Search

Background: As the COVID-19 pandemic began, wellness leadership at a large Mid-west public university anticipated an increase in mental health problems among faculty and staff. A two-part weekly webinar series entitled "Staying Calm and Well in the Midst of the COVID-19 Storm" was launched to assist faculty and staff in coping with stressful issues related to the pandemic and enhancing their well-being. This series provided the university community with evidence-based knowledge, skills, and resources to enhance their ability in taking good self-care. Aim: To assess participant mental health outcomes during the two-part mental health and well-being educational webinar series over time. Methods: A longitudinal outcomes evaluation was conducted. Evaluation data was obtained from the participants via an anonymous post-webinar survey, which included questions from the Patient-Health Questionnaire-4 (PHQ-4) to assess symptoms of anxiety and depression. The first series was conducted over the course of 8 weeks and the second series took place over 7 weeks. Descriptive statistics were used to assess responses to the PHQ-4 over time to evaluate outcomes of the webinar series. An open-ended question also asked participants about the 2 to 3 biggest concerns and worries they had at that moment. Results: The average amount of survey responses received were 1,470.25 (SD = ± 240.3) for Series One and 926.4 (SD = ± 164.3) for Series Two. Ninety-five percent of participants put the skills they learned during both series into practice. When participants reported experiencing anxiety or depressive symptoms, they most frequently reported experiencing them several days a week. The number of participants reporting no depressive or anxiety symptoms increased as the webinar series progressed over time. The types of concerns and worries reported varied across time. Conclusion: The Staying Calm and Well During the COVID-19 Pandemic webinar participants had a reduction in symptoms associated with anxiety and depression after completing the series.

Introduction:While the efficacy and guidelines for implementation of rapid response systems are well established, limited information exists about rapid response paradigms for paediatric cardiac patients despite their unique pathophysiology.Methods:With endorsement from the Paediatric Cardiac Intensive Care Society, we designed and implemented a web-based survey of paediatric cardiac and multidisciplinary ICU medical directors in the United States of America and Canada to better understand paediatric cardiac rapid response practices.Results:Sixty-five (52%) of 125 centres responded. Seventy-one per cent of centres had ∼300 non-ICU beds and 71% had dedicated cardiac ICUs. To respond to cardiac patients, dedicated cardiac rapid response teams were utilised in 29% of all centres (39% and 5% in centres with and without dedicated cardiac ICUs, respectively) [p = 0.006]. Early warning scores were utilised in 62% of centres. Only 31% reported that rapid response teams received specialised training. Transfers to ICU were higher for cardiac (73%) compared to generalised rapid response events (54%). The monitoring and reassessment of patients not transferred to ICU after the rapid response was variable. Cardiac and respiratory arrests outside the ICU were infrequent. Only 29% of centres formally appraise critical deterioration events (need for ventilation and/or inotropes post-rapid response) and 34% perform post-event debriefs.Conclusion:Paediatric cardiac rapid response practices are variable and dedicated paediatric cardiac rapid response systems are infrequent in the United States of America and Canada. Opportunity exists to delineate best practices for paediatric cardiac rapid response and standardise practices for activation, training, patient monitoring post-rapid response events, and outcomes evaluation.

Background Facial nerve injury after facelift is rare; hence, its treatment is poorly established. Botulinum toxin type A (BTXA) can be employed to resolve the asymmetry. To our knowledge, there is no protocol in the literature about the best timing for this treatment, injection sites, or recommended dose. Objectives The authors sought to propose a protocol to guide the management of asymmetries post-facelift. Methods Fifteen patients with post-rhytidectomy facial palsies were treated in the non-paralyzed side with BTXA. After analysis of the smile deviation vectors, it is possible to identify the muscles that should be treated. The dose varied from 1 to 2 volume-unit per point. Patients were examined after 15 days for outcomes evaluation and touch-up if needed. Patients were re-treated after 5 to 6 months in case of asymmetry recurrence. Results Symmetry was achieved in all cases. Six patients had definitive nerve lesions and required treatment every 6 months after the first session. Five patients had lesions affecting the upper third of the face; 4 of them were definitive nerve lesions. Two of the 4 patients who were treated less than 2 weeks after surgery recovered early from the post-facelift paralysis and developed reversed asymmetry due to the BTXA. In 7 patients, the post-facelift asymmetry was due to neuropraxis: the recovery from the nerve injury and BTXA treatment occurred symmetrically on both sides of the face in the following months after 1 single session. Conclusions Asymmetries post-facelift were successfully managed with the proposed protocol. The best time for injection was 2 to 4 weeks after surgery. Level of Evidence: 4

OBJECTIVE: The purpose of this review is to highlight critical advances and innovative approaches to the most challenging clinical situations in congenital heart surgery, to establish a new perspective from which to evaluate current clinical practice patterns and contemporary United States program ranking systems. BACKGROUND: The past decades have witnessed substantial advances in the treatment of congenital heart defects. New strategies are deeply rooted in calculated risk-taking innovations. Pioneer surgeons developed, improved and refined critical operative skills and techniques to optimize cardiovascular physiology, decrease operative mortality and improve clinical outcomes. METHODS: Unfortunately, in the modern surgical era, supportive environments to allow surgeons to make similar gains and innovative contributions remain scarce. In the current practice, overall procedure volume is prioritized to safeguard quality metrics, including hospital survival and length of stay, surgical complications, and neurocognitive outcomes. As a result, exceptional surgical results have become translated and defined by public ranking systems such as the US News and World Report Best Children’s Hospital National Ranking (USNWR) and the Congenital Heart Surgery Database of the Society for Thoracic Surgeons (CHSD-STS), primary based upon early post-operative mortality. This reality places surgeons in a vulnerable position where pressure to achieve a high clinical ranking contrasts with a surgeon definition of “acceptable” surgical risk. Currently, the most frequently used risk stratification tools do not factor in important differences in strategies, such as staged palliation versus complete repair, or bi-ventricular versus uni-ventricular physiology. This favors hospitals pursuing multistage surgical approaches, even if the result is worse long-term morbidity, mortality and increased resource utilization. This economy of ranking-based decision-making causes surgeons either avoid operating altogether or accept less advantageous multi-staged treatment strategies for patients with elevated expected mortality. Such an environment also might present much farther-reaching negative impacts on the growth and development of junior surgeons and trainees, as well as on the pursuit of new surgical innovations to aid future generations of patients. CONCLUSIONS: Risk aversive surgical behavior is creating an environment not favorable for the children born with truly complex congenital heart defects. KEYWORDS: Biventricular conversion; congenital heart surgery; multidisciplinary approach; risk-stratification; surgical outcomes

Background: Identifying those at risk for suboptimal breastfeeding outcomes remains critical for improving maternal and child health. Prenatal breastfeeding motivation may be a key predictor useful for identifying those who would benefit from additional breastfeeding support. Research Aims: To (1) validate a breastfeeding-specific adaptation of the Treatment Self-Regulation Questionnaire (TSRQ-BF); and (2) determine if breastfeeding motivation predicts prenatal breastfeeding intentions and early breastfeeding outcomes. Methods: Participants in their third trimester of pregnancy ( N = 150) completed several instruments, including the TSRQ-BF and infant feeding intention, and could opt to participate in an assessment of early breastfeeding outcomes (by medical record review). TSRQ-BF subscales were derived from factor analysis, and multivariable regression was used to evaluate the association between TSRQ-BF subscale scores and breastfeeding intention and outcomes during the birth hospitalization. Results: Autonomous (related to personal values/beliefs regarding self) and Autonomous-Baby (values/benefits for the infant) subscale scores were positively associated with intended exclusivity (aOR [95% CI]: 2.22 [1.57, 3.30], 4.94 [2.49, 11.07], respectively) while higher scores on these subscales predicted longer time to planned cessation (aHR [95% CI]: 0.72 [0.61, 0.84],0.52 [0.34, 0.81]). Higher Amotivation (lack of motivation) scores were negatively associated with intended exclusivity (0.45 [0.26, 0.74]). Higher scores on Autonomous, Autonomous-Baby, and Controlled (avoidance of negative feelings/punishment or gaining reward) subscales were associated with greater odds of hospital exclusivity (aOR [95% CI]: 3.39 [1.75, 8.00], 3.44 [1.66, 9.04] and 6.05 [1.88, 29.04]) and lower odds of 2-day formula supplementation (aOR [95% CI]: 0.31 [0.14, 0.59],0.28 [0.11, 0.59], 0.19 [0.04, 0.62]). Conclusions: The TSRQ-BF predicted breastfeeding intent and outcomes, and may be helpful for identifying patients at risk for suboptimal breastfeeding outcomes before delivery.

There is an urgent need to capture the outcomes of the ongoing global implementation of competency-based medical education (CBME). However, the measurement of downstream outcomes following educational innovations, such as CBME is fraught with challenges stemming from the complexities of medical training, the breadth and variability of inputs, and the difficulties attributing outcomes to specific educational elements. In this article, we present a logic model for CBME to conceptualize an impact pathway relating to CBME and facilitate outcomes evaluation. We further identify six strategies to mitigate the challenges of outcomes measurement: (1) clearly identify the outcome of interest, (2) distinguish between outputs and outcomes, (3) carefully consider attribution versus contribution, (4) connect outcomes to the fidelity and integrity of implementation, (5) pay attention to unanticipated outcomes, and (6) embrace methodological pluralism. Embracing these challenges, we argue that careful and thoughtful evaluation strategies will move us forward in answering the all-important question: Are the desired outcomes of CBME being achieved?

When the focus of the accreditation process for social work programs in the United States shifted to competency-based student achievement in 2008 the overall student experience in a program seemed ...

Entrepreneurship is an important engine of economic growth, job creation and social mobilization, therefore; there has been a growing attention to the promotion and development of programs to encourage female entrepreneurship within political and economic spheres. From the analysis of the traditional evaluation and follow-up methodologies, it is verified that these, traditionally, do not consider aspects inherent to participants in this type of programs and their environment. For such purposes, secondary and primary sources were reviewed, collecting the main findings of a study carried out in Costa Rica on three programs focused on promoting female entrepreneurship. In this context, this article proposes a generic model of management and results indicators of seven dimensions (governance, effectiveness and management, sustainability, efficiency, financial inclusion, impact orientation, monitoring and evaluation). The proposed model focuses its applicability on the evaluation of support programs for women-led enterprises. The results obtained and the proposed guide contribute to generating relevant information for decision-making, especially in the formulation of public policy and appropriate programs for this type of initiative and population stratum. El emprendimiento es un importante motor de crecimiento económico, creación de empleo y de movilización social, razón por la cual, se ha notado una creciente atención al fomento y desarrollo de programas para incentivar el emprendimiento femenino, en los ámbitos políticos y económicos. A partir del análisis de las metodologías tradicionales de evaluación y seguimiento se constata que éstas, tradicionalmente, no consideran aspectos inherentes a las personas que participan en este tipo de programas y su entorno. Para tales efectos se revisaron fuentes secundarias y fuentes primarias, recogiendo los principales hallazgos de un estudio realizado en Costa Rica sobre tres programas enfocados en el fomento de emprendimientos femeninos. En este contexto, esta investigación propone un modelo genérico de indicadores de gestión y resultados de siete dimensiones (gobernanza; eficacia y gestión; sostenibilidad; eficiencia; inclusión financiera; orientación al impacto; seguimiento y evaluación). El modelo propuesto enfoca su aplicabilidad en la evaluación de los programas de apoyo a emprendimientos liderados por mujeres. Los resultados obtenidos y la guía propuesta contribuyen a generar información relevante para la toma de decisiones, especialmente en la formulación de la política pública y programas adecuados para este tipo de iniciativas y estrato de la población.

BackgroundPercutaneous cervical cordotomy (PCC) offers pain relief to patients with unilateral treatment-refractory cancer-related pain. There is insufficient evidence about any effects of this intervention on patients’ quality of life.MethodComprehensive multimodal assessment to determine how PCC affects pain, analgesic intake and quality of life of patients with medically refractory, unilateral cancer-related pain.This study was set in a multidisciplinary, tertiary cancer pain service. Patient outcomes immediately following PCC were prospectively recorded. Patients were also followed up at 4 weeks.ResultsOutcome variables collected included: background and breakthrough pain numerical rating scores before PCC, at discharge and 4 weeks postprocedure; oral morphine equivalent opioid dose changes, Patient’s Global Impression of Change, Eastern Cooperative oncology group performance status and health related quality of life score, that is, EuroQol-5 dimension-5 level (EQ-5D).ConclusionsDespite significant improvement in pain and other standard outcomes sustained at 4 weeks, there was little evidence of improvement in EQ-5D scores. In patients with terminal cancer, improved pain levels following cordotomy for cancer-related pain does not appear to translate into improvements in overall quality of life as assessed with the generic EQ-5D measure.

Patient-reported outcomes measures form the backbone of outcomes evaluation in orthopaedics, with most of the literature now relying on these scoring tools to measure change in patient health status. This patient-reported information is increasingly collected routinely by orthopaedic providers but use of the data is typically restricted to academic research. Developments in electronic data capture and the outcome tools themselves now allow use of this data as part of the clinical consultation. This review evaluates the role of patient reported outcomes data as a tool to enhance daily orthopaedic clinical practice, and documents how develop-ments in electronic outcome measures, computer-adaptive questionnaire design and instant graphical display of questionnaire can facilitate enhanced patient-clinician shared decision making.

This article has been removed at the request of the author. The research was a naturalistic, non randomised, evaluation of Transactional Analysis (TA) and Gestalt psychotherapies, Integrative Counselling Psychology and Person Centred counselling within the research clinic at Metanoia Institute in the UK. Standardised measures were used to assess treatment outcomes and working alliance. Adherence to the model was evaluated in clinical supervision. The outcomes demonstrated that clients who engaged in treatment made statistically significant improvements.

Warping is the most important problem of costal cartilage grafts used in secondary rhinoplasties. The aim of this study is to show that costal cartilage grafts prepared with oblique sliced method (OSM), can solve the warping problem and provides successful results in both functional and aesthetic appearance. There are 42 patients who had previous nose surgery and dissatisfied with their facial appearance included in the study to perform secondary rhinoplasty with costal cartilage graft OSM technique. The outcomes of the operations were performed objectively using facial measurements and subjectively using rhinoplasty outcomes evaluation (ROE) scale, before and 12 months after the operation. The mean of total ROE score was 8.171 ± 3.285 on the pre-operative period and it was increased to 19.11 ± 3.652 where the P value was found to be

La forte prévalence de la victimisation sexuelle chez les jeunes et les possibles répercussions associées incitent au développement de programmes de prévention efficaces. Or, l’implication des parents afin de prévenir cette forme de violence est reconnue comme nécessaire : en ce sens, le programme Empreinte – Agir ensemble contre les agressions à caractère sexuel inclut un volet leur étant destiné, offert par l’entremise de courtes vidéos accessibles par le Web. L’objectif de cette intervention est d’amener les parents à jouer un rôle actif dans la prévention de la violence sexuelle en les incitant à créer des opportunités de discussions auprès de leur jeune. Cette étude vise à évaluer les effets de ces six capsules vidéo auprès de parents d’adolescent.es. Les résultats démontrent que le visionnement des vidéos a permis aux 78 parents d’améliorer leurs connaissances face à la violence sexuelle, leurs attitudes exemptes de préjugés et leur sentiment d’autoefficacité. De plus, 68 % des parents ont affirmé avoir entamé une discussion en lien avec la violence sexuelle avec un.e jeune de leur entourage dans le mois suivant leur visionnement des capsules vidéo. Enfin, l’appréciation envers les vidéos est fortement positive. L’utilisation de vidéos offertes par le Web afin d’impliquer les parents dans la prévention de la violence sexuelle auprès d’adolescent.es s’avère donc une avenue prometteuse., The high prevalence of sexual victimization amongst teenagers, and the possible associated consequences, urge the development of effective preventive programs. Yet, the involvement of parents is essential in order to prevent this type of violence. To that extent, the program Empreinte – Agir ensemble contre les agressions à caractère sexuel includes a parental component using online videos. The purpose of this intervention is to motivate parents’ active role in sexual violence prevention by encouraging them to create discussion opportunities with their teenagers. This study aims to evaluate the outcomes of those six brief videos with francophone parents of teenagers in their third year of high school. Results indicate that viewing the videos allowed the 78 participants to improve their knowledge about sexual violence, their unbiased attitudes, and their sense of self-efficacy. Furthermore, 68% of participants reported that they initiated a discussion on sexual violence within the month following their viewing of the videos. In addition, appreciation regarding the videos is strongly positive. Therefore, using online videos to engage parents in a sexual violence preventive strategy may prove to be a promising approach.

Objective Shared decision-making (SDM) is a process of collaboration between patients and clinicians. An increasing number of educational programs to teach SDM have been developed. We aimed to summarize and evaluate the body of evidence assessing the outcomes of these programs. Methods We conducted a systematic review of studies that aimed to teach SDM to medical trainees. Reviewers worked independently and in duplicate to select studies, extract data and evaluate the risk of bias. Results Eighteen studies were included. Most studies focused on residents/fellows (61 %) and combined a didactic component with a practical experience (50 % used a standardized patient). Overall, participants reported satisfaction with the courses. The effects on knowledge, attitudes/confidence and comfort with SDM were small; no clear improvement on SDM skills was noted. Evaluation of clinical behavior and outcomes was limited (3/18 studies). Studies had moderate risk of bias. Conclusion Very low quality evidence suggests that educational programs for teaching SDM to medical trainees are viewed as satisfactory and have a small impact on knowledge and comfort with SDM. Their impact on clinical skills, behaviors and patient outcomes is less clear. Practical implications Integration of formal and systematic outcomes evaluation (effects on behavior/clinical practice) should be part of future programs.

Early Detection and Intervention (EDI) is a system of services that promote development in the critical early years of childhood. It serves as an invaluable support to achieve Inclusive Education (...

The Expert Consensus reviews current literatures and provides clinical practice guidelines for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The main contents include the following: (1) clinical evaluation of GGN; (2) procedures, indications, contraindications, outcomes evaluation, and related complications of thermal ablation for GGN; and (3) future development directions.

Introduction & Objective: In observational studies, it is recommended to use propensity score (PS) methods or covariate adjustment for confounding effect adjustment. However, few guidelines are available regarding the choice of PS approaches or covariate adjustment for the best performance in a particular data. In this study, we compared different PS methods and conventional covariate adjustment to investigate the treatment effect for the overall population on time-to-event outcomes. Methods: In the Monte Carlo simulations, we compared the hazard ratio (HR) and precision estimated using covariate adjustment and eight different PS approaches, including matching, stratification, and inverse probability of treatment weighting (IPTW). In the Oral Squamous-Cell Carcinoma Cancer case study, we applied the aforementioned PS approaches to compare the effect of receiving post-operative radiation therapy (PORT) and having engraftable tumors on different time-to-event clinical outcomes. Results: In the simulations, both IPTW and covariate adjustment produced unbiased HR estimates with small uncertainty. In the case study, covariate adjustment showed that patients with engraftable tumors were twice as likely to have local/regional recurrence (HR 1.98 [1.23, 3.18], p-value

BACKGROUND: Although Clostridioides difficile surveillance often identifies emerging strains, clinical outcome evaluations are rarely performed. Ribotype (RT) 106 is a commonly isolated C. difficile strain worldwide; however, studies investigating RT 106 clinical outcomes are limited. The purpose of this study was to investigate clinical outcomes of RT 106 infections compared with two other endemic strains of varying virulence. METHODS: This multicenter study evaluated adults hospitalized with C. difficile infection (CDI). C. difficile samples underwent PCR ribotyping and patients infected with RT 106 were compared to patients infected with a known hypervirulent strain (RT 027) and a strain associated with less virulence (RT 014-020). Electronic medical records were reviewed by blinded investigators to assess the primary outcome of poor clinical outcome (composite of initial clinical failure, discharge to a higher level of care, 90-day CDI recurrence, and CDI-contributable mortality). RESULTS: A total of 396 patients with CDI were identified (RT 106, 32.3%; RT 027, 29.3%; RT 014-020, 38.3%). Patients infected with RT 014-020 less often experienced a poor clinical outcome (40%) compared with RT 106 (56%) and RT 027 (65%) infection (P

Background Several patient-reported outcome measures are available to monitor headache impact, but are those reliable in real-life clinical practice? Methods Two identical patient-reported outcome measures (HALT-90 and MIDAS) were applied simultaneously in each clinical visit to a series of patients treated with monoclonal antibodies for migraine and intra-individual agreement was evaluated using the intraclass correlation coefficients. Results Our sample included 92 patients, 92.4% females, 45 years old on average. Moderate (0.50 to 0.75) and even poor (Discussion We observed intra-personal variation in reliability when answering patient-reported outcome measures, persisting in repeated applications, and a decrease in the motivation to respond, which should alert clinicians for these additional challenges in real-life clinical practice.

Birthrates forecasting can help decision-makers to understand population increment patterns, in addition to many issues that support governmental decisions, especially in developing countries as Yemen. Data Mining has important new emerged technologies, support business, and decision-making requirements. Forecasting is one of Artificial Neural Networks (ANN) and Time Series (TS) applications, as data mining techniques. In this paper, birthrates two forecasting models have experimented with. The ANN and TS are used for forecasting Yemeni hospital births data. Monthly birthrates data of four years are processed by each model. The forecasting of monthly next four years had produced, based on each model. Outcomes evaluation is showed the accuracy of forecasting results. Besides, TS outperforms the ANN model, in the context of monthly births data forecasting of Yemeni hospital data.

Objective Evaluate the use of the Innovation Studio on interprofessional collaboration and attitudes toward interprofessional learning, job satisfaction, and intent to stay. Background The healthcare workforce is experiencing high burnout rates, and providers are unsatisfied with their work. Evidence supports that interprofessional collaboration is a key strategy to increase job satisfaction and intent to stay in healthcare professionals. The Innovation Studio is a tool to engage healthcare providers in interprofessional collaboration. Methods A pretest/posttest evaluation of the Innovation Studio with 14 healthcare professionals was conducted with self-reported scores on job satisfaction, readiness for interprofessional learning, and intent to stay as outcomes. Results Positive effects were found on interprofessional learning and intent to stay, but not job satisfaction. Eleven interprofessional projects were developed. Responses to open-ended questions indicated satisfaction with the Innovation Studio. Conclusions The Innovation Studio was successful in stimulating numerous interprofessional projects and had a positive effect on interprofessional learning and intent to stay.

Highlights • Three case of radial head fracture treated with radial head arthroplasty. • Evaluation of the functional outcomes after operative treatment of radial head arthroplasty. • Functional outcomes assessment with active and passive range of motion. • Satisfying result on pain and a fair result on functional outcome on patient follow-up. • Good follow up is important to minimize the complications of radial head arthroplasty., Introduction Radial head arthroplasty (RHA) has become one of the mainstay surgical treatment for radial head fracture in certain conditions. Many previous studies compared the superiority of either open reduction and internal fixation (ORIF) and RHA with inconclusive result. Our case series aim to evaluate the functional outcome of the patients treated with RHA in our institution. Presentation of case We evaluated three patients who had RHA in 2018 and 2019. The function of flexion, extension, supination and pronation of the elbow was evaluated. The range of motion (ROM) was assessed in both active and passive way. Discussion An abundant of literatures stated that RHA result is superior than radial head resection and ORIF. Our case series present a satisfying result on pain and a fair result on functional outcome from the range of motion (ROM) evaluation on patient follow-up. Conclusion A good follow up for post-operative care plays an important role in management of RHA to minimize the rate of complications. In this case series, the functional outcomes after RHA is good, but a larger number of patient and longer follow up duration is needed for a better analysis.

According to the DSM-V, gambling can be defined as a “persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress”, not better defined by a manic episode. ORTHOS is a three-week intensive residential intervention program with three follow-up meetings during the year following intensive residential interventions. ORTHOS’ philosophy envisages a non-moralistic and prejudicial approach to gambling (Zerbetto, 2002). The findings of the present study confirm the efficacy of ORTHOS treatment compared to the reduction of gambling symptoms, with over 85% of the sample in which the symptoms manifested no longer clinical relevance (scores below 5 in SOGS).

Background: An assessment of rhinoplasty from the patient’s perspective, in terms of satisfaction and quality of life, is quite important because these are the predominant factors indicating the success of rhinoplasty. Aims: To translate the Rhinoplasty Outcomes Evaluation into Turkish and then validate the new version for use in Turkish patients. Study Design: Validation study. Methods: We enrolled 30 participants who were able to read and write Turkish and underwent primary rhinoplasty. The control group consisted of 58 healthy volunteers with no need for aesthetic or functional nasal surgery. The reliability of the Rhinoplasty Outcomes Evaluation-T was analyzed according to its internal consistency and test-retest reproducibility. Discriminant validity was calculated by comparing the Rhinoplasty Outcomes Evaluation-T scores between the patient and control groups. Responsiveness and sensitivity to changes in rhinoplasty outcomes were analyzed by comparing the patients’ pre- and postoperative Rhinoplasty Outcomes Evaluation-T scores. Results: The scores for questions 1-6 of the Rhinoplasty Outcomes Evaluation-T, as well as the total scores, were significantly lower in the patient group than in the control group (all p0.05). The internal consistency of the Rhinoplasty Outcomes Evaluation-T was high, as evidenced by Cronbach’s α values of 0.887 preoperatively and 0.798 postoperatively. Conclusion: The Rhinoplasty Outcomes Evaluation-T constitutes a validated instrument with which to measure rhinoplasty outcomes among Turkish patients.

Correction of crooked nose with long-term functional and aesthetic success remains a great challenge for rhinoplasty surgeons. The aim of this study was to present the aesthetic and functional results of the cross-spreader graft technique applied for the correction of I-shaped crooked nose. A retrospective examination was made of 25 patients applied with open technique rhinoplasty using cross-spreader graft for the correction of I-shaped crooked nose between March 2016 and June 2019. The functional results of the patients were evaluated using the Nasal Obstruction Symptoms Evaluation scale. The Rhinoplasty Outcomes Evaluation was used to evaluate the subjective aesthetic results, and the external nose deviation angle was measured from the frontal aspect to evaluate the objective aesthetic results. Evaluation was made of 25 patients comprising 11 males and 14 females with a mean age of 26.64±7.08 years. The post-operative mean NOSE and ROE scores were significantly improved compared to the preoperative values (p