Social Science & Medicine最新文献

{"title":"Inequities in eating disorder diagnoses in college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)","authors":"Nicholas K. Andrysiak ,&nbsp;Payal Chakraborty ,&nbsp;Ariel L. Beccia ,&nbsp;Brittany M. Charlton ,&nbsp;Colleen A. Reynolds","doi":"10.1016/j.socscimed.2025.118587","DOIUrl":"10.1016/j.socscimed.2025.118587","url":null,"abstract":"<div><div>Eating disorders contribute significantly to negative health outcomes across a broad range of domains. Despite their often-debilitating effects, they remain understudied, especially with respect to the experiences of people who are marginalized by multiple structural systems of power and oppression. The intersectionality framework highlights the mutually constitutive nature of those systems and the ways by which they uniquely shape lived experiences within and between populations. We used data from the American College Health Association National College Health Assessment III (ACHA-NCHA III), a repeated cross-sectional survey of college students, to estimate the prevalence of eating disorder diagnoses across intersections of gender identity, sexual orientation, race/ethnicity, and parental education via a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Two models were fit, one assessing only stratum-specific variations and another including race/ethnicity, gender identity, sexual orientation, and parental education as main effects. The prevalence of eating disorder diagnoses in the sample was 5.13 %, with stratum-specific prevalence estimates ranging from 0.44 % for Black, straight, cisgender men whose parents have a bachelor's degree to 19.20 % for transfeminine and nonbinary, bisexual/pansexual, Indigenous people whose parents have more than a bachelor's degree. There was a large main effect of gender identity, with strata inclusive of transfeminine and nonbinary individuals having 6.55 times greater odds (95 % CI: 5.70–7.51) of eating disorder diagnoses compared to cisgender men. Intersectional interactions between gender identity, sexual orientation, race/ethnicity, and parental education contributed to 2.66 % excess prevalence among White, bisexual/pansexual, cisgender women whose parents had less than a bachelor's degree, and 2.93 % lower prevalence among White, gay/lesbian, transfeminine and nonbinary people whose parents had less than a bachelor's degree. These findings emphasize the concerning inequities in eating disorder diagnoses among college students, and call attention to the multiple, interlocking systems of power and oppression that shape them.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118587"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Can you bury him before he dies?” Sickle cell disease and social sites of suffering in Malawi and Uganda","authors":"Sarah Svege ,&nbsp;Joseph Rujumba ,&nbsp;Bjarne Robberstad ,&nbsp;Siri Lange","doi":"10.1016/j.socscimed.2025.118591","DOIUrl":"10.1016/j.socscimed.2025.118591","url":null,"abstract":"<div><div>In health-related research, experience of illness is commonly characterised by its physical signs and symptoms. However, the experience of illness also extends past the patients' bodily aches and ailments to influence, and possibly impair, their social interactions. Despite its relational ramifications, the field of medicine has not awarded enough attention towards social dimensions of suffering nor the ways in which chronic disease may change and constrain the tapestries of social life. During everyday encounters, ill individuals are often subjected to the objectifying, evaluative gaze of healthy onlookers, who view them from a detached, third-person perspective. This paper explores interpretations of illness in the context of the genetic blood disorder sickle cell disease in Uganda and Malawi. 11 focus group discussions were held with children above 10 years of age with sickle cell disease, while 18 discussions were performed with caregivers of children with sickle cell disease. Drawing on this data, we describe how social interplay between sickle cell ‘sufferers’, their caregivers, and surrounding ‘spectators’ was coloured by community discourses on death, misconceptions about contagiousness, and attribution of perceived deviance. Beyond clinical features of pain and pathology, sickle cell suffering would take on socially situated forms where the ideas and imageries of ‘observing others’ led to added agony and alienation among affected individuals and their intimates. When addressing the predicament of patients and their families, one should consider how the medical meaning-making and opinions of others may give rise to what we herein refer to as ‘social sites of suffering’.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118591"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protective power of social connectedness: Individual vs. community influences on psychological distress in middle-aged Black adults","authors":"Yu-Tien Hsu,&nbsp;Katelyn Kostakis,&nbsp;Shazel Muhammad,&nbsp;Yusuf Ransome","doi":"10.1016/j.socscimed.2025.118585","DOIUrl":"10.1016/j.socscimed.2025.118585","url":null,"abstract":"<div><h3>Background</h3><div>Social connectedness is a crucial determinant of mental health, yet its effects on Black adults remain understudied, particularly in distinguishing between individual and community-level influences. This study examined cross-sectional and longitudinal associations between social connectedness and psychological distress among Black adults at the individual- and neighborhood (census tract) levels.</div></div><div><h3>Methods</h3><div>Using data from the MIDUS (Midlife in the United States) study, we analyzed 897 Black adults aged 25–74 from an urban setting. Social connectedness was measured across six dimensions: neighborhood social cohesion, social integration, support from family and friends, contribution to the community, and spirituality. After extensive model diagnostics, we employed cluster-robust errors to account for clustering by census tracts. We constructed cross-sectional and longitudinal models using these cluster-robust errors with inverse probability weighting to address attrition, examining individual and census-level effects on psychological distress in immediate and long-term contexts.</div></div><div><h3>Results</h3><div>In 10-year longitudinal analyses, family support (β = −1.95, 95 % CI = −3.01, −0.90) and friend support (β = −1.09, 95 % CI = −1.66, −0.52) showed significant protective effects against psychological distress. Cross-sectional analyses confirmed protective relationships for neighborhood social cohesion (β = −2.19, 95 % CI = −3.10, −1.28), family support (β = −1.97, 95 % CI = −2.77, −1.16), and friend support (β = −0.74, 95 % CI = −1.40, −0.07). Census-level social connectedness measures were not significantly associated with psychological distress in longitudinal models.</div></div><div><h3>Conclusions</h3><div>These findings underscore the primacy of individual-level social connections in protecting against psychological distress among Black adults. Mental health interventions should prioritize strengthening personal and family-centered social support networks while incorporating community engagement components for long-term benefits.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118585"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can unlocking the potential of peripheral public health workers improve healthcare outcomes? A trial of intervention on enhancing elderly health literacy in China","authors":"Xin Xiang ,&nbsp;Ming Lu ,&nbsp;Xuan Yang ,&nbsp;Yujuan Huang ,&nbsp;Luping Dong ,&nbsp;Hongzhi Wang","doi":"10.1016/j.socscimed.2025.118571","DOIUrl":"10.1016/j.socscimed.2025.118571","url":null,"abstract":"<div><div>Despite increased policy attention and resource allocation by governments worldwide, the mismatch between the supply and demand for healthcare workers continues to worsen. This study broadens the definition of public healthcare personnel by exploring the potential role of peripheral health workers in delivering public health services, aiming to offer a broader perspective for addressing the challenges posed by the healthcare workforce crisis. This study designed and implemented a community intervention trial aimed at evaluating the role of community committee members as peripheral public health workers in enhancing the health literacy of the elderly. A total of 22 urban communities in China were randomly assigned to either the intervention group or the control group. The intervention group received health education training for community committee members, while the control group did not receive any additional interventions. Following the intervention, a survey was conducted to assess the health literacy levels of elderly residents in both groups. The results indicate that elderly participants in the intervention group scored significantly higher across all dimensions and sub-dimensions of health literacy compared to those in the control group. These finding suggest that community committee members, acting as peripheral public health workers, play a significant role in enhancing health literacy within their communities. Our research provides valuable insights for countries and regions facing shortages of healthcare professionals, offering a human resource strategy for enhancing health literacy management and strengthening primary healthcare systems to achieve universal health coverage.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118571"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A panel data analysis of the impact of government trust on support for universal and air travel vaccine mandates during the COVID-19 pandemic","authors":"Songkhun Nillasithanukroh ,&nbsp;Chul Hyun Park ,&nbsp;Robert Richards ,&nbsp;Alyssa Ghaleb","doi":"10.1016/j.socscimed.2025.118586","DOIUrl":"10.1016/j.socscimed.2025.118586","url":null,"abstract":"<div><div>Does trust in the executive branch of the government influence support for collective public health measures? While previous research has primarily examined how trust in the government influences personal health decisions, such as individual vaccination choices, this article explores the role of trust in shaping support for collective public health measures like vaccine mandates. Unlike individual vaccine acceptance, which focuses on the costs and benefits of personal health decisions, supporting vaccine mandates requires individuals to weigh community health benefits against the potential restriction of others' autonomy. Insufficient support for these measures can undermine a government's ability to achieve its public health objectives. Longitudinal panel data from 2020 to 2023 were used to assess how trust in the President and state governor affects support for universal and air travel COVID-19 vaccine mandates in the U.S. Analyses show that higher trust in the President and state governor correlates with greater support for vaccine mandates. The impact of trust in the President on support varies depending on the severity of the health threat, economic conditions, and political ideology, while the influence of trust in the state governor on support remains consistent regardless of these factors. To garner public support for health mandates that limit citizens' autonomy and achieve public health objectives, both federal and state leaders need to foster public trust. Future research should investigate how trust is developed and maintained, particularly during crises.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118586"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"natural\" in the artificial: Surrogates’ reproductive literacy in navigating the health care system","authors":"Orit Chorowicz Bar-Am","doi":"10.1016/j.socscimed.2025.118579","DOIUrl":"10.1016/j.socscimed.2025.118579","url":null,"abstract":"<div><div>This study examines how demographic changes among Israeli surrogates have transformed their approaches to medical authority and bodily autonomy within the surrogacy process. We explore the changing medical experiences of second-generation Israeli surrogates, marking a significant new trend that differs from earlier approaches. To this end, we conducted narrative interviews with 47 retired surrogates in Israel between July 2022 and March 2023, employing qualitative methodology and inductive thematic analysis. While first-generation surrogates typically embraced medicalization to create distance between themselves and the pregnancy, our findings demonstrate that contemporary surrogates actively integrate their natural reproductive capabilities into surrogacy protocols. This research suggests that demographic changes—from single mothers with lower socioeconomic status to predominantly middle-class, educated married women—have reshaped surrogate agency. Consequently, we introduce two key concepts: \"repro-tech literacy,\" the specialized knowledge that surrogates acquire to navigate ART along with their embodied knowledge, and \"hybrid model of reproduction,\" where surrogates strategically combine medical advancements with natural capabilities. Contemporary surrogates actively negotiate various medical aspects, including hormonal treatments, embryo transfers, and delivery methods, often challenging standardized protocols that they perceive as unnecessary for IVF patients without reproductive constraints. This research presents new theoretical frameworks that advance our understanding of surrogate agency in reproductive medicine and challenge existing paradigms of medicalization in third-party reproduction. Our findings reflect a broader cultural shift toward selective medicalization and have practical implications for developing more ethical, patient-centered approaches to third-party reproduction.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118579"},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex workers’ engagement with mutual aid on-the-ground and online: Exploring access to grassroots support networks among a community-based cohort in Vancouver, Canada (2020–2024)","authors":"Jennie Pearson ,&nbsp;Andrea Krüsi ,&nbsp;Kate Shannon ,&nbsp;Charlie Zhou ,&nbsp;Shira M. Goldenberg","doi":"10.1016/j.socscimed.2025.118582","DOIUrl":"10.1016/j.socscimed.2025.118582","url":null,"abstract":"<div><div>Mutual aid is the practice of grassroots support based on principles of direct action and non-hierarchical cooperation, central to the health and well-being of marginalized communities including sex workers. Despite mutual aid's centrality to sex workers' well-being, there is a dearth of health research on sex workers' uptake of mutual aid, particularly digital modes, and its relationship to supportive occupational conditions. Drawing on longitudinal cohort data, we measured recent mutual aid and its association with structural and occupational conditions among 900+ sex workers in Metro Vancouver, Canada. Informed by mutual aid principles and a structural determinants framework, we examined uptake of “digital” and “on-the-ground” (i.e., in-person) mutual aid and explored associations with occupational conditions in a community-based cohort of sex workers over four years (2020–24). Among 367 sex workers, 37.2 % and 58 % reported engaging in digital and on-the-ground mutual aid, respectively. We found higher odds of utilizing “on-the-ground” mutual aid among those experiencing recent physical/sexual violence and lower odds of digital mutual aid among sex workers who experienced lifetime incarceration. The findings affirm engagement with mutual aid as a critical support model for sex workers, while highlighting barriers to emerging digital modalities. There is need for full decriminalization of sex work and the democratization of digital tools to reduce barriers to essential resources and support networks. Further, our findings underscore the potential of mutual aid principles within public health, by learning from communities who have cultivated grassroots models of care in the context of structural exclusion.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118582"},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marginalization-related diminished returns of education level on self-rated physical and mental health among immigrants: an analysis of six high-income countries","authors":"Ali Al-kassab-Córdova ,&nbsp;Edward Mezones-Holguin ,&nbsp;Shervin Assari ,&nbsp;Jay S. Kaufman","doi":"10.1016/j.socscimed.2025.118584","DOIUrl":"10.1016/j.socscimed.2025.118584","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the association between level of education and self-rated physical and mental health is weaker for immigrants than non-immigrants, and to explore gender-based intersections.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study using data from the Wave 1 of the Global Flourishing Study—a multi-country survey with national representativeness. Data were drawn from Australia, Germany, Spain, Sweden, the United Kingdom and the United States. Self-rated physical and mental health were measured on a 11-point scale. Level of education was categorized into four levels based on country-specific classifications. Immigrant status was defined as being born outside the country of residence. We estimated linear regression models separately for each country, including interaction terms between educational level, immigration status, and gender. Country-specific estimates were then pooled using random-effects meta-analysis.</div></div><div><h3>Results</h3><div>A total of 75,464 participants were included. Self-rated health scores increased with higher education levels, but immigrants had higher scores. However, the associations between level of education and health outcomes were significantly weaker for immigrants—they have reduced health benefits. Further, diminished health returns were more pronounced among female immigrants than their male counterparts, but these estimates had poor precision.</div></div><div><h3>Conclusions</h3><div>Due to marginalization-related diminished returns, immigrants get less health benefits from the same level of education attained than their non-immigrant counterparts. This health gap is wider among female immigrants. Structural and contextual barriers obstruct the protective effects of education among marginalized populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118584"},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early effects of cognitive-impairment friendly community on health care utilization in China: Evidence from administrative data in Shanghai","authors":"Jingyi Ai ,&nbsp;Xi Chen ,&nbsp;Jin Feng ,&nbsp;Yufei Xie","doi":"10.1016/j.socscimed.2025.118570","DOIUrl":"10.1016/j.socscimed.2025.118570","url":null,"abstract":"<div><div>The study examines the early effects of cognitive-impairment (CI) friendly communities on health care utilization among older adults in Shanghai, China. By exploiting the rollout of CI-friendly communities and employing a difference-in-differences approach, we evaluate the impact of CI-friendly communities. We find that CI-friendly communities significantly increase the probability and frequency of visiting cognition-disease-related departments (CRD) by 0.7 (13.73 %) percentage points and 0.02 (17.24 %) times, respectively. In particular, the effect is more pronounced for individuals not previously received CRD care. The dominant mechanisms may include information and early screening effects. Additionally, CI-friendly communities affect health care utilization in other positive ways, such as reducing emergency room (ER) visits and promoting primary care use.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118570"},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural consonance as a mediator between maternal adversity and parenting practices across family contexts in the Dominican Republic","authors":"Arachu Castro ,&nbsp;Laura V. Sánchez-Vincitore","doi":"10.1016/j.socscimed.2025.118580","DOIUrl":"10.1016/j.socscimed.2025.118580","url":null,"abstract":"<div><h3>Background</h3><div>Adversity is linked to compromised parenting, but the mechanisms remain unclear. This study examines cultural consonance—the extent to which individuals’ lives align with shared cultural models—as a mediator between maternal adversity and three parenting practices: violent discipline, positive discipline, and cognitive stimulation.</div></div><div><h3>Methods</h3><div>We collected and analyzed data from 1019 mothers living in poverty in 2024-25 in the Dominican Republic. Maternal adversity was modeled as a latent construct including adverse childhood experiences, intimate partner violence, and depression symptoms. Cultural consonance was assessed across material-social and family dynamics domains. Structural equation models tested mediation; regressions explored predictors by family structure and maternity onset age.</div></div><div><h3>Results</h3><div>Adversity lowered material-social (β = −.56, p &lt; .001) and family dynamics consonance (β = −.87, p &lt; .001). For violent discipline, family dynamics consonance was protective (β = −.37, p = .013), while material-social consonance increased its use (β = .22, p &lt; .001); adversity's effect was fully mediated. For positive discipline, adversity had a positive direct effect (β = 39, p = .014) but negative indirect effects (β = −.31, p = .025), suggesting suppression. For stimulation, adversity's positive direct effects (β = .44, p = .018) were offset by stronger negative indirect effects (β = −.61, p &lt; .001), yielding a negative total effect. Family structure and age at first childbirth shaped these pathways. Households with both parents and other adults had better outcomes; single mothers with multiple children faced the greatest challenges. Paternal consonance consistently predicted cognitive stimulation; consonance in all family domains were protective against violent discipline.</div></div><div><h3>Conclusions</h3><div>Interventions that enhance cultural consonance may complement traditional parenting programs, but they should be tailored to the family composition and the mother's age.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118580"},"PeriodicalIF":5.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}