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  • 1.
    Ayuk, B. T.
    et al.
    Catholic University of Central Africa, Cameroon.
    Dapi Nzefa, Léonie
    Sweden-Cameroon Organization, Cameroon.
    Nchang Allo, N.
    Catholic University of Central Africa, Cameroon.
    Childhood Diarrhea Determinants in Sub-Saharan Africa: A Cross Sectional Study of Tiko-Cameroon2015In: Challenges, ISSN 2078-1547, E-ISSN 2078-1547, Vol. 6, no 2, p. 229-243Article in journal (Refereed)
    Abstract [en]

    Introduction: Diarrhea remains the second leading cause of death among children under five years globally. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea. It kills more young children than Acquired Immunodeficiency Syndrome (AIDS), malaria and measles combined. World Health Organization has accordingly underlined the need for epidemiological surveys of infantile diarrhea in all geographical areas. The main research objectives were to estimate the prevalence of diarrhea and identify factors associated with diarrheal diseases in Tiko city in Cameroon. Method: The present study was a cross-sectional community household survey which was conducted in Tiko town from 1st to 31st of August 2012. With the use of a questionnaire, a total of 602 households that had at least one child under five years of age were interviewed. Mothers/caregivers were questioned on the morbidity of diarrhea and the logistic regression model was employed to examine the determinants of childhood diarrhea. Both univariable and multivariable data analysis was performed using SPSS version 16.0. Results: The results of this study showed that the prevalence of diarrhea was 23.8% and children under 24 months were highly affected. We found children using the main toilet and other types of toilet facilities such as bushes, diaper, and streams (OR: 0.194; p < 0.001, 95% CI) and usage of narrow-mouth container for storage of drinking water (OR: 0.492; p < 0.001, 95% CI) less likely to suffer from diarrhea. In contrast, higher rates of diarrhea prevalence were seen in children from households with two or more siblings (OR: 1.222; p < 0.001, 95% CI) and whose mothers/caregivers never had the knowledge of safe sources of drinking water (OR: 1.849; p < 0.01, 95% CI). Conclusion: Childhood diarrhea is a public health problem in Tiko city. Hence, interventions aimed at reducing the prevalence should take into consideration the integration of family planning activities in the prevention of childhood diarrhea and the deployed of health personals to educate the community to adopt a hygienic behavior. Future research on the topic should be qualitative inquiry to complement the quantitative nature of this study.

  • 2.
    Dapi Nzefa, Leonie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    The impact of climate change on students in Yaoundé, Cameroon2011In: African Newsletter on Occupational Health and Safety, ISSN 0788-4877, Vol. 21, p. 50-51Article in journal (Other academic)
  • 3.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Hörnell, Agneta
    Janlert, Urban
    Stenlund, Hans
    Larsson, Christel
    Energy and nutrient intakes in relation to sex and socio-economic status among school adolescents in urban Cameroon, Africa.2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 5, p. 904-13Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

    DESIGN: Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

    SETTING: Yaoundé, Cameroon.

    SUBJECTS: Boys and girls aged 12-16 years (n 227).

    RESULTS: Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50% of boys and girls had protein below the recommendations. The intake of fat varied; 26% of the adolescents were below and 25% were above the recommendations. Inadequate intakes of vitamin B₁, vitamin B₃ and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B₂, B₃, B₆ and B₁₂ than those with high SES.

    CONCLUSIONS: A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.

  • 4.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Rocklöv, Joacim
    Nguefack-Tsague, Georges
    Tetanye, Ekoe
    Kjellstrom, Tord
    Heat impact on schoolchildren in Cameroon, Africa: potential health threat from climate change.2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health impacts related to climate change are potentially an increasing problem in Cameroon, especially during hot seasons when there are no means for protective and adaptive actions.

    OBJECTIVE: To describe environmental conditions in schools and to evaluate the impact of heat on schoolchildren's health during school days in the Cameroon cities of Yaoundé and Douala.

    METHODS: Schoolchildren (N = 285) aged 12-16 years from public secondary schools completed a questionnaire about their background, general symptoms, and hot feelings in a cross-sectional study. In Yaoundé, 50 schoolchildren were individually interviewed during school days about hourly symptoms (fatigue, headache, and feeling very hot) and performance. Lascar dataloggers were used to measure indoor classroom temperatures and humidity.

    RESULTS: There was a significant correlation between daily indoor temperature and the percentages of schoolchildren who felt very hot, had fatigue, and headaches in Yaoundé. A high proportion of schoolchildren felt very hot (48%), had fatigue (76%), and headaches (38%) in Yaoundé. Prevalences (%) were higher among girls than boys for headaches (58 vs 39), feeling 'very hot overall' (37 vs 21), and 'very hot in head' (21 vs 18). Up to 62% were absentminded and 45% had slow writing speed. High indoor temperatures of 32.5°C in Yaoundé and 36.6°C in Douala were observed in school.

    CONCLUSIONS: Headache, fatigue, and feeling very hot associated with high indoor air temperature were observed among schoolchildren in the present study. Longitudinal data in schools are needed to confirm these results. School environmental conditions should be improved in order to enhance learning.

  • 5.
    Dapi Nzefa, Léonie
    Umeå University.
    Socioeconomic and sex differences in adolescents’ dietary intake, anthropometry and physical activity in Cameroon, Africa2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: People in Cameroon are experiencing a dietary transition characterized by changing from traditional food habits to increased intake of highly processed sweet and fatty food. The rapid change in food pattern combined with an increased sedentary lifestyle has resulted in a rather high prevalence of obesity, hypertension, cardiovascular diseases and type 2 diabetes. Nutritional intake is important during adolescence for growth spurt, health, cognitive development and performance in school.

    Objective: The aim of this thesis was to assess dietary intake, anthropometry and physical activity of adolescents according to sex and socioeconomic status (SES) and to investigate food perceptions of adolescents living in urban and rural areas of Cameroon.

    Methods: Girls and boys, 12-16 years of age, were randomly selected from schools in urban and rural areas. Food frequency questionnaire, 24-hour dietary and physical activity recalls, anthropometric measurements, qualitative interviews and a background questionnaire were used for data collection.

    Results: The proportion of overweight was three times higher in girls (14%) compared to boys (4%). Stunting and underweight were more common among boys (15% and 6%) than girls (5% and 1%). The prevalence of stunting was two times higher among the urban adolescents with low SES (12%) compared to those with high SES (5%). The rural adolescents had the highest proportion of stunting but more muscle that the urban adolescents. The rural adolescents ate in order to live and to maintain health. Urban adolescents with low SES ate in order to maintain health, while those with high SES ate for pleasure. More than 30% of the adolescents skipped breakfast in the urban area. Urban adolescents with high SES and girls reported a more frequent consumption of in-between meals and most food groups compared to the rural adolescents, boys and those with low SES. Over 55% of the adolescents had a protein intake below 10% of the energy (E%). Twenty-six percent of the adolescents had fat intake below 25 E%, and 25% had fat intake above 35 E%. A large proportion of the adolescents had an intake of micronutrients below the estimated average recommendation. Boys and the adolescents with low SES reported a higher energy expenditure and physical activity level than girls and the adolescents with high SES, respectively. Both under- and over-reporting of energy intake were common among the adolescents.

    Conclusions: The present study showed that nutrient inadequacy, stunting, underweight, as well as overweight and obesity were common among the adolescents in Cameroon. Therefore an intervention program targeting both under- and overnutrition among school adolescents is needed. Sex and socioeconomic differences also need to be considered.

  • 6.
    Dapi Nzefa, Léonie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work. University of Yaounde, Cameroon.
    Ayuk, Tambe Betrand
    Institute of Medical Research and Medicinal Plant Studies, Cameroon.
    Axberg, Frida
    Umeå University.
    Lundström, Linnéa
    Umeå University.
    Hörnell, Agneta
    Umeå University.
    After giving birth to a baby, breastfeeding becomes your responsibility: Infant feeding perceptions and practices among women in Yaoundé, Bamenda and Bandja, Cameroon, Africa2018In: International Research Journal of Public and Environmental Health, ISSN 2360-8803, Vol. 5, no 3, p. 38-45Article in journal (Refereed)
    Abstract [en]

    The Ministry of Public Health of Cameroon advises mothers to follow the World Health Organization’s recommendation of exclusive breastfeeding during the first six months of life and to continue breastfeeding along with appropriate complementary foods up to two years or beyond. Despite these recommendations, malnutrition due to inadequate feeding practices is still prevalent in Cameroon. Therefore, this study aims to explore infant feeding perceptions and identify factors influencing infant feeding practices in Cameroon. Forty-nine women aged 19 to 38 who had infants aged 6 days to 15 months were purposively selected from hospitals during the vaccination days and interviewed until saturation. The research tools included six qualitative group interviews, with each group comprising 6 to 10 women. The study was conducted in the rural area of Bandja and the urban areas of Yaoundé and Bamenda. Data were analysed using content analysis. In the study, breastfeeding was agreed upon as the best way to feed infants and was commonly practised for 1 to 2 years. Nevertheless, few infants were breastfed exclusively. Complementary foods were often nutritionally inadequate; many children were not given fruit, vegetables or foods of animal origin on a daily basis. Cultural beliefs, tradition, community norms and low educational and economic levels negatively influenced the implementation of appropriate infant feeding recommendations. The short duration of exclusive breastfeeding and the poor food diversity are the main problems. In response, it is necessary to strengthen the position of women, increase the period of maternal leave, introduce sustainable and practical education for both parents about breastfeeding, and provide good, local complementary foods. 

  • 7.
    Dapi Nzefa, Léonie
    et al.
    Umeå university, Sweden.
    Janlert, Urban
    Umeå university, Sweden.
    Nouedoui, Christophe
    University of Yaoundé, Cameroon.
    Stenlund, Hans
    Umeå university, Sweden.
    Håglin, Lena
    University Hospital of Umeå, Sweden.
    Socioeconomic and gender differences in adolescents' nutritional status in urban Cameroon, Africa.2009In: Nutrition Research, ISSN 0271-5317, E-ISSN 1879-0739, Vol. 29, no 5, p. 313-319Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess adolescents' nutritional status according to socioeconomic status (SES) and sex using anthropometry in urban Cameroon, Africa. Adolescent boys (n = 248) and girls (n = 333) 12 to 16 years old were recruited from randomly selected schools in a cross sectional study in Yaoundé city and grouped according to SES. Weight, height, skinfold thickness, and circumferences were measured, and body mass index, waist/hip ratio, arm muscle, and arm fat areas were calculated. Stunting, underweight, and overweight were determined using international cutoff points. Adolescents with medium and high SES were less likely to be stunted than adolescents with low SES (odds ratio [OR], 0.40; P < .01). Prevalences of stunting (12%, 6%, and 5%) and underweight (3%, 4%, and 1%) were higher among the adolescents with low and medium SES than those with high SES. Overweight prevalence was high among the adolescents with low (8%), medium (11%), and high (9%) SES. The OR for overweight was higher among girls than boys (OR, 4.13; P < .001). Girls were less likely to be stunted and underweight than boys (OR, 0.29 [P < .001] and OR, 0.20 [P < .01], respectively). Prevalences of stunting (15% and 6%) and underweight (5% and 2%) were higher among boys than girls. Pubescent adolescents were less likely to be stunted than nonpubescent (OR, 0.53; P < .05). Adolescents with low and medium SES were more underweight and stunted than adolescents with high SES. Girls were more overweight, less stunted, and underweight than boys.

  • 8.
    Dapi Nzefa, Léonie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work. University of Yaoundé, Cameroon.
    Monebenimp, Francisca
    University of Yaoundé, Cameroon.
    Äng, Christofer
    Umeå University, Sweden.
    Undernutrition among children under five in the Bandja village of Cameroon, Africa2019In: South African Journal of Clinical Nutrition, ISSN 1607-0658, Vol. 32, no 2, p. 46-50Article in journal (Refereed)
    Abstract [en]

    Background: Sub-Saharan Africa has a long history of struggling with child undernutrition. The prevalence of undernutrition is still high and knowledge about this public health problem and the underlying causes is essential for children’s health.

    Aim: To evaluate the anthropometric status of children under five in the Bandja village of Cameroon.

    Methods: A cross-sectional study was undertaken that included 388 children. Undernutrition was evaluated in terms of wasting, stunting and underweight. Information on sex, age, birth order, birth interval, duration of breastfeeding, and mother’s age at birth, occupation and educational level were collected.

    Results: The prevalence of wasting, stunting and underweight was 3.2%, 16.4% and 5.2%, respectively. Boys were more stunted than girls (OR 2.24; 95% CI 1.16–4.34). Children less than 30 months were more often wasted than older children (OR 17.70; 95% CI 1.82–172.40). The first and second born in order were more stunted than the third or later born in order (OR 2.06; 95% CI 1.02–4.18). Children of farming mothers were more often stunted (OR 2.87; 95% CI 1.35–6.13) and underweight (OR 3.47; 95% CI 1.09–11.09) than others. Children still being breastfed were more underweight (OR 6.52; 95% CI 1.31–32.43) than those whose mothers had finished breastfeeding.

    Conclusion: Undernutrition is highly prevalent in Bandja, and is more common among boys, younger children, first born in order, children still being breastfed and children of farming mothers. This study underlines the importance of intervention to prevent and reduce undernutrition among children.

  • 9.
    Dapi Nzefa, Léonie
    et al.
    Umeå University.
    Nouedoui, Christophe
    University of Yaounde, Cameroon.
    Janlert, Urban
    Umeå University.
    Håglin, Lena
    University Hospital Umeå.
    Adolescents' Food Habits and Nutritional Status among in urban and Rural Areas in Cameroon, Africa2005In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 49, no 4, p. 151-158Article in journal (Refereed)
    Abstract [en]

    Background: Food intake in Cameroon is based on three meals daily. The diet in rural areas is based on traditional staple foods, while that of the urban population incorporates more modern foods. The health and nutrition of adolescents is important as their eating behaviour and nutrition will affect their future health.

    Objective: To describe and compare food habits and nutritional status of adolescents in Cameroon.

    Design: A cross-Stional study using an unquantified food frequency questionnaire and anthropometric data, in urban and rural areas. Fifty-two adolescents, 12–15 years old, were selected from schools.

    Results: Frequencies of consumption of meat, vegetables, cereals, milk products and junk food were significantly higher in urban than in rural adolescents (11.8 vs 4.5, 9.5 vs 3.9, 16.5 vs 11.9, 5.7 vs 0.8, 24.2 vs 8.7, respectively). The frequency of in-between meals was higher in urban than in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area (AMA, mm2) and waist/hip ratio were significantly higher in rural than in urban adolescents (3554 vs 2802 and 0.82 vs 0.79, respectively). Body mass index (BMI, kg m−2) was higher in rural than urban adolescents, although not significant (20.6 vs 19.4, respectively). There was a positive significant correlation between BMI and AMA in urban and rural areas (r=0.67 and r=0. 72, respectively).

    Conclusions: Despite a lower frequency of food consumption, rural adolescents had higher AMA and waist/hip ratio than urban adolescents. Less junk food and more traditional food consumption, more manual activities and walking in rural adolescents could explain these results.

  • 10.
    Dapi Nzefa, Léonie
    et al.
    Umeå university, Sweden.
    Omoloko, Cécile
    University of Yaoundé, Cameroon.
    Janlert, Urban
    Umeå university, Sweden.
    Dahlgren, Lars
    Umeå university, Sweden.
    Håglin, Lena
    Umeå University Hospital, Sweden.
    "I eat to be happy, to be strong, and to live." perceptions of rural and urban adolescents in Cameroon, Africa.2007In: Journal of nutrition education and behavior, ISSN 1499-4046, E-ISSN 1878-2620, Vol. 39, no 6, p. 320-326Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa.

    DESIGN: Qualitative in-depth interviews.

    SETTINGS: Yaoundé urban and Bandja rural areas.

    PARTICIPANTS: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.

    ANALYSIS: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.

    FINDINGS: Factors influencing adolescents' food perceptions from the rural area were "to live" "health" and "poverty." Among adolescents from the urban poor area, "health," "beauty," and "not enough money" were factors. Among adolescents from the urban rich area, "pleasure" and "beauty" were factors. Rural girls liked "to be fat," whereas girls from the urban poor wanted "to be a little bit fat," and girls from the urban rich wanted "to be normal."

    CONCLUSIONS AND IMPLICATIONS: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.

  • 11.
    Dapi Nzefa, Léonie
    et al.
    University of Yaoundé, Cameroon.
    Tambe, Betrand A
    Ministry of Scientific Research and Innovation, Cameroon.
    Monebenimp, Francisca
    University of Yaoundé, Cameroon.
    Myths Surrounding Albinism and Struggles of Persons with Albinism to Achieve Human Rights in Yaoundé, Cameroon2018In: Journal of Human Rights and Social Work, ISSN 2365-1792, Vol. 3, no 1, p. 11-16Article in journal (Refereed)
    Abstract [en]

    Persons with albinism (PWA) in Yaoundé, Cameroon are reported to experience stigma, discrimination and violation of their human rights based primarily on their lack of pigmentation in their skin, eyes and hair. This study explores the challenges faced by persons with albinism, with particular reference to their knowledge of albinism, social and health issues and support. This qualitative research study recruited persons with albinism through a non-probability sampling technique in the city of Yaoundé, capital city of Cameroon. Data were collected through three focus group discussions with 19 persons (13 women and 6 men, adults) with albinism and thematic content analysis was employed to analyze responses. Almost all participants revealed societal discrimination, stigmatization, human rights violations, and some reported frustration due to injustice, rejection and superstitions. All the participants had visual problems and 12 had skin diseases. These conditions were inadequately managed due to lack of care, rejection by others, superstition and limited financial resources. The majority of participants had a good understanding of albinism. This study urges social work interventions such as support groups for persons with albinism and their families; educational awareness programmes; and advocacy for the rights of persons with albinism to healthcare, education and employ- ment opportunities, and to demystify all myths and cultural beliefs surrounding albinism. 

  • 12. Nguefack-Tsague, G.
    et al.
    Dapi Nzefa, Leonie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Multidimensional nature of undernutrition: a statistical approach2011In: Journal of Medicine and Medical Sciences, ISSN 2141-9477, Vol. 2, no 2, p. 690-695Article in journal (Refereed)
  • 13.
    Oppong, Grace
    et al.
    Maastricht University, Netherlands.
    Monebenimp, Francisca
    University of Yaoundé, Cameroon.
    Dapi Nzefa, Léonie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work. University of Yaoundé, Cameroon.
    ‘You just have to grin and bear’: emotional suppression among women in polygyny in Cameroon2019In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 21, no 8, p. 946-956Article in journal (Refereed)
    Abstract [en]

    Polygyny is a matrimonial union in which a single man is simultaneously married to multiple wives. On a daily basis, women in polygynous unions suffer from financial, emotional and physical burdens. This study explores women’s perceptions of this matrimonial regime and the factors influencing their sexual health decision-making in Cameroon. Drawing on interviews with twenty-three women aged 23 to 80 years living in polygynous unions, we explore women’s daily life and perceptions on polygyny. Using content analysis, meaning units relating to respondents’ experiences and perceptions were identified and condensed into codes and categories that were later grouped into themes. Five themes emerged – refusal and tolerance; heavy workload and responsibility; lack of power in sexual health decision-making; discrimination and unequal treatment of spouses; and emotional suppression. Women reported emotional suppression, limited rights, discrimination and poor living conditions as being the most significant problems that they encountered. Addressing the discrimination faced by women in polygynous unions will entail adopting and implementing laws to protect women’s rights and promote their empowerment.

  • 14.
    Tambe, Ayuk B.
    et al.
    Inst Med Res & Med Plant Studies IMPM, Cameroon;Stellenbosch Univ, South Africa.
    Mbanga, Baleba M. R.
    Inst Med Res & Med Plant Studies IMPM, Cameroon.
    Dapi Nzefa, Léonie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Nama, Medoua G.
    Inst Med Res & Med Plant Studies IMPM, Cameroon.
    Pesticide usage and occupational hazards among farmers working in small-scale tomato farms in Cameroon2019In: Journal of the Egyptian Public Health Association, E-ISSN 2090-262X, Vol. 94, no 1, p. 1-7, article id 20Article in journal (Refereed)
    Abstract [en]

    Background: Agriculture is undoubtedly the backbone of the Cameroonian economy, and other economic activities thrive only if production in this sector is assured. It has been estimated that approximately 25 million agricultural workers worldwide experience unintentional pesticide poisoning yearly. Unfortunately, limited information exists about the health and safety of the farmers. The aim of this study was to describe the occupational health and safety (OHS) conditions of farmers working on small-scale tomato farms in the western region of Cameroon. A cross-sectional research method was used to collect data from tomato farmers in May 2017, using a questionnaire developed by the research team. Results: A total of 104 tomato farmers from small-scale farms participated in the study. The analysis revealed that the occupation is male-dominated (86.5%). The training and use of personal protective equipment (PPE) among farmers were rare (35.6%), and farmers were mostly exposed to chemical hazards. The farmers reported the following work-related health problems: skin irritation, backache, impairment of the central nervous system (CNS), visual problems, and respiratory difficulties. Conclusions: The OHS conditions on small-scale tomato farms are mostly poor, thus predisposing farmers to the risk of work-related health problems. Exposure to occupational hazards can be significantly reduced if the required PPE are available and efficiently used.

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