Clinical Gerontologist最新文献

{"title":"Evidence-Based Treatment Interventions for Substance Use Disorders or Misuse Among Older Adults in the United States: A Scoping Review.","authors":"Jeffrey A Morris, Namkee G Choi","doi":"10.1080/07317115.2026.2654711","DOIUrl":"10.1080/07317115.2026.2654711","url":null,"abstract":"<p><strong>Objectives: </strong>Substance use disorders (SUD) are rising among U.S. older adults, yet few studies have synthesized evidence on effective treatments for this population. This scoping review mapped and evaluated U.S.-based empirical literature on evidence-based treatments or evidence-based practices (EBPs) for older adults (age ≥ 60) with SUD. EBPs identified were Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Medications for SUD, particularly medications for opioid use disorder (MOUD), and Screening, Brief Intervention, and Referral to Treatment (SBIRT).</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, PsycINFO, JSTOR, and Google Scholar. Screening and data extraction were performed using Rayyan software.</p><p><strong>Results: </strong>18 studies met the inclusion criteria: three for CBT, nine for MI, three for medications for SUD, and three for SBIRT.</p><p><strong>Conclusions: </strong>Our review shows the promise of CBT, MI, MOUD, and SBIRT for older adults with SUD or substance misuse problems, but additional research is needed to establish their effectiveness. Developing specialized, evidence-based interventions remains a critical priority for addressing SUDs among aging populations.</p><p><strong>Clinical implications: </strong>Evidence-informed behavioral interventions (e.g. CBT and MI), pharmacotherapy, and SBIRT may be effective for older adults with SUD; however, more research is needed to establish evidence base.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"775-793"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Trial for Midlife and Older Adults: Sleep and Circadian Treatment Plus Memory Support and Boosters.","authors":"Laurel D Sarfan, Anne E Milner, Joshua Varghese, Estephania Ovalle Patino, Heather E Hilmoe Yates, Vera Portnova, Marlen Diaz, Emma R Agnew, Catherine A Callaway, Krista Fisher, Garret Zieve, Caitlin Gasperetti, Sondra S Tiab, Allison G Harvey","doi":"10.1080/07317115.2025.2595027","DOIUrl":"10.1080/07317115.2025.2595027","url":null,"abstract":"<p><strong>Objectives: </strong>Sleep and circadian problems are prevalent among midlife and older adults. Unfortunately, treatments for these problems are limited by poor memory for treatment.</p><p><strong>Methods: </strong>We conducted a pilot trial of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction paired with the Memory Support Intervention (TSC+MSI) for midlife and older adults with sleep and circadian problems (<i>N</i> = 26) (preregistration NCT04373538). After treatment, patients were offered optional booster messages. Aims were to (1) test change in clinical outcomes after TSC+MSI, (2) assess perceptions of TSC+MSI, and (3) evaluate patient engagement, preferences, and preliminary outcomes of booster messages.</p><p><strong>Results: </strong>Following TSC+MSI, patients significantly improved on sleep disruption, sleep-related impairment, functional impairment, and select sleep diary outcomes. Therapist use of memory support strategies moderated improvements in sleep-related and overall impairment. TSC+MSI was perceived as acceptable by patients and feasible by therapists. Most patients opted in to the boosters. Sleep-related impairment significantly improved from pre-booster to post-booster.</p><p><strong>Conclusions: </strong>Following TSC+MSI and boosters, improvements were observed in clinical outcomes, and signals supported feasibility and acceptability.</p><p><strong>Clinical implications: </strong>Although comparisons with control conditions and larger samples are needed, TSC+MSI and booster messages may improve sleep and circadian and related outcomes among midlife and older adults.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"940-955"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedtime Inhalation-Based Relaxation for Sleep Quality and Depressive Symptoms in Institutionalized Older Adults: A Pilot Randomized Controlled Trial.","authors":"Li Fen Wang, Zih Cing Syu, Chung Hsien Lo, Bin Wha Chang","doi":"10.1080/07317115.2026.2661909","DOIUrl":"10.1080/07317115.2026.2661909","url":null,"abstract":"<p><strong>Objectives: </strong>Poor sleep quality and depressive symptoms are common among institutionalized older adults. This pilot study examined the preliminary effects of bedtime inhalation-based aromatherapy on sleep and mood.</p><p><strong>Methods: </strong>A pilot, single-blind, two-arm randomized controlled trial was conducted in a Taiwanese long-term care facility. Thirty-seven residents completed the study (intervention: <i>n</i> = 19; control: <i>n</i> = 18). The intervention group inhaled bergamot and clary sage essential oils for 15 minutes nightly over four weeks, while the control group received unscented almond oil. Outcomes were assessed using the Geriatric Depression Scale-15 (GDS-15) and Pittsburgh Sleep Quality Index (PSQI). One participant in the intervention group discontinued due to mild intolerance.</p><p><strong>Results: </strong>Compared with the control group, the intervention group showed greater improvements in sleep quality (B = 2.41, <i>p</i> < .001) and reductions in depressive symptoms (B = 2.28, <i>p</i> < .001). No serious adverse events occurred.</p><p><strong>Conclusions: </strong>Bedtime inhalation-based aromatherapy appears safe and feasible, with potential to improve sleep and mood in institutionalized older adults.</p><p><strong>Clinical implications: </strong>Incorporating bedtime inhalation-based aromatherapy into routine care may provide a safe, complementary non-pharmacological approach to support sleep and mood in institutionalized older adults. These findings are preliminary and require confirmation in larger trials.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"915-927"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-Screen Group Digital Reminiscence Therapy Reduces BPSD in Dementia: Findings from a Crossover Comparative Study.","authors":"Tomoaki Asano, Kana Izumi, Takashi Ishikawa","doi":"10.1080/07317115.2026.2664051","DOIUrl":"10.1080/07317115.2026.2664051","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the effectiveness of group‑based digital reminiscence therapy (GDRT) delivered via large‑screen visual stimuli optimized for the perceptual characteristics of people with dementia. The primary aim was to reduce behavioral and psychological symptoms of dementia (BPSD) and caregiver burden.</p><p><strong>Methods: </strong>A crossover study was conducted with 44 residents from four long‑term care facilities. Participants received five weeks of GDRT and five weeks of conventional activities in alternating sequences, separated by a 12‑week washout period. GDRT employed visually enhanced photographs and videos projected on a 100‑inch screen. Primary outcomes were BPSD and caregiver burden assessed using the NPI‑NH; secondary outcomes included cognitive function (MMSE‑J) and verbal fluency.</p><p><strong>Results: </strong>Compared with conventional activities, GDRT resulted in significantly greater reductions in overall BPSD (<i>r</i> = 0.56, <i>p</i> = .001) and caregiver burden (<i>r</i> = 0.44, <i>p</i> = .011). Significant improvements were observed in apathy. Cognitive function improved during the GDRT phase (<i>r</i> = 0.44), whereas verbal fluency showed no significant change.</p><p><strong>Conclusions: </strong>GDRT tailored to visual and cognitive characteristics of people with dementia effectively reduces apathy, BPSD and caregiver burden.</p><p><strong>Clinical implications: </strong>Visually optimized, large‑screen digital reminiscence materials represent a practical and resource‑efficient approach for dementia care.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"862-873"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immersive Virtual Reality to Promote Mental Health in Older Adults: A Systematic Review.","authors":"Sunkanmi Folorunsho, Olabisi Lawal, Olamide Ogundare, Etinosa Osawe, Oluwatobi Adedoyin","doi":"10.1080/07317115.2026.2639141","DOIUrl":"10.1080/07317115.2026.2639141","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review examined the use of immersive virtual reality (IVR) to support multidimensional mental health among older adults.</p><p><strong>Methods: </strong>Seven databases were searched for peer-reviewed studies published between January 2020 and March 2025, with forward and backward citation tracking completed in April 2025 (PROSPERO ID: CRD42025644394). Eligible studies involved adults aged 60 years and older, used fully immersive IVR via head-mounted displays, and assessed mental health outcomes. Ten studies met inclusion criteria, spanning randomized, quasi-experimental, pre - post, and mixed-methods designs across North America, Europe, and Asia.</p><p><strong>Results: </strong>Eight of the 10 studies reported improvements in mental health. Virtual nature and guided meditation were most strongly associated with reductions in depression and anxiety, while reminiscence-based IVR improved positive affect and life satisfaction. Controlled studies showed stronger correlation than uncontrolled designs. Barriers such as discomfort, cybersickness, and low digital literacy were commonly addressed through facilitator support and age-friendly design, with feasibility demonstrated across community and long-term care settings.</p><p><strong>Conclusions: </strong>Immersive virtual reality is a promising non-pharmacological approach to supporting mental health and reducing social isolation in older adults.</p><p><strong>Clinical implications: </strong>When appropriately adapted, brief, facilitator-supported IVR sessions may improve mental health outcomes among older adults in community and institutional settings.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"835-846"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Controlled Trial on the Impact of Befriending on Depression, Anxiety, Loneliness, and Social Support in Older People in Aged Care.","authors":"Marcia Fearn, Robin Harper, Georgia Major, Sunil Bhar, Christina Bryant, Briony Dow, David Dunt, George Mnatzaganian, Julie Ratcliffe, Paul Dudgeon, Sandy Clarke-Errey, Colleen Doyle","doi":"10.1080/07317115.2025.2579846","DOIUrl":"10.1080/07317115.2025.2579846","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the impact of befriending on depression, anxiety, perceived social support and loneliness in older people living in residential aged care homes.</p><p><strong>Methods: </strong>A pragmatic randomized controlled trial compared depressive symptoms (Geriatric Depression Scale-15), anxiety symptoms (Geriatric Anxiety Inventory), loneliness (UCLA loneliness scale), and perceived social support (Lubben Social Network Scale) measured at baseline, 8 weeks and 16 weeks post baseline for people randomized to receive either befriending or usual care. Trial registration ANZCTR N12619000676112.</p><p><strong>Results: </strong>Among <i>N</i> = 345 participants, a significant reduction in depressive symptoms for people receiving befriending compared to the control group: 0.76 points lower on GDS at 8 weeks and 0.95 lower at 16 weeks (Cohen's d = -0.458). Loneliness (UCLA) was 2.39 units lower than the control group at 8 weeks and 2.71 units lower at 16 weeks (Cohen's d -0.481). There was no significant difference for anxiety symptoms or perceived social support.</p><p><strong>Conclusions: </strong>Befriending led to a small improvement in depressive symptoms and loneliness in older people living in residential aged care.</p><p><strong>Clinical implications: </strong>The improvement in depressive symptoms and loneliness indicates that befriending may be a useful supplement to psychological services for those living in residential aged care.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"874-887"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric Mental Health Interventions for Older Adults and Their Caregivers.","authors":"Jennifer Moye","doi":"10.1080/07317115.2026.2670928","DOIUrl":"https://doi.org/10.1080/07317115.2026.2670928","url":null,"abstract":"","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":"49 4","pages":"771-774"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Art Therapy on Executive Functions and Attention in Parkinson's Disease: Systematic Review and Meta-Analysis.","authors":"Isabel Gómez-Soria, Johanna Elizabeth Andrade Borja, Alejandra Aguilar-Latorre, Estela Calatayud, María Del Rosario Ferreira-Sánchez, Juan Nicolás Cuenca-Zaldivar","doi":"10.1080/07317115.2025.2608767","DOIUrl":"10.1080/07317115.2025.2608767","url":null,"abstract":"<p><strong>Objectives: </strong>Art therapies are emerging non-pharmacological complementary treatments for Parkinson's disease (PD). This systematic review and meta-analysis aimed to evaluate their effects on non-motor symptoms, motor symptoms, quality of life (QoL), and activities of daily living (ADLs) in adults aged 50 years and older with PD.</p><p><strong>Methods: </strong>PubMed, Scopus, Cochrane, and Web of Science databases were searched from 2014 to 2025. Of 40 initially identified studies, 33 met inclusion criteria and were included in the review; 24 were incorporated in the meta-analysis using a robust variance estimator to address repeated measurements.</p><p><strong>Results: </strong>Art therapy was associated with significant improvements in both executive functions [RVE (Mean) = 0.971, 95% CI (0.951, 0.991), Z = 50.323, <i>p</i> < .001] and attention [RVE (Mean) = 0.854, 95% CI (0.834, 0.874), Z = 10.892, <i>p</i> < .001]compared with controls in the follow-up [RVE Mean) = 0.971 95%CI(0.951, 0.991), Z = 50.323, <i>p</i> < .001]. In single-group studies, depressive symptoms decreased post-intervention [RVE (Mean) = 6.289, 95% CI (1.101, 11.477), Z = 10.878, <i>p</i> = .049] but increased again at follow-up [RVE (Mean) = 12.094, 95% CI (0.318, 23.871), Z = 10.878, <i>p</i> = .049] Conversely, outcomes such as freezing of gait, QoL, and PD progression at follow-up favored the control groups rather than the treatment groups.</p><p><strong>Conclusions: </strong>Evidence suggests that Art therapy may enhance executive functioning - especially at follow-up - and attention in older adults with PD. However, current evidence does not demonstrate consistent benefits in other non-motor or motor outcomes and ADLs. Brief, structured interventions (e.g. 20 sessions of 60 min, twice weekly) administered by dance instructors appear most promising. The improvements observed in control groups further underscore the potential value of active, structured interventions such as exercise or rehabilitation.</p><p><strong>Clinical implications: </strong>Art therapy may serve as a valuable non-pharmacological intervention to support executive functioning and attention in older adults with PD, with improvements observed at follow-up. Single-group studies suggest potential short-term benefits for depressive symptoms, although these effects may not be sustained over time. Structured interventions in high-quality controlled trials, personalized to patient profiles and preferably delivered by specialized professionals, may optimize outcomes. Further research based on high-quality, adequately powered clinical trials is needed to identify the most effective approaches and to determine whether benefits extend beyond cognitive outcomes. Direct comparisons of different art-based modalities may help identify the most effective approaches for improving patient outcomes.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"807-834"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Studio in a Time of War: Older Women's Experiences of Creativity and Continuity During Prolonged Displacement.","authors":"Tami Gavron, Ronithah Heymann, Reut Barnea, Dorel Pinto","doi":"10.1080/07317115.2026.2692492","DOIUrl":"https://doi.org/10.1080/07317115.2026.2692492","url":null,"abstract":"<p><strong>Objectives: </strong>Prolonged wartime displacement disrupts continuity, identity, and social belonging in later life. This study examined the experiences of displaced older women who participated in an Open Studio (OS) art-based group intervention during an extended evacuation.</p><p><strong>Methods: </strong>In this qualitative study, semi-structured interviews were conducted with seven women (aged 62-96) from a northern Israeli kibbutz who attended a weekly OS over approximately 18 months of displacement. The data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Four themes were identified:(1) Displacement as a rupture in continuity in later life, (2) The Open Studio as a restorative space of agency, (3) Creative processes as integrative and transformative, and (4) Relational holding through belonging, facilitation, and tensions.</p><p><strong>Conclusions: </strong>An Open Studio can provide a developmentally sensitive psychosocial response to displaced older adults experiencing collective trauma. The findings underscore the potential of creative engagement in later life to sustain identity, purpose, and growth in conditions of displacement. In contexts of forced rupture, art-based spaces may offer older adults a means of preserving continuity in the face of upheaval.</p><p><strong>Clinical implications: </strong>Community-art-based interventions can help restore agency, continuity, and belonging in later life, but trauma-informed facilitation is needed to contain vulnerability and emotional activation.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Older Adults at Risk for Future Poor Sleep Quality: A Multidimensional Predictive Framework.","authors":"Jiale Xu, Yuanxiao Ma","doi":"10.1080/07317115.2026.2690117","DOIUrl":"https://doi.org/10.1080/07317115.2026.2690117","url":null,"abstract":"<p><strong>Objective: </strong>To identify multidimensional risk factors associated with poor sleep quality and to develop and temporally validate a machine learning-based model for predicting the 2-year risk of poor sleep quality among community-dwelling older adults in China.</p><p><strong>Methods: </strong>Data were drawn from the China Health and Retirement Longitudinal Study (2011-2018). Participants aged ≥ 60 years with good baseline sleep were included. Missing data were imputed using a random forest-based iterative method, and key predictors were selected using LASSO regression. Multiple machine learning algorithms were trained with cross-validation and evaluated using discrimination, calibration, and clinical utility metrics, with SHAP used for model interpretation.</p><p><strong>Results: </strong>Among 3,471 participants, 23.2% developed poor sleep quality. Fifteen predictors across demographic, biological, psychological, and social-behavioral domains were identified. LightGBM performed slightly better overall (AUC = 0.641).</p><p><strong>Conclusions: </strong>The model demonstrated acceptable predictive performance and potential utility for early identification and targeted intervention.</p><p><strong>Clinical implications: </strong>Poor sleep quality in older adults reflects the combined contributions of demographic, biological, psychological, and social factors, underscoring the need for multidimensional assessment framework in clinical and community settings. Identifying cumulative risk across emotional, physical, and social domains may facilitate earlier detection of high-risk individuals and more targeted prevention and intervention strategies.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"1-21"},"PeriodicalIF":2.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}