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Tian X, Ruan X, Du J, Cheng J, Ju R, Mueck AO. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2221736. [PMID: 37302412 DOI: 10.1080/09513590.2023.2221736] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18-45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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Asci R, Bolat MS, Dündar C, Özdemir AZ, Atmaca A. Impact of a high visceral adiposity index on female sexual dysfunction in sexually active women? Results of a cross-sectional study. Int J Clin Pract 2021; 75:e14611. [PMID: 34235836 DOI: 10.1111/ijcp.14611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS To our knowledge, this is the first study investigating the impact of high visceral adiposity index (VAI) on female sexual dysfunction (FSD). We aimed to show the impact of increased levels of VAI on FSD compared with body mass index (BMI) and waist circumference (WC) particularly in those with metabolic syndrome (MeTS). METHODS We included 158 participants in two groups: Group 1 (n = 68 with normal sexual function) and Group 2 (n = 90 with sexual dysfunction). Demographic, clinic data, presence of MeTS and comorbidities were recorded. The BMI, WC and the VAI were calculated. Sexual function was assessed using the female sexual function index. RESULTS The mean age and all the anthropometric variables were similar between the groups (P > .05). MeTS was associated with lower arousal and lubrication scores than those without MeTS (P = .023). The higher VAI was associated with lower desire, lubrication and orgasm scores (P < .05). Each integer increase of the VAI weakly predicted decrease of desire (P = .015), arousal (P = .015), lubrication (P = .005) and satisfaction (P = .046). The WC and BMI were not a good predictor for FSD in women (OR=1.019, P = .318). CONCLUSION The VAI was linked with lower scores in some female sexual function subdomains, but the correlation coefficient was low, indicating a weak association. Further studies with a higher number of participants are needed to conclude that the VAI may increase the risk of FSD, particularly in patients with MeTS.
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Affiliation(s)
- Ramazan Asci
- Department of Urology, Ondokuz Mayis University, Samsun, Turkey
| | | | - Cihad Dündar
- Department of Public Health, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Zehra Özdemir
- Department of Obstetrics and Gynecology, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşegül Atmaca
- Department of Endocrinology, Ondokuz Mayis University, Samsun, Turkey
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Tian X, Ruan X, Du J, Wang J, Yin D, Cheng J, Ju R, Mueck AO. Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics. Reprod Sci 2021; 28:3181-3192. [PMID: 34076876 PMCID: PMC8526448 DOI: 10.1007/s43032-021-00612-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/10/2021] [Indexed: 12/20/2022]
Abstract
To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. .,Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany.
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Juan Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Dongmei Yin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.,Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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Ellibeş Kaya A, Doğan O, Yassa M, Başbuğ A, Özcan C, Çalışkan E. Do external female genital measurements affect genital perception and sexual function and orgasm? Turk J Obstet Gynecol 2020; 17:175-181. [PMID: 33072421 PMCID: PMC7538817 DOI: 10.4274/tjod.galenos.2020.89896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/19/2020] [Indexed: 01/25/2023] Open
Abstract
Objective: To provide baseline data for the anatomy of the external female genitalia and to investigate the correlation between those measurements and sexual function and genital perception. Materials and Methods: This prospective cohort study consisted of 208 healthy premenopausal women. The Female Sexual Function index (FSFI) and the Female Genital Self-image scale (FGSIS) questionnaires were administered. Participants were divided into two groups according to their female sexual dysfunction (FSD) status. External genital measurements and anterior and posterior vaginal length were measured. Results: The external female genital measurements were (cm, mean ± standard deviation): clitoral prepuce length 2.05±0.48; clitoral glans length 0.87±0.21; clitoral glans width 0.60±0.15; clitoris to urethra 2.24±0.55; anterior fornix depth 7.75±0.92; posterior fornix depth 9.25±0.75; labia minora width, right 2.12±0.86, left 2.20±0.96. A weak negative correlation was found between total FGSIS scores and clitoral prepuce length (p=0.01, r=-0.17), whereas a weak positive correlation was seen between total FGSIS scores and anterior-posterior vaginal lengths (p=0.04, r=0.13; p=0.02, r=0.15, respectively). No statistically significant difference was found between the genital measurements of participants with FSD (n=82, 39.4%) and those without FSD (n=126, 60.6%), and the total FSFI scores and orgasm subdomain scores. Conclusion: The female genital measurements were found to be distributed over a wide range. Although the relationship between genital measurements and genital perception varied, no significant relationship was found between genital measurements and sexual functions or orgasm. These findings suggest that a more cautious approach should be taken towards genital surgeries for cosmetic purposes.
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Affiliation(s)
- Aşkı Ellibeş Kaya
- Düzce University Hospital, Clinic of Obstetrics and Gynecology, Düzce, Turkey
| | | | - Murat Yassa
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Alper Başbuğ
- Düzce University Hospital, Clinic of Obstetrics and Gynecology, Düzce, Turkey
| | | | - Eray Çalışkan
- Okan University Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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Brody S, Costa RM. Vaginal orgasm is associated with indices of women's better psychological, intimate relationship, and psychophysiological function. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2017. [DOI: 10.3138/cjhs.261-a3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A recent study by Therrien and Brotto (2016) examined the associations of orgasm during intercourse, concordance of laboratory genital and subjective arousal, and demographic variables in a group of sexually dysfunctional women. The authors claimed that their results cast doubt on the large body of multi-method multi-national research demonstrating that women's orgasm from penile-vaginal intercourse, and specifically vaginal orgasm are associated with a broad range of indices of women's better psychological, intimate relationship, and psychophysiological health. The problems with Therrien and Brotto's (2016) conclusions are discussed, and include that they did not even measure vaginal orgasm (they measured orgasm during intercourse, which can in some cases consist of orgasm elicited by clitoral masturbation during intercourse), and the non-generalisability of their findings from a sexually dysfunctional sample to the general population of women. Evidence is also presented against their claims that findings regarding orgasm during intercourse have not been investigated by other researchers, and their denial of differences between vaginal orgasm and clitoral orgasm. Denial of the myriad benefits of vaginal orgasm undermines women's sexual and general health potential, and serves only the demands of political correctness.
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Affiliation(s)
- Stuart Brody
- Department of General Anthropology, Charles University, Prague, Czech Republic
| | - Rui M. Costa
- William James Center for Research, ISPA–Instituto Universitario, Lisbon, Portugal
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Steffen KJ, King WC, White GE, Subak LL, Mitchell JE, Courcoulas AP, Flum DR, Strain G, Sarwer DB, Kolotkin RL, Pories W, Huang AJ. Sexual functioning of men and women with severe obesity before bariatric surgery. Surg Obes Relat Dis 2016; 13:334-343. [PMID: 27986585 DOI: 10.1016/j.soard.2016.09.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/15/2016] [Accepted: 09/23/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. OBJECTIVES To describe sexual function and associated factors before bariatric surgery. SETTING Ten U.S. clinical facilities. METHODS Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m2) completed a survey about sexual function over the past month. Mixed effects ordinal logistic regression models were used to identify factors independently related to 4 domains of sexual function. RESULTS One third of women (34%) and one quarter of men (25%) were not sexually active, alone or with a partner, in the past month. Twenty-six percent of women and 12% of men reported no sexual desire. Physical health limited sexual activity at least moderately in 38% of women and 44% of men. About one half of the women (49%) and the men (54%) were moderately or very dissatisfied with their sexual life. Among women, older age, being Caucasian, urinary incontinence, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. In men, older age, not being married, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. CONCLUSION Before bariatric surgery, approximately one half of women and men with severe obesity are dissatisfied with their sexual life. Older age, severity of depressive symptoms, and antidepressant medication use are associated with poorer sexual function in both sexes.
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Affiliation(s)
- Kristine J Steffen
- North Dakota State University, Fargo ND; Neuropsychiatric Research Institute, Fargo, ND.
| | - Wendy C King
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Gretchen E White
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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Alves da Silva Lara L, Dos Santos Lima ML, Salata Romão G, Ferriani RA, de Albuquerque Salles Navarro PA. Response to Letter to Editor Entitled "Obesity, Overweight, Female Sexual Function, and Penile-Vaginal Intercourse Frequency". JOURNAL OF SEX & MARITAL THERAPY 2016; 42:387-390. [PMID: 26644003 DOI: 10.1080/0092623x.2015.1113592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Lucia Alves da Silva Lara
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Maria Lucia Dos Santos Lima
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Gustavo Salata Romão
- a Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Rui Alberto Ferriani
- b Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, and INCt/CNPq Hormones, Protection and Risks for Women's Health, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
| | - Paula Andrea de Albuquerque Salles Navarro
- b Sexual Medicine Service, Sector of Human Reproduction, Department of Gynecology and Obstetrics, and INCt/CNPq Hormones, Protection and Risks for Women's Health, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto-SP , Brazil
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Costa RM, Brody S. Obesity, Overweight, Female Sexual Function, and Penile-Vaginal Intercourse Frequency. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:293-296. [PMID: 26167661 DOI: 10.1080/0092623x.2015.1069434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Rui M Costa
- a William James Center for Research , ISPA-Instituto Universitário , Lisbon , Portugal
| | - Stuart Brody
- b Charles University , Department of General Anthropology, Faculty of Humanities , Prague , Czech Republic
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Emhardt E, Siegel J, Hoffman L. Anatomic variation and orgasm: Could variations in anatomy explain differences in orgasmic success? Clin Anat 2016; 29:665-72. [PMID: 26916103 DOI: 10.1002/ca.22703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 01/18/2023]
Abstract
Though the public consciousness is typically focused on factors such as psychology, penis size, and the presence of the "G-spot," there are other anatomical and neuro-anatomic differences that could play an equal, or more important, role in the frequency and intensity of orgasms. Discovering these variations could direct further medical or procedural management to improve sexual satisfaction. The aim of this study is to review the available literature of anatomical sexual variation and to explain why this variation may predispose some patients toward a particular sexual experience. In this review, we explored the available literature on sexual anatomy and neuro-anatomy. We used PubMed and OVID Medline for search terms, including orgasm, penile size variation, clitoral variation, Grafenberg spot, and benefits of orgasm. First we review the basic anatomy and innervation of the reproductive organs. Then we describe several anatomical variations that likely play a superior role to popular known variation (penis size, presence of g-spot, etc). For males, the delicate play between the parasympathetic and sympathetic nervous systems is vital to achieve orgasm. For females, the autonomic component is more complex. The clitoris is the primary anatomical feature for female orgasm, including its migration toward the anterior vaginal wall. In conclusions, orgasms are complex phenomena involving psychological, physiological, and anatomic variation. While these variations predispose people to certain sexual function, future research should explore how to surgically or medically alter these. Clin. Anat. 29:665-672, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- E Emhardt
- Class of 2016, Indiana University School of Medicine, Indianapolis, Indiana, 46220
| | - J Siegel
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, 32224
| | - L Hoffman
- Department of Anatomy, Indiana University School of Medicine, Fort Wayne, Indiana, 46805
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Phillips A, Phillips S. Recognising female sexual dysfunction as an essential aspect of effective diabetes care. Appl Nurs Res 2015; 28:235-8. [PMID: 26074296 DOI: 10.1016/j.apnr.2015.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses' knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingly (Sivrikaya et al., 2014).
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Affiliation(s)
- Anne Phillips
- Diabetes Care, Seebohm Rowntree Building-Area 5, Dept of Health Sciences, Faculty of Science, University of York, Heslington, York, YO10 5DD, UK.
| | - Stephen Phillips
- Adult Nursing, Ramsden Building, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
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