Laypersons' Assessment of Smile Esthetics in Young Individuals in Ha'il, Saudi Arabia.

INTRODUCTION: When planning esthetic dental treatments, understanding smile preferences is important for dental professionals. This study aimed to evaluate the impact of selected smile characteristics on the attractiveness of young Saudis as assessed by Saudi laypersons and explore gender-preferred changes in smile attractiveness. METHODOLOGY: This observational study assessed the dynamic smile attractiveness of 168 Saudi individuals (84 males and 84 females), selected through non-probability convenience sampling. Dynamic smiles were elicited by viewing comedic content and captured with a camera standardized for consistent positioning. Videos were edited and adjusted to images, and the frames with the most pronounced smiles were chosen. The intra-rater reliability was assessed using intra-class correlation coefficients (ICCs) and Cohen's kappa tests (κ). The highest and lowest 25th percentiles were categorized as attractive and unattractive smiles, respectively, on the visual analog scale (VAS) by laypersons. Six smile characteristics - anterior smile line, smile arc, upper lip curvature, posterior teeth displayed, smile index, and smile symmetry - were quantitatively evaluated from these images for each participant and classified into attractive and unattractive groups based on laypersons' VAS evaluations. Continuous variables were tested with the Mann-Whitney U test, and for the categorical variables, the Chi-square test was applied. The significance was set at 5%. RESULTS:  The four randomly selected out of the 22 raters had good VAS reliability; ICCs varied from 0.661 to 0.94, with an average of 0.737, and Cohen's kappa tests for smile characteristics showed values from 0.617 to 0.89. Good agreement was also found with the smile index, with ICCs of 0.775, and dynamic smile symmetry, with ICCs of 0.872. Laypersons rated female smiles as more attractive compared to male smiles (P = 0.004). Low or average anterior smile lines (P = 0.001 for males; P = 0.03 for females), parallel smile arcs (P = 0.001 for males; P = 0.02 for females), and higher smile indexes (P = 0.001 for males; P = 0.004 for females) were significantly attractive, showing no significant gender differences.  Conclusions: Laypersons reliably rated the young Saudis' dynamic smiles as attractive. Of the rated smile characteristics, those with a low or average anterior smile line, parallel smile arcs, and a larger smile index were deemed more attractive. This study's findings show no significant gender differences in the impact of the studied smile characteristics on attractiveness. This study's findings can help dental professionals customize treatment plans that meet patients' expectations.

Perceptibility and acceptability of lightness difference of a single maxillary central incisor.

OBJECTIVES: The aim of this study was to assess the lightness difference perceptibility and acceptability thresholds, for a single maxillary central incisor, and to investigate possible differences in these thresholds regarding the direction (+ΔL* vs. -ΔL*), the observer group (dentists vs. laypersons), and the gender and age of the observers. MATERIALS AND METHODS: A series of images with varying lightness (L*), were created by altering the right maxillary central incisor of a male Caucasian, on a frontal view full-portrait image. Digital modification of one central incisor by 1 ΔL* unit resulted in 15 different images: one control, seven with increased and seven with decreased lightness. The images were presented in random order, on a digitally calibrated monitor, to 158 observers, grouped into 79 dentists, and 79 laypersons, who were asked to evaluate every image and answer whether they perceive a difference and if yes, whether they accept this difference. A multifactorial analysis of covariance was performed to analyze the perception and acceptance of any difference in the central incisors and to estimate the thresholds. The statistical significance level was α = 0.05. RESULTS: Overall, the magnitude of ΔL*, direction of ΔL*, observer group and age were each significant (p < 0.001), as was gender (p = 0.03). The effect of the magnitude of ΔL* interacted with its direction and the observer group (p = 0.045), and the effect of age interacted with the direction of ΔL*, and the gender and the group of the observers. Estimated 50%:50% perceptibility thresholds ranged from 0.1 to 2.7, and 50%:50% acceptability thresholds ranged from 2.3 to 4.5. Overall, dentists perceived lightness differences at lower magnitudes than laypersons; difference in lightness was perceived and accepted at lower magnitudes when the tooth become lighter instead of darker; and female observers perceived and accepted lightness differences at lower magnitudes compared to males. As age increased overall, differences of lightness were perceived and accepted at higher magnitudes. CONCLUSIONS: Perceptibility and acceptability of lightness differences of a single maxillary central incisor are affected by the magnitude and the direction of lightness change, as well as the gender, the age, and the type of the observers. CLINICAL SIGNIFICANCE: Even small changes in lightness are perceivable; however, thresholds of perception and acceptance are dependent on the magnitude and the direction of change and are also dependent on the observer, with women, dentists and younger people perceiving and accepting changes at lower magnitudes of ΔL*.

The effect of standalone audio-visual feedback devices on the quality of chest compressions during laypersons' cardiopulmonary resuscitation training: a systematic review and meta-analysis.

AIMS: Individual studies that investigated the effect of standalone audio-visual feedback (AVF) devices during laypersons' cardiopulmonary resuscitation (CPR) training have yielded conflicting results. This review aimed to evaluate the effect of standalone AVF devices on the quality of chest compressions during laypersons' CPR training. METHOD AND RESULT: Randomized controlled trials of simulation studies recruiting participants without actual patient CPR experience were included. The intervention evaluated was the quality of chest compressions with standalone AVF devices vs. without AVF devices. Databases, such as PubMed, Cochrane Central, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and PsycINFO, were searched from January 2010 to January 2022. The risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis alongside a narrative synthesis was used for examining the effect of standalone AVF devices.Sixteen studies were selected for this systematic review. A meta-analysis revealed an increased compression depth of 2.22 mm [95% CI (Confidence Interval), 0.88-3.55, P = 0.001] when participants performed CPR using the feedback devices. Besides, AVF devices enabled laypersons to deliver compression rates closer to the recommended range of 100-120 per min. No improvement was noted in chest recoil and hand positioning when participants used standalone AVF devices. CONCLUSION: The quality of the included studies was variable, and different standalone AVF devices were used. Standalone AVF devices were instrumental in guiding laypersons to deliver deeper compressions without compromising the quality of compression rates. However, the devices did not improve the quality of chest recoil and placement of the hands. REGISTRATION: PROSPERO: CRD42020205754.

Effectiveness of blended learning basic life support module on knowledge and skills: A systematic review of randomized controlled trials.

Aim: To examine the effectiveness of the BLS blended learning module on knowledge and skills of BLS compared to the traditional module. Method: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were utilized using key words to searched PubMed, Web of Science, and Cochrane Library for the studies published between January 2018 to May 2022. The risk of bias was assessed utilizing the Joanna Briggs Institute (JBI) critical appraisal checklist. Two reviewers separately extracted data from the included trials using a standardized data extraction form. Results: From 400 articles retrieved by the initial search, 11 studies were found to be eligible. Most studies' participants were laypersons (80.9 %), and the rest were either nursing (12.6 %) or medical students (6.5 %). The review shows superiority of utilizing the blended strategy in applying the BLS module in skills and knowledge retention, rather than using the traditional learning, which could improve the quality and outcomes of patients. Conclusions: Blended learning is effective in teaching BLS like the traditional face-to-face method, but more advantages of the blended learning module include improvement in retaining knowledge, skills acquisition, patient outcomes, and cost saving. The COVID-19 pandemic made blended learning crucial and using this method in BLS was effective and efficient. Future research to assess the effectiveness of blended learning on patient outcomes is recommended.

The Power Is in the Word-Do Laypeople Interpret Descriptors of Dog Emotional States Correctly?

A basic understanding of dog behaviour and emotion is relevant not only for professionals, such as veterinary personnel or dog trainers, but also for dog owners and for people with little contact with dogs. Information about dog behaviour and emotions is mostly conveyed verbally. This study explores whether definitions of dog behaviour and emotion are understood in such a way that they can be allocated to a descriptor (i.e., a label such as "fearful"), even by people with low background knowledge. If people can match descriptors to definitions, this suggests that the definitions are distinct enough and elicit mental representations of behaviour that can fit the label. Good agreement on the definitions is a prerequisite for the validity of the descriptors used; however, no study to date has tested this. A sample of 236 adults was asked to match descriptors of Qualitative Behaviour Assessment (QBA) for veterinary and shelter situations to their correct definitions, e.g., the descriptor "fearful" to its definition "dog may try to flee, hide or freeze; ears back". Matching was substantially above chance; nonetheless, the mean proportion of correct responses was only 50% (SD ± 16.6%) for the veterinary QBA set and 33% (SD ± 14.3%) for the shelter QBA set. Performance in the matching task was positively correlated with measures of experience with dogs. Taken together, the results suggest that descriptor-definition pairs used to describe dog behaviour need to be clearly defined to avoid misinterpretations when teaching laypeople how to interpret canine behaviour.

Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis.

Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, "(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists)." Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis (p < 0.05) after being sub-grouped into "Opening vs. Closure" and "No remodeling vs. Dental remodeling vs. Dental and gingival remodeling" groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided.

Comparative evaluation of nasolabial appearance of unilateral cleft lip and palate patients by professional, patient and layperson using 2 aesthetic scoring systems: A cross sectional study.

OBJECTIVE: To compare the perspective of healthcare providers (orthodontists), cleft patients and laypersons in judging nasolabial aesthetics in patients with complete unilateral cleft lip, with or without cleft palate (UCL ± P) using 2 scoring systems. DESIGN: This cross-sectional study was conducted in a tertiary care government hospital. PATIENTS: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years (mean age-12.2 ± 3.93 years) were included in this study. METHOD: Photographic records of 100 patients with complete UCL ± P from the age group of 5-18 years were included. A panel of 3 orthodontists, 3 laypersons and 3 cleft patients rated nasolabial aesthetics using 2 scoring systems i.e. Asher-McDade index (AMAI) and Cleft Aesthetic Rating Scale (CARS). Spearman's split-half reliability, Intra-class correlation coefficient and Cronbach's alpha were computed to measure internal consistency and reliability. Inter-panel agreement between pair of groups was determined by means of Spearman correlation coefficient. RESULTS: Estimated reliability of CARS for 3 raters in each panel was in moderate agreement for orthodontists and cleft patients (0.849 and 0.810). Good repeatability and agreement were recorded with moderate to high intra-panel reliability for all parameters of both AMAI and CARS. Overall inter-panel agreement was moderate for both AMAI and CARS. Pair-wise inter-panel agreement showed a moderately positive correlation in both scales (AMAI and CARS) by cleft patients and professionals. CONCLUSION: CARS index can be reliably used for assessment of nasolabial aesthetics by cleft patients, professionals and lay persons on 2D facial photographs. Patients were more critical than clinicians and laypersons using both indices (CARS and AMAI) as they are more self-aware and conscious. Thus, a clear communication between clinician and patient regarding expectations, perception and satisfaction with surgical results is strongly recommended.

Strengthening Altitude Knowledge: A Delphi Study to Define Minimum Knowledge of Altitude Illness for Laypersons Traveling to High Altitude.

Berendsen, Remco R., Peter Bärtsch, Buddha Basnyat, Marc Moritz Berger, Peter Hackett, Andrew M. Luks, Jean-Paul Richalet, Ken Zafren, Bengt Kayser, and the STAK Plenary Group. Strengthening altitude knowledge: a Delphi study to define minimum knowledge of altitude illness for laypersons traveling to high altitude. High Alt Med Biol. 23:330-337, 2022. Introduction: A lack of knowledge among laypersons about the hazards of high-altitude exposure contributes to morbidity and mortality from acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE) among high-altitude travelers. There are guidelines regarding the recognition, prevention, and treatment of acute-altitude illness for experts, but essential knowledge for laypersons traveling to high altitudes has not been defined. We sought expert consensus on the essential knowledge required for people planning to travel to high altitudes. Methods: The Delphi method was used. The panel consisted of two moderators, a core expert group and a plenary expert group. The moderators made a preliminary list of statements defining the desired minimum knowledge for laypersons traveling to high altitudes, based on the relevant literature. These preliminary statements were then reviewed, supplemented, and modified by a core expert group. A list of 33 statements was then presented to a plenary group of experts in successive rounds. Results: It took three rounds to reach a consensus. Of the 10 core experts invited, 7 completed all the rounds. Of the 76 plenary experts, 41 (54%) participated in Round 1, and of these 41 a total of 32 (78%) experts completed all three rounds. The final list contained 28 statements in 5 categories (altitude physiology, sleeping at altitude, AMS, HACE, and HAPE). This list represents an expert consensus on the desired minimum knowledge for laypersons planning high-altitude travel. Conclusion: Using the Delphi method, the STrengthening Altitude Knowledge initiative yielded a set of 28 statements representing essential learning objectives for laypersons who plan to travel to high altitudes. This list could be used to develop educational interventions.

The Influence of Gingival Exposure on Smile Attractiveness as Perceived by Dentists and Laypersons.

Background and Objectives: Smile is an important mark of beauty, and smile attractiveness can be influenced by various factors, one of these being the amount of gingival exposure. The aim of this research was to evaluate the perception of an ideal gingival exposure in smile in a sample of Romanian dentists and laypersons, and to find out what is the most important aspect that influences the smile perception for the respondents included in the study sample. Materials and Methods: An online survey was conducted between 3 February 2020 and 31 October 2020. The authors developed a short questionnaire consisting of 7 items. The first four items investigated the respondents' age, gender, profession and whether or not they underwent an orthodontic treatment in the past. For items 5 and 6, participants had to choose the most and the least attractive amount of gingival exposure, and for the last item they had to choose the factor that mostly influences the smile attractiveness in their opinion. Results: 235 questionnaires remained in the study. The sample consisted of 194 women and 41 men, 162 laypersons and 73 dentists. The average value for the most attractive amount of gingival exposure was −0.57 ± 2.407 mm, with a median value of 0 mm while the average value for the least attractive amount of gingival exposure was 1.43 ± 3.785 mm, with a median value of 4 mm. The differences between the most or least attractive gingival exposure perceived by the participants were not significant according to gender or professional category (p > 0.05), but, when compared between having or not having an orthodontic treatment in the past the differences were statistically significant (p < 0.05). As such, participants who had an orthodontic treatment in the past perceived a significantly higher value for the most attractive gingival exposure, and a significantly higher value for the least attractive gingival exposure (p = 0.026) than the participants who didn't have an orthodontic treatment in the past. As for the factor that mainly influences smile attractiveness, laypersons chose significantly more frequent white teeth or aligned teeth (96%, 71.7%) while dentists chose significantly more frequent a gingival exposure between 0−3 mm (70.4%) as smile factors for an aesthetic smile (p < 0.001). Conclusions: In this study sample, the respondents considered that the most attractive smile involved a covering of 0.57 mm (in average) of the upper incisors by the upper lip. Although smile attractiveness did not appear to be influenced by gender or profession in this study population, it was influenced by previous orthodontic treatment. The participants' roles of dentist or layperson influenced the factors chosen for an aesthetic smile.

African Swine Fever Outbreak Investigations-The Significance of Disease-Related Anecdotal Information Coming from Laypersons.

Veterinarians who have conducted numerous investigations of African swine fever outbreaks in pig farms in various European countries over the years shared their experiences during a workshop in Germany in early 2020. One focus was on the so-called "anecdotal information" obtained from farmers, farm workers or other lay people during the outbreak investigations. Discussions revolved around how to correctly interpret and classify such information and how the subjective character of the statements can influence follow-up examinations. The statements of the lay persons were grouped into three categories according to their plausibility: (i) statements that were plausible and prompted further investigation, (ii) statements that were not plausible and could therefore be ignored, and (iii) statements that were rather implausible but should not be ignored completely. The easiest to deal with were statements that could be classified without doubt as important and very plausible and statements that were not plausible at all. Particularly difficult to assess were statements that had a certain plausibility and could not be immediately dismissed out of hand. We aim to show that during outbreak investigations, one is confronted with human subjective stories that are difficult to interpret but still important to understand the overall picture. Here, we present and briefly discuss an arbitrary selection of reports made by lay persons during outbreak investigations.

The Impact of Dental Midline on Asymmetric Faces: Perspective of Laypersons and Dentists.

BACKGROUND: The objective was to determine if asymmetric facial features, nasal and chin deviations, affect the perception of attractiveness of a dental midline angulation, and if it is consistent among both dentists and laypeople. It was also analyzed if factors, such as the sex, age group of the participants and the dentist's area of operation are relevant in their assessment. METHODS: A cross-sectional study, approved by the Ethics Committee of Fernando Pessoa University. From a symmetrical facial model (SFM) image, a natural-looking asymmetrical face was created. Based on this asymmetric facial model six images were created, with different directions and degrees of inclination of the dental midline. In total, 236 laypersons and 242 dentists completed the online questionnaire where they rated the self-perception of attractiveness of the eight images (VAS scale from 0 to 10). Non-parametric comparisons (IBM© SPSS Statistics vs. 27.0, p < 0.05). RESULTS: The results showed a significant difference in the perception of attractiveness between laypeople and dentists. This finding was consistent regarding every image, except for the SFM. The factors, sex of the people participating and dentist's area of operation, seemed only to contribute to a significant difference in the perception when it came to the SFM. The perceived attractiveness of the images, for dentists and laypersons, did not differ by age group of the participant, apart from images 6 and 8. CONCLUSIONS: Dentists are more rigorous about dental midline inclinations than laypersons. The perception of attractiveness was affected by the age group and sex of the participants and the dentist's area of operation.

Aesthetic evaluation of the labiolingual position of maxillary lateral incisors by orthodontists and laypersons.

BACKGROUND: The maxillary anterior teeth play a crucial role in smile aesthetics. Previous studies regarding the importance of maxillary lateral incisors for smile aesthetics concentrated on their size, incisor edge level, and inclination, etc. However, the aesthetic effect of lateral incisor movement in the spatial position has not been studied yet. Therefore, the purpose of this study was to explore the influence of the labiolingual position of maxillary lateral incisors on the aesthetic perception of smiles by orthodontists and laypersons, as well as analyze differences in this perception between male and female raters. METHODS: A three-dimensional (3D) dental model was generated from the photograph of a man's smile using iOrtho7.0 software (Time Angel, Wuxi, China). Based on this model, seven images were generated with different labiolingual positions of the maxillary lateral incisors in 0.5 mm increments (+ indicating labial translation, and-indicating lingual translation). The images were evaluated by 86 orthodontists and 161 laypersons using a visual analog scale, with lower scores indicating less attractiveness. Data were analyzed using Student's t test and one-way analysis of variance with post hoc test. RESULTS: There was no significant difference in smile ratings by males and females. Orthodontists assigned lower scores to all images than laypersons. The smile at + 1.5 mm was considered the least attractive by orthodontists, while smiles at + 1.5 mm and - 1.5 mm were regarded as the least attractive by laypersons. The smile at 0 mm was evaluated as the most attractive by all raters. Laypersons gave different scores to smiles at 0 or - 0.5 mm, but orthodontists did not. CONCLUSIONS: The labiolingual position of maxillary lateral incisors does affect the perception of smile aesthetics. Orthodontists may rate smile aesthetics more critically than laypersons. Therefore, communication and discussion between orthodontists and patients is needed to achieve better therapeutic and aesthetic outcomes.

Correlation between facial attractiveness and facial components assessed by laypersons and orthodontists.

BACKGROUND/PURPOSE: Relationship between facial attractiveness and facial components is not completely clear. The aim was to analyze the correlation between facial attractiveness and facial components assessed by laypersons and orthodontists. MATERIALS AND METHODS: The attractiveness of 100 adult patients (50 males and 50 females with their frontal, lateral, and frontal smiling photos), before orthodontic treatment, was assessed by 24 laypersons and 24 orthodontists using visual analog scale. Pearson correlation coefficient and stepwise regression were used for statistical analysis. RESULTS: When laypersons assessed, a significant correlation was found between facial attractiveness and the chin (r = 0.671), eyes (r = 0.669), lips (r = 0.585), hair (r = 0.527), teeth (r = 0.338), and nose (r = 0.247); the chin was responsible for 45.1% of the variation in facial attractiveness, the eyes for 14.3%, and the lips for 0.8%. When orthodontists assessed, a significant correlation was found between facial attractiveness and the lips (r = 0.789), eyes (r = 0.646), hair (r = 0.613), chin (r = 0.565), nose (r = 0.264), and teeth (r = 0.221); the lips were responsible for 62.2% of the variation in facial attractiveness, the eyes for 8.2%, the chin for 1.4%, and the hair for 0.5%. CONCLUSION: When laypersons evaluate, the chin contributes the most to facial attractiveness, and when orthodontists evaluate, the lips contribute the most. Whether in the evaluation of laypersons or orthodontists, the contribution of teeth to facial attractiveness is significantly less than that of the lips and chin.

Assessing knowledge and skills of laypersons bringing victims of road traffic collisions to Queen Elizabeth Central Hospital in Blantyre, Malawi.

In Malawi, pre-hospital care assistance is mainly provided by laypersons who witnessed the event. The aim of our study was to determine the knowledge and skills of such persons who bring victims of road traffic crashes to hospital. The study was conducted at Adult Emergency and Trauma Centre at Queen Elizabeth Central Hospital in Blantyre, Malawi. A total of 392 participants were interviewed. Most were merchants (22%) and unskilled labourers (14.5%). Three quarters (75.8%) provided assistance on the scene. The most common assistance provided was transporting victim to the hospital (68.7%), assisting with safe lifting (57.9%) and calling for help (39.7%). Airway protection was provided by only 1% of participants. Therefore, it is recommended to establish some formal pre-hospital assistance to reduce morbidity and mortality from road traffic crashes. Laypersons, especially merchants, students and drivers are potential strong first responders, and training them may help improve pre-hospital care outcome.

Perception of Dental Students and Laypersons to Altered Dentofacial Aesthetics.

AIMS AND OBJECTIVES: The aims of the study were to comprehensively assess the perception of altered dentofacial aesthetics between dental students and laypersons and to identify the threshold where different variables such gender and clinical training impair dentofacial attractiveness. MATERIALS AND METHODS: Ten photographs were digitally manipulated involving three facial, two smile, four dental, and one gingival components. Fifty images were randomized and rated according to attractiveness by two groups dental students which subdivided into preclinical students and clinical students, and laypersons. The participants evaluated the original and manipulated images using a visual analog scale. The responses were then analyzed using Mann-Whitney U test. RESULTS: The results showed threshold levels of noticeable differences between varying levels of discrepancy. The overall perception of aesthetics was high among dental clinical students with the highest perception toward facial profile and the lowest toward gingival margin height. Of the respondents, no differences were found in the perception between male and female participants. Dental students perceived aesthetic components more accurately than laypersons. CONCLUSION: Dental students group had a better perception of dentofacial aesthetics than included laypersons. Unlike gender, clinical training has a substantial positive effect on the assessment of beauty. Dental students sub divided into dental preclinical students and dental clinical students (clinical training is a variable of all subgroups).

Evaluation of nasolabial aesthetics by different groups in operated unilateral cleft lip and palate.

AIM: The aim of this study is to evaluate and to compare the perception of nasolabial aesthetic by experienced professionals, inexperienced professionals, cleft patients and laypersons in children with unilateral cleft lip and palate (UCLP) using the Asher-McDade Scoring System. MATERIALS AND METHODS: In this retrospective study, 75 patients who applied to Ege University, Faculty of Dentistry, Department of Orthodontics and whose primary surgery operations were completed in Ege University, Faculty of Medicine Department of Plastic and Reconstructive Surgery, were evaluated from the extra-oral and profile photographs. All photographs were arranged according to Asher-McDade Scoring System and evaluated by 4 different groups. 5 people were evaluated in each group consisting of experienced professionals, inexperienced professionals, cleft patients and the laypersons. Nasal form, nasal deviation, vermilion border and nasal profile were evaluated in 5 different categories according to Asher-McDade Scoring System. Statistical analyzes were performed using STATA 11 and MEDCALC software. G Power, Fleiss Kappa, Weighted Kappa and Friedman statistical analyzes were performed for determination of number of individuals, interobserver and intraobserver reliability and comparison of scoring between groups, respectively. RESULTS: In this study, the interobserver agreement was found to be between 0.75 and 0.80 that shows a high degree of reliability. In the comparision made between the groups; experienced professionals and inexperienced professionals; there was moderate agreement in nasal profile scoring (WK 0.2857) (-0.9673/0.6596). There was agreement between experienced professionals and cleft patients in mostly vermilion border (WK 0.5454) (-0.1643/1.0000). There was no agreement between vermilion border between inexperienced professionals and cleft patients (WK 0.9230) (-1.0000/-0.2878), and compliance with the nasal profile mostly (WK 0.5454) (-0.1643/1.0000). There was a similar insignificant agreement between experienced and inexperienced professionals, cleft patients among the laypersons, at all values (WK 0,0000) (-0.0000/0.0000). According to the scoring results of the photographs for experienced professionals; nasal form, nasal deviation, vermilion border and nasal profile were evaluated as bad and close the bad (4.00±0.00, 3.80±0.44, 3.80±0.44, 3.60±0.54); it was found fair and near the bad for inexperienced professionals (3.00±0.00, 3.00±0.00, 3.40±0.54 3.20±0.44) and close the bad for cleft patients (3.60±0.54, 3.80±0.44, 3.80±0.44, 3.40±0.54). But it was found to be acceptable and good for laypersons (2.00±0.00, 2.00±0.00, 2.40±0.54, 1.40±0.54). Laypersons showed statistically significant difference in the evaluation of nasal form, nasal deviation and nasal profile from the cleft patients (P<0.05), while they showed statistically significant difference in all the score from the experienced professionals (P<0.05, P<0.01). CONCLUSION: The aesthetic appearance of nasolabial region is one of the important tools to evaluate the success of the treatment in patients with CLP. The success of primary surgery has one of the most important effects for nasolabial aesthetics on patients with clefts. As a result of the study, the evaluation of cleft patients was found to be similar to that of experienced professionals and lower than that of inexperienced professionals and the laypersons. This result shows us that patients with CLP have higher awareness of self-perception, but these patients may have psychosocial problems ranging from low self-esteem to social isolation risk.

Laypersons' perception of common cold and influenza prevention-a qualitative study in Austria, Belgium and Croatia.

Background: Common cold and influenza result in an increased number of primary care consultations, significant work/school absences and cause a socio-economic burden. Laypeople's perceptions and knowledge regarding common cold and influenza prevention is poorly understood and under-researched.Objectives: Our study explores laypeople's knowledge of prevention of common cold and influenza across three European countries. Furthermore, it investigates if there is any distinction between prevention activities focussing on reasons impacting the attitude towards influenza vaccination as well as investigating cross-country variation.Methods: In total, 85 semi-structured individual interviews were performed across three European countries (Austria n = 31, Belgium n = 30, Croatia n = 24). Qualitative thematic content analysis was performed.Results: Most participants across all three countries made no distinction between the prevention of the common cold and influenza and referenced the same preventative measures for both conditions. They mainly expressed negative attitudes towards influenza vaccination possibly effective but only intended for high-risk groups (bedridden/older people, chronic patients or health workers). There were very few cross-country differences in results.Conclusion: The perception of health risk of contracting influenza and a primary healthcare physicians' recommendation played an important role in shaping participants' decisions towards vaccination. Primary healthcare physicians are invited to assess and if necessary adjust inappropriate prevention behaviour through their everyday patient consultations as well as add to the knowledge about influenza severity and influenza vaccination benefits to their patients.

The Views of Health Care Professionals and Laypersons Concerning the Relevance of Health-Related Behaviors in Prioritizing Patients.

This article aims to investigate to what extent health care professionals in Portugal find health-related behaviors relevant as a criterion to priority setting, to study what type of risk behavior they consider relevant in such decisions and to compare their views with those of laypersons. An online questionnaire was used to collect data from a sample of 178 health care professionals and 295 laypersons. The statistical analysis was performed through the application of generalized linear models and logistic regressions. Health professionals consider more than laypersons that information about health-related behaviors is relevant in prioritization between individuals. Both groups regard information about illegal drug abuse, excessive alcohol consumption, and smoking more important to priority setting decisions than information about overweight or lack of physical exercise. The findings are important for the definition of rationing policies as the professionals' decisions are those that, ultimately, influence health expenditure.

Perception of smile attractiveness among orthodontists, restorative dentists, and laypersons in Saudi Arabia.

BACKGROUND: A smile is defined as a universal welcome. The perception of smile attractiveness is affected by the persons' social background and their own experiences. The existing literature states that orthodontists, restorative dentists, and laypersons have different opinions. AIMS: The aim of this study is to compare the perception of orthodontists, restorative dentists, and laypersons regarding smile esthetics. MATERIALS AND METHODS: A survey-based study was conducted. The target population was orthodontists, restorative dentists, and laypersons in Saudi Arabia. An electronic survey that included digitally altered photographs representing different smile parameters was designed by an Adobe Photoshop Certified Expert. Participants were asked to choose the most attractive smile in each question. RESULTS: Unilateral changes in the width or length of the central incisors were the least attractive among the three groups. About 38%, 48%, and 41% of the participating orthodontics, restorative dentists, and laypersons, respectively, found that wider buccal corridors were more attractive. Moreover, 27% of the laypersons found the reversed smile arc to be attractive. CONCLUSION: The tolerance level in evaluating the asymmetry and the width of the buccal corridors was similar for the three groups. Laypersons were less sensitive to the deviations from the ideal in the smile arc and the amount of lower lip coverage of the incisors. CLINICAL SIGNIFICANCE: Understanding the differences in the perception of smile attractiveness among orthodontists, restorative dentists and laypersons will undoubtedly be beneficial in diagnosis, setting treatment objectives and treatment planning.

Stigmatizing attitudes toward persons with psoriasis among laypersons and medical students.

BACKGROUND: Perceived stigma among patients with psoriasis contributes to poor quality of life. OBJECTIVE: To determine the prevalence and predictors of stigmatizing attitudes toward persons with psoriasis among laypersons and medical trainees. METHODS: Laypersons were recruited from Amazon.com's Mechanical Turk (MTurk) (n = 198). Additionally, 187 medical students were recruited via e-mail. Participants completed an online survey in which they viewed images of persons with visible psoriasis. Participants reported their desire to socially avoid the persons in the images, their emotional responses to the persons in the images, and their endorsement of psoriasis-related stereotypes and myths. RESULTS: MTurk participants endorsed social avoidance items such as not wanting to shake hands with (39.4%) or have the persons in the images in their home (32.3%). Participants stereotyped persons with psoriasis as contagious (27.3%) and endorsed the myth that psoriasis is not a serious disease (26.8%). Linear regression analyses showed that having heard of or knowing someone with psoriasis predicted fewer stigmatizing attitudes (P < .05). The medical students reported less stigmatizing attitudes than the MTurk participants (P < .01). LIMITATIONS: Self-report, single-institution study. CONCLUSION: Stigmatizing views of persons with psoriasis are prevalent among people in the United States. Educational campaigns for the public and medical trainees may reduce stigma toward persons with psoriasis.