based oxidase in inflammation of the colon.

Oxidative stress-induced alternative splicing of transformer 2beta (SFRS10) and CD44 pre-mRNAs in gastric epithelial cells.

The tra2beta gene encoding an alternative splicing regulator, transformer 2-beta (Tra2beta), generates five alternative splice variant transcripts (tra2beta1-5). Functionally active, full-length Tra2beta is encoded by tra2beta1 isoform. Expression and physiological significance of the other isoforms, particularly tra2beta4, are not fully understood. Rat gastric mucosa constitutively expressed tra2beta1 isoform and specifically generated tra2beta4 isoform that includes premature termination codon-containing exon 2, when exposed to restraint and water immersion stress. Treatment of a gastric cancer cell line (AGS) with arsenite (100 microM) preferentially generated tra2beta4 isoform and caused translocation of Tra2beta from the nucleus to the cytoplasm in association with enhanced phosphorylation during the initial 4-6 h (acute phase). Following the acute phase, AGS cells continued upregulated tra2beta1 mRNA expression, and higher amounts of Tra2beta were reaccumulated in their nuclei. Treatment with small interference RNAs targeting up-frameshift-1 or transfection of a plasmid containing tra2beta1 cDNA did not induce tra2beta4 isoform expression and did not modify the arsenite-induced expression of this isoform, suggesting that neither the nonsense-mediated mRNA decay nor the autoregulatory control by excess amounts of Tra2beta participated in the tra2beta4 isoform generation. Knockdown of Tra2beta facilitated skipping of the central variable region of the CD44 gene and suppressed cell growth. In contrast, overexpression of Tra2beta stimulated combinatorial inclusion of multiple variable exons in the region and cell growth. The similar skipping and inclusion of the variable region were observed in arsenite-treated cells. Our results suggest that Tra2beta may regulate cellular oxidative response by changing alternative splicing of distinct genes including CD44.

Interleukin-18 is a crucial determinant of vulnerability of the mouse rectum to psychosocial stress.

Psychosocial factors are important determinants of disease manifestations, treatment efficacy, and prognosis of functional and inflammatory bowel disorders. Isolation of C57BL/6J mice from their 4 brothers growing in the same cage reduced goblet cells and MUC2 expression with a peak on day 8 in the rectum, but not in the colon. Gene expression analysis using a whole mouse genome microarray showed that the stress induced a 10-fold larger change in the gene expression in the rectum (722 genes) than in the colon (72 genes). The Ingenuity Pathway Analysis (IPA) application organized the rectum-specific 711 genes into stress response-related pathways. Nuclear factor-kappaB-related cytokine networks constructed with IPA showed selective up-regulation of interleukin (IL)-18 mRNA expression, which was also confirmed by real-time polymerase chain reaction. The stress produced active forms of caspase 1, IL-18, and a negative regulator for goblet cells, Notch 1, only in the rectum. IL-18-knockout mouse rectum had significantly increased goblet cells and MUC2 mucin, compared with wild-type mouse rectum. The absence of IL-18 completely blocked the stress-induced changes in gene expression and the goblet cell responses in the rectum. Thus, IL-18 may be a crucial determinant for the vulnerability of the rectum to psychosocial stress.

Tumor necrosis factor alpha activates transcription of the NADPH oxidase organizer 1 (NOXO1) gene and upregulates superoxide production in colon epithelial cells.

NADPH oxidase 1 (Nox1) is a multicomponent enzyme consisting of p22(phox), Nox organizer 1 (NOXO1), Nox1 activator 1, and Rac1. Interleukin-1beta, flagellin, interferon-gamma, and tumor necrosis factor alpha (TNF-alpha) similarly induced Nox1 in a colon cancer cell line (T84), whereas only TNF-alpha fully induced NOXO1 and upregulated superoxide-producing activity by ninefold. This upregulation was canceled by knockdown of NOXO1 with small interfering RNAs. TNF-alpha rapidly phosphorylated p38 mitogen-activated protein kinase and c-Jun N-terminal kinase 1/2, followed by phosphorylation of c-Jun and c-Fos and appearance of an AP-1 binding activity within 30 min. We cloned the 5' flank of the human NOXO1 gene (-3888 to +263 bp), and found that the region between -585 and -452 bp, which contains consensus elements of YY-1, AP-1, and Ets, and the GC-rich region encoding three putative binding sites for SP-1, was crucial for TNF-alpha-dependent promoter activity. Serial mutation analysis of the elements identified an AP-1 binding site (from -561 to -551 bp, agtAAGtcatg) as a crucial element for TNF-alpha-stimulated transcription of the human NOXO1 gene, which was also confirmed by the AP-1 decoy experiments. Thus, TNF-alpha acts as a potent activator of Nox1-based oxidase in colon epithelial cells, suggesting a potential role of this oxidase in inflammation of the colon.