Adult Laypersons Research Articles

Interpersonal impressions of cleft and non-cleft adolescents: A panel assessment study of peers, laypersons, and clinicians using 3dMD images

BackgroundPatients with cleft lip and palate anomalies suffer from associated negative psychosocial effects despite undergoing reconstructive surgeries. Discrimination from others may be a contributing factor. We aim to understand whether people react differently to cleft and non-cleft subjects in questions regarding aesthetic appraisal and interpersonal impressions, as well as whether diverging opinions exist between people of different backgrounds. Materials and MethodsUsing the 3dMD system, three-dimensional craniofacial images of cleft (n=20) and non-cleft (n=5) pediatric individuals were obtained and used to create a Likert scale-based questionnaire. Participants from three different backgrounds, including adolescent peers, adult laypersons, and plastic surgeons, were recruited to complete the assessment. The resulting data was transferred to a bar graph and analyzed with the Item Response Theory- Graded Response Model to estimate the latent traits and capability of each subject. ResultsNon-cleft images obtained more positive responses than cleft images in questions of both aesthetic appraisal and interpersonal impressions. However, some of the cleft images were rated similarly, or even superior, to non-cleft images in questions regarding interpersonal impressions. Surgeons showed the greatest latent capability in differentiating between cleft and non-cleft images, followed by adult laypersons, and then adolescent peers. ConclusionDespite cleft patients experiencing drastic improvements in appearance post-repair, all subject groups responded differently to questions concerning aesthetic and social impressions of pediatric cleft and non-cleft images. Plastic surgeons were more critical than others. These findings may offer further insight to clinicians, educators, and caregivers into the social challenges faced by cleft individuals.

The understandability and quality of telephone-guided bystander cardiopulmonary resuscitation in the Western Cape province of South Africa: A manikin-based study

BackgroundThe incidence of cardiovascular disease is on the increase in Africa and with it, an increase in the incidence of out-of-hospital cardiac arrest (OHCA). OHCA carries a high mortality, especially in low-resource settings. Interventions to treat OHCA, such as mass cardiopulmonary resuscitation (CPR) training campaigns are costly. One cost-effective and scalable intervention is telephone-guided bystander CPR (tCPR). Little data exists regarding the quality of tCPR. This study aimed to determine quality of tCPR in untrained members of the public. Participants were also asked to provide their views on the understandability of the tCPR instructions. MethodsThis study followed a prospective, simulation-based observational study design. Adult laypeople who have not had previous CPR training were recruited at public CPR training events and asked to perform CPR on a manikin. Quality was assessed in terms of hand placement, compression rate, compression depth, chest recoil, and chest exposure. tCPR instructions were provided by a trained medical provider, via loudspeaker. Participants were also asked to complete a short questionnaire afterwards, detailing the understandability of the tCPR instructions. Data were analysed descriptively and compared to recommended quality guidance. ResultsFifty participants were enrolled. Hand placement was accurate in 74 % (n = 37) of participants, while compression depth and chest recoil only had compliance in 20 % (n = 10) and 24 % (n = 12) of participants, respectively. The mean compression rate was within guidelines in just under half (48 %, n = 24) of all participants. Only 20 (40 %) participants exposed the manikin's chest. Only 46 % (n = 23) of participants felt that the overall descriptions offered during the tCPR guidance were understandable, while 80 % (n = 40) and 36 % (n = 18) felt that the instructions on hand placement and compression rate were understandable, respectively. Lastly, 94 % (n = 47) of participants agreed that they would be more likely to perform bystander CPR if they were provided with tCPR. ConclusionThe quality of CPR performed by laypersons is generally suboptimal and this may affect patient outcomes. There is an urgent need to develop more understandable tCPR algorithms that may encourage bystanders to start CPR and optimise its quality.

Aesthetic perception of gingival display on smiling among laypeople seeking dental treatment

Abstract Objective The present study aimed to determine the influence of gingival display on smile perception of adult patients seeking dental treatment. Materials and methods A smiling photograph was digitally modified to simulate gingival exposures from -4 mm to +4 mm, each in 2 mm increments. Using a validated questionnaire, 117 subjects were recruited and asked to rate the attractiveness of the smile displayed by the photographs. Friedman tests were applied to compare the perceptions of the overall subjects in addition to subjects within each category. Kruskal–Wallis tests were used to compare perceptions between the genders, different ages, and ethnicity. Statistical significance was set at P < 0.05. Results The most aesthetic gingival display was at -2 mm and the least aesthetic at -4 mm among all subjects. Females were more critical in evaluating smiles than males. Subjects 50 years or older and the Chinese ethnicity were less sensitive to the range of gingival displays. Conclusions Smile perception of varying gingival display among adult laypeople was found to be the most aesthetic at -2 mm, least aesthetic at -4 mm and was influenced by gender, age, and ethnicity.

Early or late booster for basic life support skill for laypeople: a simulation-based randomized controlled trial.

Retention of skills and knowledge has been shown to be poor after resuscitation training. The effect of a "booster" is controversial and may depend on its timing. We compared the effectiveness of an early versus late booster session after Basic Life Support (BLS) training for skill retention at 4months. We performed a single-blind randomized controlled trial in a simulation environment. Eligible participants were adult laypeople with no BLS training or practice in the 6months prior to the study. We provided participants with formal BLS training followed by an immediate BLS skills post-test. We then randomized participants to one of three groups: control, early booster, or late booster. Based on their group allocation, participants attended a brief BLS refresher at either 3weeks after training (early booster), at 2months after training (late booster), or not at all (control). All participants underwent a BLS skills retention test at 4 months. We measured BLS skill performance according to the Heart and Stroke Foundation's skills testing checklist for adult CPR and the use of an automated external defibrillator. A total of 80 laypeople were included in the analysis (control group, n = 28; early booster group, n = 23; late booster group, n = 29). The late booster group achieved better skill retention (mean difference in checklist score at retention compared to the immediate post-test = - 0.8 points out of 15, [95% CI - 1.7, 0.2], P = 0.10) compared to the early booster (- 1.3, [- 2.6, 0.0], P = 0.046) and control group (- 3.2, [- 4.7, - 1.8], P < 0.001). A late booster session improves BLS skill retention at 4months in laypeople. NCT02998723.

Impact of different methods to activate the pediatric mode in automated external defibrillators by laypersons – A randomized controlled simulation study

IntroductionDefibrillation with automated external defibrillators (AEDs) for smaller children with out-of-hospital cardiac arrest (OHCA) should be performed using a pediatric mode. This study aims to investigate the easiest and fastest way to activate the pediatric mode on AEDs for pediatric OHCA. MethodsThis randomized, controlled simulation study recruited 90 adult laypersons. Laypersons were randomized to use one of three AEDs with different methods to activate the pediatric mode: a Lifepak CR-T Trainer requiring switch of electrodes, a Phillips Heartstart FR3 Trainer with a “pediatric key”, or a CU Medical IPAD SP1 Trainer with a pediatric button. Laypersons were asked to use an AED on a pediatric manikin and informed that activation of a pediatric mode was recommended. ResultsActivation of the pediatric mode was achieved by 0/30 (0%) participants when switching electrodes (Lifepak CRT), 2/30 (7%) participants when using a key (Phillips FR3) and 18/30 (64%) participants when pushing a button (CU Medical SP1) (p < 0.001). The median (interquartile range) time to first shock among those who activated the pediatric mode were 102 (95–107) in the CU Medical SP1 group and 78 (78–78) in the Phillips FR3 group (p = 0.21). Most participants used the anterior-lateral position for electrodes. ConclusionLaypersons’ ability to activate the pediatric mode on AEDs and correctly attach the electrodes was generally poor. More participants were able to activate the pediatric mode by pushing a button when compared to using a key or switching electrodes. Use of the Phillips FR3 AED was associated with faster shock delivery.

The perception of attractiveness of the facial profile among people of Telangana ethnicity

Background: The success of orthodontic treatment to a significant extent is largely dependent on the patient's and lay peoples' perception. Treatment can influence the soft tissue profile of the face, which is why, it is important for orthodontists to perceive what is considered attractive and unattractive amongst locals, and further, incorporate this knowledge in their diagnosis and treatment planning for population-specific groups.Aim: To evaluate differences in perception of attractiveness of the human face (in profile view) among ethnic Telangana subjects when compared to ideal Caucasian facial profile attractiveness standards.Methods: Profile silhouettes of ethnic Telangana subjects with straight, convex and concave facial profiles were rated by 10 adult laypersons (ethnic Telangana origin) and scored from least to most attractive. Fifteen relevant soft-tissue parameters from the Ricketts, Legan-Burstone, Steiner's and Z-Merrifield analysis were then evaluated on lateral cephalometric radiographs of the highest scoring subjects (considered most attractive) and sample t test statistical analysis was done in order to investigate differences between obtained values of the 'attractive' group as compared to standard values given in these analyses.Results: Of 15 parameters compared, significant differences from standard cephalometric values were evident for- vertical lip-chin ratio, lower lip protrusion, mento-labial sulcus and Z- angle. These measurements were smaller in the evaluated population group as compared to orthodontic norms.Conclusion: People of ethnic Telangana origin considered a shorter and less prominent lower lip and chin and a shallower mento-labial sulcus to be more attractive, as compared to standard orthodontic cephalometric norms of Caucasian populations.

Assessment of breathing in cardiac arrest: a randomised controlled trial of three teaching methods among laypersons

BackgroundThe aim of this trial was to compare a video- and a simulation-based teaching method to the conventional lecture-based method, hypothesizing that the video- and simulation-based teaching methods would lead to improved recognition of breathing patterns during cardiac arrest.MethodsIn this Danish, investigator-initiated, stratified, randomised controlled trial, adult laypersons (university students, military conscripts and elderly retirees) participating in European Resuscitation Council Basic Life Support courses were randomised to receive teaching on how to recognise breathing patterns using a lecture- (usual practice), a video-, or a simulation-based teaching method. The primary outcome was recognition of breathing patterns in nine videos of actors simulating normal breathing, no breathing, and agonal breathing (three of each). We analysed outcomes using logistic regression models and present results as odds ratios (ORs) with 95% confidence intervals (CIs) and P-values from likelihood ratio tests.ResultsOne hundred fifty-three participants were included in the analyses from February 2, 2018 through May 21, 2019 and recognition of breathing patterns was statistically significantly different between the teaching methods (P = 0.013). Compared to lecture-based teaching (83% correct answers), both video- (90% correct answers; OR 1.77, 95% CI: 1.19–2.64) and simulation-based teaching (88% correct answers; OR 1.48; 95% CI: 1.01–2.17) led to significantly more correct answers. Video-based teaching was not statistically significantly different compared to simulation-based teaching (OR 1.20; 95% CI: 0.78–1.83).ConclusionVideo- and simulation-based teaching methods led to improved recognition of breathing patterns among laypersons participating in adult Basic Life Support courses compared to the conventional lecture-based teaching method.

How to Read Daniel

How to Read Daniel

Effects of positive dispatcher encouragement on the maintenance of bystander cardiopulmonary resuscitation quality.

Background: Implementation of dispatcher-assisted cardiopulmonary resuscitation (DACPR) has increased the likelihood of bystander CPR upon cardiac arrest. However, the quality of CPR has been found to be very low. In this study, we aimed to compare CPR quality between the current DACPR practices and the interventional instruction of adding verbal encouragement from the dispatcher.Methods: In this randomized controlled trial, we recruited adult (age ≥18) laypersons who were non-health care providers and had never received any previous verified CPR training. They were randomly selected to perform DACPR using metronome sounds (mDACPR) as per the standard protocol, or DACPR with metronome sounds along with human encouragement (mheDACPR). The ratio of accurate compression rate, depth, and complete release for each CPR phase was examined.Results:Sixty nine records (34, mDACPR; 35, mheDACPR) were taken. The median proportion of accurate chest compression rate was initially 29.5% with mDACPR, and significantly increased to 71% after 2 minutes of CPR administration (P = .046). However, the median ratio of accurate chest compression depth was 61.5% in the first phase, and significantly decreased to 0% in the last phase (P < .001). In contrast, for the mheDACPR group, a high accurate compression rate was maintained throughout the 2 minutes of CPR administration (91%, 100%, 100%, 100%).Conclusion: To maintain the quality of CPR administered by bystanders, continuous feedback and repeated human encouragement should be provided during DACPR. Active dispatcher intervention reduces the time required to reach an appropriate CPR rate and allows for the maintenance of accurate compression rates.

Perceptions and Preferences of Laypersons in the Management of Positional Plagiocephaly.

Uncertain clinical evidence for treating positional plagiocephaly, especially with helmet therapy, creates difficulties in counseling parents of patients. This study investigates layperson perceptions and treatment preferences for positional plagiocephaly to provide patient-oriented evidence for management. Adult laypersons were recruited through crowdsourcing to view digitally-modified images of normal, mildly, moderately, or severely plagiocephalic infant heads. Participants provided demographic information and rated the infant's head shape and potential related social difficulties, likelihood of consulting a physician for treatment options, and likelihood of seeking helmeting treatment for the infant. Nine hundred forty-five individuals participated in the study. Perception of head shape, prediction of future embarrassment and social difficulties, likelihood of seeking physician evaluation, likelihood of choosing helmet therapy, and willingness-to-pay for helmet therapy were pairwise-different between 4 plagiocephaly severities (corrected-P < 0.001 for all), except between normocephaly (n = 194) and mild (n = 334) plagiocephaly or between moderate (n = 203) and severe (n = 214) plagiocephaly. Younger respondents were more likely to consult a physician (uncorrected-P = 0.016) and choose helmet therapy (uncorrected-P = 0.004) for infants with normocephaly or mild plagiocephaly. Parents of children with physical disabilities were 6 times as likely as other participants to choose helmet therapy for mild plagiocephaly (corrected-P = 0.036). Laypersons perceived moderate and severe plagiocephaly as equally abnormal and mild plagiocephaly as normal, consistent with their treatment preferences. Parents of physically disabled children were significantly more likely than other participants to choose helmet therapy. Our findings provide medical professionals with lay perspectives on positional plagiocephaly that may facilitate effective counseling of parents.

Communication of Scientific Uncertainty about a Novel Pandemic Health Threat: Ambiguity Aversion and Its Mechanisms

Communicating scientific uncertainty about public health threats is ethically desirable but challenging due to its tendency to promote avoidance of choice options with unknown probabilities—a phenomenon known as “ambiguity aversion.” This study examined this phenomenon’s potential magnitude, its responses to different communication strategies, and its mechanisms. In a factorial experiment, 2701 adult laypersons in Spain read one of three versions of a hypothetical newspaper article describing a pandemic vaccine-preventable disease (VPD), but varying in scientific uncertainty about VPD risk and vaccine effectiveness: No-Uncertainty, Uncertainty, and Normalized-Uncertainty (emphasizing its expected nature). Vaccination intentions were lower for the Uncertainty and Normalized-Uncertainty groups compared to the No-Uncertainty group, consistent with ambiguity aversion; Uncertainty and Normalized-Uncertainty groups did not differ. Ambiguity-averse responses were moderated by health literacy and mediated by perceptions of vaccine effectiveness, VPD likelihood, and VPD severity. Communicating scientific uncertainty about public health threats warrants caution and further research to elucidate its outcomes, mechanisms, and management.

Psychosocial acceptance of cleft patients: has something changed?

The main purpose of this study was to analyse the reactions of a panel (non-cleft adults) when observing cleft lip morphology. Although rehabilitation of cleft lip and palate is improving, there are still indications of social rejection of cleft patients by the people around them. Polarity profiles have been used since 1973 to measure social distance with regard to cleft patients. Because rehabilitation results and education of the society have improved in recent decades, we investigated whether social distance has been affected. The setting of this study is the Department of Oral, Craniomaxillofacial, and Facial Plastic Surgery, University Hospital of Leipzig, Germany Using a cross-sectional study design, we enrolled a sample of adult laypersons (n = 273). For the survey, we followed the concept of photograph presentation and questionnaire investigation reported by Sergl and Schmid (1973). We presented anonymised frontal and profile pictures of the faces of 50 cleft patients and asked the laypersons to specify social distance. Three predictor variables (layperson gender, profession and year of evaluation) were grouped. Although social distance has reduced during the last 40 years, life situations which require emotional proximity still cause some concern. Professional background and gender affect laypersons' attitudes. Although rehabilitation of cleft lip and palate is much better than 40 years ago, social distance remains a problem in society. It is necessary to improve both results of rehabilitation of cleft patients and social acceptance by the people around them.

Is the Truth in Your Words? Distinguishing Children’s Deceptive and Truthful Statements

Children’s (N = 48) and adults’ (N = 28) truthful and deceptive statements were compared using a linguistics-based computer software program. Children (4 to 7 years of age) and adults (18 to 25 years of age) participated in a mock courtroom experiment, in which they were asked to recount either a true or fabricated event. Testimonies were then analyzed using Linguistic Inquiry and Word Count Software (LIWC; Pennebaker et al. 2007). This software has been previously used to detect adults’ deceptive statements (e.g., Bond and Lee, 2005). To date, no research has used this method on children’s narratives, nor has this software been used to compare those narratives to adult counterparts. Markers generated through the LIWC program achieved detection rates of 72.40% for samples of both children’s and adults’ narratives combined. In contrast, adult laypersons’ (N = 48) detection rates, for the same narratives (i.e., both children and adults) were close to chance. More specifically, detection rates were above chance for truth (65.00%) and below chance for lies (45.00%). Thus, the linguistic profile provided through LIWC yielded greater accuracy for evaluating the veracity of children’s and adults’ narratives compared to adult laypersons’ detection accuracy.

Evaluation of Chest Compression Depth during Nine Minutes of Hands-Only Cardiopulmonary Resuscitation Performed by a Lone Rescuer and its Effect by Age Group: A Pilot Simulation Study Using a Manikin

Objective There have been few studies on the use of long-standing hands-only cardiopulmonary resuscitation (CPR) by a lone rescuer. This study aimed to evaluate the long-standing (nine minutes) hands-only CPR by a lone rescuer, and the change of chest compression depth over time. The effect of age of rescuer on chest compression depth was also studied. Methods From a total of 404 adult lay-persons who participated in CPR training, 91 subjects were enrolled in the simulation trial of nine minutes of hands-only CPR using a manikin with a Skill-Reporter™. The quality of the chest compression over time and the effects of rescuer age were analysed. Results Of the 91 participants, 74 (81%) fully completed the nine minutes of CPR. No significant differences of incomplete CPR rate between each age group were observed. No significant differences in the degree of reduction in effective chest compressions were observed based on the time course among the different age groups. The total number of compressions decreased abruptly from the six-minute time point onwards (five minutes vs. six minutes, p=0.038). Conclusions Most trained lay-persons could complete the 9 minutes of hands-only CPR. The rate of chest compression shows a significant decrease after 6 minute. We do not find a significant difference in the decrease of adequate chest compressions over time among various age groups in this pilot simulation study.

Abstract 199: Automated External Defibrillator Awareness and Knowledge Among the Lay Public in a Busy Urban Transportation System

Background: The prompt utilization of automatic external defibrillators (AEDs) by bystanders can greatly improve survival from sudden cardiac arrest occurring in public locations. A recent study of laypersons in a European transportation hub has suggested public knowledge and surrounding AED use is lacking; we sought to confirm and extend these findings in similar settings in the US. We hypothesized that awareness of AEDs and who can use them will be low among the general public. Objectives: To characterize layperson knowledge about AED use and emergency response in a major US metropolitan area transportation system. Methods: A survey instrument was adapted from a prior investigation performed in Europe. Trained survey personnel administered this oral survey (approx. five minute duration) to adult laypersons at two public transportation centers in a large US city during May 2012. The participants were asked questions relating to their knowledge of AEDs and who is permitted to use them, as well as their willingness to utilize an AED in an emergency. Results: Surveys were completed by 222 individuals. Mean age of respondents was 49.4±17.1 y, 44% were female and 25% reported prior CPR training within the past 5 years. When presented with a hypothetical cardiac arrest scenario, 63% said they would call for help and/or dial 911, but only 8% of respondents spontaneously suggested using an AED when prompted for other actions. When an AED was described, 59% of participants were aware that AEDs are available in public places, but only 38% were aware that AEDs can be used by laypersons. When informed regarding the availability for layperson use, 60% of respondents said that they would be willing to use an AED in an emergency situation. Conclusions: Though the majority of layperson respondents were willing to use an AED in an emergency when educated, few respondents considered an AED in their immediate response and the minority were aware that AEDs could be accessed by the general public. Additional broad efforts to educate the US public about AED availability and use should be prioritized.

“Knows what is good and bad”, “Can teach you things”, “Does lots of crosswords”: Children's knowledge about wisdom

Whereas a number of studies have investigated adult laypersons' understanding of the concept of wisdom, children's knowledge about wisdom has not yet been studied. A total of 461 Austrian elementary-school children filled out a questionnaire about wisdom. Results showed an increase in self-reported familiarity with the term “wisdom” from 43.0% in grade 1 to 92.1% in grade 4. Children's open definitions of wisdom as well as their wisdom-typicality judgements of a list of adjectives focused on cognitive aspects, especially fluid intelligence, and social aspects of wisdom, especially friendliness. Aspects involving reflection, such as learning from experience or perspective taking, were seldom mentioned. The frequency with which old age was judged as typical for wisdom increased across grades 1 to 4. Gender differences were mostly found in nominations of wise figures, where boys nominated male figures more often than girls.

Debating Music “Appreciation” outside the American Classroom, 1930–1950

Those teaching to American schoolchildren faced a fissure of sorts during the 1930s and 1940s. On one side of this divide stood Carl Seashore and the educators who embraced his philosophy. They promoted a sometimes arduous form of teaching and believed that the results of this tutelage could be quantitatively assessed. On the other side stood pedagogues influenced by the era's burgeoning learner-centered philosophy, educators who embraced the more individualized and friendly approach advocated by James Mursell and Mabelle Glenn. This well-known binary paradigm was born just as a impulse swept through America. The increasingly popular listening lessons billed as music became not just an aspect of in-school education for children but also a veritable music-appreciation industry targeting adults. It is my contention that the fissure in education, while certainly reflective of specific pedagogical trends and debates, also related to a more basic dialogue about what it meant to appreciate music. In this article, I will connect the Seashore-Mursell/Glenn binary to contemporaneous discourse about the meaning of extracurricular appreciation--discourse that occurred in many musical fields and also affected life across the Atlantic. More importantly, I will demonstrate that this discourse also played out within the pages of music-appreciation literature. This exploration will ultimately show that, while teachers were certainly grappling with new ideas about learner-centered education, this process was also influenced by and reflective of larger skirmishes about the nature of highbrow achievement that accompanied the fervor of the 1930s and 1940s. Debating Appreciation in Middlebrow America and American Schools Some comments about terminology must precede the analysis. While the phrase appreciation was prevalent in several contexts in early twentieth-century America, two uses predominated. On the one hand, schoolteachers often used this descriptor in reference to the era's increasingly popular lessons in listening. On the other hand, the term appreciation was also applied more generally to education offered to the adult layperson. While these two understandings are complex, the terrain of early twentieth-century appreciation is even thornier because there was a good deal of overlap between its curricular and extracurricular varieties. Many instructional books, for example, were written by renowned educators but were nevertheless aimed at both young students and adult laypeople. Nonetheless, terminology must be adopted to help readers make the distinction. I most often employ the phrase education to indicate school teaching (of appreciation, performance, or anything else). The term teachers will also be used in reference to official education within the school. The terms appreciation and education, meanwhile, will generally be used in discussions of the appreciation industry and its wares. Words such as educational and pedagogical will be utilized more generally. Discussion of the term is also needed. As others have chronicled the history of this term (1) and as its negative connotations burgeoned after the period discussed in this article, here I will unpack its meaning only briefly. The term became widely pejorative during the middle of the twentieth century through the writings of authors such as Russell Lynes and Dwight MacDonald. (2) MacDonald is especially important because he arguably brought criticism of the midcult and the middlebrow to new heights. Janice Radway has summarized MacDonald's critique of the Book-of-the-Month Club in a manner that astutely captures his overall perspective: [In 1960] MacDonald railed against the spreading 'tepid ooze of Midcult' and identified the Book-of-the-Month Club and its judges . …

Panel and patient perceptions of nasal aesthetics after secondary cleft rhinoplasty with versus without columellar grafting

Background Cleft-lip nasal deformity alters patient’s self-image, as well as posing unique challenges for the rhinoplastic surgeon. Objectives The main purpose of this study was to compare the panel perceptions of nasal aesthetics following secondary cleft rhinoplasty with versus without caudal septal extension grafting (columella grafting). We also investigated whether patient’s self-assessment and satisfaction correlated with 4 other variables: (1) rhinoplasty techniques; (2) patients’ age; (3) patients’ gender; and (4) panel perceptions. Methods Using a cross-sectional study design, we enrolled a sample of adult laypersons and medical experts. The predictor variable was the rhinoplasty techniques (with/without columellar grafting). The outcome variable was the panel rankings of nasal aesthetics based on the photographs of 50 nonsyndromic cleft patients before and after the rhinoplasty. Other variables included the patient’s subjective assessment and satisfaction, demographic and anatomic variables. Appropriate descriptive, uni- and bivariate statistics were calculated. The significance level was set at P ≤ 0.05 and <0.05 for single- and two-tailed tests of hypothesis, respectively. Results The sample consisted of 507 laypersons and 51 professionals who gave comparative ratings ( P > 0.05). Columellar grafting was associated with higher rankings of postoperative nasal aesthetics ( P = 0.04). Most of the patients (90%) rated positive outcomes. Surgical techniques, patients’ age and gender, and panel perceptions were not individually significantly associated with subjective measures and satisfaction. Conclusions Our results suggest that caudal septal extension grafting improves the nasal aesthetics of the cleft patients, as judged by the panel. Patient’s self-assessment seems unreliable to be used as an outcome measure.

Secondary cleft rhinoplasty rejuvenates the nose: a suggestion from a panel survey

Cleft-lip nasal deformity (CLND) affects the overall facial appearance and attractiveness. The CLND nose shares some features in part with the aging nose. This questionnaire survey examined: 1) the panel perceptions of the role of secondary cleft rhinoplasty in nasal rejuvenation; and 2) the influence of a medical background in cleft care, age and gender of the panel members on the estimated age of the CLND nose. Using a cross-sectional study design, we enrolled a random sample of adult laypersons and health care providers. The predictor variables were secondary cleft rhinoplasty (before/after) and a medical background in cleft care (yes/no). The outcome variable was the estimated age of nose in photographs derived from 8 German nonsyndromic CLND patients. Other study variables included age, gender, and career of the assessors. Appropriate descriptive and univariate statistics were computed, and a P value of <.05 was considered to be statistically significant. The sample consisted of 507 lay volunteers and 51 medical experts (407 [72.9%] were female; mean age ± SD = 24.9 ± 8.2 y). The estimated age of the CLND noses was higher than their real age. The rhinoplasty decreased the estimated age to a statistically significant degree (P < .0001). A medical background, age, and gender of the participants were not individually associated with their votes (P > .05). The results of this study suggest that CLND noses lack youthful appearance. Secondary cleft rhinoplasty rejuvenates the nose and makes it come close to the actual age of the patients.

Adults’ Abilities to Discern Children’s True and False Memories

Adults’ evaluations of children’s eyewitness reports can determine whether legal proceedings are undertaken and whether they ultimately lead to justice. The current study involved 92 undergraduates and 35 adult laypersons who viewed and evaluated videotaped interviews with children. The children’s reports fell into the following categories based on a 2 (event type: true vs. false) X 2 (child report: assent vs. denial) factorial design: Accurate reports, false reports, accurate denials, or false denials. Results revealed that adults were generally better able to correctly judge accurate reports and accurate denials compared to false reports and false denials. Of interest, adults’ ratings of false denials indicated that the adults were, on average, “confident” that the event had not occurred, even though the event had in fact been experienced. Adults’ ratings of false reports were more accurate: Adults were, on average, “somewhat confident” the event had not happened. These results underscore the greater difficulty adults had in evaluating false denials compared to other types of reports. Individual-difference factors (e.g., participants’ age) predicted performance. Implications for legal procedures are discussed.