Pharmacokinetic Basis for Using Saliva Matrine Concentrations as a Clinical Compliance Monitoring in Antitumor B Chemoprevention Trials in Humans.

This study reports the first clinical evidence of significantly high secretion of matrine in a multi-component botanical (Antitumor B, ATB) into human saliva from the systemic circulation. This is of high clinical significance as matrine can be used as a monitoring tool during longitudinal clinical studies to overcome the key limitation of poor patient compliance often reported in cancer chemoprevention trials. Both matrine and dictamine were detected in the saliva and plasma samples but only matrine was quantifiable after the oral administration of ATB tablets (2400 mg) in 8 healthy volunteers. A significantly high saliva/plasma ratios for Cmax (6.5 ± 2.0) and AUC0-24 (4.8 ± 2.0) of matrine suggested an active secretion in saliva probably due to entero-salivary recycling as evident from the long half-lives (t1/2 plasma = 10.0 ± 2.8 h, t1/2 saliva = 13.4 ± 6.9 h). The correlation between saliva and plasma levels of matrine was established using a population compartmental pharmacokinetic co-model. Moreover, a species-relevant PBPK model was developed to adequately describe the pharmacokinetic profiles of matrine in mouse, rat, and human. In conclusion, matrine saliva concentrations can be used as an excellent marker compound for mechanistic studies of active secretion of drugs from plasma to saliva as well as monitor the patient's compliance to the treatment regimen in upcoming clinical trials of ATB.

Examining the impact of cooperative learner simulation order on performance outcomes of nursing students using a haptic intravenous simulator.

This study's aim was to examine the impact of cooperative learner simulation order (LSO) on performance on a haptic intravenous (IV) simulator. Research has highlighted the value of cooperative learning in acquiring skills, but little is known about the processes that might contribute to outcomes. A convenience sample (N = 81) of students were randomized into LSO and then into IV teams. LSO reflected the sequencing pattern and who was to attempt the simulation first, second or third in their team. A randomized posttest only comparison group design was used to determine the impact of LSO on performance, operationalized as initial performance scores and number of attempts to earn a passing performance score. Linear mixed effects ANCOVAs were computed to determine the impact of LSO on performance outcomes, controlling for team size and prior experience. LSO was a significant factor in initial performance scores, explaining 21% of the variance. Past experience accounted for an additional 10% of variance in initial performance while team size explained 17% of variance in number of attempts. The impact of LSO, team size and past experience reflect team processes that relate to performance during learning and are important factors to consider when teaching in simulation.

Comparing Intravenous Insertion Instructional Methods with Haptic Simulators.

Objective. The objective of this review was to compare traditional intravenous (IV) insertion instructional methods with the use of haptic IV simulators. Design. An integrative research design was used to analyze the current literature. Data Sources. A search was conducted using key words intravenous (IV) insertion or cannulation or venipuncture and simulation from 2000 to 2015 in the English language. The databases included Academic Search Complete, CINAHL Complete, Education Resource Information Center, and Medline. Review Methods. Whittemore and Knafl's (2005) strategies were used to critique the articles for themes and similarities. Results. Comparisons of outcomes between traditional IV instructional methods and the use of haptic IV simulators continue to show various results. Positive results indicate that the use of the haptic IV simulator decreases both band constriction and total procedure time. While students are satisfied with practicing on the haptic simulators, they still desire faculty involvement. Conclusion. Combining the haptic IV simulator with practical experience on the IV arm may be the best practice for learning IV insertion. Research employing active learning strategies while using a haptic IV simulator during the learning process may reduce cost and faculty time.