“Why Does It Hurt When I Have Sex?” (And What To Do About It)
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This is one that affects mostly women, with 43% of American women reporting such issues at some point. There’s a distribution curve to this, with higher incidence in younger and older women; younger while first figuring things out, and older with menopause-related body changes. But, it can happen at any time (and often not for obvious reasons!), so here’s what OB/GYN Dr. Jennifer Lincoln advises:
Many possibilities, but easily narrowed down
Common causes include:
- vaginal dryness, which itself can have many causes (half of which are “low estrogen levels” for various different reasons)
- muscular issues, which can be in response to anxiety, pain, and occur as a result of pelvic floor muscle tightening
- vulvar issues, ranging from skin disorders (e.g. lichen sclerosis or lichen planus) to nerve disorders (e.g. vestibulitis or vestibulodynia)
- uterine issues, including endometriosis, fibroids, or scar tissue if you had a surgery
- infections, of the STI variety, but bear in mind that some STIs such as herpes do not necessarily require direct sexual contact per se, and yeast infections definitely don’t. Some STIs are more serious than others, so getting things checked out is a good idea (don’t worry, clinics are discreet about this sort of thing)
- bowel issues, notwithstanding that we have been talking about vaginal sex here, it can’t be happy if its anatomical neighbors aren’t happy—so things like IBS, Crohn’s, or even just constipation, aren’t irrelevant
- trauma, of various kinds, affecting sexual experiences
That’s a lot of possibilities, so if there’s not something standing out as “yes, now that you mention it, it’s obviously that”, Dr. Lincoln recommends a full health evaluation and examination of medical history, as well as a targeted physical exam. That may not be fun, but at least, once it’s done, it’s done.
Treatments vary depending on the cause, of course, and there are many kinds of physical and psychological therapies, as well as surgeries for the uterine issues we mentioned.
Happily, many of the above things can be addressed with simpler and less invasive methods, including learning more about the relevant anatomy and physiology and how to use it (be not ashamed; most people never got meaningful education about this!)*, vulvar skin care (“gentle” is the watchword here), the difference a good lube can make, and estrogen supplementation—which if you’re not up for general HRT, can be a topical estrogen cream that alleviates sexual function issues without raising blood serum estradiol levels.
*10almonds tip: check out the recommended book “Come As You Are” in our links below; it has 400 pages of stuff most people never knew about anatomy and physiology down there; you can thank us later!
Meanwhile, for more on each of these, enjoy:
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Want to learn more?
You might also like to read:
- Water-based Lubricant vs Silicon-based Lubricant – Which is Healthier? (counterintuitively, it’s the silicon! But do give it a quick read, because here be science)
- How To Avoid Urinary Tract Infections (may be relevant; always good to know)
- Come As You Are – by Dr. Emily Nagoski (book; if we could only recommend one book on responsible vagina ownership, this would be the one)
Take care!
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Can We Side-Step Age-Related Alienation?
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When The World Moves Without Us…
We’ve written before about how reduced social engagement can strike people of all ages, and what can be done about it:
How To Beat Loneliness & Isolation
…but today we’re going to talk more about a specific aspect of it, namely, the alienation that can come with old age—and other life transitions too, but getting older is something that (unless accident or incident befall us first) all of us will definitely do.
What’s the difference?
Loneliness is a status, alienation is more of a process. It can be the alienation in the sense of an implicit “you don’t belong here” message from the world that’s geared around the average person and thus alienates those who are not that (a lack of accessibility to people with disabilities can be an important and very active example of this), and it can also be an alienation from what we’ve previously considered our “niche” in the world—the loss of purpose many people feel upon retirement fits this bill. It can even be a more generalized alienation from our younger selves; it’s easy to have a self-image that doesn’t match one’s current reality, for instance.
Read more: Estranged by Time: Alienation in the Aging Process
So, how to “un-alienate”?
To “un-alienate”, that is to say, to integrate/reintegrate, can be hard. Some things may even be outright impossible, but most will not be!
Consider how, for example, former athletes become coaches—or for that matter, how former party-goers might become party-hosts (even if the kind of “party” might change with time, give or take the pace at which we like to live our lives).
What’s important is that we take what matters the most to us, and examine how we can realistically still engage with that thing.
This is different from trying to hold on grimly to something that’s no longer our speed.
Letting go of the only thing we’ve known will always be scary; sometimes it’s for the best, and sometimes what we really need is just more of a pivot, like the examples above. The crux lies in knowing which:
- Is our relationship with the thing (whatever it may be) still working for us, or is it just bringing strife now?
- If it’s not working for us, is it because of a specific aspect that could be side-stepped while keeping the rest?
- If we’re going to drop that thing entirely (or be dropped by it, which, while cruel, also happens in life), then where are we going to land?
This latter is one where foresight is a gift, because if we bury our heads in the sand we’re going to land wherever we’re dropped, whereas if we acknowledge the process, we can make a strategic move and land on our feet.
Here’s a good pop-science article about this—it’s aimed at people around retirement age, but honestly the advice is relevant for people of all ages, and facing all manner of life transitions, e.g. career transitions (of which retirement is of course the career transition to end all career transitions), relationship transitions (including B/B/B/B: births, betrothals/break-ups, and bereavements) health transitions (usually: life-changing illnesses and/or disabilities—which again, happens to most of us if something doesn’t get us first), etc. So with all that in mind, this becomes more of a “how to reassess your life at those times when it needs reassessing”:
How to Reassess Your Life in Retirement
But that doesn’t mean that letting go is always necessary
Sometimes, the opposite! Sometimes, the age-old advice to “lean in” really is all the situation calls for, which means:
- Be ready to say “yes” to things, and if nobody’s asking, be ready to “hey, do you wanna…?” and take a “build it and they will come” approach. This includes with people of different ages, too! Intergenerational friendships can be very rewarding for all concerned, if done right. Communities that span age-ranges can be great for this—they might be about special interests (this writer has friends ranging through four generations from playing chess, for instance), they could be religious communities if we be religious, LGBT groups if that fits for us, even mutual support groups such as for specific disabilities or chronic illness if we have such—notice how the very things that might isolate us can also bring us together!
- Be open-minded to new experiences; it’s easy to get stuck in a rut of “I’ve never done that” and mistake that self-assessment for an uncritical assumption of “I’m not the kind of person who does that”. Sometimes, you really won’t be! But at least think about it and entertain the possibility, before dismissing it out of hand. And, here’s a life tip: it can be really good to (within the realms of safety, and one’s personal moral principles, of course) take an approach of “try anything once”. Even if we’re almost certain we won’t like it, and even if we then turn out to indeed not like it, it can be a refreshing experience—and now we can say “Yep, tried that, not doing that again” from a position of informed knowledge. That’s the only way we get to look back on a richly lived life of broad experiences, after all, and it is never too late for such.
- Be comfortable prioritizing quality over quantity. This goes for friends, it goes for activities, it goes for experiences. The topic of “what’s the best number of friends to have?” has been a matter of discussion since at least ancient Greek times (Plato and Aristotle examined this extensively), but whatever number we might arrive at, it’s clear that quality is the critical factor, and quantity after that is just a matter of optimizing.
In short: make sure you’re investing—in your relationships, in your areas of interest, in your community (whatever that may mean for you personally), and most of all, and never forget this: in yourself.
Take care!
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Strong Curves – by Bret Contreras & Kellie Davis
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The title (and subtitle) is, of course, an appeal to vanity. However, the first-listed author is well-known as “The Glute Guy”, and he takes this very seriously, not just for aesthetic reasons but also for practical reasons.
After all, when it comes to posture and stability, a lot rests on our hips, and hips, well, they rest on our butt and thighs. What’s more, the gluteus maximus is the largest muscle in the human body, so really, is it a good one to neglect? Probably not, and your lower back will definitely thank you for keeping your glutes in good order, too.
That said, while it’s a focal point, it’s not the be-all-and-end-all, and this book does cover the whole body.
The book takes the reader from “absolute beginner” to “could compete professionally”, with clearly-illustrated and well-described exercises. We also get a strong “crash course” in the relevant anatomy and physiology, and even a chapter on nutrition, which is a lot better than a lot of exercise books’ efforts in that regard.
For those who like short courses, this book has several progressive 12-week workout plans that take the reader from a very clear starting point to a very clear goal point.
Another strength of the book is that while a lot of exercises expect (and require) access to a gym, there are also whole sections of “at home / bodyweight” exercises, including 12-week workout plans for such, as described above.
Bottom line: there’s really nothing bad that this reviewer can find to say about this one—highly recommendable to any woman who wants to get strong while keeping a feminine look.
Click here to check out Strong Curves, and rebuild your body, your way!
PS: at first glance, the cover art looks like an AI model; it’s not; that’s the co-author Kellie Davis, who also serves as the model through the book’s many photographic illustrations.
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What Are The “Bright Lines” Of Bright Line Eating?
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This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.
We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.
What does she want us to know?
Bright Line Eating’s general goal
Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.
You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):
When BMI Doesn’t Quite Measure Up
Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.
What are these “bright lines”?
Bright Line Eating comes with 4 rules:
- No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
- No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
- No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
- Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).
You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”
The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.
You will note that this is completely in opposition to the expert opinion we hosted last week:
What Flexible Dieting Really Means
Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”
Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?
But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:
Where does the psychology come in?
Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.
So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.
You may be wondering: ”doesn’t sticking to what we decided still require willpower?”
And… Potentially. But the key here is shutting down self-negotiation.
Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.
In short, there are lots of opportunities to rationalize the decision to eat the cake.
With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.
So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.
Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:
Bright Line Eating | Research Publications
Counterpoint: pick your own “bright lines”
Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.
So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:
Bright Lines as Guidelines for Weight Loss
The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.
Want to know more from Dr. Thompson?
You might like her book, which we reviewed a while ago:
Bright Line Eating – by Dr. Susan Peirce Thompson
Enjoy!
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Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others
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ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.
Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.
“He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.
Warren told her the noise hurt.
Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.
The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.
“I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.
“It can get to the extreme where it can cause physical discomfort,” she said.
When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.
That can be stressful, not melodic, Follmer said.
To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.
“When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.
Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.
“For him, researching it and looking into it I think grounds him a little bit,” Reed said.
Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.
Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.
“Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.
For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.
It’s not always bad, though. The cicada’s song can also be a relief.
For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.
“The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.
As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.
Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.
“If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.
Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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5 Stretches To Relieve The Pain From Sitting & Poor Posture
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Sitting is not good for the health, yes often it’s a necessity of modern life, especially if driving. To make things worse, it can often be difficult to remember to maintain good posture the rest of the time, if it’s not a habit. So, while reducing sitting and improving posture are both very good things to do, here are 5 stretches to mitigate the damage meanwhile:
Daily doses:
These are best done at a rate of 2–3 sets daily:
Cat-Cow Stretch:
- Benefits: eases spinal tension, boosts flexibility, improves posture.
- How to: start on all fours, alternate between arching and rounding your back while syncing with your breath (10-15 times).
Butterfly Stretch:
- Benefits: loosens tight hips, improves lower back flexibility, and enhances mobility for activities like squats.
- How to: sit with soles of feet together, let knees fall toward the floor, lean forward slightly, and hold for 30 seconds to 1 minute.
Supine Twist:
- Benefits: unlocks the spine, relieves post-workout tension, and relaxes the shoulders and hips.
- How to: lie on your back, bend knees, twist to one side while keeping shoulders grounded, and hold for 30 seconds to 1 minute per side.
Calf Stretch:
- Benefits: improves ankle mobility, loosens tight calves, and prevents injuries like Achilles tendinitis.
- How to: stand facing a wall, extend one leg back with the heel on the ground, lean into the stretch, or use a step for deeper stretches. Hold for 30 seconds to 1 minute per leg.
Child’s Pose:
- Benefits: decompresses the spine, relaxes hips, and relieves tension in back and thighs.
- How to: start on hands and knees, sit back onto your heels, stretch arms forward, and rest forehead on the mat. Hold for 30 seconds to 1 minute.
For more on each of these, plus visual demonstrations, enjoy:
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Want to learn more?
You might also like:
10 Tips To Reduce Morning Pain & Stiffness With Arthritis
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Blood, urine and other bodily fluids: how your leftover pathology samples can be used for medical research
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A doctor’s visit often ends with you leaving with a pathology request form in hand. The request form soon has you filling a sample pot, having blood drawn, or perhaps even a tissue biopsy taken.
After that, your sample goes to a clinical pathology lab to be analysed, in whichever manner the doctor requested. All this is done with the goal of getting to the bottom of the health issue you’re experiencing.
But after all the tests are done, what happens with the leftover sample? In most cases, leftover samples go in the waste bin, destined for incineration. Sometimes though, they may be used again for other purposes, including research.
Kaboompics.com/Pexels Who can use my leftover samples?
The samples we’re talking about here cover the range of samples clinical labs receive in the normal course of their testing work. These include blood and its various components (including plasma and serum), urine, faeces, joint and spinal fluids, swabs (such as from the nose or a wound), and tissue samples from biopsies, among others.
Clinical pathology labs often use leftover samples to practise or check their testing methods and help ensure test accuracy. This type of use is a vital part of the quality assurance processes labs need to perform, and is not considered research.
Leftover samples can also be used by researchers from a range of agencies such as universities, research institutes or private companies.
They may use leftover samples for research activities such as trying out new ideas or conducting small-scale studies (more on this later). Companies that develop new or improved medical diagnostic tests can also use leftover samples to assess the efficacy of their test, generating data needed for regulatory approval.
What about informed consent?
If you’ve ever participated in a medical research project such as a clinical trial, you may be familiar with the concept of informed consent. In this process, you have the opportunity to learn about the study and what your participation involves, before you decide whether or not to participate.
So you may be surprised to learn using leftover samples for research purposes without your consent is permitted in most parts of Australia, and elsewhere. However, it’s only allowed under certain conditions.
In Australia, the National Health and Medical Research Council (NHMRC) offers guidance around the use of leftover pathology samples.
One of the conditions for using leftover samples without consent for research is that they were received and retained by an accredited pathology service. This helps ensure the samples were collected safely and properly, for a legitimate clinical reason, and that no additional burdens or risk of harm to the person who provided the sample will be created with their further use.
Another condition is anonymity: the leftover samples must be deidentified, and not easily able to be reidentified. This means they can only be used in research if the identity of the donor is not needed.
Leftover pathology samples are sometimes used in medical research. hedgehog94/Shutterstock The decision to allow a particular research project to use leftover pathology samples is made by an independent human research ethics committee which includes consumers and independent experts. The committee evaluates the project and weighs up the risks and potential benefits before permitting an exemption to the need for informed consent.
Similar frameworks exist in the United States, the United Kingdom, India and elsewhere.
What research might be done on my leftover samples?
You might wonder how useful leftover samples are, particularly when they’re not linked to a person and their medical history. But these samples can still be a valuable resource, particularly for early-stage “discovery” research.
Research using leftover samples has helped our understanding of antibiotic resistance in a bacterium that causes stomach ulcers, Helicobacter pylori. It has helped us understand how malaria parasites, Plasmodium falciparum, damage red blood cells.
Leftover samples are also helping researchers identify better, less invasive ways to detect chronic diseases such as pulmonary fibrosis. And they’re allowing scientists to assess the prevalence of a variant in haemoglobin that can interfere with widely used diagnostic blood tests.
All of this can be done without your permission. The kinds of tests researchers do on leftover samples will not harm the person they were taken from in any way. However, using what would otherwise be discarded allows researchers to test a new method or treatment and avoid burdening people with providing fresh samples specifically for the research.
When considering questions of ethics, it could be argued not using these samples to derive maximum benefit is in fact unethical, because their potential is wasted. Using leftover samples also minimises the cost of preliminary studies, which are often funded by taxpayers.
The use of leftover pathology samples in research has been subject to some debate. Andrey_Popov/Shutterstock Inconsistencies in policy
Despite NHMRC guidance, certain states and territories have their own legislation and guidelines which differ in important ways. For instance, in New South Wales, only pathology services may use leftover specimens for certain types of internal work. In all other cases consent must be obtained.
Ethical standards and their application in research are not static, and they evolve over time. As medical research continues to advance, so too will the frameworks that govern the use of leftover samples. Nonetheless, developing a nationally consistent approach on this issue would be ideal.
Striking a balance between ensuring ethical integrity and fostering scientific discovery is essential. With ongoing dialogue and oversight, leftover pathology samples will continue to play a crucial role in driving innovation and advances in health care, while respecting the privacy and rights of individuals.
Christine Carson, Senior Research Fellow, School of Medicine, The University of Western Australia and Nikolajs Zeps, Professor, School of Public Health and Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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