Diabetic Medicine最新文献

{"title":"Discovering the hidden emotional burden: Systematic screening for diabetes distress in adults with type 1 diabetes in nurse-led routine diabetes care.","authors":"Vibeke Stenov, Mette Due-Christensen, Jette Normann Christensen, Ingrid Willaing, Bryan Cleal","doi":"10.1111/dme.70064","DOIUrl":"https://doi.org/10.1111/dme.70064","url":null,"abstract":"<p><strong>Aim: </strong>To gain insights into the experience of adults with type 1 diabetes (T1D) using a systematic screening method to assess and address diabetes distress (DD) in nurse-led routine diabetes care.</p><p><strong>Methods: </strong>DD screening in 30 consultations incorporated the Type 1 Diabetes Distress Scale-7 (T1-DDS-7), a short-form, validated instrument capturing the most common sources of DD, and a dialogue model to support diabetes specialist nurses (DSNs) in addressing DD. Semi-structured interviews were conducted with 30 adults with T1D who participated in DD screening. Interviews were analysed using thematic text condensation.</p><p><strong>Results: </strong>Participant mean age and diabetes duration were 47 and 26 years, respectively. Sixteen participants reported moderate to high DD (total T1-DDS-7 score ≥14). Participants described positive experiences discussing DD with DSNs during annual consultations. Three themes emerged from interviews: (1) an eye-opener that enhanced emotional support in adults with T1D, (2) meaningful conversations and personalised diabetes care and (3) increased satisfaction and engagement with diabetes care in adults with T1D.</p><p><strong>Conclusion: </strong>Systematically assessing and addressing DD in clinical consultations was both useful and acceptable. Participants reported high levels of satisfaction with the screening method, noting that DSNs used open-ended questions and active listening skills to support managing DD, reflecting good fidelity with the dialogue model. Future research should explore methods for implementing the screening tools to ensure consistent detection of DD in adults with T1D during consultations as well as timely referral to effective interventions.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70064"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076815","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 association of environmental mastery and diabetes distress among young adults with type 1 diabetes.","authors":"Kathryn E Nagel, Tracy Dearth-Wesley, Allison N Herman, Robert C Whitaker","doi":"10.1111/dme.70061","DOIUrl":"https://doi.org/10.1111/dme.70061","url":null,"abstract":"<p><strong>Aims: </strong>We determined whether a global measure of environmental mastery (EM) was associated with diabetes distress (DD) among young adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>In 2017, an online survey was completed by 423 of 743 (57%) young adults (19-31 years) with T1D receiving care at a speciality clinic in New York City. Linear regression was used to examine the association between EM scores (7-item scale from Ryff's Scales of Psychological Well-Being) and DD scores (17-item Diabetes Distress Scale), adjusting for HbA1_c levels and sociodemographic and clinical covariates.</p><p><strong>Results: </strong>Among the 416 participants with complete data on EM and DD, the mean (SD) age was 24.5 (3.2) years. Fifty-nine per cent were female and 70% were Non-Hispanic White. The mean HbA1_c level was 64 (18) mmol/mol/8.0 (1.7) %, the mean EM score was 33.5 ± 8.7 and the mean DD score was 2.3 ± 1.0. For each 1 SD increase in EM score, there was a 0.51 SD decrease (95% confidence interval [CI]: 0.43, 0.59) in the covariate-adjusted DD score. This inverse association between EM and DD was of similar magnitude among those with HbA1_c levels in the target range (<53 mmol/mol [<7.0%]) and those with HbA1_c levels not in the target range.</p><p><strong>Conclusions: </strong>Greater EM was associated with lower DD. Reducing DD in young adults with T1D may require a better understanding of the developmental processes that lead to a sense of global mastery.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70061"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994809","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":"Supporting women with diabetes experiencing menopause: A workshop to co-design research recommendations for improving the understanding of and support for women with diabetes experiencing menopause.","authors":"Steven Parks, Nia Otake John, Anna Morris, Kamini Shah, Elizabeth Eves, Dawn Adams, Eleanor Barry, Vicki Causer, Rachel Churm, Sahir Ahmed-Evans, Alex Vienne Haggett, Reena Patel, Rita Forde, Rebecca Reynolds","doi":"10.1111/dme.70039","DOIUrl":"https://doi.org/10.1111/dme.70039","url":null,"abstract":"<p><strong>Aims: </strong>Based on direct feedback on the challenges faced by women with diabetes navigating menopause, the Diabetes Research Steering Groups (DRSGs), organised by Diabetes UK, conducted a workshop aimed at outlining key research priorities in this area. The statement will provide actionable recommendations for researchers and funders, ensuring future studies address the unique needs and lived experiences of women living with diabetes during this life phase. The DRSGs also highlighted the need to bring researchers and healthcare professionals in the field of diabetes together with those working in women's health to collaborate in this field. The goal is to bridge the gap in understanding and support, driving research that informs more effective care strategies and improves quality of life during this critical and often challenging life stage.</p><p><strong>Methods: </strong>In November 2023, Diabetes UK convened a workshop on diabetes and menopause, bringing together 49 participants, including people with lived experience, researchers, healthcare professionals, and representatives from charities and funding bodies. The workshop began with presentations from experts and case studies, followed by small-group discussions facilitated by Diabetes UK staff. Participants were asked to identify key evidence gaps and refine research questions related to diabetes and menopause. Groups focused on thematic topics, discussing barriers and potential solutions. Insights from these discussions were collated and thematically analysed, resulting in key recommendations to address health inequalities in diabetes research.</p><p><strong>Results: </strong>The following key areas were identified for increased future research focus: Improving the understanding of the mechanisms underlying the impact of menopause on blood glucose control in women with diabetes Understanding the safety and efficacy of treatments, technology, and exercise in the management of diabetes and menopause Understanding how to best support women from underserved communities in their management of diabetes and menopause Understanding the impact of menopause on the mental health of women with diabetes and tailoring psychosocial interventions that support women during this period. Supporting healthcare professional education in how to effectively support women with diabetes experiencing menopause. Exploring how innovative models of care can support women with diabetes experiencing menopause more effectively.</p><p><strong>Conclusions: </strong>This position statement presents recommendations to address the unmet needs of women with diabetes experiencing menopause. The diabetes research community is to act upon these recommendations to ensure the views and needs of this group are well-represented.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70039"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974586","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":"Stability and impact of diabetes distress over time: The potential value and uses of the type 1 diabetes distress assessment system (T1-DDAS).","authors":"Danielle M Hessler, William H Polonsky, Lisa Strycker, Diana Naranjo, Katherine Greenberg, Lawrence Fisher","doi":"10.1111/dme.70066","DOIUrl":"https://doi.org/10.1111/dme.70066","url":null,"abstract":"<p><strong>Aims: </strong>To document stability and change over time, define a minimal clinically important difference (MCID), and examine the predictive validity of the new Type 1 Diabetes Distress Assessment System (T1-DDAS).</p><p><strong>Methods: </strong>A total of 574 adults with type 1 diabetes recruited through national registries and previous studies completed the T1-DDAS Core and Source scales alongside a report of insulin taking and glycaemic measures at baseline and 6 months later.</p><p><strong>Results: </strong>The MCID for the T1-DAS is ±0.27. T1-DDAS scores were highly stable over 6 months: 88% of individuals with elevated Core Diabetes Distress (DD) in the study continued to report elevated DD at or above the 2.0 threshold 6 months later; 57% reported no improvement or a worsening in Core DD based on MCID. Elevated DD at baseline was linked to worsening in reported missed insulin bolus taking and HbA1c at 6 months.</p><p><strong>Conclusions: </strong>Findings add to our understanding of DD and the utility of the T1-DDAS by demonstrating the stability and predictive validity of the T1-DDAS Core and Source scales to assess DD.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70066"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968586","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":"Exploring the complexity of safe insulin management during transfer of care using qualitative methods.","authors":"Catherine Leon, Clare Crowley, Helen Hogan, Yogini H Jani","doi":"10.1111/dme.70054","DOIUrl":"https://doi.org/10.1111/dme.70054","url":null,"abstract":"<p><strong>Aims: </strong>Managing insulin during care transfers requires improvement. Understanding factors that impact insulin management during this process improves the likely effectiveness of interventions. This study aimed to map the processes involved in managing insulin during transfers of care and the factors that affect them to identify potential areas for safety improvement interventions.</p><p><strong>Methods: </strong>A qualitative, case study approach was used to undertake documentary analysis, interviews, focus groups and observation. Participants included people with diabetes who use insulin, caregivers and primary and secondary care healthcare professionals. A framework approach guided analysis and subtheme categorisation under the domains of people, tools, tasks or environments.</p><p><strong>Results: </strong>Insulin management during transfers of care was mapped across hospital admission and discharge along with factors that impact this process. Six stages of the care transfer process were identified. Workforce pressures and demand impacted safe insulin management. Four themes were identified: (1) People with diabetes hold vital information not otherwise available, (2) their ability to manage their diabetes care in hospital was limited, (3) healthcare staff lacked confidence managing insulin and (4) people anticipated and acted to prevent known issues.</p><p><strong>Conclusions: </strong>A detailed picture of factors impacting insulin management during the transfer of care was developed. Incorporating the expertise of people who use insulin and removing barriers to insulin self management across the care pathway, ensuring staff have adequate knowledge, skills and confidence in the management of insulin and promoting proactive interventions to support safe outcomes represent key interventions to improve safety for people who use insulin.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70054"},"PeriodicalIF":3.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974803","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":"Teaching Kitchens: An innovative program for enhancing self-management skills in adolescents living with type 1 diabetes (T1D) - A feasibility study.","authors":"Rachel J Lim, Naomi E Crosby, Amelia J Harray, Andrea Begley, Luise Russell, Joanne White, Nola Harrington, Beth Wright, Vinutha B Shetty","doi":"10.1111/dme.70053","DOIUrl":"https://doi.org/10.1111/dme.70053","url":null,"abstract":"<p><strong>Aims: </strong>Adolescents living with type 1 diabetes (T1D) are faced with unique challenges to nutrition management. The current Perth Children's Hospital (PCH) T1D management model includes individualised education at diagnosis and annual reviews. Currently, no group education is provided to develop self-management skills for healthy meal preparation. Teaching Kitchens offers a skills-based program in food literacy and nutrition. This feasibility study explored if a Teaching Kitchens program at PCH engaged adolescents aged between 13 and 17 years, living with T1D.</p><p><strong>Methods: </strong>Each workshop involved a demonstration followed by hands-on cooking and a discussion (e.g. core food-groups, carbohydrate counting, food safety, mindfulness and exercise). Pre- and post-questionnaires were captured electronically from participants and their parents. Quantitative and qualitative data were extracted for content analysis. Feasibility was assessed through ease of recruitment, attendance and retention.</p><p><strong>Results: </strong>Twenty-one participants (12F;9M) attended sessions held in October 2022 and March 2023. Content analysis identified participants response patterns of learning new culinary skills, especially vegetable and fruit preparation and how to incorporate everyday healthy eating habits. 47.4% reported enjoying making new friends and interacting positively with peers and 94.7% responded, 'yes' to recommending the program. Parent responses included their child's increased confidence and interest in cooking at home. The workshops had an 92.4% attendance and an 88.9% retention rate.</p><p><strong>Conclusions: </strong>The first Teaching Kitchen in Australia for adolescents with T1D showed positive engagement and feedback. This is a feasible program that could be incorporated into routine clinical care at PCH.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70053"},"PeriodicalIF":3.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966095","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":"Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols.","authors":"Stephanie Baddock, Lisa Raven, Gimhani Abeygunasekara, Mirelle Roche, Carolyn Petersons","doi":"10.1111/dme.70063","DOIUrl":"https://doi.org/10.1111/dme.70063","url":null,"abstract":"<p><strong>Aims: </strong>To compare variable-rate intravenous insulin infusion (VRIII) to fixed-rate intravenous insulin infusion (FRIII) on the incidence of hypoglycaemia during DKA management. Secondary outcomes were time to resolution of ketosis and hospital length of stay.</p><p><strong>Method: </strong>Single-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.</p><p><strong>Results: </strong>Eighty participants were included, 45 treated with VRIII and 35 with FRIII. Hypoglycaemia incidence did not differ, n = 7 (16%) in VRIII and n = 8 (23%) in FRIII (p = 0.565). Of those who developed early hypoglycaemia (<12 h) 88% were in the FRIII cohort versus 29% in VRIII (p = 0.041). Time to resolution of ketosis did not differ between groups (VRIII median 11.5 h [IQR 7-24] vs. FRIII median 9 h [IQR 6-14.5], p = 0.163). The VRIII cohort had both longer hospital length of stay (VRII median 3 days [IQR 1-7] vs. FRIII median 2 days [IQR 1-4], p = 0.049) and longer time on insulin infusion (VRIII median 25 h [IQR 18-41] vs. FRIII median 18 h [IQR 14-28], p = 0.018).</p><p><strong>Conclusions: </strong>There were similar rates of hypoglycaemia between VRIII and FRIII protocols; however, FRIII was associated with higher rates of early hypoglycaemia. Although time to resolution of ketosis was similar, VRIII was associated with longer hospital length of stay and time on insulin infusion. Further research is needed to determine the optimal insulin infusion regimen.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70063"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991152","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":"Does glycaemic control or renal function provide a better indicator for the service support required in type 1 diabetes?","authors":"Adrian H Heald, Mike Stedman, Edward Jude, Hellena Habte-Asres, Angus Forbes, Martin Whyte, J Martin Gibson, William Ollier","doi":"10.1111/dme.70050","DOIUrl":"https://doi.org/10.1111/dme.70050","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70050"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991285","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":"Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA_1c reliability.","authors":"Anxious J Niwaha, Priscilla A Balungi, Timothy J McDonald, Andrew T Hattersley, Beverley M Shields, Moffat J Nyirenda, Angus G Jones","doi":"10.1111/dme.70011","DOIUrl":"https://doi.org/10.1111/dme.70011","url":null,"abstract":"<p><strong>Aims: </strong>HbA_1c testing in African populations may be limited due to high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment. We aimed to assess the performance of glycated albumin (GA) and fructosamine in comparison to HbA_1c for determining glycaemic control in Africans living with type 2 diabetes.</p><p><strong>Methods: </strong>We compared the relationship between fructosamine, GA, and HbA_1c with mean continuous glucose monitoring (CGM) glucose and assessed the impact of sickle cell trait (SCT), anaemia and renal impairment on the relationship between each measure and CGM glucose.</p><p><strong>Results: </strong>The overall association of HbA_1c, GA and fructosamine with CGM glucose was similar (r = 0.88 [95%CI: 0.84, 0.91], 0.84 [0.79, 0.88] and 0.84 [0.79, 0.88]), respectively. For detecting those with mean CGM glucose >8 mmol/L HbA_1c had similar diagnostic accuracy to GA and fructosamine, even in those with conditions reported to affect HbA_1c performance (n = 63). We found no evidence that SCT (n = 43/192) altered the relationship between HbA_1c, fructosamine or GA with CGM glucose (p > 0.3 for all). However, individuals with anaemia showed an underestimation of CGM glucose by HbA_1c and fructosamine compared to those without anaemia (p for interaction <0.005 for both). In contrast, GA with average CGM glucose between those with anaemia and those without were not significantly different.</p><p><strong>Conclusions: </strong>Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA_1c in a population with high prevalence of conditions reported to affect HbA_1c reliability.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70011"},"PeriodicalIF":3.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982712","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":"Improving access to diabetes technologies in children and young people with type 1 diabetes: Healthcare professionals' perspectives and views.","authors":"Rachel Dlugatch, David Rankin, Mark Evans, Nick Oliver, Sze May Ng, Julia Lawton","doi":"10.1111/dme.70058","DOIUrl":"10.1111/dme.70058","url":null,"abstract":"<p><strong>Aims: </strong>To understand and explore the strategies, resources, and interventions healthcare professionals are implementing, or recommend implementing, to promote more equitable access to diabetes technology amongst children and young people (CYP) with type 1 diabetes in the UK.</p><p><strong>Methods: </strong>Interviews were conducted with (n = 29) healthcare professionals working in paediatric diabetes in England from (n = 15) purposively selected sites. Data were analysed thematically.</p><p><strong>Results: </strong>Healthcare professionals reported many strategies to help address diabetes technology access disparities in CYP, structured under the following themes: 'Re-evaluating staff levels, roles, and efficiency'; 'Improving communication'; 'Promoting peer support and community outreach'; 'Providing financial and social support for deprived CYP/caregivers'; 'Encouraging CYP/caregiver choice;' and 'Funding, sustainability, and burnout.' Many of these strategies appeared to be local (e.g., site-specific) solutions, made possible by short-term, one-off funding schemes and innovation by individual team members. While some proposed strategies appeared to improve staff time-efficiencies allowing greater numbers of CYPs to be moved onto technology, others, as interviewees noted, could add to individual team members' workloads and stress.</p><p><strong>Conclusions: </strong>Healthcare professionals appeared highly committed to addressing technology access disparities in CYP. While some of their recommendations may be easier to implement than others, our findings underscore the importance of adopting a joined-up, integrated approach to promoting equitable technology access across the UK. This would require closer collaboration and resource-sharing within and across sites, backed by sustainable, long-term funding, with a significant portion dedicated to increasing staffing capacity to support the practical implementation of these strategies.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70058"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974534","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}