Tear Osmolarity Changes Following External and Trans-Canalicular Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction

Purpose: The aim of this study is to evaluate the tear osmolarity(TO) in patients with epiphora caused by primary acquired nasolacrimal-duct obstructions(PANDOs), before and one month after an external dacryocystorhinostomy(E-DCR) and trans-canalicular laser-assisted endoscopic dacryocystorhinostomy(TLA-DCR).Material-Methods: Twenty eyes of 21 patients(16 women, 5 men) who suffered from epiphora and, 20 healthy eyes of the same subjects were included in this study. External(Group 1) or laser-assisted(Group 2) DCR were applied to all patients with PANDO.Results: The mean age of the subjects was 60.09±8.46 in Group 1, 57.50±9.41 in Group 2 and, 55.13±9.38 in healthy control subjects. The mean period for complaints of epiphora was 1.9±0.7 years. Nasolacrimal duct irrigation was successful in all patients at the first-month visit after surgery. Group 1 had a mean TO of 284.16±12.43 mOsm/l and, Group 2 had 286.70±10.46 mOsm/l before DCR, and this increased to 295.75±5.86 mOsm/l and, 298.70±8.76 mOsm/l one month after DCR, respectively. Preoperative TO values in both groups were significant hypoosmolar compared with the control group (292.27±9.65 mOsm/l). No significant differences were detected between postoperative and control group TO values.Conclusion: We found no significant osmolarity changes between surgery and control groups.

Anonymous Asynchronous Ratchet Tree Protocol for Group Messaging

Signal is the first application that applies the double ratchet for its end-to-end encryption protocol. The core of the double ratchet protocol is then applied in WhatsApp, the most popular messaging application around the world. Asynchronous Ratchet Tree (ART) is extended from ratchet and Diffie-Hellman tree. It is the first group protocol that applies Forward Secrecy (FS) with Post-Compromised Security (PCS). However, it does not consider protecting the privacy of user identity. Therefore, it makes sense to provide anonymous features in the conditions of FS and PCS. In this paper, the concepts of Internal Group Anonymity (IGA) and External Group Anonymity (EGA) are formalized. On the basis of IGA and EGA, we develop the “Anonymous Asynchronous Ratchet Tree (AART)” to realize anonymity while preserving FS and PCS. Then, we prove that our AART meets the requirements of IGA and EGA as well as FS and PCS. Finally, the performance and related issues of AART are discussed.

The Role of Blame Attribution in Post-Concussion Syndrome Morbidity: A Retrospective Analysis of Patients at a Subspecialty Clinic

ObjectiveTo compare the presentation of Post-Concussion Syndrome (PCS) based on whom the patient blames for the initial concussion.BackgroundPsychological risk factors, such as pre-injury psychiatric disease and ongoing litigation, are associated with worsened PCS. We investigated whether blame attribution is another one of these psychological risk factors.Design/Methods111 new patients presenting with PCS at a Canadian subspecialty concussion clinic were seen over 2 years. 91 patients (56 females, 35 males) were included. 20 patients were excluded for inability to define specific causative event (n = 13), underlying structural lesion (n = 1) or evidence of intracranial bleed (n = 6). Patients were separated into three groups: those attributing external blame (n = 70) those describing the incident as accidental (n = 20) and those attributing internal blame (n = 1). Patient observations included: subjective percentage of recovery (SPR), presence and severity of both headaches and psychiatric symptoms, and duration of symptoms at initial presentation. Psychiatric symptoms were graded 0–3 (0-absence, 1-mild, 2-moderate, 3-severe). Headache frequency was graded 0–4 (0-absence, 1-rare, 2-episodic, 3-chronic, 4-persistent).ResultsMore patients belonged to the External group compared to Accidental or Internal groups (p < 0.0001). Mean SPR in the Accidental group was 73% as compared to 44% in External (p < 0.0001). Mean headache frequency was 1.7 for Accidental and 2.64 for External (p = 0.001) Mean severity of psychiatric symptoms was 0.55 in Accidental and 2.24 in External (p < 0.0001). 77% of patients in the External group were diagnosed with post-injury PTSD, with 0% diagnosed in the Accidental group (p < 0.0001). Post-injury depression and anxiety each occurred 3 times more frequently in the External group compared to Accidental (p < 0.0001). Mean symptom duration at initial presentation was 10.2 months in Accidental and 22.49 months in External (p = 0.001). The External and Accidental groups did not differ significantly in age (p = 0.938), number of concussions (p = 0.72), gender (p = 0.908), or preexisting psychiatric illness (p = 0.735).ConclusionsThis study suggests blame attribution may be an important factor in determining patients at risk of a more severe and prolonged course of PCS.

Reformulasi Identitas Buddha Jawi Wisnu dan Sam Kaw Hwee Ke Dalam Buddhayana di Lampung Reformulating Identity of Buddha Jawi Wisnu and Sam Kaw Hwee Into Buddhayana in Lampung

The formulation of a social group identity is strongly influenced by the historical context and institutional site in which reformulation of social identity occurred. As a result, the group has a common understanding and categories that unite them into sameness identity. It is what we have seen on the Sam Kaw Hwee Buddhist sect group as well as Buddha Jawi Wisnu sect group who in early New Order regime changed their identity into becoming Buddhayana Buddhist sect in Lampung. At a glance, the Majelis Buddhayana Indonesia (MBI, or Indonesian Buddhayana Council) was a meeting point of which Javanese and Chinese are encountered. Furthermore, MBI is regarded as a shared identity for most Buddhists in Lampung. This paper wants to explain the background and the process of reformulating new social identity, as well as the impacts around it.The paper is based on a qualitative research that tries to understand the early formation of Buddhayana sect as the largest Buddhist sect in Lampung. MBI was as a new social identity resulting from interaction and negotiation its followers with external group who threatened the Buddhist group in Lampung in the past.Abstrak Terbentuknya identitas suatu kelompok sosial sangat dipengaruhi konteks sejarah dan situasi tertentu yang menyebabkan munculnya kesamaan pemahaman dan kategori yang menyatukan kelompok tersebut. Demikian pula terhadap kelompok penganut sekte Buddha Sam Kaw Hwee dan Buddha Jawi Wisnu yang kemudian, karena kesamaan-kesamaan yang ada, membentuk identitas baru menjadi sekte Agama Buddha Buddhayana di Lampung di awal Orde Baru. Saat ini Majelis Buddhayana Indonesia (MBI) diterima secara meluas dalam melakukan pembinaan dan pengorganisasian umat Buddha di Lampung, yang terdiri dari etnis Jawa dan Tionghoa. MBI hadir sebagai identitas bersama dan wadah bagi sebagian besar umat Buddha di Lampung. Tulisan ini hendak menjelaskan latar belakang dan proses reformulasi identitas tersebut, serta dampak yang muncul di sekitar itu. Tulisan hasil penelitian kualitatif ini menunjukkan bahwa Buddhayana sebagai aliran yang terbesar umat Buddha di Lampung, semakin kokoh sebagai identitas sosial yang dihasilkan dari interaksi dan negosiasi dengan pihak eksternal yang dilalui dengan cukup menegangkan pada masanya.

Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

Background The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship. Methods The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and mean scores calculated. Rating frequencies for each role were compared using the χ2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Spearman ρ statistic, and analysing qualitative data generated by the questionnaire. Results Preparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only significant for three roles (Medical expert, Communicator, Collaborator). Qualitative data provided further insights into the reasons for these associations. Conclusions Intern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.

Manuscript: Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

Abstract Background The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship. Methods The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and mean scores calculated. Rating frequencies for each role were compared using the χ 2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Spearman ρ statistic, and analysing qualitative data generated by the questionnaire. Results Preparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only significant for three roles (Medical expert, Communicator, Collaborator). Qualitative data provided further insights into the reasons for these associations. Conclusions Intern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.

Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

Abstract Background The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship. Methods The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and mean scores calculated. Rating frequencies for each role were compared using the χ 2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Spearman ρ statistic, and analysing qualitative data generated by the questionnaire. Results Preparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only significant for three roles (Medical expert, Communicator, Collaborator). Qualitative data provided further insights into the reasons for these associations. Conclusions Intern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.

Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

Abstract Background The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship. Methods The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and average scores calculated. Rating frequencies for each role were compared using the χ2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Pearson r statistic. Results Preparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only statistically significant for three roles (Medical expert, Communicator, Collaborator). Conclusions Intern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.

Right-Wing Authoritarianism and Social Dominance Orientation Predict Outsiders' Responses to an External Group Conflict: Implications for Identification, Anger, and Collective Action

Members of groups in conflict may take collective action: actions to improve conditions for their group as a whole. The psychological antecedents of collective action for groups that are party to conflict and inequality are well-established. Comparatively little is known about how uninvolved outsiders respond to an external intergroup conflict. We investigate how personal ideological orientations of Social Dominance Orientation (SDO) and Right-Wing Authoritarianism (RWA) shape outsiders’ willingness to take collective action in support of groups engaged in external conflict. In Study 1, US residents read about conflicts between disadvantaged citizens and an advantaged government in Greece and Russia. In Study 2, US residents read about a similar conflict in a fictional country, Silaria. Path analyses revealed that SDO and RWA shaped psychological appraisals of the conflict contexts, which predicted intentions to take collective action on behalf of either group. SDO and RWA were positively associated with advantaged group identification and anger at a disadvantaged group, and negatively associated with disadvantaged group identification and anger at an advantaged group. Group identification and anger predicted subsequent collective action intentions on behalf of either group. The sensitivity of outsiders’ appraisals to ideological orientations suggests strategies for both advantaged and disadvantaged groups to recruit outsiders as allies in group conflict.