Revista da Escola de Enfermagem da U S P最新文献

{"title":"Mobile application for self-care in people with heart failure: a quasi-experimental study.","authors":"Wallison Pereira Dos Santos, Mailson Marques de Sousa, André Atanasio Maranhão Almeida, Taciana da Costa Farias Almeida, Fernanda Beatriz Dantas de Freitas, Bernadete de Lourdes André Gouveia, Simone Helena Dos Santos Oliveira","doi":"10.1590/1980-220X-REEUSP-2025-0537en","DOIUrl":"10.1590/1980-220X-REEUSP-2025-0537en","url":null,"abstract":"<p><strong>Objective: </strong>To compare the self-care scores of people with heart failure before and after using the \"Tum-Tum\" mobile application.</p><p><strong>Method: </strong>A single-group, quasi-experimental, before-and-after study involving a sample of 57 individuals treated at the cardiology outpatient clinic of a public university hospital in the city of João Pessoa, Paraíba, conducted between January and May 2024. To measure self-care, the Self-Care of Heart Failure Index was used before (T0) and 60 days after (T1) using the mobile application. Data analysis involved descriptive statistics and the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>54.4% of participants were male. The median age was 60 years, and the median number of years of education was six years. A statistically significant difference was observed between the pre-intervention (T0) and post-intervention (T1) time points regarding the heart failure self-care maintenance and self-care confidence subscales.</p><p><strong>Conclusion: </strong>The use of the \"Tum-Tum\" mobile app had a positive influence on increasing scores. The app has the potential to support educational strategies promoted by healthcare professionals-particularly nurses-regarding self-care for people with heart failure. The study was registered with ReBEC - registry RBR-5zx8rvc.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20250537"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946548","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":"Effects of intradialytic nutrition on dialysis adequacy and fatigue in hemodialysis patients: a randomized crossover study.","authors":"Esra Köse, Meral Gün","doi":"10.1590/1980-220X-REEUSP-2026-0010en","DOIUrl":"10.1590/1980-220X-REEUSP-2026-0010en","url":null,"abstract":"<p><strong>Objective: </strong>To assess intradialytic nutrition's effects on dialysis adequacy and fatigue in maintenance hemodialysis patients.</p><p><strong>Methods: </strong>A randomized, two-period, two-sequence, self-controlled crossover trial was conducted in two outpatient hemodialysis centers in Türkiye. Thirty-six patients were randomized; 32 completed both periods. The participants received standardized intradialytic nutrition in one period and no food intake during the control period. Dialysis adequacy was evaluated using the urea reduction ratio and single-pool Kt/V. Intradialytic blood pressure was recorded during dialysis sessions, and fatigue severity was measured using the Piper Fatigue Scale at the end of each period.</p><p><strong>Results: </strong>No significant differences were observed in dialysis adequacy or fatigue scores between the two periods. Intradialytic nutrition was associated with greater reductions in systolic and diastolic blood pressure, particularly during the second hour of dialysis. No clinically relevant adverse events occurred.</p><p><strong>Conclusion: </strong>Intradialytic nutrition did not compromise dialysis adequacy or worsen fatigue severity but was associated with increased intradialytic blood pressure reductions. Individualized clinical decisions and careful hemodynamic monitoring are warranted when implementing intradialytic nutritional interventions.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT07687498.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20260010"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946553","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":"Health promotion strategies for adolescents with suicidal behavior: a scoping review.","authors":"Erika Augusta do Amaral Coelho Bezerra, Ivonete Teresinha Schulter Buss Heidemann, Aldalice Aguiar de Souza, Eliana Rosa da Fonseca, Camila Trindade Coelho, Paola Margarita Oñate Daza, Richard Augusto Thomann Beckert, Alaidistânia Aparecida Ferreira","doi":"10.1590/1980-220X-REEUSP-2025-0338en","DOIUrl":"10.1590/1980-220X-REEUSP-2025-0338en","url":null,"abstract":"<p><strong>Objective: </strong>To map strategies for promoting the health of adolescents with suicidal behavior.</p><p><strong>Method: </strong>Scoping review in accordance with JBI methodological guidelines, without language or time limitations. Inclusion criteria for the studies: adolescents aged ten to 19 years with suicidal behavior to explore the concept of health promotion, in any health service, but without limiting this context. Sources consulted: MEDLINE/PubMed, PubMed Central/NLM, CINAHL, Academic Search Premier, Fonte Acadêmica/EBSCO, Scopus, Embase/Elsevier, LILACS, BDENF, INDEXPSI, CUMED, BINACIS, LIPECS, MedCarib, BBO, ARGMSAL, BDNPAR, BIGG, BRISA, HomeoIndex, PAHOIRIS, SES-SPBVS, SciELO, PsycInfo/APA.</p><p><strong>Results: </strong>Of the 22 articles selected, two strategic approaches emerged targeting adolescents: development of life skills - peer support, mental health literacy, youth engagement - and involvement of different social actors - family, professionals, community leaders, intersectoral support networks.</p><p><strong>Conclusion: </strong>Health promotion strategies were identified and mapped using two strategic approaches: first, they were directed at adolescents; then, they involved different social actors, broadening the scope of health promotion.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20250338"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932207","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":"Vaccine hesitancy and refusal: perspectives of midwives working in family health centers - a descriptive cross-sectional study.","authors":"Şeyma Çatalgöl, Eda Can","doi":"10.1590/1980-220X-REEUSP-2025-0469en","DOIUrl":"10.1590/1980-220X-REEUSP-2025-0469en","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the views of midwives working in family health centers regarding vaccine hesitancy and refusal, as well as the solution strategies they propose for this issue.</p><p><strong>Method: </strong>This descriptive cross-sectional study was conducted with 81 midwives working in family health centers in the province of Uşak, Türkiye, between March 24 and May 18, 2021. Data were collected via Google Forms using a structured questionnaire developed based on the literature. The data were analyzed using descriptive statistics, including frequencies and percentages.</p><p><strong>Results: </strong>According to midwives' reports, the most frequently cited factors contributing to vaccine hesitancy and refusal include exposure to anti-vaccine websites (90.1%), concerns about vaccine ingredients (70.4%), the influence attributed to community leaders (66.7%), and religious beliefs (65.4%). Other reported factors include past vaccination experiences (56.8%), distrust of vaccine manufacturers (44.4%), and distrust of healthcare workers and the healthcare system (38.3%). An analysis of vaccine information sources revealed that patients most frequently used the internet (37.0%), their social environment (30.9%), healthcare institutions (24.7%), and television (7.4%). 65.4% of midwives reported encountering anti-vaccine individuals. The most frequently recommended strategies include: presenting television content supporting vaccination (70.4%), broadcasting public service announcements via television and the internet (67.9%), and providing information about vaccines through healthcare workers (58.0%).</p><p><strong>Conclusion: </strong>Midwives' field observations suggest that vaccine hesitancy and refusal may be associated with digital misinformation, trust-related concerns, and sociocultural factors. Strengthening education initiatives led by healthcare workers and media-based information strategies could potentially contribute to increasing vaccine acceptance.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20250469"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932300","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":"Demystifying HIV: academic training for undergraduate nursing students.","authors":"Naomi Tamima Estevam Cipriano, Jacks Soratto, Cristiane Damiani Tomasi","doi":"10.1590/1980-220X-REEUSP-2026-0023en","DOIUrl":"10.1590/1980-220X-REEUSP-2026-0023en","url":null,"abstract":"<p><strong>Objective: </strong>To develop and evaluate a participatory and dialogic health education program with nursing students at a community college in Criciúma, SC, on the Human Immunodeficiency Virus and its care pathway.</p><p><strong>Method: </strong>Action research, grounded in Critical Pedagogy, conducted with 19 nursing students in their 8th through 10th semesters of the program. The training took place in four stages: exploratory, planning, action, and evaluation, with questionnaires administered before and after the intervention.</p><p><strong>Results: </strong>Before the training, self-assessments of knowledge regarding Pre-Exposure Prophylaxis, Post-Exposure Prophylaxis, and Antiretroviral Therapy were predominantly rated as fair or poor/very poor. After the intervention, all participants rated their knowledge as very good or good. There was also an increase in the perceived readiness to welcome and counsel people regarding the Human Immunodeficiency Virus care pathway within the Unified Health System, from 52.6% to 94.7%.</p><p><strong>Conclusion: </strong>The participatory and dialogic health education program developed with nursing students proved effective in expanding knowledge about HIV and its care pathway, as well as in strengthening participants' confidence in approaching people living with HIV.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20260023"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932265","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":"Active learning-based reinforcement in nursing education: a cluster-randomized controlled trial using Roper, Logan and Tierney's life model.","authors":"Nadiye Barış Eren, Bahar Çiftçi","doi":"10.1590/1980-220X-REEUSP-2026-0022en","DOIUrl":"10.1590/1980-220X-REEUSP-2026-0022en","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effect of puzzle-based reinforcement on nursing students' academic achievement and motivation toward instructional materials.</p><p><strong>Method: </strong>To conduct a cluster-randomized controlled trial with 70 first-year nursing students allocated to intervention and control groups. Both groups received a 2-hour interactive lecture on Roper, Logan, and Tierney's Life Model. The intervention group completed a one-week puzzle-based reinforcement program, while the control group received no additional intervention. Data were collected using achievement tests and the Instructional Material Motivation Scale and analyzed using paired-samples t-tests, independent-samples t-tests, and regression analysis.</p><p><strong>Results: </strong>Knowledge scores increased in the intervention group, whereas knowledge scores decreased in the control group. Between-group comparisons and regression analysis showed that puzzle-based reinforcement was associated with higher post-test knowledge scores and relatively higher motivation subscale scores compared with the control group (p < 0.01).</p><p><strong>Conclusion: </strong>The findings suggest that puzzle-based reinforcement may be a valuable instructional approach, associated with positive learning outcomes and relatively higher motivation toward instructional materials in nursing education.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT07090850.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20260022"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922409","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":"Assessment of the quality of notifications and investigations of congenital syphilis in Bahia, 2010-2021.","authors":"Jeane Magnavita da Fonseca Cerqueira, Maria Aparecida Araújo Figueiredo, Nila Mara Smith Galvão, Monique Magnavita Borba da Fonseca Cerqueira, Magno Merces Weyll Pimentel","doi":"10.1590/1980-220X-REEUSP-2025-0582en","DOIUrl":"10.1590/1980-220X-REEUSP-2025-0582en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the quality of the information in the congenital syphilis notification and investigation forms as a tool for epidemiological surveillance to monitor children with the disease.</p><p><strong>Methods: </strong>An ecological time-trend study was conducted using secondary data from the SINAN system in Bahia between 2010 and 2021. The study assessed the annual percentages of incompleteness, the proportional percentage variation, and the percentage of inconsistency. The temporal trend in incompleteness was analyzed using Spearman's correlation coefficient.</p><p><strong>Results: </strong>Among the ten maternal variables evaluated, a reduction in data incompleteness was observed for seven of them. In the fields pertaining to the child, there was a reduction in the degree of data incompleteness for nine of the 11 variables evaluated (p ≤ 0.05). In the child follow-up, the study found that 86.7% of the investigation forms did not contain information on the nontreponemal test in peripheral blood at birth. For the treponemal test after 18 months, the percentage of forms lacking this information was 99.3%.</p><p><strong>Conclusion: </strong>Despite the reduction in the number of incomplete fields on the congenital syphilis investigation form, the high percentage of forms lacking information on laboratory results compromises the assessment of clinical progression and follow-up of children with syphilis.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20250582"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932285","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":"Trauma levels and coping strategies of health sciences students following the large-scale earthquakes in Türkiye.","authors":"Gözde Yıldız Daş Geçim, Kübra Okuyucu","doi":"10.1590/1980-220X-REEUSP-2026-0270en","DOIUrl":"10.1590/1980-220X-REEUSP-2026-0270en","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the trauma levels and associated coping strategies with earthquake stress experienced by health sciences students after the large-scale earthquakes that occurred in Türkiye in 2023.</p><p><strong>Method: </strong>This cross-sectional study was carried out using online surveys in April-July 2023 with 398 students living in Türkiye and studying the faculty of health sciences. Data were collected with a Participant Information Form, Post-Earthquake Trauma Level Determination Scale (PETLDS) and the Coping with Earthquake Stress Scale (CESS).</p><p><strong>Results: </strong>The students' average PETLDS score was determined as 54.6 ± 16.81 (range: 20-100) indicating that the students were traumatised. The post-earthquake trauma levels were associated with the level of positive reappraisal coping (r = 0.186, p < 0.001). Compared to students from other departments, nursing students showed higher scores on the CESS subscales of religious coping (r = 0.110, p = 0.028), positive reappraisal (r = 0.224, p < 0.001), and seeking for social support (r = 0.137, p = 0.006), while reporting lower levels of trauma.</p><p><strong>Conclusion: </strong>Students exhibited high post-earthquake trauma levels, which were associated with several demographic and exposure-related factors. Compared with students from other health sciences departments, nursing students had lower trauma levels. They also reported higher use of positive reappraisal, religious coping, and seeking social support strategies.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20260270"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932210","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":"Experiences and perceptions of sleep quality among older adults in Bangka Belitung, Indonesia: a qualitative study.","authors":"Indah Permata Sari, Tita Hariyanti, Retno Lestrari, Respati Suryanto Dradjat","doi":"10.1590/1980-220X-REEUSP-2026-0008en","DOIUrl":"10.1590/1980-220X-REEUSP-2026-0008en","url":null,"abstract":"<p><strong>Objective: </strong>To explore older adults' perceptions and experiences of sleep and strategies used to cope with poor sleep quality.</p><p><strong>Method: </strong>A qualitative descriptive study was conducted with 27 purposively selected older adults from community and institutional settings in Bangka Belitung. Data were collected from June to August 2025 through in-depth interviews and analyzed thematically with triangulation, member checking, and adherence to COREQ guidelines.</p><p><strong>Results: </strong>Participants were mostly women aged 60-74 years, many widowed and with chronic conditions. Two themes emerged: poor sleep experiences and coping strategies. Common problems included difficulty initiating and maintaining sleep, nighttime awakenings, early awakening, and daytime fatigue. Sleep disruption was linked to psychological distress and environmental discomfort. Coping strategies included behavioral changes, spiritual practices, daytime naps, and activity adjustment.</p><p><strong>Conclusion: </strong>The findings suggest that sleep among participating older adults in Bangka Belitung is perceived as multidimensional, shaped by physiological, psychological, environmental, and spiritual factors, highlighting the need for culturally sensitive, community-based support beyond self-initiated strategies.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20260008"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148915067","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":"Hope in breastfeeding in the context of breastfeeding counseling: a qualitative analysis based on the Multidimensional Model of Hope.","authors":"Allison Scholler de Castro Villas Boas, Monika Wernet, Mariana Torreglosa Ruiz, Aline Oliveira Silveira, Zaida Charepe, Ana Maria Linares, Jéssica Aparecida da Silva","doi":"10.1590/1980-220X-REEUSP-2025-0394en","DOIUrl":"10.1590/1980-220X-REEUSP-2025-0394en","url":null,"abstract":"<p><strong>Objective: </strong>To understand hope in breastfeeding from the perspective of women who received breastfeeding counselling.</p><p><strong>Method: </strong>A qualitative study nested within a clinical trial, based on thematic analysis guided by the Multidimensional Model of Hope. The study included 11 women interviewed between 14 and 18 months postpartum, all of whom had participated in the pilot study of a clinical trial and had received breastfeeding counselling in rooming-in units of maternity hospitals located in Minas Gerais, Rio de Janeiro, and Bahia, Brazil. A single, semi-structured, audio-recorded interview was conducted between May and September 2024.</p><p><strong>Results: </strong>Women perceived breastfeeding as an act that positively affects child health and promotes mother-child bonding, both regarded as expected outcomes. Breastfeeding counselling was essential in helping them overcome doubts, fears, and breastfeeding-related challenges. This supportive relationship constituted an experience that activated dimensions of hope and left lasting emotional memories.</p><p><strong>Conclusion: </strong>The relationship with the breastfeeding counsellor, a component of the affiliative dimension of hope, facilitated and structured women's coping with breastfeeding challenges toward the hoped-for outcome.</p>","PeriodicalId":94195,"journal":{"name":"Revista da Escola de Enfermagem da U S P","volume":"60 ","pages":"e20250394"},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893290","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}