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Liu BP, Jia CX, Qin P, Zhang YY, Yu YK, Luo X, Li SX. Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies. EClinicalMedicine 2022; 49:101461. [PMID: 35747199 PMCID: PMC9126760 DOI: 10.1016/j.eclinm.2022.101461] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Longitudinal evidence for sociodemographic and clinic factors deviating risk for suicide and repetition following SH (self-harm) varied greatly. METHODS A comprehensive search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted from January 1st, 2010 to April 5th, 2022. Longitudinal studies focusing on examining associating factors for suicide and repetition following SH were included. PROSPERO registration CRD42021248695. FINDINGS The present meta-analysis synthesized data from 62 studies published from Jan. 1st, 2010. The associating factors of SH repetition included female gender (RR, 95%CI: 1.11, 1.04-1.18, I2=82.8%), the elderly (compared with adolescents and young adults, RR, 95%CI: 0.67, 0.52-0.87, I2=86.3%), multiple episodes of SH (RR, 95%CI: 1.97, 1.51-2.57, I2=94.3%), diagnosis (RR, 95%CI: 1.60, 1.27-2.02, I2=92.7%) and treatment (RR, 95%CI: 1.59, 1.40-1.80, I2=93.3%) of psychiatric disorder. Male gender (RR, 95%CI: 2.03, 1.80-2.28, I2=83.8%), middle-aged adults (compared with adolescents and young adults, RR, 95%CI: 2.40, 1.87-3.08, I2=74.4%), the elderly (compared with adolescents and young adults, RR, 95%CI: 4.38, 2.98-6.44, I2=76.8%), physical illness (RR, 95%CI: 1.95, 1.56-2.43, I2=0), multiple episodes of SH (RR, 95%CI: 2.02, 1.58-2.58, I2=87.4%), diagnosis (RR, 95%CI: 2.13, 1.67-2.71, I2=90.9%) and treatment (RR, 95%CI: 1.36, 1.16-1.58, I2=58.6%) of psychiatric disorder were associated with increased risk of suicide following SH. INTERPRETATION Due to the substantial heterogeneity for clinic factors of suicide and repetition following SH, these results need to be interpreted with caution. Clinics should pay more attention to the cases with SH repetition, especially with poor physical and psychiatric conditions. FUNDING This work was supported by National Natural Science Foundation of China (NSFC) [No: 82103954; 30972527; 81573233].
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
- Corresponding author at: Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine of University of Oslo, Oslo, Norway
| | - Ying-Ying Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Yao-Kun Yu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Xiao Luo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Shi-Xue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Corresponding author at: Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Huang SH, Hsing SC, Sun CA, Chung CH, Tsao CH, Chung RJ, Wang BL, Huang YC, Chien WC. Inequality in Health: The Correlation between Poverty and Injury-A Comprehensive Analysis Based on Income Level in Taiwan: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:349. [PMID: 33803828 PMCID: PMC8003303 DOI: 10.3390/healthcare9030349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022] Open
Abstract
Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher's exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of "fall," "suicide," and "homicide" incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.
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Affiliation(s)
- Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Shih-Chun Hsing
- Center for Healthcare Quality Management, Cheng Hsin General Hospital, Taipei 11220, Taiwan
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Heath Sciences, Taipei 10608, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei 24205, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei 24205, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Medical Research, National Defense Medical Center, Tri-Service General Hospital, Taipei 11490, Taiwan
| | - Chang-Huei Tsao
- Department of Medical Research, National Defense Medical Center, Tri-Service General Hospital, Taipei 11490, Taiwan
- Department of Microbiology & Immunology, National Defense Medical Center, Taipei 11490, Taiwan
| | - Ren-Jei Chung
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yao-Ching Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Medical Research, National Defense Medical Center, Tri-Service General Hospital, Taipei 11490, Taiwan
- The Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
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Chung CH, Chien WC, Yeh HW, Tzeng NS. Psychiatric consultations as a modifiable factor for repeated suicide attempt-related hospitalizations: A nationwide, population-based study. J Affect Disord 2021; 278:157-164. [PMID: 32961411 DOI: 10.1016/j.jad.2020.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The risk of mortality and morbidity increased in repeated suicide attempts. This study aimed to investigate how psychiatric consultations, a modifiable factor, affects the risk of repeated suicide attempts in patients. METHODS The National Health Insurance Research Database was used in this study. All inpatients aged ≧10 with suicide attempts were recruited in Taiwan from 2000 through 2015. Both the cross-sectional and cohort studies were used to evaluate the risk of repeated suicide attempts associated with psychiatric consultations. RESULTS In the cross-sectional approach, a total of 88,161 suicide attempts and 7,997 with repeated suicide attempts were found. Multivariable logistic regression found that the patients with psychiatric consultations were associated with the decreased risk of repeated suicide attempt-related hospitalization (SARD), as per the adjusted odds ratio of 0.527 (95% confidence interval [CI]=0.416-0.859, p <0.001). In the retrospective cohort approach, the Fine and Gray's survival analysis revealed that the patients with psychiatric consultations were associated with a lower risk of repeated SARD (adjusted subdistribution hazard ratio [SHR] =0.533( 95% CI, 0.332-0.850, p <0.001). CONCLUSIONS Overall, psychiatric consultations for the patients could be a modifiable factor, which were associated with the decreased risk of repeated suicide attempts. The age of clinicians and their experience could be the primary variable above and beyond the mental illness or the performed suicide attempt method.
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Affiliation(s)
- Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Hui-Wen Yeh
- Institute of Bioinformatics and System Biology, National Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.
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Cenderadewi M, Franklin RC, Peden AE, Devine S. Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. PLoS One 2020; 15:e0231861. [PMID: 32442177 PMCID: PMC7244177 DOI: 10.1371/journal.pone.0231861] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Unintentional drowning deaths are only part of the drowning profile, with little attention being paid to intentional drowning in Australia. Strategies for the prevention of intentional drowning deaths are likely to be different from unintentional. Quality documentation, analysis and dissemination of intentional deaths data is crucial for developing appropriate strategies for prevention. OBJECTIVE To conduct a systematic literature review to investigate the mortality rates and risk factors of intentional drowning deaths in Australia. METHODS A systematic search guided by PRISMA was performed using Ovid MEDLINE, CINAHL, PsycINFO (ProQuest), Scopus, Google Scholar, and BioMed Central databases to locate relevant original research articles published between 2007 and 2018. RESULTS Ten papers reporting the mortality rates and risk factors of intentional drowning deaths in Australia published between 2007 and 2018, with study periods of the included articles spanning from 1907 to 2012, were reviewed. Most studies investigated suicidal drowning deaths in Australia, none reported homicidal drowning deaths. The downward trend of fatal suicide drowning was identified in Australia. The annual rate of intentional drowning between 1994 and 2012 can be inferred from eight studies, ranging from 0.06 to 0.21 for nation-wide mortality rates. The highest annual state-wide mortality rate was identified in the state of Queensland, ranging from 0.02 to 0.11 per 100,000 individuals. Of four studies examining the risk factors of fatal intentional drowning in Australia, being of older age groups, being female, and the presence of substance use were identified as important factors for suicidal drowning deaths. The national-scale proportion of suicide drowning in Australia, ranging from 2% to 3% of all intentional self-harm deaths, was also identified. CONCLUSION Limited publications reporting the mortality rates and risk factors of intentional drowning deaths in Australia were identified. Being of older age groups and being female were recognised as factors for suicide drowning deaths, and psychoactive substances were widely identified amongst cases. Future research on improving death reporting systems and the legal framework for medico-legal death investigation, along with the investigation of the risk factors of intentional drowning, are required to inform the planning, implementation, and evaluation of prevention interventions for intentional drowning deaths in Australia.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
- * E-mail:
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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Kim DH, Rodríguez Andrés A, Leigh JP. Sex-Specific Impact of Changes in Job Status on Suicidal Ideation. CRISIS 2019; 41:89-96. [PMID: 31140318 DOI: 10.1027/0227-5910/a000605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Around the globe, 800,000 people die from suicide every year. Despite being one of the leading causes of death, suicide remains a low public health priority. Korea has the second highest total suicide rate among Organisation for Economic Co-operation and Development (OECD) countries. Aims: The aim of this study was to explore how changes of job status influence suicidal risk in Korea, which lags behind other OECD countries in job security because temporary and part-time jobs are more prevalent in Korea. Method: We made use of a large longitudinal dataset, the Korea Health Panel (KHP). Results: Our findings revealed that a negative change in employment status increased the risk of suicide, but only for males. Limitations: Some individuals might intentionally change their job status, but the data do not indicate why the job status of an individual changes. Conclusion: These findings provide useful insights regarding the Korean labor market. In particular, tackling the issue of job stability, providing training polices for the unemployed and under-employed, and considering social insurance schemes may help to reduce suicide risk.
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Affiliation(s)
- Dae-Hwan Kim
- Department of Economics, Dong-A University, Busan, South Korea
| | - Antonio Rodríguez Andrés
- Department of National Economy, Faculty of Economics, Technical University of Ostrava, Czech Republic.,Department of Business, Faculty of Business and Communication, International University of La Rioja, Logroño, Spain
| | - J Paul Leigh
- Department of Public Health Science, University of California, Davis, CA, USA
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Suicidal Ideation and Psychological Strain Among Patients Diagnosed With Stomach Cancer: The Mediation of Psychopathological Factors. J Nerv Ment Dis 2017; 205:550-557. [PMID: 28323661 DOI: 10.1097/nmd.0000000000000679] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with stomach cancer are at high risk to experience suicidal ideation. Strain theory of suicide assumes that suicide is preceded by psychological strain. Despite wide international acceptance of the theory, its use with a sample of patients with stomach cancer has not previously been reported. The aims were to examine the relationship between psychological strain and suicidal ideation among patients with stomach cancer and to determine whether psychopathological factors act as mediators. A cross-sectional study was undertaken involving subjects with no history of mental disorder, and questionnaires were administered by face-to-face interview. Patients who experienced more psychological strain, especially coping strain, are more likely to experience suicidal ideation. The mediation effects of hopelessness and psychological distress are significant. Psychological strain, hopelessness, and psychological distress may be the vital factors among patients with stomach cancer in the suicide-risk assessment interview and for care planning and psychological intervention.
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Song HB, Lee SA. Socioeconomic and lifestyle factors as risks for suicidal behavior among Korean adults. J Affect Disord 2016; 197:21-8. [PMID: 26967916 DOI: 10.1016/j.jad.2016.02.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/17/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Preventing suicide has become a major public health priority in Korea. The aim of this study was to evaluate the associated factors of suicidal ideation (SI(1)) and attempt (SA(2)) among Korean adults. METHODS The data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES), a nationally representative sample recruited using a multi-stage clustered probability design. The association of putative risk factors focused on nutrition and health behaviors which were evaluated using multiple logistic regression analyses after adjusting for confounding factors. Survey sample weights were used for all analysis. RESULTS The 12-month prevalence of SI and SA in Korea was 15.0% and 0.85%, respectively. Female, previously married status, lower education and lower household income were associated with SI and SA. In particular, the effect of age on SI presented a reverse pattern based on gender; there was a positive association for men and a negative association for women. Additionally, drinking, smoking, physical activity above moderate intensity and eating fewer meals were associated with SA in women, whereas regular exercise was protective against SI in men. LIMITATIONS The data were collected using a cross-sectional survey, embedding possible bias. CONCLUSIONS Higher prevalence of SI and SA among women was associated with smoking, drinking, avoiding regular exercise and insufficiency of food. Lower prevalence of SI was observed in men who engaged in physical activity while men with insufficient food showed a higher prevalence of SI and SA.
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Affiliation(s)
- Han-Byol Song
- Department of Preventive Medicine, Kangwon National University, Kangwon-do, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University, Kangwon-do, Republic of Korea.
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Fisher G, Foster C. Examining the Needs of Paediatric Nurses Caring for Children and Young People Presenting with Self-Harm/Suicidal Behaviour on General Paediatric Wards: Findings from a Small-Scale Study. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/13575279.2015.1118013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wetherall K, Daly M, Robb KA, Wood AM, O'Connor RC. Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income. Soc Psychiatry Psychiatr Epidemiol 2015; 50:929-37. [PMID: 25893994 DOI: 10.1007/s00127-015-1050-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/23/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Low income is an established risk factor for suicidal thoughts and attempts. This study aims to explore income within a social rank perspective, proposing that the relationship between income and suicidality is accounted for by the rank of that income within comparison groups. METHODS Participants (N = 5779) took part in the Adult Psychiatric Morbidity Survey across England. An income rank variable was created by ranking each individual's income within four comparison groups (sex by education, education by region, sex by region, and sex by education by region). Along with absolute income and demographic covariates, these variables were tested for associations with suicidal thoughts and attempts, both across the lifetime and in the past year. RESULTS Absolute income was associated with suicidal thoughts and attempts, both across the lifetime and in the past year. However, when income rank within the four comparison groups was regressed on lifetime suicidal thoughts and attempts, only income rank remained significant and therefore accounted for this relationship. A similar result was found for suicidal thoughts within the past year although the pattern was less clear for suicide attempts in the past year. CONCLUSIONS Social position, rather than absolute income, may be more important in understanding suicidal thoughts and attempts. This suggests that it may be psychosocial rather than material factors that explain the relationship between income and suicidal outcomes.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK,
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Tapola V, Wahlström J, Kuittinen M, Lappalainen R. The co-occurrence of nonsuicidal and suicidal self-injurious acts in adult women: A pilot study of similarities and differences. NORDIC PSYCHOLOGY 2015. [DOI: 10.1080/19012276.2014.997784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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