The Department of Clinical Sciences and Nutrition has an experienced team of researchers, with an international reputation. Their main research themes are Public Health Nutrition and Physical Activity, Cardiometabolic Health, and Clinical Practice.

Recent Submissions

  • Visualisation of xanthan conformation by atomic force microscopy

    Moffat, Jonathan; Morris, Victor J.; Al-Assaf, Saphwan; Gunning, A. Patrick; Asylum Research an Oxford Instruments Company; Norwich Research Park; University of Chester (Elsevier, 2016-04-20)
    Direct visual evidence obtained by atomic force microscopy demonstrates that when xanthan is adsorbed from aqueous solution onto the heterogeneously charged substrate mica, its helical conformation is distorted. Following adsorption it requires annealing for several hours to restore its ordered helical state. Once the helix state reforms, the AFM images obtained showed clear resolution of the periodicity with a value of 4.7 nm consistent with the previously predicted models. In addition, the images also reveal evidence that the helix is formed by a double strand, a clarification of an ambiguity of the xanthan ultrastructure that has been outstanding for many years.
  • Effects of temperature and solvent condition on phase separation induced molecular fractionation of gum arabic/hyaluronan aqueous mixtures

    Hu, Bing; Han, Lingyu; Gao, Zhiming; Zhang, Ke; Al-Assaf, Saphwan; Nishinari, Katsuyoshi; Phillips, Glyn O.; Yang, Jixin; Fang, Yapeng; Hubei University of Technology; Wrexham Glyndwr University (Elsevier, 2018-05-14)
    Effects of temperature and solvent condition on phase separation-induced molecular fractionation of gum arabic/hyaluronan (GA/HA) mixed solutions were investigated. Two gum arabic samples (EM10 and STD) with different molecular weights and polydispersity indices were used. Phase diagrams, including cloud and binodal curves, were established by visual observation and GPC-RI methods. The molecular parameters of control and fractionated GA, from upper and bottom phases, were measured by GPC-MALLS. Fractionation of GA increased the content of arabinogalactan-protein complex (AGP) from ca. 11% to 18% in STD/HA system and 28% to 55% in EM10/HA system. The phase separation-induced molecular fractionation was further studied as a function of temperature and solvent condition (varying ionic strength and ethanol content). Increasing salt concentration (from 0.5 to 5 mol/L) greatly reduced the extent of phase separation-induced fractionation. This effect may be ascribed to changes in the degree of ionization and shielding of the acid groups. Increasing temperature (from 4oC to 80oC) also exerted a significant influence on phase separation-induced fractionation. The best temperature for GA/HA mixture system was 40oC while higher temperature negatively affected the fractionation due to denaturation and possibly degradation in mixed solutions. Increasing the ethanol content up to 30% showed almost no effect on the phase separation induced fractionation.
  • Arabinoxylans: Bioactivities in Relation to Their Molecular Structure

    Li, Weili; Zhang, Zhengxiao; Smith, Christopher J.; University of Chester; Manchester Metropolitan University (Bentham Science, 2017-03-09)
    Arabinoxylans are a group of compounds with a basic structure consisting of a xylose backbone with arabinose side chains. Variations in structure occur as a result of variations in the xylose chain length, the ratio of arabinose to xylose and the introduction of alternative side-chains. This allows for an enormous potential range of structures. Arabinoxylans are major components of the cell walls of cereals. They have been reported to have numerous health benefits. This chapter presents a systematic description of the molecular features of arabinoxylans and relates these to the different extraction technologies used to obtain them. The proposal, that their immune modulation activity is related to their molecular weight and structure, is presented. Results demonstrating the effects of various arabinoxylans in various in vitro immunological tests are discussed.
  • Modulation of Innate and Adaptive Immune Responses by Arabinoxylans

    Fadel, Abdulmannan; Plunkett, Andrew; Li, Weili; Ashworth, Jason J.; Manchester Metropolitan University; University of Chester; Al-Baha University; Al-Ahliyya Amman University; Universiti Putra Malaysia; Istanbul Universitesi (Wiley, 2017-11-30)
    Humans are exposed to harmful pathogens and a wide range of noxious substances every day.The immune system reacts to, and destroys, these pathogens and harmful substances. The immunesystem is composed of innate and adaptive immunity, which liaise to protect the host and maintainhealth. Foods, especially cereals, have been reported to modulate the immune response.Arabinoxylans are nonstarch polysaccharides that have been shown to possess immune-modulatory activities. This review article discusses the fundamentals of the immune system andprovides an overview of the immunomodulatory potential of arabinoxylans in conjunction withtheir structural characteristics and proposed similarities with lipopolysaccharides
  • The development of vegetarian omega-3 oil in water nanoemulsions suitable for integration into functional food products

    Lane, Katie E.; Li, Weili; Smith, Christopher J.; Derbyshire, Emma J.; Liverpool John Moores University; University of Chester (Elsevier, 2016-03-31)
    Global trends show that habitual omega-3 intakes are short of recommended guidelines, particularly among vegetarians and vegans. The potential health implications of low long chain omega-3 polyunsaturated fatty acid (LCω3PUFA) intakes coupled with concerns about sustainability of fish stocks call for innovative approaches to provide food based solutions to this problem. Nanoemulsions are systems with extremely small droplet sizes that could provide a solution while improving the bioavailability of LCω3PUFA. Oil in water nanoemulsion systems were successfully created using ultrasound with oil loads of up to 50% (w/w) using vegetarian LCω3PUFA oils (flaxseed and algae). Nanoemulsions of 50% (w/w) with mean droplet size measurements of 192 (flaxseed) and 182 nm (algae) using combinations of the emulsifiers Tween 40 and lecithin were prepared. This technique could be applied to create vegetarian LCω3PUFA nanoemulsions suitable for integration into enriched functional food products with the potential to increase LCω3PUFA intake and bioavailability
  • Health-related effects and improving extractability of cereal arabinoxylans

    Fadel, Abdulmannan; Mahmoud, Ayman M.; Ashworth, Jason J.; Li, Weili; Ng, Yu L.; Plunkett, Andrew; Manchester Metropolitan University; Beni-Suef University; Charité-University Medicine; University of Chester (Elsevier, 2017-11-11)
    Arabinoxylans (AXs) are major dietary fibers. They are composed of backbone chains of -(1–4)- linked xylose residues to which -l-arabinose are linked in the second and/or third carbon positions. Recently, AXs have attracted a great deal of attention because of their biological activities such as their immunomodulatory potential. Extraction of AXs has some difficulties; therefore, various methods have beenusedto increase the extractability ofAXs withvaryingdegrees of success, suchas alkaline, enzymatic, mechanical extraction. However, some of these treatments have been reported to be either expensive, such as enzymatic treatments, or produce hazardous wastes and are non-environmentally friendly, such as alkaline treatments. On the other hand, mechanical assisted extraction, especially extrusion cooking, is an innovative pre-treatment that has been used to increase the solubility of AXs. The aim of the current review article is to point out the health-related effects and to discuss the current research on the extraction methods of AXs.
  • Characterization of Nitric Oxide Modulatory Activities of Alkaline-Extracted and Enzymatic-Modified Arabinoxylans from Corn Bran in Cultured Human Monocytes

    Zhang, Zhengxiao; Smith, Christopher J.; Li, Weili; Ashworth, Jason J.; Manchester Metropolitan University; University of Chester (American Chemical Society, 2016-10-10)
    The ingestion of foods and food-derived substances that may mediate the immune system is widely studied. Evidence suggests cereal arabinoxylans (AXs) have immunomodulatory activities that may impart health benefits in terms of immune enhancement. This study extracted AXs from corn bran using alkali and developed a modification process using three endoxylanases to obtain fractions of lower molecular weight ranges. In vitro studies showed extracted and modified AXs significantly (P < 0.05) elevated nitric oxide (NO) synthesis by the human U937 monocytic cell line (ranging from 53.7 ± 1.1 to 62.9 ± 1.2 μM per million viable cells) at all concentrations tested (5–1000 μg/mL), indicative of immune enhancement compared to an untreated control (43.7 ± 1.9 μM per million viable cells). The study suggested the dose range and Mw distribution of AXs are key determinants of immune-modulatory activity. AXs in the low Mw range (0.1–10 KDa) were the most effective at inducing NO secretion by U937 macrophages at low AX concentration ranges (5–50 μg/mL), with NO production peaking at 62.9 ± 1.2 μM per million viable cells with 5 μg/mL of AX (P = 0.0009). In contrast, AXs in the high Mw range (100–794 kDa) were most effective at inducing NO at high AX concentration ranges (500–1000 μg/mL) with NO production reaching a maximum of 62.7 ± 1.3 μM per million viable cells at 1000 μg/mL of AX (P = 0.0011). The findings suggest that dietary AXs from corn bran may heighten innate immune responses in the absence of infection or disease.
  • Regulation of Nitric Oxide Synthase Expression by Structure Modified Arabinoxylans from Wheat Flour in Cultured Human Monocytes

    Zhang, Zhengxiao; Smith, Christopher J.; Ashworth, Jason J.; Li, Weili; Manchester Metropolitan University; University of Chester (Wiley, 2018-01-08)
    The immunomodulatory activity of the arabinoxylans (AXs) extracts from cereal sources has been reported to impart health benefits in terms of immune enhancement. This study investigated the effect of enzymatic extraction on extraction yield and structure of AXs from wheat flour pentosan fraction. Under the optimised conditions, the extraction yield of AXs reached up to 81.25%. Furthermore, the study determined whether water-extracted AXs (WEAXs) and enzyme-extracted AXs (E-WEAXs) from wheat flour were able to differentially stimulate nitric oxide (NO) secretion through increased levels of inducible nitric oxide synthase (iNOS) in human U937 monocytes. The results indicated that AXs concomitantly induced (P < 0.05) both NO and iNOS productions in U937 monocytes compared to untreated cells. Compared with WEAXs, E-WEAXs resulted in a higher proportion of low Mw (1–10 KDa) AXs (49.51% vs. 19.11% in WEAXs), a higher A/X ratio (0.83 vs. 0.48 in WEAXs) and a higher yield (12.83 ± 0.35% vs. 7.54 ± 0.47% in WEAXs). Moreover, E-WEAXs induced significantly (P < 0.05) greater NO and iNOS production per million viable cells (61.8 ± 2.7 μm and 42.41 ± 3.83 ng respectively) than WEAXs (51.6 ± 2.6 μm and 33.46 ± 1.48 ng, respectively). The findings suggest AXs may heighten innate immune activity in the absence of infection or disease through an iNOS-mediated stimulation of NO production. The immunomodulatory activity of the wheat-derived AXs was enhanced by enzyme treatment, with low Mw and high A/X ratio associated with elevated NO/iNOS levels in human monocytes compared to water extraction.
  • A 1-h time interval between a meal containing iron and consumption of tea attenuates the inhibitory effects on iron absorption: a controlled trial in a cohort of healthy UK women using a stable iron isotope.

    Ahmad Fuzi, Salma F.; Koller, Dagmar; Brugrabber, Sylvaine; Pereira, Dora I. A.; Dainty, Jack R.; Mushtaq, Sohail; University of Chester; Elsie Widdowson Laboratory, Cambridge; University of East Anglia; University Putra Malaysia (American Society for Nutrition, 2017-10-18)
    Background: Tea has been shown to be a potent inhibitor of nonheme iron absorption, but it remains unclear whether the timing of tea consumption relative to a meal influences iron bioavailability. Objective: The aim of the study was to investigate the effect of a 1-h time interval of tea consumption on nonheme iron absorption in an iron-containing meal in a cohort of iron-replete, nonanemic female subjects with the use of a stable isotope (57Fe). Design: Twelve women (mean 6 SD age: 24.8 6 6.9 y) were administered a standardized porridge meal extrinsically labeled with 4 mg 57Fe as FeSO4 on 3 separate occasions, with a 14-d time interval between each test meal (TM). The TM was administered with water (TM-1), with tea administered simultaneously (TM-2), and with tea administered 1 h postmeal (TM-3). Fasted venous blood samples were collected for iron isotopic analysis and measurement of iron status biomarkers. Fractional iron absorption was estimated by the erythrocyte iron incorporation method. Results: Iron absorption was 5.7% 6 8.5% (TM-1), 3.6% 6 4.2% (TM-2), and 5.7% 6 5.4% (TM-3). Mean fractional iron absorption was found to be significantly higher (2.2%) when tea was administered 1 h postmeal (TM-3) than when tea was administered simultaneously with the meal (TM-2) (P = 0.046). An w50% reduction in the inhibitory effect of tea (relative to water) was observed, from 37.2% (TM-2) to 18.1% (TM-3). Conclusions: This study shows that tea consumed simultaneously with an iron-containing porridge meal leads to decreased nonheme iron absorption and that a 1-h time interval between a meal and tea consumption attenuates the inhibitory effect, resulting in increased nonheme iron absorption. These findings are not only important in relation to the management of iron deficiency but should also inform dietary advice, especially that given to those at risk of deficiency. This trial was registered at as NCT02365103.
  • Impact of vitamin D supplementation on endothelial and inflammatory markers in adults: A systematic review.

    Agbalalah, Tari; Hughes, Stephen F.; Freeborn, Ellen J.; Mushtaq, Sohail; University of Chester (Elsevier, 2017-01-23)
    This systematic review aims to evaluate randomised controlled trials (RCTs) investigating the effect of vitamin D supplementation on endothelial function and inflammation in adults. An electronic search of published randomised controlled trials, using Cochrane, Pubmed and Medline databases was conducted, with the search terms related to vitamin D and endothelial function. Inclusion criteria were RCTs in adult humans with a measure of vitamin D status using serum/plasma 25(OH)D and studies which administered the intervention through the oral route. Among the 1107 studies retrieved, 29 studies met the full inclusion criteria for this systematic review. Overall, 8 studies reported significant improvements in the endothelial/inflammatory biomarkers/parameters measured. However, in 2 out of the 8 studies, improvements were reported at interim time points, but improvements were absent post-intervention. The remaining 21 trial studies did not show significant improvements in the markers of interest measured. Evidence from the studies included in this systematic review did not demonstrate that vitamin D supplementation in adults, results in an improvement in circulating inflammatory and endothelial function biomarkers/parameters. This systematic review does not therefore support the use of vitamin D supplementation as a therapeutic or preventative measure for CVD in this respect.
  • Optimising the management of bone disease for coeliac patients in a dietetic-led clinic

    Martin, Kirsty J.; Woodall, Alison; University Hospital Aintree and The Walton Centre NHS Foundation Trust; University of Chester (Science and Education Publishing Co., 2016-06)
    Coeliac disease (CD) is a chronic autoimmune inflammatory condition of the small bowel; the only treatment is lifelong adherence to a gluten free diet (GFD). Adherence to a GFD also minimises the risk of associated conditions such as osteoporosis in CD patients. The present study aimed to evaluate and optimise management of bone disease in CD patients in a dietetic-led clinic. This study was conducted in two parts: study 1 utilised retrospective data to evaluate management of bone disease with reference to British Society of Gastroenterology (BSG) guidelines in 229 CD patients. Based on the results from study 1, study 2 developed a tool to estimate dietary calcium intake in CD patients, which was then trialled on 50 patients. There were no significant differences between the population demographics for study 1 and study 2. 65% of patients had a diagnosis of osteopenia or osteoporosis, in a female predominant population (74.6%). Reported mean dietary calcium intake was over estimated at 1239.6mg/day (SD ± 377.1mg) in study 1 and corrected to 852mg/day (SD ± 264.57mg) using improved methodology (study 2) (p≤0.05). Understanding and compliance with dietary advice correlated positively with GFD (p≤0.001) but not osteoporosis or fracture risk. Overall patients attending the clinic did not meet the BSG recommended calcium intake. However, 30% of patients could meet the 2014 BSG target from oral diet alone. Utilising individual dietary prescriptions and targeted use of calcium supplementation maximised the opportunity to reduce risk of bone disease and improved compliance with BSG recommendations.
  • Dietary management of heart failure: room for improvement?

    Butler, Thomas; Department of Clinical Sciences and Butrition, University of Chester (Cambridge University Press, 2016-02)
    There is growing awareness of the role of diet in both health and disease management. Much data are available on the cardioprotective diet in the primary and secondary prevention of CVD. However, there is limited information on the role of diet in the management of heart failure (HF). Animal models of HF have provided interesting insight and potential mechanisms by which dietary manipulation may improve cardiac performance and delay the progression of the disease, and small-scale human studies have highlighted beneficial diet patterns. The aim of this review is to summarise the current data available on the role of diet in the management of human HF and to demonstrate that dietary manipulation needs to progress further than the simple recommendation of salt and fluid restriction.
  • Inequalities in dental health: An ecological analysis of the interaction between the effects of water fluoridation and social deprivation on tooth decay in children living in England

    Tocque, Karen; Kennedy, Lynne; University of Chester; KT Intelligence CIC (Academic Journals, 2015-07-31)
    Oral health in England has improved considerably in recent years but continues to show a strong inequalities gradient. This study was aimed at investigating variations in dental decay and elation to social deprivation and local water fluoridation. An ecological analysis using the 2007 and 2008 National Dental Epidemiology Programme survey of 5 year old children in England. Postcode of residence was mapped to census lower super output area (LSOA). LSOAs were assigned a national deprivation quintile and a fluoridation category based upon therapeutic level of 1 mg/L. Multiple logistic regression was applied to determine independent influences on tooth decay. Analysis of covariance (ANCOVA) was used to investigate interactions between fluoridation and deprivation on the mean levels of dental caries. Analysis is based on 142,030 clinical dental examinations, representing 25% of estimated population of 5 year olds in England. Overall, 31% of children had at least one decayed missing or filled tooth (dmft). Multiple logistic regression showed that children living in the most deprived areas were three times more likely to experience tooth decay than those living in affluent areas; whereas children living in fluoridated areas were 1.5 times less likely to have dmft than those living in non-fluoridated areas. Therefore, although both are independently significant, living in the most deprived quintile of social deprivation doubled the impact on the likelihood of dental decay compared to non-fluoridation. ANCOVA showed a strong gradient of increasing mean dmft with increasing social deprivation in both water-fluoridated and non-fluoridated areas, with 3 times more dental decay in more deprived areas than in more affluent areas. In all deprivation quintiles, children living in fluoridated areas have significantly (p < 0.001) lower mean dmft than those living in equivalent deprivation with no water fluoridation. Fluoridated drinking water may moderate dental caries; however, socioeconomic deprivation has a stronger influence on dental decay than local fluoridation of water.
  • Death by effectiveness: exercise as medicine caught in the efficacy trap!

    Beedie, Chris; Mann, Steven; Jimenez, Alfonso; Kennedy, Lynne; Lane, Andrew M.; Domone, Sarah; Wilson, Stephen; Whyte, Greg; Aberystwyth University; ukactive Research Institute; Universidad Europea; University of Chester; University of Wolverhampton; Liverpool John Moores University (BMJ Publishing Group, 2015-02-12)
    Sport and Exercise Medicine (SEM) has had a good run. For a while it was the low-cost magic bullet. With efficacy demonstrated in study after study, the conclusion was clear: ‘Exercise is Medicine’, a potential public health panacea. Sadly, the early promise waned. While we continue to be bombarded by original research and reviews extoling the efficacy of exercise, there is an apparent dearth of evidence of its effectiveness. This fact is highlighted in 2014 reports from the UK Government1 and Public Health England.2
  • Self-efficacy for temptations is a better predictor of weight loss than motivation and global self-efficacy: Evidence from two prospective studies among overweight/obese women at high risk of breast cancer.

    Armitage, Christopher J.; Wright, Claire E.; Parfitt, Gaynor; Pegington, Mary; Donnelly, Louise S.; Harvie, Michelle N.; University of Manchester; University of Chester; University of South Australia; University Hospital South Manchester (Elsevier, 2014-02-03)
    OBJECTIVES: Identifying predictors of weight loss could help to triage people who will benefit most from programs and identify those who require additional support. The present research was designed to address statistical, conceptual and operational difficulties associated with the role of self-efficacy in predicting weight loss. METHODS: In Study 1, 115 dieting overweight/obese women at high risk of breast cancer were weighed and completed questionnaires assessing motivation, global self-efficacy and self-efficacy for temptations. The main outcome measure was weight, measured 3-months post-baseline. Study 2 was identical (n=107), except changes in psychological variables were computed, and used to predict weight 6-months post-baseline. RESULTS: In Study 1, self-efficacy for temptations was a significant predictor of weight loss at 3-month follow-up. In Study 2, improved self-efficacy for temptations between baseline and four-weeks was predictive of lower weight at 6 months. CONCLUSION: The key finding was that self-efficacy for temptations, as opposed to motivation and global self-efficacy, was predictive of subsequent weight loss. PRACTICE IMPLICATIONS: The implication is that augmenting dieters' capability for dealing with temptations might boost the impact of weight loss programs.
  • Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy

    Basu, Andrea J.; Kennedy, Lynne; Tocque, Karen; Jones, Sharn; University of Chester; Wrexham Maelor Hospital (BioMed Central, 2014-07-04)
    Background: Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject. Methods A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated. Results 43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as ‘better’ (95% CI 85 to 100), as opposed to 3% stating ‘stayed the same’ – 60% stated ‘much better’. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either ‘much’ or ‘somewhat better’ (95% CI 66 to 93), as opposed to 17% stating ‘stayed the same’. 89% indicated confidence to discuss eating habits and physical activity was ‘much’ or ‘somewhat better’ (95% CI 73 to 97) as opposed to 11% stating ‘stayed the same’. Emergent themes highlighted that training was positively received and relevant to midwifery practice. Conclusions This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.
  • Abortion 'on the NHS': The National Health Service and abortion stigma

    Astbury-Ward, Edna; University of Chester (BMJ journals, 2015-03-05)
    Before the creation of the National Health Service (NHS), the health of the British nation was in a perilous state and hospitals survived on the philanthropy of rich benefactors. Following its introduction on 5 July 1948, the NHS was the biggest and most expensive social reform of the era.1 It was founded on three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that its use should be based on clinical need, not ability to pay. These principles govern the NHS today. The NHS should not discriminate against anyone who requires health care. Yet abortion care remains almost the only acute health need not comprehensively provided for within the NHS.2 In England and Wales in 2013, 98% (185 331) of all abortions were funded by the NHS,3 but only 34% of abortions took place in NHS settings. The majority were in the independent sector, funded by the NHS.4 This is in sharp contrast to Scotland, where in 2013 only 40 women out of 12 447 (0.3%) had their abortions in a non-NHS setting.5 The question is why?
  • Practising at a higher level. Interview by Alison Moore.

    Astbury-Ward, Edna; Deeside Community Hospital (Scutari Projects, 2000)
  • The erectile dysfunction revolution

    Astbury-Ward, Edna; Deeside Community Hospital (Scutari Projects, 2001-04)
    Erectile dysfunction affects approximately one in ten men at some point in their lives. This article describes its causes and the treatments available, and examines the effect it can have on those who experience the condition.
  • A questionnaire survey of the provision of training in human sexuality in schools of nursing in the UK

    Astbury-Ward, Edna; Glyndŵr University (Taylor & Francis, 2011-10-05)
    The inconsistent and haphazard approach to the provision of training in human sexuality to health professionals in the UK and elsewhere has been a matter of concern for over half a century. This article discusses the implications of findings from a questionnaire survey of 41 schools of nursing in the UK regarding their provision of training in human sexuality. Schools of nursing were chosen, as nurses form by far the largest employment group in the NHS today. The aim of this questionnaire survey was to obtain information on the provision of training in human sexuality in schools of nursing in the UK. The 20-item mixed qualitative and quantitative questionnaire was designed to elicit maximum information about research questions, it was independently validated after focus group discussion. The results drawn from this study will be primarily presented as observations, rather than statistically tested statements. The provision of training in human sexuality in the pre-registration nursing curricula in the UK is inadequate to meet the current varied needs of patients. On average, a mere 6.8 hours out of a potential 2300 hours of theoretical learning is dedicated to teaching human sexuality in schools of health in the UK. This is considerably less time than is dedicated to other areas of learning within the curriculum. The overall provision of training in human sexuality in the nursing curricula does not seem to have significantly improved, regardless of pleas from such esteemed bodies as the World Health Organisation and others.

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