The effect of culture on pain sensitivity

Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case-control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. Pressure pain threshold (PPT) and tolerance (PPTo) were measured over one hand and two masticatory muscles. Electrical perception threshold and electrical pain threshold (EPT) and tolerance (EPTo) were recorded between the thumb and index fingers. Italian females reported significantly lower PPT in the masseter muscle than other cultures (P < 0.001) and in the temporalis muscle than Saudis (P = 0.003). Swedes reported significantly higher PPT in the thenar muscle than other cultures (P = 0.017). Italians reported significantly lower PPTo in all muscles than Swedes (P ≤ 0.006) and in the masseter muscle than Saudis (P < 0.001). Italians reported significantly lower EPTo than other cultures (P = 0.01). Temporomandibular disorder cases, compared to TMD-free controls, reported lower PPT and PPTo in all the three muscles (P < 0.001). This study found cultural differences between groups in the PPT, PPTo and EPTo. Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test

A Systematic Review of the Selected Evidences on the Effectiveness of Inter-professional Education (IPE) in Developing Interprofessional Learning Environment

Purpose: This systematic review aimed to provide available evidence in determining for the effectiveness of IPE as a modality in developing interprofessional learning environment for healthcare students.Methods: The computerized searches from 2009-2015 in ten electronic databases were performed. Two independent reviewers were consulted to assess the eligibility, level of evidences and methodological quality in each study. Result: nine out of ten studies were retrieved. These studies include (a) two RCT studies; scored eight and seven out of eight, (b) Three quasi-experimental pretestposttest design; scored seven, six, and six out of eight, (c) Three controlled before and after study; scored six, six, five and five out of eight, and (d) one controlled longitudinal; scored six out of eight respectively.Conclusion: Based on the systematic review, evidence showed that IPE was effective in building strong interprofessional learning environment. On the other hand, the authors recommend considering conduct of similar systematic review grounded on IPE with larger sample size within the health allied discipline

Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain

Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P 50% due to back pain compared to Italians or Swedes (P < 0·01). Headache was the most common comorbid condition in all three cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P < 0·01). For both back and head pain, higher average pain intensities (P < 0·01) and interference with daily activities (P < 0·01) were reported by TMD-pain cases, compared to TMD-free controls. Among TMD-pain cases, Italians reported the highest pain-related disability (P < 0·01). Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation

Sufficiency and Efficiency of Field Training for Radiology Students During Internship Experience in Najran University, Saudi Arabia

Purpose: The study was design to evaluate the effectiveness and adequacy of the internship period employing quantitative study descriptive survey approach. &nbsp; Theoretical framework: Internship is requirement of every student of radiology program of Radiological Sciences patch for the award of bachelor's degree at Najran University, Saudi Arabia. The competency level would demonstrate influence the sufficiency and efficiency of clinical training during internship period which represent six months after completing nine levels of radiology program. &nbsp; Design\Methodology\Approach: The survey was distributed to the tow levels of the last year of radiological sciences which composed of 81 male and female students which gathered seventy-seven (77) participants. Data collected through a questionnaire and summarized as percentages, frequencies, means and standard deviations using SPSS version 20.0. &nbsp; Findings: The study revealed un adequacy of the internship period and showed low efficiency due to its short duration. &nbsp; Research, Practical, Social Implication:The research construct and variables are identified the effectiveness and adequacy of the internship period.this&nbsp; study will be the modele of internship with a new qualitative change related to a period of time acceptable to students, similar to other universities. &nbsp; Originality/Value:&nbsp;The originality and value in this study are the framework conceptance and questionnaire that prepared and proved for evaluating the effectiveness and adequacy of the internship period for student of radiology program. &nbsp; Conclusion: In general internship period must be efficient and adequate to enhance sufficiency and efficiency experience by intern trainees

Critically ill patients with diabetes and Middle East respiratory syndrome:a multi-center observational study

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p &lt;0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS

Critically ill patients with diabetes and Middle East respiratory syndrome:a multi-center observational study

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms andsigns, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine ifdiabetes was an independent predictor of 90-day mortality.Results: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely topresent with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p &lt;0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality(odds ratio, 2.09; 95% confidence interval, 1.18–3.72).Conclusions: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS

The Effectiveness of E-Mentoring Program to Develop Mothers Awareness of Protecting their Children from Sexual Harassment in Kindergarten

The research aims to measure the effectiveness of an E-mentoring program to educate mothers about the mechanisms of protecting children from sexual harassment and to identify the symptoms and methods that must be followed when kindergarten children are subjected to harassment, in order to answer the research questions, the semi- experimental approach was used because it is the most appropriate for the nature of the research to rely on changing something and studying the impact of this change on something else, and a random sample of mothers of children enrolled in kindergarten. The research tools consist of an electronic counselling program to develop mothers awareness on mechanisms to protect their children from sexual harassment in kindergarten by researchers, as well as a questionnaire to measure mothers awareness of mechanisms to protect their children from sexual harassment in kindergartens prepared by researchers. One of the most prominent findings of the research is that the indicative level of mothers awareness of the symptoms of sexual harassment of their children in kindergarten, their protection mechanisms, and the methods to be followed when sexually harassing children was less than 0.05, which indicates that there are differences in favor of the dimensional measurement, which proves the effectiveness of the program in improving mothers awareness of mechanisms to protect their children from sexual harassment in kindergarten

Sandstone matrix acidizing knowledge and future development

To meet rising global demands for energy, the oil and gas industry continuously strives to develop innovative oilfield technologies. With the development of new enhanced oil recovery techniques, sandstone acidizing has been significantly developed to contribute to the petroleum industry. Different acid combinations have been applied to the formation, which result in minimizing the near wellbore damage and improving the well productivity. A combination of hydrofluoric acid and hydrochloric acid (HF:HCl) known as mud acid has gained attractiveness in improving the porosity and permeability of the reservoir formation. However, high-temperature matrix acidizing is now growing since most of the wells nowadays become deeper and hotter temperature reservoirs, with a temperature higher than 200 °F. As a result, mud acid becomes corrosive, forms precipitates and reacts rapidly, which causes early consumption of acid, hence becoming less efficient due to high pH value. However, different acids have been developed to combat these problems where studies on retarded mud acids, organic-HF acids, emulsified acids, chelating agents have shown their effectiveness at different conditions. These acids proved to be alternative to mud acid in sandstone acidizing, but the reaction mechanism and experimental analysis have not yet been investigated. The paper critically reviews the sandstone acidizing mechanism with different acids, problems occurred during the application of different acids and explores the reasons when matrix stimulation is successful over fracturing. This paper also explores the future developing requirement for matrix acidizing treatments and new experimental techniques that can be useful for further development, particularly in developing new acids and acidizing techniques, which would provide better results and information of topology, morphology and mineral dissolution and the challenges associated with implementing these “new” technologies

A preliminary screening and characterization of suitable acids for sandstone matrix acidizing technique: a comprehensive review

Matrix acidizing is a broadly developed technique in sandstone stimulation to improve the permeability and porosity of a bottom-hole well. The most popular acid used is mud acid (HF–HCl). It is a mixture of hydrofluoric acid and hydrochloric acid. However, one of the conventional problems in sandstone acidizing is that mud acid faces significant issues at high temperature such as rapid rate of reaction, resulting in early acid consumption. This downside has given a negative impact to sandstone acidizing as it will result in not only permeability reduction, but can even extend to acid treatment failure. So, the aim of this study is to provide a preliminary screening and comparison of different acids based on the literature to optimize the acid selection, and targeting various temperatures of sandstone environment. This paper has comprehensively reviewed the experimental works using different acids to understand the chemical reactions and transport properties of acid in sandstone environment. The results obtained indicated that fluoroboric acid (HBF4) could be useful in enhancing the sandstone acidizing process, although more studies are still required to consolidate this conclusion. HBF4 is well known as a low damaging acid for sandstone acidizing due to its slow hydrolytic reaction to produce HF. This would allow deeper penetration of the acid into the sandstone formation at a slower rate, resulting in higher porosity and permeability enhancement. Nevertheless, little is known about the effective temperature working range for a successful treatment. Considering the pros and cons of different acids, particularly those which are associated with HF and HBF4, it is recommended to perform a comprehensive analysis to determine the optimum temperature range and effective working window for sandstone acidizing before treatment operation. Prior to sandstone acid stimulation, it is essential to predict the feasibility of acid selected by integrating the effects of temperature, acid concentration and injection rate. Therefore, this manuscript has thrown light into the research significance of further studies