International Journal of Social Psychiatry最新文献

{"title":"Individualized Occupational Therapy in Severe Mental Illness-A Recovery Model Approach from a Tertiary care Centre in South India.","authors":"Rachna George Joseph, Farah Cj James, Elizabeth Ninan, Arun Rachana, Suja Kurian","doi":"10.1177/00207640251317008","DOIUrl":"https://doi.org/10.1177/00207640251317008","url":null,"abstract":"<p><strong>Background: </strong>The Recovery Model for mental illness explores a broad range of domains for individuals with severe mental illness (SMI) which is not merely the absence from illness but attaining self-sufficiency. The individualized occupational therapy intervention which is part of the recovery model approach includes any or a combination of trainings like Social Skills training, Vocational training, Assertiveness training, Anger Management training, Life Skills training, Stress Management, Study Skills training, Cognitive retraining and Anxiety management.</p><p><strong>Aims: </strong>The objective of the current study was to evaluate the effectiveness in terms of functioning of individuals with (SMI) who had undergone individualized OT intervention.</p><p><strong>Method: </strong>Patients who had undergone individualized OT intervention were evaluated at designated time points i.e. at discharge, at 3 months and further at 6 months. The outcome measure of functional capacity was scored using the Global Assessment of Functioning instrument.</p><p><strong>Result: </strong>A total of 31 patients were sampled. The diagnosis of Schizophrenia was seen in 77.4% (<i>n</i>-24) of the sample, Bipolar Affective Disorder in 12.9% (<i>n</i>-4) and Schizoaffective Disorder 9.7% (<i>n</i>-3). The mean GAF for the sample showed improvement and the increment in GAF was maintained on follow up.</p><p><strong>Conclusions: </strong>In services with limited skilled human resources and where community-based services are not established, culturally adapted interventions with individualized OT interventions can ensure positive gains in terms of socio-occupational functioning.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"207640251317008"},"PeriodicalIF":2.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between neighborhood socioeconomic deprivation and mental health in low- and middle-income countries: A scoping review.","authors":"Vandad Sharifi, Homayoun Amini, Narges Radman, Hoora Noorbakhsh, Caitlin McClurg, Scott B Patten","doi":"10.1177/00207640241284968","DOIUrl":"10.1177/00207640241284968","url":null,"abstract":"<p><strong>Background: </strong>Environmental research on mental health primarily originates from high-income countries, while information about the rest of the world remains limited.</p><p><strong>Aims: </strong>This study examined: (1) the available published research evidence regarding the association between neighborhood-level deprivation and indicators of mental health and illness in low- and middle-income countries (LMICs), and (2) the gaps in the relevant research in LMIC settings that should be addressed in future studies.</p><p><strong>Method: </strong>First, we systematically searched for relevant primary studies in electronic databases (Ovid Medline, Scopus, Socindex, and PsycINFO) and citations in the reference lists. Then, a two-stage screening procedure was employed to select the relevant studies by screening the titles and abstracts and reviewing the selected full texts by independent researchers. After charting the data from the selected study reports, we collated, summarized, and discussed the results.</p><p><strong>Results: </strong>We retrieved 51 studies across 19 LMICs, with only one study originating from a low-income country. Most studies focused on adult mental health topics and few explored children's mental health. Notably, a significant majority of these studies (<i>N</i> = 37) reported a positive association between neighborhood deprivation and mental health/disorder. However, the research methods used varied significantly, and there were several methodological limitations.</p><p><strong>Conclusions: </strong>This review highlights the need for more original studies in LMICs on the association between neighborhood deprivation and mental health, employing stronger methodologies.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"5-24"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the 2023 Türkiye-Syria earthquakes on the mental health of children.","authors":"Sirwan Khalid Ahmed, AbdulRahman A Saied, Abdulqadir J Nashwan","doi":"10.1177/00207640241278983","DOIUrl":"10.1177/00207640241278983","url":null,"abstract":"<p><p>The seismic events that struck southern Turkey and Syria in February 2023, with magnitudes of 7.8 and 7.6 respectively, have significantly impacted the well-being of millions, particularly children and adolescents. This correspondence highlights the psychological repercussions faced by minors in the aftermath of the earthquakes, including anxiety, PTSD, and depression. Despite efforts to provide humanitarian aid, there remains a critical gap in addressing the psychosocial needs of affected children. With limited mental health resources in both countries, innovative approaches such as Psychological First Aid (PFA) interventions and telepsychiatry are advocated for efficient and scalable support. Additionally, safeguarding children from abuse and ensuring access to education and stable environments are paramount in post-disaster recovery efforts. This correspondence underscores the urgency for a holistic response to mitigate the long-term impact of seismic events on the vulnerable population in Turkey and Syria.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"209-211"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culture and ICD-11 personality disorder: Implications for clinical practice across diverse ethnic groups.","authors":"Luis Hualparuca-Olivera, Tomás Caycho-Rodríguez, Julio Torales, Cristian Ramos-Vera, Dayana Ramos-Campos, Luis Córdova-Gónzales, Elsa Vigo-Ayasta","doi":"10.1177/00207640241288205","DOIUrl":"10.1177/00207640241288205","url":null,"abstract":"<p><strong>Background: </strong>Personality disorder (PD) in ICD-11 is defined primarily by self and interpersonal dysfunction and optionally by other qualifiers. This definition is inseparable from relativism of cultural determinants.</p><p><strong>Aims: </strong>This review aimed to synthesize the relevant aspects of the influence of culture on clinical practice and health management for this condition, aligning them to the ICD-11 PD model.</p><p><strong>Method: </strong>In Scopus, we systematically searched for studies that included the text strings: cultur* | personality AND (disorder* OR patholog*) without any restrictions on publication date or language or other exclusion criteria, up to November 2022.</p><p><strong>Results: </strong>Evidence suggests that cultural variables in ethnic groups (Western and non-Western) such as the individualist/collectivist philosophy, historical/generational trauma, immigration, acculturation, religion, and gender influence the etiology, semiology, epidemiology, evaluation, diagnosis, treatment, and management of health services for ICD-11 PD. We discuss the limitations and propose future lines of research on this topic based on our knowledge and experience. In this review, we provide the scientific community and clinicians with relevant cultural information to guide their practice and propose strategies to manage PD from the ICD-11 model.</p><p><strong>Conclusions: </strong>More research is needed using mixed study methodologies on stigma, the experiences of patients, clinicians, and health agencies, to reduce the care gaps and achieve a culturally comprehensive, inclusive, and competent use of this new model.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"25-54"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dinesh Bhugra: An icon in psychiatry and mental health advocacy.","authors":"Albert Persaud, Julio Torales, Rachel Tribe, João Mauricio Castaldelli-Maia, Afzal Javed, Antonio Ventriglio","doi":"10.1177/00207640241313417","DOIUrl":"10.1177/00207640241313417","url":null,"abstract":"","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"216-217"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing impacts of social determinants on youth mental health in Australia.","authors":"David G Baker, Mengmeng Wang, Kate M Filia, Shu Mei Teo, Rikki Morgan, Myriam Ziou, Pat McGorry, Vivienne Browne, Caroline X Gao","doi":"10.1177/00207640241280910","DOIUrl":"10.1177/00207640241280910","url":null,"abstract":"<p><strong>Aims: </strong>Most lifetime mental health disorders begin by age 25 years, and the prevalence among young people has been increasing over recent years. We sought to understand what impact, if any, social determinants have had on this increase through the analysis of an Australian longitudinal dataset (with data from 2007 to 2021).</p><p><strong>Methods: </strong>The analysis focused on five social determinants: loneliness and lack of social support, family relationships, participation in education and employment, receipt of government benefits and relative socio-economic status. We analysed cross-sectional changes in self-reported psychological distress between 2007 and 2021 (using the Kessler-10 item; K10 scores) and examined the effects of these five social determinants on psychological distress using weighted linear regression models.</p><p><strong>Results: </strong>We identified a significant increase in psychological distress among Australians from 2007 to 2021, with the sharpest rise among those aged 15 to 25 years, who saw more than doubling in the percentage of high and very high K10. This period also saw an increase in the prevalence of social determinants such as loneliness and lack of social support, as well as poor family relationships, particularly in 2021 post COVID-19 pandemic. Regression models suggest loneliness and lack of social support had the most pronounced and increasing impact on psychological distress, followed by poor family relationships.</p><p><strong>Discussion: </strong>The observed significant and steady increases in psychological distress and related social determinant factors, particularly loneliness and lack of social support among young people, highlight the urgent need for comprehensive actions. Coordinated research and community-based initiatives are needed to deliver intrapersonal, interpersonal and socially-focused interventions with a holistic approach to support psychosocial wellbeing. Policymakers must adopt a comprehensive shift in political commitment and a whole-of-government approach to address these challenges.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"116-128"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of <i>brain drain</i> among physicians in Turkey: Findings from a national exploratory study.","authors":"Abdulbari Bener, Antonio Ventriglio, Furkan Almas, Dinesh Bhugra","doi":"10.1177/00207640241285834","DOIUrl":"10.1177/00207640241285834","url":null,"abstract":"<p><strong>Background: </strong>The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians' migration to developing or high-income countries, defined as <i>brain drain</i>, threatens the sustainability of the national healthcare system.</p><p><strong>Aims: </strong>This study explored the driving factors associated with Turkish Physicians' <i>brain drain</i>, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad.</p><p><strong>Methods: </strong>A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the <i>Brain Drain</i> questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS).</p><p><strong>Results: </strong>Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (<i>all p</i> ⩽ .018). The main reasons for <i>brain drain</i> included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all <i>p</i> ⩽ .013). Additionally, key predictors of <i>brain drain</i> were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the <i>brain drain</i> in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants.</p><p><strong>Conclusion: </strong>Physicians' migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"179-187"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and socio-demographic determinants of suicide-related mortality in Türkiye: An epidemiological study from 2009 to 2022.","authors":"Didem Han Yekdeş, Miraç Çağlayan, Ali Cem Yekdeş, Safiye Takır Stewart, Emine Gökçen Selçuk, Ülfiye Çelikkalp, Galip Ekuklu","doi":"10.1177/00207640241285817","DOIUrl":"10.1177/00207640241285817","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a leading cause of death, particularly among the young age group, in Türkiye, a country with a high population of young people.</p><p><strong>Aim: </strong>The aim of this study is determine the suicide related mortality trend and some associated socio-demographic factors in Türkiye between 2009 and 2022.</p><p><strong>Methods: </strong>The study includes an epidemiological trend on suicide. The Turkish Statistical Institute's data portal was used. The study population is 46,691 people (Male/female ratios = 74.6%/ 25.4%). Changes in mortality trends were evaluated using the Joinpoint Regression method with Annual Percentage Change (APC) and Average Percentage Change (AAPC) analysis.</p><p><strong>Results: </strong>Over the past 14 years in Türkiye, there has been a statistically significant increase in the standardized mortality rate among males (2009-2022 APC = .76, <i>p</i> = .012) and a statistically non-significant decrease among females (2009-2022 APC = -1.62, <i>p</i> = .083). According to the Nomenclature of Territorial Units for Statistics (NUTS-1) classification, the highest increase is observed in the Central Anatolia region followed by the Western Black Sea region (APC = 3.0 and 2.7, respectively; <i>p</i> < .005). While the percentage of primary school and below has decreasing trends (2009-2022 APC = -7.11, <i>p</i> < .005), there is a significant increase in the percentage of university graduates (2009-2016 APC = 10.87, <i>p</i> < .001). Regarding the marital status, there is a significant decrease in the percentage of those who are married (2009-2013 APC = -3.36, <i>p</i> < .001; 2013-2016 APC = 2.42, <i>p</i> = .037; 2016-2022 APC = -2.31, <i>p</i> = .003) and a significant increase in those who have never been married (2009-2013 APC = 2.63, <i>p</i> < .001; 2013-2016 APC = -1.36, <i>p</i> = .002).</p><p><strong>Conclusion: </strong>Although suicide related mortality is below the global average, there has been an increasing trend in turkey in the last 14 years. Analytical and intervention studies on the socio-demographic determinants supporting the increasing trend are needed.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"188-198"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trajectory of substance use disorder among people formerly in foster care: A survival analysis.","authors":"Sogol Olamazadeh, Ahmed N Hassan, Bernard Le Foll","doi":"10.1177/00207640241287088","DOIUrl":"10.1177/00207640241287088","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorder (SUD) represents a significant public health challenge, especially among individuals who have faced early life adversities. Foster care aims to provide a supportive environment for children; however, the relationship between a history of foster care and SUD development remains unclear.</p><p><strong>Aims: </strong>This study aims to examine the likelihood of developing SUD among individuals with a history of foster care, who have used substances during their lifetime, compared to those raised by biological parents.</p><p><strong>Method: </strong>Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we analyzed the prevalence of social demographics and clinical variables among individuals who have used alcohol, nicotine, or cannabis. We calculated the probabilities of developing SUD for each factor, including exposure to foster care. Various covariates that could impact SUD occurrence were also assessed. The duration from initial substance use to SUD onset was calculated for both groups. Survival analysis curves were generated for each substance to depict the probability of SUD development over time.</p><p><strong>Results: </strong>Our analysis revealed that foster care may act as a protective factor against Cannabis Use Disorder (CUD), with a hazard ratio of 0.25 (95% CI [0.07, 0.88]). No significant associations were found with Alcohol Use Disorder (AUD) or Nicotine Use Disorder (NUD). Both foster and non-foster care groups exhibited higher probabilities of developing NUD compared to the general population. For cannabis users, the probability of developing CUD stabilizes after approximately 10 years. Family history of SUD and clinical predictors such as mood disorders consistently showed significant associations across all substance groups, highlighting their importance in SUD development.</p><p><strong>Conclusion: </strong>Our findings suggest that foster care may offer some protective benefits, particularly against CUD, emphasizing the need for further research into its protective factors and the development of targeted interventions to reduce SUD prevalence in this population.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"159-167"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Impaired in life': Analyzing people's accounts of depression in Ethiopia - Implications for a cultural-eco social approach to global mental health.","authors":"Gojjam Limenih, Arlene MacDougall, Max Well J Smith, Elysee Nouvet","doi":"10.1177/00207640241280620","DOIUrl":"10.1177/00207640241280620","url":null,"abstract":"<p><strong>Background: </strong>Depression is a global crisis and a major concern in mental health interventions, particularly in low- and middle-income countries (LMICs), where it significantly impacts disability, quality of life, and economic stability. These chronic stressors have been used to argue for scaling up the detection and treatment of depression as a public health and development priority.</p><p><strong>Aim: </strong>This study aimed to explore illness narratives of depression among patients' and to gain insights into multifaceted suffering, its impact on persons' lives, and help seeking. This study is part the broader study which examined global mental health, biopolitics, and depression in Ethiopia, conducted in hospice setting to explore the conception of depression in Bahirdar city, Northern Ethiopia, among patients and health care providers. In this study, we focus on patients' accounts of depression.</p><p><strong>Method: </strong>We employed an ethnography method using in-depth interviews, fieldnotes, and observation to collect the data. A thematic analysis was used to analyze the data. Drawing from cross-cultural and critical psychiatry perspectives, we situate depression within its cultural-eco social framework.</p><p><strong>Results: </strong>The study revealed that patients' experiences and conception of depression are deeply intertwined with Ethiopia's sociocultural, economic, and spiritual context. Depression was often described as a state of being 'impaired in life', reflecting the complex interplay of individual struggles and societal pressures. Integrating quotes from patients, we demonstrated in this analysis the ways in which biographically specific challenges, societal pressures, and mental well-being are understood by study participants in accordance with Ethiopian cultural and religious norms.</p><p><strong>Conclusion: </strong>The study suggests moving beyond narrow interpretative frameworks in GMH praxis to understand and address the complex dimensions of depression in Ethiopia and similar contexts. The study advocates for a cultural-ecosocial approach to depression, emphasizing the need for mental health interventions that consider the broader social and cultural factors contributing to mental distress.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"78-89"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}