Although most drugs are considered safe and compatible with breastfeeding, cases of toxic drug exposure have been reported. Active efflux transporters have been implicated as a mechanism in the transfer of drugs from mother to baby via breastmilk. Using breastmilk as a source of human mammary epithelial cells, this novel longitudinal study investigated the expression of four active transporters, namely, MDR1, MRP1, MRP2 and BCRP in the lactating human breast. BCRP gene was found to be strongly overexpressed with levels peaking at 5 months postpartum, potentially indicating a time where a breastfed infant may be at risk of inadvertent exposure to BCRP substrates. Serum albumin, a major component of human breastmilk was increasingly downregulated as lactation progresses. Xanthine oxidase/dehydrogenase, an enzyme in breastmilk attributed to a reduced risk of gastroenteritis caused by Escherichia coli and Salmonella enteritides, was downregulated. Lysozyme and fatty acid synthase are progressively upregulated. This study also shows that breastmilk-derived epithelial cells, when propagated in culture, exhibit characteristics significantly different to those derived directly from breastmilk. This serves to warn that in vitro studies are not a true representation of in vivo processes in the lactating breast; hence, application of in vitro data should be conducted with caution.
Background. It is often challenging to engage students in learning difficult concepts in pharmacology as well as other pharmaceutical biology disciplines. Gamification, serious games and simulations are gaining popularity as new approaches to teaching and learning in higher education. Gamification has the potential in enhancing motivation and engagement and is used in pharmacology teaching. This study explores the use of gamification and game-based learning in pharmacology teaching with the aim to transform students' perceptions from 'pharmacology equals an extensive amount to know and remember' to 'pharmacology equals an interesting and essential subject that enhances competency in both clinical pharmacology and the prescription of medications' Methods. A series of pharmacology games, including Drug Review Bingo, Speedy Drug Challenge block game, Pharmacology crossword puzzle and Speed Drug Dating were developed and used in Pharmacology teaching in the second and third year of the Bachelor of Pharmacy course. Collective and accumulative qualitative feedback were obtained through the University evaluation process, eVALUate, from 2012 to 2017. Students' perception on the benefits, favourite game(s) and areas for improvement were analysed using NViVo analysis. Results. Based on the qualitative comments by students through eVALUate, Drug Review Bingo and the Speedy Drug Challenge Block game used as revision for each module of the pharmacology units were the two favourite tools perceived to enhance students learning. The usefulness of the Speed Drug Dating varied depending on the collaborative nature of the class in preparation of tasks before the activities. In classes where students came prepared, all comments indicated that it had been beneficial in fostering deep learning. Conclusions. Overall students commented that the various games were engaging, fun and improved their ability to understand more complex content of pharmacology and foster internalisation of knowledge allowing long term memory to occur more effortlessly.
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