A quantitative structure-permeability relationship model for split-thickness skin absorption, reasoning for the choice of the database.

The skin is the largest organ in the human body, protecting the body from xenobiotic invasion (1). Local and systemic drugs may also be administered through the skin, therefore the need to measure the permeability of the skin to chemicals has long been apparent. The use of in vivo or in vitro techniques is time-consuming, since it is not only necessary to conduct a permeation study, but also to optimize experimental conditions and build analytical methods for each chemical. Moreover, it is not possible to assess the permeability of compounds not yet synthesised. An alternative option can be the development of Quantitative Structure-Permeability Relationships (QSPRs). These in silico models aim to form a relationship between the absorption of chemicals through the skin and their physico-chemical and/or structural properties (2). Knowing that permeability can be affected by different experimental conditions, the aim of this study is to build a QSPR based on uniform and consistent experimental conditions, but with a significant database size. Two different databases were compared: the first one was obtained only from Zhang et al (3), the second one was created from multiple literature sources, fulfilling the following conditions: - Data (log Kp values) were obtained by an in vitro diffusion system; - The membrane was human stratum corneum and viable epidermis; - The donor solvent was an aqueous solution; - No permeation enhancement technologies were used; - No association with other chemicals were considered. The geometrical structures of all chemicals were optimized with MM2 forcefield. Molecular descriptors and fingerprints were generated where possible. For each database, a wide range of Multi Linear Regression models were built using QSARins (4, 5) through a stepwise forward regression process. The models have been validated according to Golbraikh and Tropsha (6) criteria and the best ones have been selected according to the Multi-Criteria Decision Making (7). The model calculated from the data obtained from a single source shows better correlation, robustness, and predictivity, revealing a grade of uncertainty coming from an inter laboratory variability of the different sources used to build the database. REFERENCES 1. Baba H, Takahara J-i, Mamitsuka H. In Silico Predictions of Human Skin Permeability using Nonlinear Quantitative Structure–Property Relationship Models. Pharmaceutical Research. 2015;32(7):2360-71. 2. Moss GP, Cronin MTD. Quantitative structure–permeability relationships for percutaneous absorption: re-analysis of steroid data. International Journal of Pharmaceutics. 2002;238(1):105-9. 3. Zhang K, Chen M, Scriba GKE, Abraham MH, Fahr A, Liu X. Human Skin Permeation of Neutral Species and Ionic Species: Extended Linear Free Energy Relationship Analyses. Journal of Pharmaceutical Sciences. 2012;101(6):2034-44. 4. Gramatica P, Chirico N, Papa E, Cassani S, Kovarich S. QSARINS: A new software for the development, analysis, and validation of QSAR MLR models. Journal of Computational Chemistry. 2013;34(24):2121-32. 5. Gramatica P, Cassani S, Chirico N. QSARINS-chem: Insubria datasets and new QSAR/QSPR models for environmental pollutants in QSARINS. Journal of Computational Chemistry. 2014;35(13):1036-44. 6. Golbraikh A, Tropsha A. Beware of q2! Journal of Molecular Graphics and Modelling. 2002;20(4):269-76. 7. Keller HR, Massart DL, Brans JP. Multicriteria decision making: A case study. Chemometrics and Intelligent Laboratory Systems. 1991;11(2):175-89.Peer reviewedFinal Published versio

Delirium Care Pathways: final report for NSW Health and Health Care of Older Australian Standing Committee

This report provides an overview of the “Delirium Care Pathways” project which was commissioned to be delivered by NSW Health on behalf of the Health Care of Older Australians Standing Committee (HCOASC). The School of Nursing, Midwifery & Indigenous Health (SNMIH), University of Wollongong (UoW), was sub-contracted to deliver this project to NSW Health. This final report has been informed by ongoing progress reports presented to the Project Management team, HCOASC, and the Project Advisory Group. In this report, there will be a discussion of the background to the project, project management details, data collection and data analysis techniques, a description of the outcomes for the project, and conclusions about how the “Delirium Care Pathways” can be used to inform health care policy and practice. Included in the report is a submission of the “Delirium Care Pathways” Final Version which has been reviewed by HCOSAC. NSW Health will submit the documentation to HCOASC who will manage printing and publication of the documentation

Graphic designed bedroom doors to support dementia wandering in residential care homes: Innovative practice

Dementia-friendly designs are important in residential care homes but an aspect that remains neglected is the potential role of door designs in promoting wayfinding. A pilot project in NSW, Australia, tested the effects of unique room door designs for a small group of individuals living with dementia in a residential care home. Internal doors were transformed using a giant adhesive poster created by a commercial graphic designer. The poster replicated the look of traditional front doors, including a range of bright bold colours and architectural features, such as brass doorknockers, letterboxes and door guards. The Revised Algase Wandering Scale (RAWS) was used to identify the effects of introducing the doors on persistent walking, eloping behaviours and spatial disorientation. A total of nine individuals living with dementia participated in the project. The post-intervention data demonstrated that there was a reduction in persistent walking, eloping behaviours and spatial disorientation. In addition, ongoing anecdotal evidence found that individuals continued to seek out others to showcase their unique door

The effects of spending time outdoors in daylight on the psychosocial wellbeing of older people and family carers: a comprehensive systematic review protocol

Review question/objective The overall objective of this research is to undertake a systematic review of the effects of spending time outdoors in daylight on the psychosocial wellbeing of older adults and family carers. The specific questions to be addressed are: Which aspects of psychosocial wellbeing are affected by spending time outdoors in daylight in older adults and family carers? To what extent is spending time outdoors in the daylight effective in improving aspects of psychosocial wellbeing in older adults and family carers

Predicting Skin Permeability by means of Computational Approaches : Reliability and Caveats in Pharmaceutical Studies

© 2019 American Chemical Society.The skin is the main barrier between the internal body environment and the external one. The characteristics of this barrier and its properties are able to modify and affect drug delivery and chemical toxicity parameters. Therefore, it is not surprising that permeability of many different compounds has been measured through several in vitro and in vivo techniques. Moreover, many different in silico approaches have been used to identify the correlation between the structure of the permeants and their permeability, to reproduce the skin behavior, and to predict the ability of specific chemicals to permeate this barrier. A significant number of issues, like interlaboratory variability, experimental conditions, data set building rationales, and skin site of origin and hydration, still prevent us from obtaining a definitive predictive skin permeability model. This review wants to show the main advances and the principal approaches in computational methods used to predict this property, to enlighten the main issues that have arisen, and to address the challenges to develop in future research.Peer reviewedFinal Accepted Versio

Is it my job? The role of RNs in the assessment and identification of delirium in hospitalized older adults: an exploratory qualitative study

Delirium is characterized by acute and fluctuating cognitive decline, which is often missed in older adults who are assumed to be experiencing age-related changes or dementia. Delirium affects up to 50% of hospitalized older adults. The aim of the current study was to (a) explore current practices of RNs in assessing and identifying delirium in hospitalized older adults and (b) inform new educational initiatives. Qualitative methods were adopted using eight semi-structured group interviews with 24 RNs. Thematic analysis revealed a dichotomy in practice where RNs described delirium assessment and identification as (a) It\u27s Not My Job, (b) It is My Job, and (c) It\u27s Complex. The imperative to improve delirium assessment and identification to create safer and more caring health care environments means the current findings provide important evidence to build into practice and education strategies. The current authors have developed engaging educational interventions and begun implementation at the study site to develop delirium assessment and identification capacity, which moves clinicians beyond awareness and aims at practice adherence or the consistent application of evidence-based delirium assessment

The effect of spending time outdoors in daylight on the psychosocial well-being of older people and their family carers

Abstract of presentation from the Dementia Collaborative Research Centres\u27 (DCRC) 2014 National Dementia Research Forum, Sydney, 19 September 2014

Giving women a voice - narratives on accessing (or not) drug and alcohol services

Abstract of a presentation at the ADDICTION 2015: the Australian & New Zealand Addiction Conference, Gold Coast, Australia, 20-22 May

Using learning objects to provide context in simulation

Incorporating simulation in curricula is a strategy that provides innovative opportunities to address the challenges of preparing learners for the complexities of clinical practice (Jefferies, 2007). However, where students have had limited exposure to clinical practice their understanding of the context of this may impact on the quality of the learning experience. This is especially so when students are expected to engage in simulation activities that include role play. Using learning objects as a teaching tool and embedding these within the structure of simulation can enhance the quality of the learning experience through facilitating an understanding of the practice context, including how patients present (Windle, McCormick, Dandrea & Wharrad 2011). This presentation outlines the development and use of a DVD that depicted a series of scenarios related to the assessment and care of a patient with delirium, and how this was incorporated within the structure of simulation in the Challenges of Ageing subject in the Bachelor of Nursing at The University of Wollongong. The results of an initial evaluation of the usefulness of using the DVD as a learning object in simulation, including student and staff perspectives will be presented. Incorporating learning objects in simulation has transferability to other health professions and will be of interest to academics and practitioners interested in teaching methods that prepare students for simulation and enhance the quality of the learning experience