South African Family Practice最新文献

{"title":"Community-based primary care approaches to supporting families of children with developmental disabilities: Experts' perspectives using the capabilities framework.","authors":"Lumka Magidigidi-Mathiso, Jose Frantz, Gerard Filies","doi":"10.4102/safp.v67i1.6217","DOIUrl":"10.4102/safp.v67i1.6217","url":null,"abstract":"<p><strong>Background: </strong>Families raising children with developmental disabilities face complex, interconnected challenges requiring coordinated support across multiple professional domains. While interdisciplinary collaboration is widely endorsed in policy and practice guidelines, significant knowledge gaps exist regarding how healthcare professionals operationalise these collaborative approaches in real-world settings.</p><p><strong>Methods: </strong>A qualitative study was conducted using individual semi-structured interviews with 12 experts representing diverse disciplines. The study was grounded in the Capabilities Approach as both a theoretical lens and a methodological framework. Data were analysed using Braun and Clarke's six-step thematic analysis, with the Capabilities Approach framework informing each analytical phase.</p><p><strong>Results: </strong>Five major themes emerged from the capability-guided analysis: facilitating emotional transformation, building system navigation competence, creating inclusive participation opportunities, strengthening family functioning and fostering adaptive identity development. Across all themes, participants consistently emphasised three critical mechanisms for effective interdisciplinary support: coordinated care delivery as capability enhancement, comprehensive emotional support as capability development and whole-family capability strengthening interventions.</p><p><strong>Conclusion: </strong>The findings highlight the significance of interdisciplinary approaches informed by the Capabilities Approach in providing comprehensive support for parents of children with developmental disabilities. Rather than traditional deficit-focused models, participants systematically described how they enhance family capabilities by functioning as capability facilitators who orchestrate conversion factors, build emotional capabilities while respecting family agency and create environmental modifications that expand family possibilities.Contribution: This study contributes a novel capability-focused framework for understanding interdisciplinary collaboration in developmental disability support, moving beyond traditional service coordination models to emphasise systematic capability enhancement approaches that build sustainable family strengths across multiple domains simultaneously.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e8"},"PeriodicalIF":1.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of symptomatic polyneuropathy in patients with type 2 diabetes mellitus attending the diabetes clinic at Helen Joseph Tertiary Hospital, South Africa.","authors":"Kaveer Thejpal, Reyna Daya, Zaheer Bayat","doi":"10.4102/safp.v67i1.6233","DOIUrl":"10.4102/safp.v67i1.6233","url":null,"abstract":"<p><strong>Background: </strong>Diabetic neuropathy has an estimated prevalence of 50% among individuals with longstanding diabetes, with distal symmetric polyneuropathy (DSPN) being the most common manifestation. Poor glycaemic control is a recognised risk factor for DSPN. This study aimed to determine the prevalence of symptomatic DSPN in patients with type 2 diabetes mellitus (T2D) using a validated symptom-screening questionnaire - the diabetic neuropathy symptom (DNS) score. In addition, the association between haemoglobin A1c (HbA1c) and DSPN was investigated.</p><p><strong>Methods: </strong>A cross-sectional study was performed at the diabetes clinic at Helen Joseph Tertiary Hospital, Johannesburg, South Africa. A total of 206 consecutive patients with T2D were included. Underlying comorbidities and HbA1c values were obtained from patient records. The DNS score was used to assess for the presence of symptomatic DSPN.</p><p><strong>Results: </strong>The prevalence of symptomatic DSPN was 61.2%. Among those who screened positive for DSPN, 58% were not receiving pharmacological treatment for DSPN. Patients with HbA1c values of 7% - 10% and 10% were 2.9 and 3.7 times, respectively, likely to have DSPN (prevalence ratio [PR] = 2.9; 95% confidence interval [CI] 1.5-5.4, p = 0.001; PR = 3.7; 95% CI 2.0-7.0, p  0.001, respectively), compared with those with an HbA1c value 7%.</p><p><strong>Conclusion: </strong>A higher than expected prevalence of symptomatic DSPN was observed in this study population, indicating the need for enhanced screening. Furthermore, a significant proportion of symptomatic patients were not receiving treatment. Poor glycaemic control with HbA1c values 7% significantly increases the risk of DSPN.Contribution: The DNS score can easily be implemented at a primary care level to detect symptomatic neuropathy and facilitate prompt treatment.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors contributing to delayed diagnosis of cervical cancer in human immunodeficiency virus-positive women.","authors":"Frenzar M Tshiruruvhela, Mbuyisa J Makhubu, Gert J O Marincowitz, Clara Marincowitz","doi":"10.4102/safp.v67i1.6221","DOIUrl":"10.4102/safp.v67i1.6221","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is more prevalent in human immunodeficiency virus (HIV)-positive women and is frequently diagnosed in an advanced stage. This study sought to understand factors contributing to the delayed diagnosis of cervical cancer in HIV-positive women at Mokopane Hospital in the Limpopo Province of South Africa.</p><p><strong>Methods: </strong>A qualitative phenomenological study was conducted using individual interviews among purposively sampled HIV-positive women who were diagnosed with cervical cancer. Interviews were recorded, transcribed verbatim, translated and analysed thematically.</p><p><strong>Results: </strong>Four major themes emerged from the study, providing possible explanations for the delay in cervical cancer diagnosis. Firstly, women believed that Papanicolaou (PAP) smears are diagnostic and should be performed when symptoms appear, rather than for screening. Secondly, their readiness, fear and embarrassment to do the procedure delayed them from having a PAP smear. Thirdly, consulting traditional healers initially, also caused delays. Fourthly, a lack of equipment, inadequate follow-up, health workers' low index of suspicion and unwillingness to do the procedure further delayed diagnosis.</p><p><strong>Conclusion: </strong>Human immunodeficiency virus-positive women have an inadequate understanding of cervical cancer screening and its importance. Patient education and health worker training are urgently needed to improve the screening. To counteract delays in screening, adequate staffing, regular maintenance and availability of equipment are vital for improved care for HIV-positive women.Contribution: This study highlights how a poor understanding of cervical cancer screening, patients' readiness, fear and embarrassment to do the procedure, as well as inadequate equipment and poorly motivated health workers, all contribute to the delayed cervical cancer diagnosis in HIV-positive women.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-centred interventions for drug-resistant tuberculosis: A scoping review.","authors":"Ndiviwe Mphothulo, Marian Loveday, Hanlie Myburg","doi":"10.4102/safp.v67i1.6180","DOIUrl":"10.4102/safp.v67i1.6180","url":null,"abstract":"<p><strong>Background: </strong>People on drug-resistant tuberculosis (DR-TB) treatment face multiple challenges, which include severe disease and treatment side effects, together with psychosocial and socioeconomic challenges. These challenges impact patients' ability to remain in care and complete their treatment.</p><p><strong>Methods: </strong>We conducted a scoping review to synthesise evidence on patient-centred care interventions that have been offered to DR-TB patients to facilitate retention in care. Studies published from 2005 until 2023 were retrieved from primary research articles, grey literature and review articles published in peer-reviewed journals.</p><p><strong>Results: </strong>Among the 347 articles sought for retrieval, 172 were subsequently excluded from the analysis for various reasons. Ultimately, 14 studies met the inclusion criteria, providing valuable insights into patient-centred interventions for DR-TB patients. These interventions aimed to mitigate the complex challenges faced by DR-TB patients during treatment and were categorised into four groups, consistent with the World Health Organization (WHO) recommendations on social support for people with DR-TB: (1) informational, (2) emotional, (3) companionship and (4) material support. Most studies (n = 11) offered DR-TB patients integrated forms of support. Material support was the most common form of support utilised across the studies (n = 12), followed by informational (n = 9), companionship (n = 7) and emotional support (n = 5).</p><p><strong>Conclusion: </strong>Patient-centred care interventions improve retention in care and treatment outcomes among DR-TB patients.Contribution: The study contributes to the discourse on the value of patient-centred care in managing people with DR-TB.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes towards seizure first aid among attendees of Gateway Clinic in Bloemfontein.","authors":"Ilias P Masinde, Aileen M Kamwendo, Desiree R Thapo, Likhona Jaca, Lolwethu L Qulu, Lungelo A Gwala, Tebogo W Kgasi, Joseph B Sempa, Chika K Egenasi","doi":"10.4102/safp.v67i1.6208","DOIUrl":"10.4102/safp.v67i1.6208","url":null,"abstract":"<p><strong>Background: </strong>Providing first aid during an epileptic seizure can be lifesaving; however, many individuals lack the necessary knowledge and skills because of persistent misconceptions about epilepsy. This study assessed knowledge and attitudes towards seizure first aid among attendees of the Gateway Clinic in Bloemfontein.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted using a structured questionnaire to evaluate participants' knowledge and attitudes regarding seizure first aid.</p><p><strong>Results: </strong>Of the 466 questionnaires distributed, 391 were included in the study. Most participants were knowledgeable, with a median score of 13.0 (interquartile range [IQR]: 9.0-16.0). Attitudes towards epilepsy were positive, with a median score of 6.0 (IQR: 3.0-9.0). A majority, 64.7% of participants, believed that an object should be placed in the mouth during a seizure, and 33.5% were unsure whether epilepsy was contagious.</p><p><strong>Conclusion: </strong>Participants at the Gateway Clinic were knowledgeable and had positive attitudes towards epilepsy and seizure first aid. Nonetheless, misconceptions persist, particularly regarding harmful practices during seizures. Public education and structured training on seizure first aid remain essential to improve safety and awareness.Contribution: This study highlights the need to strengthen community awareness and education on epilepsy and seizure first aid to reduce stigma and enhance appropriate responses during seizure events.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e11"},"PeriodicalIF":1.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional anaesthesia in the emergency centre: Knowledge, attitudes and practices of doctors in the Western Cape, South Africa.","authors":"Andrew D Fourie, Adéle De Goede, Michael Pather","doi":"10.4102/safp.v67i1.6194","DOIUrl":"10.4102/safp.v67i1.6194","url":null,"abstract":"<p><strong>Background: </strong>Regional anaesthesia in emergency centres (ECs) offers clear benefits for patient care and system efficiency. However, its use in South African ECs remains inconsistent, and the knowledge, attitudes and practices of emergency doctors are not well understood. A notable gap exists in formal training.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among EC doctors at four district hospitals in the Metro-East health district of the Western Cape, South Africa. Data were collected via an electronic questionnaire exploring knowledge, attitudes and practices related to regional anaesthesia.</p><p><strong>Results: </strong>Eighty-five doctors participated (58% response rate). Among them, 67.1% had prior training in peripheral nerve blocks, predominantly informal and peer-based (98.2%), with only 8.8% receiving formal training. Most (96.5%) expressed interest in further training. Regional anaesthesia was underused: 36.5% used it less than monthly, 23.5% weekly and only 2.4% daily. Despite this, 77.6% rated it as important or very important, and 75.3% scored its usefulness ≥ 7/10. Barriers included limited confidence in managing local anaesthetic toxicity and inconsistent monitoring: 39.1% never monitored, while only 25% did so consistently. The most cited barrier (92.9%) was a lack of knowledge.</p><p><strong>Conclusion: </strong>Despite strong interest and favourable attitudes, regional anaesthesia remains underutilised because of limited knowledge, informal training and concerns about safety and monitoring.Contribution: This study reveals a disconnect between positive clinician attitudes and limited practical competence. It underscores the need for structured, formal educational initiatives to support safe and effective regional anaesthesia use in district ECs.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond antenatal care: Need for a life-course approach to women's health, South Africa.","authors":"Jagidesa Moodley, Yogan Pillay, Olive P Khaliq","doi":"10.4102/safp.v67i1.6202","DOIUrl":"10.4102/safp.v67i1.6202","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden risks of first-line regimen switching in antiretroviral therapy-treated patients.","authors":"Shira Kimberley, Mergan Naidoo","doi":"10.4102/safp.v67i1.6171","DOIUrl":"10.4102/safp.v67i1.6171","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir (DTG) became central to South Africa's (SA's) first-line human immunodeficiency virus (HIV) regimen since 2019, offering improved tolerability, fewer drug-drug interactions, and a higher resistance barrier compared to efavirenz (EFV). Concerns remain about the long-term cardiovascular, metabolic, and renal consequences of DTG-based therapy in people living with HIV (PLHIV). This study compared demographic and clinical outcomes across three groups: (1) those on tenofovir, emtricitabine and efavirenz (TEE); (2) those on tenofovir, lamivudine and dolutegravir (TLD); and (3) those switched from TEE to TLD.</p><p><strong>Methods: </strong>This retrospective, analytical study was conducted at an urban district hospital in KwaZulu-Natal. A sample of 212 patients was calculated using a chi-squared test for multiple proportions (80% power, 95% confidence interval). Data extracted at baseline, 6 and 12 months, were analysed with SPSS version 28.0.</p><p><strong>Results: </strong>There were statistically significant differences between the three groups. The Switch group showed a higher incidence of new hypertension (HT) (9.9%, p = 0.03) and chronic kidney disease (CKD) (12.1%, p = 0.01). TLD group maintained stable outcomes. TEE group had the highest incidence of newly diagnosed dyslipidaemia.</p><p><strong>Conclusion: </strong>DTG-based therapy remains the preferred regimen in SA, its long-term metabolic and renal impact in patients switching from EFV warrants careful surveillance. The increased rates of HT and CKD in the Switch Group emphasises the need for closer monitoring to mitigate against complications.Contribution: This research contributes to the body of evidence on DTG, highlighting its benefits and the clinical challenges of managing ageing PLHIV with multimorbidity.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge translation and integration of research evidence into practice: A national mandate.","authors":"John Musonda, Deidre Pretorius, Christiaan Visser, Olufemi Omole","doi":"10.4102/safp.v67i1.6158","DOIUrl":"10.4102/safp.v67i1.6158","url":null,"abstract":"<p><p>New medical knowledge is being rapidly added to the existing body of scientific understanding. However, the degree to which knowledge translation and the integration of research evidence into clinical practice are aligned and implemented remains unclear. This paper aims to promote the implementation of research evidence, thereby influencing professional behaviors, patient outcomes, and health policy. The focus is on the district research outcomes to facilitate changes in practice. An analysis of the dissemination of research findings within the health district is presented. A locally designed, innovative model is introduced, and global evidence-based models are incorporated to provide further insights. We conclude by reaffirming that utilizing evidence-based tools to develop and implement clinical guidelines and policies could transform practice and enhance patient outcomes. Contribution: The article's contribution is in motivating health care workers to engage in research to expand their competencies, and promote the alignment of research findings with implementation.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A socio-ecological analysis of parents' experiences of stillbirth in Limpopo, South Africa.","authors":"Lunghile Shivambo, Dumile Gumede","doi":"10.4102/safp.v67i1.6119","DOIUrl":"10.4102/safp.v67i1.6119","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth is a profoundly personal experience shaped by sociocultural norms, healthcare systems, and policies. Limited research exists on parents' lived experiences in South Africa. This study explored socio-ecological factors influencing parents' experiences of stillbirth in Limpopo, South Africa.</p><p><strong>Methods: </strong>This qualitative exploratory study used in-depth interviews with 12 purposively selected parents. Interviews were conducted in Xitsonga, transcribed, translated, and thematically analysed using ATLAS.ti.</p><p><strong>Results: </strong>The findings revealed that parents' experiences of stillbirth were shaped by a range of interconnected factors across multiple levels of the socio-ecological framework. At the individual level, participants expressed varying understandings of stillbirth, emotional distress, self-doubt and fear of recurrence. Interpersonal relationships played a dual role, with some participants receiving strong emotional support from partners and family members, while others experiencing blame and stigma. Organisational factors included positive and negative experiences with religious institutions and healthcare services, with reports of compassionate care and critical gaps in communication and response time. Societal influences were reflected in cultural beliefs, such as Xirheti, which shaped perceptions of repeated stillbirths and contributed to stigma. At the policy level, participants not only recognised the importance of antenatal care as promoted by national guidelines but also highlighted systemic barriers such as delayed transport and limited access to timely healthcare services.</p><p><strong>Conclusion: </strong>Addressing the impact of stillbirth requires a multi-level approach that integrates personal, social, cultural, healthcare, and policy dimensions to support parents.Contribution: This study offers evidence to inform more family-centred and system-responsive approaches in primary and maternal healthcare.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e11"},"PeriodicalIF":1.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}