Journal of Nepal Health Research Council最新文献

{"title":"Prevalence of Anxiety and Depressive Symptoms among Hospitalized Patients Diagnosed with COVID-19.","authors":"Sandipa Sharma, Siddinath Gyawali, Niranjan K C, Subash Sapkota, Siddhartha Kumar Shrestha, Pujan Bataju, Rumi K C, Ram Prashad Lamichhane","doi":"10.33314/jnhrc.v22i01.4835","DOIUrl":"10.33314/jnhrc.v22i01.4835","url":null,"abstract":"<p><strong>Background: </strong>A series of acute, atypical respiratory diseases was identified in Wuhan, China, which was named Coronavirus disease (COVID-19) by the World Health Organization (WHO), and the disease was later declared a pandemic. This disease has psychological effects in addition to physiological symptoms. This study aims to find out the psychological impacts of disease in the form of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19.</p><p><strong>Methods: </strong>A multicentric descriptive cross-sectional study was conducted among patients diagnosed with COVID-19 who were admitted from July 1, 2021 to August 15, 2021 in six different hospitals. Ethical approval was obtained from the Nepal Health Research Council (reference number 284). COVID-19 was diagnosed using Reverse Transcription Polymerase Chain Reaction (RT-PCR) or COVID-19 antigen test. Data were collected from the patients using proforma containing the demographic profile and two questionnaires (Hospital Anxiety and Depression scale and Global Health Questionnaire-12) translated into the Nepali language.</p><p><strong>Results: </strong>Among 360 patients who participated in the study, 194 (53.9%) were males and 166 (46%) were females. Symptoms of anxiety and depression were seen in 161 (44.7%) and 253 (70.3%) of the participants respectively. Similarly 349 (96.9%) of them were found to have clinically significant mental distress.</p><p><strong>Conclusions: </strong>The prevalence of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19 is significantly high compared to the general population.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855795","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":"Barriers to Abortion among Women and Girls in Selected Districts of Nepal.","authors":"Parash Prasad Phuyal, Tejaswee Bhattarai, Prakash Dev Pant, Bishnu Devkota, Jivan Devkota, Madhav Prasad Dhakal, Sujan Karki, Jagadishwor Ghimire, Brittany Moore","doi":"10.33314/jnhrc.v22i01.4935","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4935","url":null,"abstract":"<p><strong>Background: </strong>Even after two decades of legalization of abortion in Nepal, most women and girls still do not have knowledge on abortion legality and face abortion barriers. This study will explore perceived barriers to safe abortion and the factors associated with it.</p><p><strong>Methods: </strong>A Mixed method study design was conducted in 30 wards of 20 Municipals of seven districts of Lumbini and Sudurpaschim provinces. Quantitative data was analyzed for 673 women of reproductive age of 15-49 years. For qualitative data, key informant interviews were conducted. The analysis was done on five different barriers and a composite variable was created from them.</p><p><strong>Results: </strong>Most women and girls perceived social (34.6%), followed by family (30.6%), physical (30.6%), personal (29.5%), and health facility (14.9%) barriers to access safe abortion services. The key finding was that women and girls with knowledge on abortion legality were more likely to perceive barriers to abortion (AOR:2.31, CI:1.574-3.394). Women and girls with higher educational and economic status as well as Dalit women were less likely to perceive barriers to abortion services whereas never married women and girls perceived more barriers in accessing abortion services.</p><p><strong>Conclusions: </strong>Women and girls perceived several barriers to access safe abortion services. Women who have better knowledge on abortion legality recognize more barriers regarding abortion. This highlights the importance of raising awareness of women and girls on abortion rights to empower them in recognizing and advocating for the removal of the obstacles that stop them from getting abortion services.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"12-20"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855749","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":"Detection of Cervical Precancer Using Visual Inspection Method with Acetic Acid.","authors":"Gehanath Baral, Lila Oli, Sheela Verma, Snigdha Rai, Parshuram Aryal, Suman Tiwari","doi":"10.33314/jnhrc.v22i01.5024","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.5024","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer screening is the priority activity of the government. Visual inspection with Acetic acid (VIA), Pap smear Liquid-based cytology, and HPV DNA testing are different methods of screening. VIA-based screening is the cost-effective method of screening in a resource-constrained setting like in our country as this doesn't require cyto-histological testing, can be performed by trained paramedics too, and is as accurate as a cytological test. The aim is to explore pre-cancer cervical lesions by screening women in the community by visual inspection using acetic-acid.</p><p><strong>Methods: </strong>Community-based cross-sectional study done at a health camp setting for three months from March to June 2023. The married non-pregnant women of 30-60 years were screened. Descriptive tests as well as sub-group analysis performed by Chi-Square tests.</p><p><strong>Results: </strong>From ten community health camps, 1255 cases were screened and screen positivity was 14.3%. Positive results were proportionately distributed to all parity by 13-19%. Half of the positive results (47.2%) were in the 34-40 age group. There were no significant differences in screen positivity by parity or vaginal discharge. Menopausal women had 7.7% screen positivity.</p><p><strong>Conclusions: </strong>The prevalence of VIA positivity in the community was found double the previous facility-based prevalence; and there was no significant difference by parity, menopausal status, and vaginal discharge. The positivity was more in 30-45 years of age.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855770","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":"Fetomaternal Outcome of Pregnant Women at Term Undergoing Cesarean Section.","authors":"Sonu Bharati, Ganesh Dangal, Kenusha Devi Tiwari, Sunita Maharjan, Srijana Bhandari, Aruna Karki, Hema Kumari Pradhan, Ranjana Shrestha, Kabin Bhattachan","doi":"10.33314/jnhrc.v22i01.4599","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4599","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section is one of the most common procedures performed in obstetric practice today and is a lifesaving surgery for mother and fetus. Cesarean sections are classified traditionally, as elective cesarean section or emergency cesarean. The purpose of this study is to compare the maternal and neonatal outcomes in elective and emergency cesarean section so that measures can be taken to reduce maternal and neonatal morbidity and mortality.</p><p><strong>Methods: </strong>A descriptive study including 400 pregnant women who underwent caesarean section were included in this study. Patients were subjected to elective or emergency cesarean section as per the indication and protocol of institute. were included in the study.</p><p><strong>Results: </strong>During the study period there were total 1080 deliveries. The average age of the women was 29.21±4.07 years. Of the 400 cesarean section cases, only 2.8% had wound infection, 3.8% had fever, 4.8% urinary tract infection (UTI) whereas no women had observed with post-partum hemorrhages (PPH) and maternal death. Regarding fetal outcome, neonatal intensive care unit (NICU) admission was observed in 16%, birth asphyxia was 2.3% poor Apgar score 2.5% and neonatal death was not observed. Rate of fever, UTI, wound infection, need of resuscitation and poor Apgar score was significantly high in emergency section than elective caesarean section whereas NICU admission was not statistically significant. The most common indication of emergency cesarean section were fetal dress and for previous LSCS.</p><p><strong>Conclusions: </strong>Emergency cesarean was associated with increased maternal and perinatal complications than in elective cesarean section.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855776","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":"Trends and Inequities in Use of Abortion Services in Nepal: A Nepal Demographic and Health Survey Data Analysis 1996-2022 A.D.","authors":"Manish Gautam, Suresh Mehata, Sujan Karki, Jagadishwor Ghimire, Sanju Maharjan, Bhogendra Raj Dotel","doi":"10.33314/jnhrc.v22i01.4944","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4944","url":null,"abstract":"<p><strong>Background: </strong>Despite policy advances and public health initiatives in Nepal to improve access to reproductive healthcare, disparities persist in utilization of abortion services. Grounded in longitudinal data from the Nepal Demographic and Health Survey from 1996 to 2022, this study aims to shed light on evolving patterns in pregnancy outcomes and inequities in use of abortion services across ecological zones and wealth quintiles.</p><p><strong>Methods: </strong>Utilizing six rounds of Nepal Demographic and Health Survey data, pregnancy outcomes were categorized as abortion, delivery, miscarriage, or stillbirth. Income-related inequality in the utilization of abortion services was assessed through the concentration index, ranging from -1 to 1. Trends over time were evaluated using the annual rate of change.</p><p><strong>Results: </strong>The ARC indicated a substantial rise in induced abortion rates, surging from 0.4% in 1996 to 8.8% in 2022. In contrast, live births witnessed a decline from 92.8% to 81.2%. Significant variations were observed across ecological zones and wealth quintiles, with the Mountain zone and the Poorest group experiencing the most pronounced increases in induced abortion rates. By 2022, the concentration index reached a near-zero value, signifying a near-elimination of income-related disparities in the use of induced abortion services.</p><p><strong>Discussion: </strong>The findings suggest that while there has been significant progress in access to and use of abortion services in Nepal, particularly post-2002 policy shifts, challenges remain. Women from lower socio-economic backgrounds continue to face barriers, indicating the need for a multi-pronged approach to address residual challenges.</p><p><strong>Conclusions: </strong>Nepal has made remarkable strides in enhancing equitable access to and use of induced abortion services, but more needs to be done to guarantee equitable access for all women. Future efforts should focus on policy reforms, infrastructural improvements, and societal change to eliminate existing barriers to reproductive healthcare.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855812","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":"Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior.","authors":"Ram Naresh Yadav, Shrijana Joshi, Ji Sun Park","doi":"10.33314/jnhrc.v22i01.5095","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.5095","url":null,"abstract":"<p><strong>Background: </strong>Menstrual Hygiene Management stands as a critical health concern for girls entering reproductive age on a global scale. This transition often induces fear and anxiety due to inadequate knowledge about menstruation and a lack of resources to comprehend bodily changes. Notably, school-aged girls in marginalized communities face formidable barriers to MHM, given the insufficient facilities, supplies, and awareness in educational institutions.</p><p><strong>Methods: </strong>A Mixed method study was conducted adopting a mixed-methods approach. It engaged 562 respondents across five local levels of Bajura district, including three municipalities (Badimalika, Budhiganga, and Tribeni) and two rural municipalities (Gaumul and Khaptad Chhedaha).</p><p><strong>Results: </strong>The study unveiled over 90% awareness on on five out of seven MHM rights related statements and over 85% self-efficacy on 5 out of 8 statements regarding MHM among female adolescent respondents. However, their actual practices fell short of expectations, marked by the prevalence of restrictive norms and perceived risks pertinent to MHM. Notably, 27% (N=154) expressed fear of divine consequences for not adhering to menstrual customs. Malpractices were observed, including 66% using cloth during menstruation, inadequate pad changing frequencies, and some girls staying in Chhaugoth during menstruation. Despite a high awareness (97%) of menstrual rights, behavioral practices did not consistently align with this awareness.</p><p><strong>Conclusions: </strong>The study highlights high awareness and self-efficacy in menstrual hygiene management among female adolescents, yet challenges persist due to cultural norms, perceived risks, and insufficient infrastructure, necessitating multifaceted solutions for behavioral change and access to resources.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855748","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":"Knowledge, Practice and Factors associated with Utilization of Cervical Cancer Screening Services.","authors":"Nancy Bhattarai, Siddhi Laxmi Bajracharya","doi":"10.33314/jnhrc.v22i01.4896","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4896","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is treatable with regular screening and follow-up practices. The utilization of cervical cancer utilization services is found to be unsatisfactory in the context of Nepal. The objective of this study was to assess the factors that influence knowledge, practice, and utilization of cervical cancer screening among women in the Dhulikhel Municipality, Nepal.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 156 married women residing in Dhulikhel Municipality. The study participants were selected using the convenience sampling method. A standard questionnaire was used to collect the information. This study examined socio-demograhic data, knowledge, practice, and factors associated with cervical cancer screening. Descriptive and inferential statistics were used to analyze the data.</p><p><strong>Results: </strong>Only one-fifth (17.9%) of the participants had received a cervical cancer screening. Most participants possessed a sufficient level, 134 out of 85.9%, of information about cervical cancer and cervical cancer screening. Annual healthcare visits (p=0.00), participant knowledge (p=0.014), and perceived barriers (p=0.001) were statistically significant factors in the uptake of cervical cancer screening. Out of those who felt they were highly susceptible, just one-fourth, or 25%, had undergone cervical cancer screening services.</p><p><strong>Conclusions: </strong>The number of medical visits, participants' knowledge, and perceived barriers had a significant impact on the uptake of cervical cancer screening. However, there was not found any relationship between the use of cervical cancer screening and perceived susceptibility and other socio-demographic factors.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855790","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":"An Estimate of Abortion Incidence and Unintended Pregnancies.","authors":"Jagadishwor Ghimire, Bibek Kumar Lal, Sujan Karki, Suresh Mehata, Bhogendra Raj Dotel, Nisha Joshi, Gauri Shrestha Pradhan, Manish Gautam, Deeb Shrestha Dangol, Parash Prasad Phuyal, Kritee Lamichhane, Navaraj Bhattarai, Anna Lynam","doi":"10.33314/jnhrc.v22i01.4945","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4945","url":null,"abstract":"<p><strong>Background: </strong>After the legalization of abortion in Nepal, there has been remarkable changes in policies and service delivery. However, even after two decades of legalization, access to and use of safe abortion services remains limited. The objective of this study is to estimate the incidence of abortion and unintended pregnancies in Nepal.</p><p><strong>Methods: </strong>A cross sectional study was conducted in 767 health facilities using structured questionnaires to assess the availability of abortion services, and 231 key informant interviews were conducted. Information on medical abortion drugs was collected from distributors and pharmacies. Abortion estimations were segmented into categories: those performed within healthcare facilities, those conducted outside healthcare facilities, and those using other traditional methods. To estimate pregnancy outcomes, we utilized secondary data from national censuses and health surveys.</p><p><strong>Results: </strong>The total incidence of induced abortion cases in Nepal was estimated to be 333,343 for the year 2021. Only 48 percent of abortion services were provided from the listed (legal) sites and providers. The estimates showed that total facility based induced abortion in Nepal was 176,216 in 2021, more than half were medical abortions. The highest and lowest abortion cases were in Bagmati and Karnali province respectively. The result showed that more than half of the pregnancies were unintended (53.3%).</p><p><strong>Conclusions: </strong>Despite a relatively liberal legal environment, more than half of all abortions are extra-legal in Nepal. Unintended pregnancies are also common, resulting in induced abortion. This demands for increasing access to information and services on contraception and safe abortion among women and girls.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"50-57"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855747","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":"Perception of Climate Change Vulnerability and its Impact on Sexual and Reproductive Health and Rights in Khutiya and Banganga River Basins.","authors":"Khusbu Poudel, Sujan Karki, Kritee Lamichhane, Amit Timilsina, Sally Dijkerman, Jagadishwor Ghimire","doi":"10.33314/jnhrc.v22i01.4940","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4940","url":null,"abstract":"<p><strong>Background: </strong>Nepal is one of the most vulnerable countries to climate change. The drivers of climate risk include its topography, ecological diversity, climatic variability, natural resource dependency, under-development, and socioeconomic vulnerabilities. Climate change affects women and girls in unique ways. Research conducted in Asia Pacific region highlight negative sexual and reproductive health outcomes from climate change-related stressors such as droughts, floods, and air pollution, factors also linked to decreased SRH services utilization, increased maternal mortality rates, and repercussions on women's mental health.</p><p><strong>Methods: </strong>This is a mixed methods study conducted in two river basins including household surveys with 384 females ages 18-49, 12 focus group discussions, and 22 key informant interviews. We conducted descriptive and thematic analysis.</p><p><strong>Results: </strong>More than half relied on agriculture for income (66%). Despite one-third being heads of households, land ownership was low (13%). Climate change perceptions included rising temperatures (88%), increased heat wave (70%), drying water source (99%), and delayed monsoons (83%), impacting agriculture and increasing women's workload (61%) due to displacement and male migration. 64% reported disturbances in antenatal and postnatal care visits . Inaccessible healthcare facilities during the rainy season increased maternal mortality risks. Heavy river flooding hindered female community health volunteers access leading to childbirth complications. 82% of women feared being unable to protect their children post-climate events. Moreover, 21% of women faced gender-based violence during or after climate disasters.</p><p><strong>Conclusions: </strong>Our findings suggest clear impacts of climate change on women and the communities. Thus, climate adaptation efforts must be designed to address the unique impacts of the crisis on women and girls, making space for their increased participation and leadership.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"25-33"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855794","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":"Advancing Health and Population Research and Innovations for Achieving Sustainable Development Goals in Nepal.","authors":"Meghnath Dhimal, Pramod Joshi","doi":"10.33314/jnhrc.v22i01.5234","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.5234","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"i-ii"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855745","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}