Search

This paper briefly discusses different research approaches in CALL and makes a case for applying grounded theory (GT) to data gathered from an electronic role-play conducted in L2. The article shows that this method can help gain a better understanding of what learners do when engaged in the task. Through the process of open coding, four categories emerge which are introduced in turn. (Contains 9 figures and 9 notes.)

Trisomy 21 or Down syndrome is the most common chromosomal abnormality reported worldwide. The prevalence of infantile spasms was 3% in our population with Down syndrome, which is slightly higher than the median lifetime prevalence of 2.1% (range 0.4-12.8) of epileptic spasms recently reported.5 Studies focusing on treatments and outcomes of infantile spasms in cohorts with Down syndrome are lacking. Abbreviations ACTH Adrenocorticotropic hormone ICISS International Collaborative Infantile Spasms Study What this paper adds The prevalence of infantile spasms in Down syndrome was 3%. Vigabatrin was responsible for most ( I n i =10), followed by combination prednisolone and vigabatrin ( I n i =6), prednisolone ( I n i =4), sodium valproate ( I n i =2), and other ( I n i =3). [Extracted from the article]

An upgrade of the previous self-consistent and environment-dependent linear combination of atomic orbitals Hamiltonian (referred as SCED-LCAO) has been developed. This improved version of the semi-empirical SCED-LCAO Hamiltonian, in addition to the inclusion of self-consistent determination of charge redistribution, multi-center interactions, and modeling of electron-electron correlation, has taken into account the effect excited on the orbitals due to the atomic aggregation. This important upgrade has been subjected to a stringent test, the construction of the SCED-LCAO Hamiltonian for boron. It was shown that the Hamiltonian for boron has successfully characterized the electron deficiency of boron and captured the complex chemical bonding in various boron allotropes, including the planar and quasi-planar, the convex, the ring, the icosahedral, and the fullerene-like clusters, the two-dimensional monolayer sheets, and the bulk alpha boron, demonstrating its transferability, robustness, reliability, and predictive power. The molecular dynamics simulation scheme based on the Hamiltonian has been applied to explore the existence and the energetics of ~230 compact boron clusters BN with N in the range from ~100 to 768, including the random, the rhombohedral, and the spherical icosahedral structures. It was found that, energetically, clusters containing whole icosahedral B12 units are more stable for boron clusters of larger size (N > 200). The ease with which the simulations both at 0 K and finite temperatures were completed is a demonstration of the efficiency of the SCED-LCAO Hamiltonian. [ABSTRACT FROM AUTHOR]

Structures and relative stabilities of carbon clusters belonging to different families have been investigated for diameters d≤5 nm based on an efficient semiempirical molecular dynamics (MD) scheme as well as a density functional theory based simulation. Carbon clusters studied include fullerenes and fullerene-derived structures (e.g., cages and onions), icosahedral structures, bucky-diamond structures, and clusters cut from the bulk diamond with spherical and facetted truncations. The reason for using a semiempirical MD is partly due to the large number of different cases (or carbon allotropes) investigated and partly due to the size of the clusters investigated in this work. The particular flavor of the semiempirical MD scheme is based on a self-consistent and environment-dependent Hamiltonian developed in the framework of linear combination of atomic orbitals. We find that (i) among the families of carbon clusters investigated, fullerene structures have the lowest energy with the relative energy ordering being Efullerene≤Eonionicosahedral≤Ebucky-diamond≤Ebulk-truncated, (ii) a crossover between bucky-diamond and icosahedral structures is likely at d∼8 nm, (iii) the highest occupied molecular orbital-lowest unoccupied molecular orbital gap as a function of the diameter for the case of fullerenes shows an oscillatory behavior with the gap ranging from 2 eV to 6 meV, and the gap approaching that of gapless graphite for d>3.5 nm, and (iv) there can be three types of phase transformations depending on the manner of heating and cooling in our simulated annealing studies: (a) a bucky-diamond structure→an onionlike structure, (b) an onionlike→a cage structure, and (c) a bucky-diamond→a cage structure. [ABSTRACT FROM AUTHOR]

Assimilation of remotely sensed soil moisture data (SM-DA) to correct soil water stores of rainfall-runoff models has shown skill in improving streamflow prediction. In the case of large and sparsely monitored catchments, SM-DA is a particularly attractive tool. Within this context, we assimilate satellite soil moisture (SM) retrievals from the Advanced Microwave Scanning Radiometer (AMSR-E), the Advanced Scatterometer (ASCAT) and the Soil Moisture and Ocean Salinity (SMOS) instrument, using an Ensemble Kalman filter to improve operational flood prediction within a large (> 40 000 km²) semi-arid catchment in Australia. We assess the importance of accounting for channel routing and the spatial distribution of forcing data by applying SM-DA to a lumped and a semi-distributed scheme of the probability distributed model (PDM). Our scheme also accounts for model error representation by explicitly correcting bias in soil moisture and streamflow in the ensemble generation process, and for seasonal biases and errors in the satellite data. Before assimilation, the semi-distributed model provided a more accurate streamflow prediction (Nash-Sutcliffe efficiency, NSE = 0.77) than the lumped model (NSE = 0.67) at the catchment outlet. However, this did not ensure good performance at the "ungauged" inner catchments (two of them with NSE below 0.3). After SM-DA, the streamflow ensemble prediction at the outlet was improved in both the lumped and the semi-distributed schemes: the root mean square error of the ensemble was reduced by 22 and 24%, respectively; the false alarm ratio was reduced by 9% in both cases; the peak volume error was reduced by 58 and 1%, respectively; the ensemble skill was improved (evidenced by 12 and 13% reductions in the continuous ranked probability scores, respectively); and the ensemble reliability was increased in both cases (expressed by flatter rank histograms). SM-DA did not improve NSE. Our findings imply that even when rainfall is the main driver of flooding in semi-arid catchments, adequately processed satellite SM can be used to reduce errors in the model soil moisture, which in turn provides better streamflow ensemble prediction. We demonstrate that SM-DA efficacy is enhanced when the spatial distribution in forcing data and routing processes are accounted for. At ungauged locations, SM-DA is effective at improving some characteristics of the streamflow ensemble prediction; however, the updated prediction is still poor since SM-DA does not address the systematic errors found in the model prior to assimilation. [ABSTRACT FROM AUTHOR]

Assisting patients to deal with loss is a major, yet unrecognized, role of general practitioners. Although instruments exist for measuring grief resulting from a given loss, such as bereavement, none exists that detects and measures grief from any loss. This study describes the development of the Grief Diagnostic Instrument for this purpose in general practice patients. Evaluation showed it to be a concise, valid, reliable and sensitive measure, and acceptable to general practice patients. The instrument investigates and measures grief from multiple losses rather than a single loss compared to other grief scales. Suggestions have been made for further validation studies. Its use in future grief research and clinical practice are described. [ABSTRACT FROM AUTHOR]

Background and Objectives: The 2011 American Academy of Pediatrics guidelines recommended a renal and bladder ultrasound (RBUS) after the first febrile urinary tract infection (UTI) in infants. Abnormal RBUS findings may be due to inflammation from the acute UTI or from vesicoureteral reflux (VUR), which may require a voiding cystourethrogram (VCUG) to diagnose, increasing health care costs. Our objective was to evaluate the effect of timing of imaging relative to the acute illness on abnormal dilation on RBUS and VCUG findings., Methods: Multicenter, retrospective study of patients aged 2 to 24 months presenting with first UTI and RBUS from January 1, 2015, to December 31, 2019. Demographics, isolated pathogen, and timing of RBUS and VCUG relative to urine culture date were recorded and compared., Results: A total of 227 patients were included. On multivariable logistic regression, increased time in days to RBUS was associated with decreased odds of abnormal dilation (adjusted odds ratio, 0.980; P = .018) in those patients meeting culture criteria for UTI (for each additional day of delay in obtaining RBUS, the adjusted odds of detecting dilation decreased by ∼2%). There was no significant association between timing of imaging and VUR on VCUG. Additionally, 32% of patients underwent RBUS who did not meet UTI culture criteria but had similar rates of abnormal dilation and VUR to those meeting UTI culture criteria., Conclusions: Increased time to RBUS led to decreased odds of abnormal dilation, suggesting that delaying RBUS may lead to fewer false-positive results, which may limit unnecessary additional testing and reduce health care costs. Additionally, a significant number of patients who did not meet UTI culture criteria underwent RBUS but had similar results to those meeting criteria, suggesting that the previous colony-forming unit definition for UTI may be suboptimal., Competing Interests: CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2024 by the American Academy of Pediatrics.)

Fatty acid omega hydroxylase P450s consist of enzymes that hydroxylate various chain-length saturated and unsaturated fatty acids (FAs) and bioactive eicosanoid lipids. The human cytochrome P450 gene 4 family (CYP4) consists of 12 members that are associated with several human diseases. However, their role in the progression of metabolic dysfunction-associated fatty liver disease (MASLD) remains largely unknown. It has long been thought that the induction of CYP4 family P450 during fasting and starvation prevents FA-related lipotoxicity through FA metabolism to dicarboxylic acids that are chain-shortened in peroxisomes and then transported to the mitochondria for complete oxidation. Several studies have revealed that peroxisome succinate transported to the mitochondria is used for gluconeogenesis during fasting and starvation, and recent evidence suggests that peroxisome acetate can be utilized for lipogenesis and lipid droplet formation as well as epigenetic modification of gene transcription. In addition, omega hydroxylation of the bioactive eicosanoid arachidonic acid to 20-Hydroxyeicosatetraenoic acid (20-HETE) is essential for activating the GPR75 receptor, leading to vasoconstriction and cell proliferation. Several mouse models of diet-induced MASLD have revealed the induction of selective CYP4A members and the suppression of CYP4F during steatosis and steatohepatitis, suggesting a critical metabolic role in the progression of fatty liver disease. Thus, to further investigate the functional roles of CYP4 genes, we analyzed the differential gene expression of 12 members of CYP4 gene family in datasets from the Gene Expression Omnibus (GEO) from patients with steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. We also observed the differential expression of various CYP4 genes in the progression of MASLD, indicating that different CYP4 members may have unique functional roles in the metabolism of specific FAs and eicosanoids at various stages of fatty liver disease. These results suggest that targeting selective members of the CYP4A family is a viable therapeutic approach for treating and managing MASLD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: There is emerging evidence on the impact of social and environmental determinants of health on paediatric intensive care unit (PICU) admissions and outcomes. We analysed UK paediatric intensive care data to explore disparities in the incidence of admission according to a child's ethnicity and the degree of deprivation and pollution in the child's residential area., Methods: Data were extracted on children <16 years admitted to UK PICUs between 1st January 2008 and 31st December 2021 from the Paediatric Intensive Care Audit Network (PICANet) database. Ethnicity was categorised as White, Asian, Black, Mixed or Other. Deprivation was quantified using the 'children in low-income families' measure and outdoor air pollution was characterised using mean annual PM2.5 level at local authority level, both divided into population-weighted quintiles. UK population estimates were used to calculate crude incidence of PICU admission. Incidence rate ratios were calculated using Poisson regression models., Findings: There were 245,099 admissions, of which 60.7% were unplanned. After adjusting for age and sex, Asian and Black children had higher relative incidence of unplanned PICU admission compared to White (IRR 1.29 [95% CI: 1.25-1.33] and 1.50 [95% CI: 1.44-1.56] respectively), but there was no evidence of increased incidence of planned admission. Children living in the most deprived quintile had 1.50 times the incidence of admission in the least deprived quintile (95% CI: 1.46-1.54). There were higher crude admission levels of children living in the most polluted quintile compared to the least (157.8 vs 113.6 admissions per 100,000 child years), but after adjustment for ethnicity, deprivation, age and sex there was no association between pollution and PICU admission (IRR 1.00 [95% CI: 1.00-1.00] per 1 μg/m 3 increase)., Interpretation: Ethnicity and deprivation impact the incidence of PICU admission. When restricting to unplanned respiratory admissions and ventilated patients only, increasing pollution level was associated with increased incidence of PICU admission. It is essential to act to reduce these observed disparities, further work is needed to understand mechanisms behind these findings and how they relate to outcomes., Funding: There was no direct funding for this project. HM was funded by an NIHR Academic Clinical Fellowship (ACF-2022-18-017)., Competing Interests: Peter Davis has a paid role as Clinical Reference Group Chair for Paediatric Critical Care until 07/2022 and an unpaid role as Clinical Reference Group Member for Paediatric Critical Care from 08/2022. Sarah Seaton is funded by the Healthcare Quality Improvement Partnership (and equivalent funders from Scotland, Wales, Northern Ireland and Republic of Ireland) in her role as co-PI of PICANet. Hannah Mitchell is funded by an NIHR Academic Clinical Fellowship. The authors have no conflicts of interest relevant to this article to disclose., (© 2024 The Authors.)

Objective: To explore the experience of patients with incontinence and incontinence-associated dermatitis (IAD) in acute care hospitals and their family caregivers, including their perceptions and management, as well as the impact on their wellbeing., Method: A qualitative exploratory study design was employed in 18 wards across six acute/subacute hospitals in New South Wales, Australia. Patients with incontinence (with or without IAD) were invited to participate. Where interviews were not possible with the patient, their family caregiver was invited to participate. Semi-structured interviews were conducted., Results: There were 45 interviewees in the study; 41 were patients with incontinence (11 of whom had IAD) and four were family caregivers. The experience of incontinence was captured by three themes: 'incontinence interrupts every aspect of my life'; 'actively concealing and cloaking'; and 'perceived as irreversible'. Incontinence was expected by the patients at their age and did not come as a surprise. It was normalised and approached with stoicism. As such, patients self-managed their incontinence by developing strategies to ensure they avoided episodes of incontinence during their stay. Incontinence left patients feeling anxious, embarrassed and with a sense of shame, and they did not communicate these feelings, or engage with health professionals about their incontinence, nor did health professionals discuss their incontinence with them. There was a strong sense of resignation that incontinence was irreversible and nothing could be done to improve it. All participants displayed little knowledge of IAD. The experience of having IAD was characterised by the theme 'debilitating and desperate for relief' and was experienced as a particularly painful, itching and burning condition that left patients distressed and irritable., Conclusion: Patients with incontinence in acute settings required further education from health professionals to reduce the stigma of incontinence, and provide further support to manage their incontinence. Health professionals can also play a key role in educating patients about the risks of developing IAD and how it can be prevented.

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence-associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi-experimental pre-and post-study, conducted in 18 wards, was part of a larger implementation science study on incontinence-associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre-intervention) and July and August 2021 (post-intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three-in-one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre-intervention = 964, post-intervention = 933). A total of 343 (35.6%) pre-intervention patients and 351 (37.6%) post-intervention patients had incontinence. The prevalence of hospital-acquired IAD was 6.71% in the pre-intervention group and 4.27% in the post-intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID-19 pandemic in the post-intervention group compared with the pre-intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital-acquired IAD, suggesting enduring effectiveness of the intervention., (© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Many experimental studies show that metrics of visual image quality can predict changes in visual acuity due to optical aberrations. Here we use statistical decision theory and Fourier optics formalism to demonstrate that two metrics known in the field of vision sciences are approximations of two different theoretical models of linear observers. The theory defines metrics of visual acuity to potentially predict changes in visual acuity due to optical aberrations, without needing a posteriori scale or offset. We illustrate our approach with experiments, using combinations of defocus and spherical aberration, and pure coma.

Competing Interests: Competing interests: No conflict of interest to declare.

Lay Abstract: Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication.

Gene fusions involving tumor protein p63 gene (TP63) occur in multiple T and B cell lymphomas and portend a dismal prognosis for patients. The function and mechanisms of TP63 fusions remain unclear, and there is no target therapy for patients with lymphoma harboring TP63 fusions. Here, we show that TP63 fusions act as bona fide oncogenes and are essential for fusion-positive lymphomas. Transgenic mice expressing TBL1XR1::TP63, the most common TP63 fusion, develop diverse lymphomas that recapitulate multiple human T and B cell lymphomas. Here, we identify that TP63 fusions coordinate the recruitment of two epigenetic modifying complexes, the nuclear receptor corepressor (NCoR)-histone deacetylase 3 (HDAC3) by the N-terminal TP63 fusion partner and the lysine methyltransferase 2D (KMT2D) by the C-terminal TP63 component, which are both required for fusion-dependent survival. TBL1XR1::TP63 localization at enhancers drives a unique cell state that involves up-regulation of MYC and the polycomb repressor complex 2 (PRC2) components EED and EZH2. Inhibiting EZH2 with the therapeutic agent valemetostat is highly effective at treating transgenic lymphoma murine models, xenografts, and patient-derived xenografts harboring TP63 fusions. One patient with TP63 -rearranged lymphoma showed a rapid response to valemetostat treatment. In summary, TP63 fusions link partner components that, together, coordinate multiple epigenetic complexes, resulting in therapeutic vulnerability to EZH2 inhibition.

Recurrent JAK2 alterations are observed in myeloproliferative neoplasms, B-cell acute lymphoblastic leukemia, and other hematologic malignancies. Currently available type I JAK2 inhibitors have limited activity in these diseases. Preclinical data support the improved efficacy of type II JAK2 inhibitors, which lock the kinase in the inactive conformation. By screening small molecule libraries, we identified a lead compound with JAK2 selectivity. We highlight analogs with on-target biochemical and cellular activity and demonstrate in vivo activity using a mouse model of polycythemia vera. We present a co-crystal structure that confirms the type II binding mode of our compounds with the "DFG-out" conformation of the JAK2 activation loop. Finally, we identify a JAK2 G993A mutation that confers resistance to the type II JAK2 inhibitor CHZ868 but not to our analogs. These data provide a template for identifying novel type II kinase inhibitors and inform further development of agents targeting JAK2 that overcome resistance., Competing Interests: Declaration of interests S.R.H. and O.S. are co-founders, equity holders, and scientific advisory board members of Ajax Therapeutics, Inc. N.S.G. is a founder, science advisory board member (SAB) and equity holder in Syros, C4, Allorion, Lighthorse, Voronoi, Inception, Matchpoint, CobroVentures, GSK, Larkspur (board member), and Soltego (board member). T.Z. is a founder, equity holder, and consultant for Matchpoint. The Gray lab receives or has received research funding from Novartis, Takeda, Astellas, Taiho, Jansen, Kinogen, Arbella, Deerfield, Springworks, Interline, and Sanofi. D.M.W. is an employee of Merck and co-founder and equity holder of Ajax Therapeutics, Inc. and Travera. D.M.W. is an advisor or consultant for Bantam, Ajax Therapeutics, Inc., Secura, Travera, AstraZeneca, and Daiichi Sankyo. The Weinstock lab has received research support from Daiichi Sankyo, Verastem, Secura, and Abcuro. T.Z., Y.L., Z.H., M.H., N.S.G., D.M.W., and L.S.L. are co-inventors on patent number WO 2020/097400 A1 related to this work. K.E.S. is now an employee of Novartis and K.L.J. is now an employee of AstraZeneca., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Metrics of retinal image quality predict optimal refractive corrections and correlate with visual performance. To date, they do not predict absolutely the relative change in visual performance when aberrations change and therefore need to be a-posteriori rescaled to match relative measurements. Here we demonstrate that a recently proposed metric can be used to predict, in an absolute manner, changes in contrast sensitivity measurements with Sloan letters when aberrations change. Typical aberrations of young and healthy eyes (for a 6 mm pupil diameter) were numerically introduced, and we measured the resulting loss in contrast sensitivity of subjects looking through a 2 mm diameter pupil. Our results suggest that the metric can be used to corroborate measurements of visual performance in clinical practice, thereby potentially improving patient follow-ups., Competing Interests: The authors declare no conflicts of interest., (© 2023 Optica Publishing Group under the terms of the Optica Open Access Publishing Agreement.)

Typical assessments of balance impairment are subjective or require data from cumbersome and expensive force platforms. Researchers have utilized lower back (sacrum) accelerometers to enable more accessible, objective measurement of postural sway for use in balance assessment. However, new sensor patches are broadly being deployed on the chest for cardiac monitoring, opening a need to determine if measurements from these devices can similarly inform balance assessment. Our aim in this work is to validate postural sway measurements from a chest accelerometer. To establish concurrent validity, we considered data from 16 persons with multiple sclerosis (PwMS) asked to stand on a force platform while also wearing sensor patches on the sacrum and chest. We found five of 15 postural sway features derived from the chest and sacrum were significantly correlated with force platform-derived features, which is in line with prior sacrum-derived findings. Clinical significance was established using a sample of 39 PwMS who performed eyes-open, eyes-closed, and tandem standing tasks. This cohort was stratified by fall status and completed several patient-reported measures (PRM) of balance and mobility impairment. We also compared sway features derived from a single 30-second period to those derived from a one-minute period with a sliding window to create individualized distributions of each postural sway feature (ID method). We find traditional computation of sway features from the chest is sensitive to changes in PRMs and task differences. Distribution characteristics from the ID method establish additional relationships with PRMs, detect differences in more tasks, and distinguish between fall status groups. Overall, the chest was found to be a valid location to monitor postural sway and we recommend utilizing the ID method over single-observation analyses.

The effects of COVID-19 have been profoundly felt across higher education as across broader society. In particular, the pandemic has revealed that many of our most stubbornly entrenched inequalities do not simply follow gendered fault lines, but rather care fault lines. In this article, we adopt a maternal epistemology and collaborative witnessing to outline the disruption that academic mothers have experienced during the pandemic. However, we argue that this disruption is not simply obstructive to academic mothers and other caregivers. Rather, COVID-19 has provided a potentially transformative moment for the visibility and normalisation of care in the academy. It has forced the complex negotiation of paid work and care work that academic mothers must constantly manage into the spotlight. The pandemic has provoked an opportunity for a different performance of mothering in the academy; one that does not require us to invisibilise our care to be valued. This (re)performance and revaluation has the potential to reform the cultural landscapes of the academy, towards spaces in which care is reimagined as not simply an encumberment but also an enrichment., (© 2022 John Wiley & Sons Ltd.)

We measure the effect of defocus blur on contrast sensitivity with Sloan letters in the 0.75-2.00 arc min range of letter gaps. We compare our results with the prediction of the Dalimier and Dainty model [J. Opt. Soc. Am. A25, 2078 (2008)JOAOD60740-323210.1364/JOSAA.25.002078] and propose a new metric of retinal image quality that we define as the model limit for very small letters. The contrast sensitivity is measured for computationally blurred Sloan letters (0, 0.25, and 0.50 diopters for a 3 mm pupil) of different sizes (20/40 to 20/15 visual acuity), and subjects look through a small (2 mm) diaphragm to limit the impact of their own aberration on measurements. Measurements and model predictions, which are normalized by the blur-free condition, weakly depend on letter size and are in good agreement with our metric of retinal image quality. Our metric relates two approaches of modeling visual performance: complete modeling of the optotype classification task and calculation of retinal image quality with a descriptive metric.

Background: Incontinence-associated dermatitis is a common, under-recognized painful skin condition associated with poorer quality of life, increased nurse workloads, and costs., Objective: To systematically review economic evidence for the prevention and treatment of incontinence-associated dermatitis., Design: Systematic review of quantitative research., Data Sources: PubMed, MEDLINE, EMBASE, Cochrane Library, York Centre for Reviews and Dissemination database, Econlit, Tufts' Cost-Effectiveness Analysis Registry, and Web of Science., Review Methods: A comprehensive search for studies on resource use (costs), health outcomes, and cost-effectiveness of interventions for incontinence-associated dermatitis was conducted. Screening, data extraction, and initial quality assessment were conducted independently by two reviewers, with disagreements/queries regarding quality settled through consensus with the larger team. Quality evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist and results narratively arranged., Findings: Seventeen studies (10 for prevention, one for treatment and six for both prevention and treatment) included. All studies measured resource use from a healthcare provider perspective; 14 quantified resources in monetary terms. Considerable variation existed in the resource use data primarily due to differences in the type of resources counted, selected time horizons, valuation methods, and reporting approaches. Ten studies provided evidence of their intervention to be cost saving (or at least cost avoiding). Five studies on barrier products provided evidence to be cost saving: three for prevention, one for treatment, and one for both prevention and treatment. Two studies of cleanser and barrier products provided evidence to be cost saving for the prevention and treatment of incontinence-associated dermatitis. One study found a cleanser to be a cost saving preventative intervention. One bowel management system was found to be cost saving over time only, and one nurse education intervention was found to be cost saving for preventing and treating incontinence-associated dermatitis. One barrier product was found to be cost-effective for preventing and treating the condition. Finally, one study found a cleanser and barrier product was time saving for prevention. None of the studies incorporated a multi-attribute quality of life measure; however, two studies included person-reported outcome measures for pain. A narrow range of resources (mainly products) were considered, and there was limited information on how they were counted and valued. Analyses relating to heterogeneity among patients/hospital wards or health facilities and uncertainty were lacking., Conclusions: Barrier products are possibly a more cost-effective treatment than others; however, this evidence lacks certainty. Structured health economic evaluations are required for a reliable evidence-base on the interventions for incontinence-associated dermatitis., Tweetable Abstract: Most incontinence-associated dermatitis studies lack person-reported outcomes, costs beyond product/staff time, and economic evaluation., Competing Interests: Declaration of Competing Interest Professor Fiona Coyer declares that she has consultancies with both Molynlycke and Striker., (Copyright © 2022. Published by Elsevier Ltd.)

Purpose: This study examined clinicians' knowledge of incontinence-associated dermatitis (IAD) using the Barakat-Johnson Incontinence-Associated Dermatitis Knowledge Tool (Know-IAD)., Design: A cross-sectional multicenter survey., Subjects and Setting: The setting was 6 hospitals across 5 health districts in New South Wales, Australia. The participants were nurses (registered nurses and enrolled nurses), physicians, allied health (occupational therapists, dietitians, and physiotherapists), and students (nursing and allied health)., Methods: Data about IAD knowledge were collected from November 2019 to January 2020. The Know-IAD, an 18-item validated instrument that measures knowledge of IAD in 3 domains (etiology and risk, classification and diagnosis, and prevention and management), was administered to a cross section of eligible clinicians. The participants anonymously completed hard copy surveys. Descriptive and exploratory analyses were conducted to quantify clinicians' knowledge about the etiology and risk, classification and diagnosis, and prevention and management of IAD. A mean knowledge score of 70% was considered to be satisfactory., Results: Four hundred twelve respondents completed the survey. One hundred twenty nine respondents (31.3%) achieved 70% correct responses and greater for the entire set of items. For the etiology and risk domain, 348 respondents (84.5%) obtained a score of 70% correct responses and greater, 67 respondents (16.3%) achieved 70% correct responses and greater for the classification and diagnosis domain, and 84 respondents (20.4%) achieved 70% correct responses and greater for the prevention and management domain., Conclusion: Clinicians tend to have low knowledge and recognition of IAD, particularly in the areas of classification and diagnosis along with prevention and management. They tend to have higher knowledge of how IAD is caused and the risk factors. This study has identified knowledge gaps for further education that can improve assessment, prevention, and management of IAD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 by the Wound, Ostomy and Continence Nurses Society.)