{"title":"Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.","authors":"Kyle Tan","doi":"10.1177/2752535X241273831","DOIUrl":"10.1177/2752535X241273831","url":null,"abstract":"<p><p>Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"405-409"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908517","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}
Arabia Mohamad Ali, Marie Claire Van Hout, Lannah Kent, Isabelle Salameh, Elie Aaraj
{"title":"A Community Rights and Gender Assessment of Tuberculosis Diagnosis, Treatment and Care in Lebanon.","authors":"Arabia Mohamad Ali, Marie Claire Van Hout, Lannah Kent, Isabelle Salameh, Elie Aaraj","doi":"10.1177/2752535X251355731","DOIUrl":"https://doi.org/10.1177/2752535X251355731","url":null,"abstract":"<p><p>TB remains a significant global health challenge despite being preventable and curable. The Global Plan to End TB 2023-2030 is underpinned by a rights-based, public health and people-centred approach to ending TB. Lebanon is a low TB endemic country, where for the first time a community, rights, and gender (CRG) assessment of the national TB response was conducted in 2024. Despite the universal availability and cost-free access to TB care in Lebanon, systemic barriers continue to hinder patient accessibility. Low disease awareness, transportation costs, financial challenges, and pervasive stigma frequently compel individuals to conceal their TB diagnosis, thereby undermining contact tracing and treatment adherence. Beyond medical treatment, TB patients receive minimal psychosocial or financial support, disproportionately affecting key vulnerable groups who are already marginalized in Lebanese society. Insufficient community engagement and chronic funding shortages further weaken the Lebanese TB response. While Lebanon upholds advanced medical protocols, its outdated TB laws fail to protect crucial patient rights, including privacy, confidentiality, and informed consent. Gender disparities also persist, with a lack of gender-specific data to inform policies, and inadequate sensitization among healthcare personnel (e.g., transgender women, women with HIV, women who use drugs). There is a pressing need for accountability mechanisms for TB program implementers and labor protections to prevent workplace discrimination against TB patients. Strengthening the National TB Program and addressing the structural deficiencies in Lebanon through targeted interventions, legal reforms, and a gender-inclusive, rights-based approach is essential to ensuring available, accessible, acceptable and quality TB services in Lebanon.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251355731"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Cruz-Salazar, Neil S Hwang, Shirshendu Chatterjee, Kathryn P Derose, Karen R Flórez
{"title":"Are Remitters at Risk for Lower Food Security and Dietary Quality? An Exploratory Study of Mexican Immigrants in NYC.","authors":"Daniela Cruz-Salazar, Neil S Hwang, Shirshendu Chatterjee, Kathryn P Derose, Karen R Flórez","doi":"10.1177/2752535X251355455","DOIUrl":"10.1177/2752535X251355455","url":null,"abstract":"<p><p>ObjectiveTo examine whether remitting behavior among Mexican immigrants in the Bronx is associated with increased food insecurity and lower dietary quality, with a particular focus on potential gender differences in these associations.DesignDescriptive and bivariate statistics are shown, and binary logistic multivariate regression models are computed.SettingData come from a study exploring the social networks, dietary behaviors and outcomes of Mexican immigrants recruited from a Catholic Church in the Bronx between January 2019 and June 2019.Participants81 Mexican immigrants 18 years or older living in the Bronx, New York City.ResultsA statistically significant (<i>p</i> < .1) relationship was not found between sending remittances and food insecurity; however, we found that women remitters had higher odds than men remitters of having low dietary quality (<i>p</i> < .060). We also found that a higher Body Mass Index was associated with higher odds of experiencing low and very low food security (<i>p</i> < .037).ConclusionsFurther research with nationally representative data is needed to investigate the full extent of the association between remittances and nutritional outcomes of remitters.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251355455"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oluwaseyi O Isehunwa, Satish K Kedia, Michael Schmidt, Coree Entwistle, Erik L Carlton, Patrick J Dillon
{"title":"A Qualitative Study on Barriers and Facilitators to Effective Collaboration Between Local Health Departments and Hospitals.","authors":"Oluwaseyi O Isehunwa, Satish K Kedia, Michael Schmidt, Coree Entwistle, Erik L Carlton, Patrick J Dillon","doi":"10.1177/2752535X251348526","DOIUrl":"https://doi.org/10.1177/2752535X251348526","url":null,"abstract":"<p><p>A central component of the Public Health 3.0 model is building partnerships between local public health departments and other community organizations/stakeholders, including public and private hospitals, as a means of promoting data sharing, service coordination, and collective action. Evidence suggests that such partnerships remain challenging and infrequent. This qualitative study used in-depth interviews to identify barriers and facilitators to building effective collaboration between local health departments (LHDs) and hospitals. We purposively recruited LHD officials (<i>n</i> = 12) across the United States. A directed qualitative content analysis of the interview transcripts revealed five barriers and five facilitators to building effective collaboration between the two entities. Perceived barriers included competition, inconsistent participation and engagement, communication breakdown, time constraints, and lack of financial and human resources. Perceived facilitators included finding common ground, well-established relationships, aligning and leveraging resources, open communication, and leadership commitment. Findings highlight challenges and opportunities to promote effective collaboration between LHDs and hospitals.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251348526"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara E Baumann, Leigh Anne Schmidt, Annika Agarwal, RaNaja Kennedy, Robert W S Coulter, Brigit Joseph, Elizabeth Miller, Christina Mair
{"title":"\"It's Important to Use Dialogue that Promotes a Safe Space of Inclusivity\": Reflections From a Community Engagement Studio to Inform Creative Alcohol Research.","authors":"Sara E Baumann, Leigh Anne Schmidt, Annika Agarwal, RaNaja Kennedy, Robert W S Coulter, Brigit Joseph, Elizabeth Miller, Christina Mair","doi":"10.1177/2752535X251341639","DOIUrl":"https://doi.org/10.1177/2752535X251341639","url":null,"abstract":"<p><p>There is a pressing need for research that prioritizes the inclusion of diverse communities in the alcohol research field. A community-engaged approach can lead to more sustainable approaches, enhance buy-in, and lead to actions that are more equitable. The Community Engagement Studio (CES) model, which facilitates discussions between researchers, community engagement coordinators, and community experts, is one structured method to support conducting community-engaged research. In our creative alcohol study, we utilized Collaborative Filmmaking (CF) - a participatory, visual research method - to explore structural and neighborhood effects on alcohol use. We applied the CES model to enhance our study with community input prior to launch, which is particularly important when applying novel methodologies. The CES discussion illuminated several topics for the research team to consider regarding research study logistics (e.g., filmmaking prompts, recruitment, filmmaking support) and how to approach the research topic of alcohol use (e.g., trauma, sensitivity). This allowed the research team to make critical adjustments to their approach to ensure the tools, data collection techniques, and recruitment methods were appropriate. Input from community experts also uncovered important considerations related to trauma, ethics, and trust, which are vital for creative, participatory health research. Overall, the CES served as a valuable model for fostering community dialogue and can be used to enhance the impact of creative research.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251341639"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"En Route to Midwifery Professionalisation: Contextualising Midwifery Care in the Indian Public Health System.","authors":"Sanjana Santosh","doi":"10.1177/2752535X251340760","DOIUrl":"https://doi.org/10.1177/2752535X251340760","url":null,"abstract":"<p><p>BackgroundThe 'Guidelines on Midwifery Services Initiative, 2018' introduces the Nurse Practitioner in Midwifery (NPM) cadre to improve maternal mortality rates, quality of care, and reduce overmedicalisation in the Indian public health system. The paper examines how the NPM cadre is envisioned in the guidelines, positioned within the medical hierarchy, and aligned within the existing maternal health context. It also looks at how existing midwives and midwifery advocates perceive the changes introduced and the accompanying professionalisation process.MethodologyThe study employed two methods: (a) qualitative document analysis (QDA) of the midwifery guidelines and (b) semi-structured in-depth interviews with 14 nurse-midwifery leaders and advocates.FindingsThe QDA uncovers the underlying themes of task shifting and institutional deliveries as dominant, discussions on professional autonomy and primary health care receiving less importance and even less reflection on the history of midwifery in India. The interview findings highlight (a) tensions around carving out a separate profession, (b) the implications of midwifery at the primary healthcare level and (c) the need for an enabling environment for midwives. This paper reveals how the guidelines frame midwifery as a cost-effective, specialised nursing care within the institutional delivery framework and distanced from its traditional connotations.DiscussionIt elucidates tensions around autonomous midwifery involving professional boundaries, negotiations with medical professionals, institutional perceptions, and historical stereotypes. It builds on the broader literature on 'professions' in sociology by identifying aspects of 'professional boundary work' embedded in policy documents and experiences of participants - thereby unpacking the midwifery professionalisation process in the Indian context.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251340760"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erika R Cheng, Brittany Smart, Sarah E Wiehe, Karen Comer, Lisa K Staten, Aruna Manisekaran, Nichole Wilson, Jay Foster, Shadreck Kamwendo, Rachael Peters, Tatyana Roberts, Shelley Hoffman, Brownsyne Tucker Edmonds
{"title":"Launching the Indianapolis Health Equity, Access, outReach & Treatment (iHEART) Collaborative: A Case Study.","authors":"Erika R Cheng, Brittany Smart, Sarah E Wiehe, Karen Comer, Lisa K Staten, Aruna Manisekaran, Nichole Wilson, Jay Foster, Shadreck Kamwendo, Rachael Peters, Tatyana Roberts, Shelley Hoffman, Brownsyne Tucker Edmonds","doi":"10.1177/2752535X251342307","DOIUrl":"https://doi.org/10.1177/2752535X251342307","url":null,"abstract":"<p><p><b>Objective:</b> To describe the creation, deployment, and initial impact of a place-based, multi-level, multi-component initiative designed to prevent cardiovascular health disparities in high-risk neighborhoods in Indianapolis, Indiana. <b>Methods:</b> The Indianapolis Health Equity Access outReach & Treatment (iHEART) Collaborative uses a community-driven, place-based approach and leverages partnerships with local organizations, businesses, and residents to implement health screenings, educational outreach, and support for social determinants of health (SDOH). <b>Results:</b> From September 2022 - September 2024, iHEART conducted 4048 blood pressure screenings; 3135 in community settings. >38% of participants were identified as having Stage 1 hypertension or being at risk. 29% of 1219 individuals with elevated CVD risk were previously undiagnosed. 94.6% of 223 individuals referred for medical care completed follow-up care. Barbershop 2.0 screened 378 patrons, with 126 returning for additional screenings. >50% of these returning participants demonstrated improvements between their initial and follow-up screenings. The Convenient Home Evaluation for Cardiovascular Health and Individual Tracking (CHECK-IT) program enrolled 1105 patients; 63.9% achieved blood pressure control, or their last recorded blood pressure reading below 140/90 mmHg, by the end of the 4-month program. <b>Conclusions:</b> iHEART's approach highlights the potential benefits of combining health and SDOH interventions, offering a promising model for addressing health inequities.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251342307"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fiona Carter-Tod, Jessie V Ford, Jessica L Weissman
{"title":"\"You Start With the Community\": The Value of Community-Based Approaches to COVID-19 in Sri Lanka.","authors":"Fiona Carter-Tod, Jessie V Ford, Jessica L Weissman","doi":"10.1177/2752535X251337660","DOIUrl":"https://doi.org/10.1177/2752535X251337660","url":null,"abstract":"<p><p><b>Background:</b> Despite the previous success of a universal health care system, Sri Lanka is facing novel challenges including non-communicable diseases such as diabetes and cancer, an aging population, and most recently, the COVID-19 pandemic. Previous pandemic and disaster responses worldwide have centered local community approaches as crucial for effective solutions. However, there is a gap in the literature surrounding the role of community organizations in Sri Lanka's public health response. <b>Purpose:</b> This study investigates the role of community-based responses during the COVID-19 pandemic in Sri Lanka through the perspective of public health professionals and nongovernmental organization (NGO) affiliates. <b>Research Design:</b> The study is based on qualitative interviews and the antecedent literature review, used to triangulate the collected qualitative data.<b>Study Sample:</b> Ten interviews were conducted to gain an understanding of the role of community organizations in Sri Lanka's COVID-19 pandemic response from both those who work within the public health sector as well as community organizations that assisted with public health efforts. <b>Results:</b> Findings demonstrate that community organizations aided in the COVID-19 response through various forms of hands-on support, most commonly including fundraising and the provision of resources, food, safety equipment, and educational materials. In addition, community organizations' were most successful in navigating the pandemic climate when they communicated closely with communities, engaged in ongoing collaboration with the government, and used innovative strategies. <b>Conclusion:</b> We see this work as exploratory and important for informing future research on the Sri Lankan public health context. Our findings suggest that community organizations should not be overlooked in global public health contexts as they are often well positioned to combat arising public health issues through their unique networks and potential for new and creative solutions.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251337660"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joely Wilder Merriman, Gabriel Jeferson Rodríguez Machado, Marcos Almeida Matos, Atson Carlos de Souza Fernandes, Adrienne Morgan, Lavínia Boaventura Silva Martins, Renata Roseghini, Sidney Carlos de Jesus Santana, Amancio Jose de Souza
{"title":"Enhancing Interprofessional Community Engagement and Humanistic Interactions in Health Professional Education in Salvador, Brazil: The Programa Candeal Experience.","authors":"Joely Wilder Merriman, Gabriel Jeferson Rodríguez Machado, Marcos Almeida Matos, Atson Carlos de Souza Fernandes, Adrienne Morgan, Lavínia Boaventura Silva Martins, Renata Roseghini, Sidney Carlos de Jesus Santana, Amancio Jose de Souza","doi":"10.1177/2752535X251334862","DOIUrl":"https://doi.org/10.1177/2752535X251334862","url":null,"abstract":"<p><p>Twenty years of existing medical literature speak to a global interest in interprofessional experiences and the role of community engagement in the formation of 21st century health professionals, with recent literature highlighting shortcomings in the ability to form satisfactory therapeutic alliances with patients of lower socioeconomic status. A paucity of literature regarding effective interventions to rectify these gaps in care remains. This manuscript reports the findings of a retrospective analysis of participant satisfaction with Programa Candeal, a previously un-evaluated interprofessional health education program at the Bahiana School of Medicine and Public Health in Salvador, Brazil, seeking to improve the capacity of health professional students to work successfully on interdisciplinary health care teams through hands-on experience interacting with disenfranchised populations outside of the traditional roles of provider and patient. Results of a mixed quantitative-qualitative survey reveal that Programa Candeal is successful in encouraging health professional students to practice community engagement, cultivates a literacy with the concept of multi professional teamwork, and promotes humanistic interactions with community members at some of the widest socioeconomic divides in Brazil. This manuscript also highlights the relative ease of implementing a semi-automated online evaluation protocol without undue administrative burden in a low-resource environment.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251334862"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonya S Shin, Ami Shah, Janette North-Kabore, Virginia Rowthorn, Kevin P Fiori, Ruth Dudding, Rev Alexander Plum, Dana M Parke, Carmen George, Stephen Thomas, Randal Pinkett, Keshia M Pollack Porter, Adam Sirois, Vera Cordeiro, Yolanda Ogbolu
{"title":"Global Learning for Health Equity: A Survey of Five Global Learning Sites in the United States.","authors":"Sonya S Shin, Ami Shah, Janette North-Kabore, Virginia Rowthorn, Kevin P Fiori, Ruth Dudding, Rev Alexander Plum, Dana M Parke, Carmen George, Stephen Thomas, Randal Pinkett, Keshia M Pollack Porter, Adam Sirois, Vera Cordeiro, Yolanda Ogbolu","doi":"10.1177/2752535X231210046","DOIUrl":"10.1177/2752535X231210046","url":null,"abstract":"<p><p>Global learning is the practice of adopting and adapting global ideas to local challenges. To advance the field of global learning, we performed a case study of five communities that had implemented global health models to advance health equity in a U.S. setting. Surveys were developed using a Consolidated Framework for Implementation Research (CFIR) framework, and each site completed surveys to characterize their global learning experience with respect to community context, the learning and implementation process, implementation science considerations, and health equity. The immense diversity of sites and their experiences underscored the heterogenous nature of global learning. Nonetheless, all cases highlighted core themes of addressing social determinants of health through strong community engagement. Cross-sector participation and implementation science evaluation were strategies applied by many but not all sites. We advocate for continued global learning that advances health equity and fosters equitable partnerships with mutual benefits to origination and destination sites.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"275-290"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016332","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}