Health & Place最新文献

{"title":"Investigating the impacts of alcohol outlet zoning policy on alcohol consumption and access to non-alcoholic services: A spatial agent-based simulation","authors":"Tingting Ji ,&nbsp;Ivana Stankov ,&nbsp;Niles Sherman Egan ,&nbsp;Kristen Hassmiller Lich ,&nbsp;Rachel L.J. Thornton ,&nbsp;Qi Wang ,&nbsp;Takeru Igusa ,&nbsp;Hsi-Hsien Wei ,&nbsp;Pamela A. Matson","doi":"10.1016/j.healthplace.2025.103489","DOIUrl":"10.1016/j.healthplace.2025.103489","url":null,"abstract":"<div><div>Debates continue over the effectiveness of limiting alcohol outlet density in reducing alcohol consumption, and its broader impacts on access to non-alcoholic services in low-income urban communities remain underexplored. This study addresses this gap by investigating the impacts of alcohol outlet zoning policies on alcohol consumption and walkable access to non-alcoholic services in low-income urban communities with different baseline densities of liquor and grocery stores. We developed a spatial agent-based model of Baltimore City neighborhoods, simulating the closure of non-conforming liquor stores following the city's zoning code rewrite. The model was calibrated using national survey data and empirical research on alcohol consumption and walkable access to alcohol, food, lottery, and ATM outlets by subgroups. We observed non-linear relationships and differences by gender and employment status in the effects of liquor store closures on heavy drinking, with policies showing limited effectiveness in neighborhoods with high baseline liquor store density. While the policies had minimal impact on access to food and ATMs due to high prevalence of grocery stores, they reduced access to lottery services. Our modeling approach serves as a valuable decision-making tool for policymakers to explore hypothetical scenarios, identify tipping points of policy impacts, and provide actionable insights into the complex interactions between zoning policies and neighborhood dynamics concerning alcohol consumption and access to essential goods and services.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103489"},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123165","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":"Local descriptive norms, smoking and body mass index in the Netherlands: Population-based study between 2012 and 2020","authors":"Dorien T. Beeres ,&nbsp;Joost Oude Groeniger ,&nbsp;Lili L. Kókai ,&nbsp;Frank J. van Lenthe","doi":"10.1016/j.healthplace.2025.103481","DOIUrl":"10.1016/j.healthplace.2025.103481","url":null,"abstract":"<div><div>Understanding the relationship between local health norms and individual behaviors can inform policies to reduce neighbourhood health inequalities. This study examines how local descriptive norms, measured as the prevalence of smoking and overweight in neighbourhoods, relate to individual smoking and body mass index (BMI) over time.</div><div>We used data from the Dutch Lifelines cohort and an existing policy instrument, SMall Area estimates for Policymakers (SMAPs), to estimate neighbourhood smoking and overweight prevalence in the Northern Netherlands (2012, 2016) and changes between these years. These estimates were linked to individual smoking and BMI in 2020 and to changes from 2016 to 2020. Generalized Linear Models were used to estimate the probability of individual smoking and overweight related to (changes) in the neighbourhood prevalence of smoking and overweight, controlling for prior health (behaviors) and socio-demographic factors. Generalized Additive Models were fitted to assess non-linearity.</div><div>The sample included 31,753 individuals across 957 neighbourhoods. A five percent higher prevalence of neighbourhood smoking in 2016 was associated with an increased relative risk of individual smoking in 2020 (RR = 1.13, 95 %CI 1.04–1.23). A five percent higher prevalence of overweight in 2016 was related to a nearly half-point higher individual BMI in 2020 (B = 0.47, 95 %CI 0.40–0.55). Non-linear associations were observed between neighbourhood overweight prevalence (2012, 2016) and individual BMI (2020), with steeper BMI increases in neighbourhoods where around half of the residents were overweight. For smoking the relationship was linear. Neighbourhood prevalence was not related to individual changes in smoking and BMI from 2016 to 2020.</div><div>Considering local descriptive norms might offer opportunities to tackle neighbourhood inequalities in health more effectively.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103481"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071839","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":"Nature contact and health risk Behaviours: Results from an 18 country study","authors":"Leanne Martin ,&nbsp;Mathew P. White ,&nbsp;Sabine Pahl ,&nbsp;Jon May ,&nbsp;John N. Newton ,&nbsp;Lewis R. Elliott ,&nbsp;Marta Cirach ,&nbsp;James Grellier ,&nbsp;Gregory N. Bratman ,&nbsp;Mireia Gascon ,&nbsp;Maria L. Lima ,&nbsp;Mark Nieuwenhuijsen ,&nbsp;Ann Ojala ,&nbsp;Anne Roiko ,&nbsp;Matilda van den Bosch ,&nbsp;Lora E. Fleming","doi":"10.1016/j.healthplace.2025.103479","DOIUrl":"10.1016/j.healthplace.2025.103479","url":null,"abstract":"<div><div>Emerging evidence suggests that residential greenspace is associated with a lower prevalence of health risk behaviours, but it remains unclear whether these effects are generalizable across countries or different types of nature contact. Using representative cross-sectional samples from 18 countries/regions, we examined the associations between two types of nature contact (greenspace, nature visits), current smoking and everyday drinking. After controlling for a range of covariates, greenspace was inversely associated with current smoking and everyday drinking. Visiting natural spaces at least once a week was linked to a lower prevalence of current smoking, but unrelated to everyday drinking. Increasing residential greenspace could be a promising strategy for reducing multiple health risk behaviours, whilst visit-based interventions may be a more appropriate target for smoking cessation.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103479"},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941526","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":"Changes in activity spaces, life spaces, and exposures to physical activity-promoting environments among women with overweight or obesity","authors":"Nana Luo ,&nbsp;Jiue-An Yang ,&nbsp;Calvin P. Tribby ,&nbsp;Sheri J. Hartman ,&nbsp;Loki Natarajan ,&nbsp;Cheryl Rock ,&nbsp;Dorothy D. Sears ,&nbsp;Tarik Benmarhnia ,&nbsp;Marta M. Jankowska","doi":"10.1016/j.healthplace.2025.103483","DOIUrl":"10.1016/j.healthplace.2025.103483","url":null,"abstract":"<div><div>Understanding factors associated with successful adherence and maintenance of weight loss interventions is important to potentially increase efficacy. Activity spaces and environmental exposures are two understudied factors that may be associated with intervention adherence and outcomes. Women with overweight or obesity (n = 498) from two weight loss intervention studies, Reach for Health and Metabolic, Exercise, and Nutrition at University of California San Diego, wore accelerometer and Global Positioning System (GPS) devices for 1 week at baseline and at 6-month follow up. Changes in activity spaces and time spent in three life space domains (<em>Home</em>, <em>Neighborhood</em>, and <em>Beyond Neighborhood</em>) were assessed at the two timepoints for total time and the subset of time in physical activity (PA). Relationships between repeated GPS-measured exposure to PA promoting environments (walkability; recreation; and greenness) were assessed with linear mixed effects models with an interaction between intervention and timepoint. There was no significant change in the average total or PA-related activity space size. There was no significant change in the amount of total time spent in life space domains by intervention group. However, for PA time in life spaces, the Intervention group increased percent of PA time in the <em>Neighborhood</em> (1.49 %–1.71 %; p = 0.011) and <em>Beyond Neighborhood</em> domains (from 5.85 %–6.60 %; p &lt; 0.0001), whereas PA time at <em>Home</em> was not significantly different (p = 0.755). For the mixed effects models with PA-related time, being in the Intervention group was associated with (−0.06, 95 % CI: −0.19, −0.07; p &lt; 0.01) less exposure to walkability and this was attenuated at time 2, compared to controls. Results suggest that PA-focused interventions did not increase the size of participants’ total and PA-related activity spaces but were associated with a higher percent of PA-related time outside of the home. There were not consistent associations between the Intervention group and increased exposure to PA-supportive environments.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927538","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":"Public space and loneliness in young adults in the Netherlands: An experiment with virtual environments","authors":"Yuwen Zhao ,&nbsp;Pauline van den Berg ,&nbsp;Bregje Schulten ,&nbsp;Astrid Kemperman","doi":"10.1016/j.healthplace.2025.103480","DOIUrl":"10.1016/j.healthplace.2025.103480","url":null,"abstract":"<div><div>As levels of loneliness in young adults are increasing, it is important to design loneliness reducing interventions for this age group. In this study, we specifically focus on built environment interventions that could alleviate young adults’ momentary feelings of emotional loneliness. We used an online survey incorporating a stated preference experiment with virtual public spaces in which seven attributes (presence of people, grass, water, benches, trees, vertical greenery, and traffic volume) were varied systematically. Respondents reported their momentary emotions (safe, relaxed, excited) and feelings of emotional loneliness after each video. The data were analyzed with regression models to determine the separate effects of these seven public space attributes on momentary loneliness and emotions. The results indicate that state loneliness is affected by the presence of other people in public space, as well as by the presence of trees and grass. Trees and other green elements (grass, water, vertical green), but also the presence of people have positive effects on feelings of safety, relaxation, and excitement. Public spaces with well-designed green elements and spaces that encourage liveliness can therefore contribute to reduced state loneliness, positive emotions and enhanced well-being.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103480"},"PeriodicalIF":3.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928766","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":"Scenescape and youth tobacco use in China: a symbolic study of expressive and volatile scenes","authors":"Chengzhe C. Xu,&nbsp;Xiaozhao Y. Yang","doi":"10.1016/j.healthplace.2025.103485","DOIUrl":"10.1016/j.healthplace.2025.103485","url":null,"abstract":"<div><div>Previous research often measured sites and venues as proxies for place, but the place effect on health also comes from the symbolic value emanating from a place—namely the scenescape. This study investigates how scenescapes affected adolescent tobacco use by combining the number of venues and the symbolic meanings of each venue measured via separate surveys. We sampled 2800 adolescents and youths (age 15–25) from 33 schools from 4 major Sinitic cultural regions and tested whether exposure to highly expressive and volatile scenescapes increases the likelihood of tobacco use. We assessed and calculated the scores of expressiveness and volatility of the neighbourhood within the 3 km radius of the respondent's household. Then, we conducted hierarchical logistic regression on tobacco use and the scene scores, adjusted for random effects and covariates. The results indicate that adolescents living in volatile scenes were more likely to smoke combustible cigarettes (3.66, p &lt; 0.05), whereas expressive scenes were negatively associated with smoking (−3.58, p &lt; 0.01). Vaping e-cigarettes showed no significant association with either expressiveness or volatility. These findings highlight the importance of the symbolic scenes in understanding youth substance use.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103485"},"PeriodicalIF":3.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923396","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":"Evaluating the effectiveness of the global position system beaded bracelets to improve the uptake of antenatal care, health facility delivery, and post-natal care services among pastoralist women in Kenya","authors":"Dahabo Adi Galgalo ,&nbsp;Patrick Nyamemba Nyakundi ,&nbsp;Ákos Várnagy ,&nbsp;Viktória Prémusz","doi":"10.1016/j.healthplace.2025.103484","DOIUrl":"10.1016/j.healthplace.2025.103484","url":null,"abstract":"<div><h3>Background</h3><div>Antenatal Care (ANC), Health Facility Delivery (HFD), and Postnatal Care (PNC) are the leading indicators of improving maternal and child healthcare globally. This study investigated the effectiveness of a prototyped Global Position System (GPS) beaded bracelet intervention in enhancing maternal healthcare services uptake among pastoralist communities.</div></div><div><h3>Methods</h3><div>In this Randomized Control Trial (RCT), one hundred and seven pregnant women in their first trimester were randomly allocated to the intervention group (n = 52) and control group (n = 55). A GPS-beaded bracelet was given to the intervention group for the study duration of 16 months (6 months before delivery and 10 months after delivery). Meanwhile, the non-intervention group received routine ante- and postnatal care. The Pearson X² test and multivariate logistic regression analysis were conducted using IBM SPSS version 27.0, following the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Model fit was assessed using, the Omnibus test of model Co-efficient, classification table, Nagelkerke R Square, and the Hosmer-Lemeshow test. The significance level was set at p &lt; 0.05. RCT was registered (ISRCTN15438206), and the GPS beaded bracelet was patented by Kenya Industrial Property Institutes (KIPI) NO: KE/UM/19/1211.</div></div><div><h3>Results</h3><div>Women in the intervention group have nine-fold higher likelihood of having more than four ANC visits (AOR 9.13, 95 % CI 1.75–47.54), three-fold higher likelihood of having postnatal care (AOR 2.71, 95 % CI 0.74–9.96), and a fourfold higher of giving live birth (AOR 3.56, 95 % CI 0.47–27.07) compared to women in the control group. No significant differences were noted between groups when it comes to place of delivery, indicating that while GPS may facilitate access to health facilities, it did not markedly change delivery outcomes based on location, but there is likelihood of delivering in a health facility (OR 2.0, 95 % CI 0.39–8.21). Other variables like age group, literacy level, and distance from health facility didn't exhibit a statistically significant association. All three methods of model fit assessment indicated good model fit.</div></div><div><h3>Conclusion</h3><div>The study result showed the effectiveness of GPS-beaded bracelets by significantly improving ANC, HFD, and PNC attendance and reducing infant mortality. Future studies should focus on refining these technologies to explore the long-term impacts and scalability of such interventions across diverse pastoralist populations to improve maternal and child healthcare.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103484"},"PeriodicalIF":3.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923397","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":"Crossing waters, crossing divides: A qualitative exploration of patient navigation experiences in Philippine Island communities","authors":"Cristela Mae C. Candelario ,&nbsp;Eleanor C. Castillo","doi":"10.1016/j.healthplace.2025.103482","DOIUrl":"10.1016/j.healthplace.2025.103482","url":null,"abstract":"<div><div>Navigating healthcare systems registers unique challenges in geographically isolated areas, where physical barriers and spatial inequities influence access to care. Patient navigation is well positioned to address these persistent health disparities, however, services remain scant in island communities of the Philippines. This study employs a situated intersectionality framework to investigate how place intersects with individual characteristics and social resources to drive patient navigation experiences in these geographically disadvantaged areas, examining the dynamic interactions between physical isolation, digital connectivity, social networks, and healthcare access. Through a relational understanding of health and place, this study utilized purposive sampling to invite participants for four focus group discussions and six key informant interviews. Thematic analysis revealed several key dimensions of patient navigation in this geographical context, including how digital navigation services help overcome geographical barriers while simultaneously creating new forms of inequality based on technological access and capability; how community resources and social capital create virtual bridges to mainland healthcare facilities; and how navigation services reduce the temporal and economic burdens unique to island settings. The analysis demonstrated how these factors interact differently across demographic groups and spatial locations within the island context. These findings elucidate how geographical context cuts through individual and social factors to create both opportunities and constraints in healthcare navigation, demonstrating the value of situated intersectionality in understanding how multiple forms of disadvantage traverse within specific spatial contexts. Recommendations include place-sensitive institutionalization of patient navigation services, strategic investment in geographically distributed technological infrastructure, and strengthening community-based navigation support systems to ensure effectiveness and sustainability of such endeavors in island communities.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103482"},"PeriodicalIF":3.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912764","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":"Left behind? A longitudinal ecological study of ‘regional deprivation amplification’ and life expectancy growth in in England (2004 to 2020)","authors":"Julija Simpson ,&nbsp;Viviana Albani ,&nbsp;Luke Munford ,&nbsp;Clare Bambra","doi":"10.1016/j.healthplace.2025.103478","DOIUrl":"10.1016/j.healthplace.2025.103478","url":null,"abstract":"<div><div>Geographical inequalities in health are substantial and increasing in many countries. In England, there is a life expectancy gap amongst the 20 % most deprived local authorities – between those in the northern regions and those in the rest of the country. We sought to quantify the size and evolution of this gap and to investigate potential contributing factors.</div><div>We used data from official national statistics covering years 2004–2020 for the 20 % most deprived local authorities in England, divided into north and rest of England. We conducted a Blinder-Oaxaca decomposition which quantified the size of the life expectancy gap for both men and women and identified the key contributing factors drawing on ‘deprivation amplification’ concept and other theories of health inequalities.</div><div>We have found that there is a long-standing and widening gap in life expectancy between local authorities in the north and the rest of England. The gap is greater for women than for men (11.7 vs. 7.0 months on average); the widening of the gap over the past two decades has also been greater for women. Our decomposition analysis indicates that regional differences in income are the main contributor to this gap for both men and women (explaining 69 % and 44 % of the gap, respectively), with behavioural factors such as smoking having no explanatory power.</div><div>Overall, our findings suggest that providing additional income-based resources to areas lagging behind in life expectancy may be an effective way of reducing place-based health inequalities both in England and in similar regionally imbalanced economies.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103478"},"PeriodicalIF":3.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912762","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":"Revisiting public open space and physical activity: What we know, what we still don't, and emerging issues—A decade later","authors":"Mohammad Javad Koohsari ,&nbsp;Koichiro Oka ,&nbsp;Tomoki Nakaya ,&nbsp;Emily Talen ,&nbsp;Andrew T. Kaczynski","doi":"10.1016/j.healthplace.2025.103465","DOIUrl":"10.1016/j.healthplace.2025.103465","url":null,"abstract":"<div><div>Public open spaces provide settings for physical activity, but research on their role continues to develop. A decade ago, a paper published by Koohsari et al. (2015) in <em>Health &amp; Place</em> identified key conceptual and methodological challenges in public open spaces and physical activity research. Since its publication, the paper has been widely cited, with over 340 citations and a field-weighted citation impact of 10.70 (Scopus). The current interdisciplinary commentary revisits the original study, evaluates progress over the past decade, and discusses emerging issues. While some conceptual and methodological gaps have been addressed, challenges remain. Emerging issues such as intensifying climate change, pandemics, and technological shifts continue to shape how public open spaces influence physical activity. Further interdisciplinary studies among urban designnce, parks and recreation, geography, public health, and other relevant fields are needed to address these challenges.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"94 ","pages":"Article 103465"},"PeriodicalIF":3.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895040","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}