Midwifery最新文献

{"title":"Midwives and dietitians’ perspectives on an empowerment programme to enhance diet quality in pregnant women: A mixed-method study","authors":"Renske M. van Lonkhuijzen ,&nbsp;Jeanne H.M. de Vries ,&nbsp;Susanne Cremers ,&nbsp;Annemarie Wagemakers","doi":"10.1016/j.midw.2025.104627","DOIUrl":"10.1016/j.midw.2025.104627","url":null,"abstract":"<div><h3>Background</h3><div>Healthy nutrition during pregnancy is essential for mother and child. Midwives, as trusted sources of information, play a key role in supporting maternal health but current nutrition communication remains limited. The Power 4 a Healthy Pregnancy (P4HP) aims to improve the diet quality of pregnant women through four additional empowerment consultations on nutrition (three with midwives, one with a dietitian). The objective of this study was to evaluate the implementation of the P4HP programme from the perspective of healthcare professionals (HCPs), with a focus on interprofessional collaboration, facilitators, and barriers.</div></div><div><h3>Methods</h3><div>A mixed-method process evaluation was conducted in the Netherlands, incorporating quantitative data from online surveys (<em>n</em> = 29; 18 midwives, 11 dietitians) using the Measurement Instrument for Determinants of Innovations, along with in-depth interviews (<em>n</em> = 36 HCPs). Survey data were analysed using descriptive statistics, while interview data were analysed through thematic analysis.</div></div><div><h3>Results</h3><div>HCPs reported improved understanding of each other's roles in nutritional care and enhanced interprofessional collaboration. While dietitian consultations provided valuable personalized advice that empowered women to make healthier dietary choices, midwives played a crucial role in supporting the maintenance of these changes. Key facilitators included the program's clear procedures, implementation flexibility, and the HCPs' commitment to promoting healthy eating. The main barriers identified were time constraints and limited staff availability among midwives, as well as the financial burden associated with consulting a dietitian.</div></div><div><h3>Conclusion</h3><div>The P4HP programme successfully enhanced interprofessional collaboration between midwives and dietitians, offering significant nutritional support to pregnant women. However, addressing the financial barrier of out-of-pocket costs is crucial for facilitating broader integration into routine antenatal care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104627"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248049","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":"Pregnancy psychological distress: A concept analysis.","authors":"Mi Zhao, Jing Han, Suting Zhang, Ting Luo","doi":"10.1016/j.midw.2025.104626","DOIUrl":"https://doi.org/10.1016/j.midw.2025.104626","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy psychological distress is a critical determinant of maternal and infant health outcomes, however, there is a lack of clarity regarding its definition and conceptual meaning.</p><p><strong>Aim: </strong>This concept analysis aimed to explore the concept of pregnancy psychological distress and establish an operational definition for application in practice, research and policy.</p><p><strong>Methods: </strong>The Walker and Avant's concept analysis was used to explore the concept of pregnancy psychological distress. A systematic literature search was conducted across five English (CINAHL, PubMed, Web of Science, Scopus, and Embase) and three Chinese (CNKI, WanFang, and VIP) literature databases from their date of inception to 1 October 2024. All selected papers were analysed for definitions of pregnancy psychological distress, as well as for its defining attributes, antecedents and consequences.</p><p><strong>Results: </strong>Twenty-five papers were included. The defining attributes of pregnancy psychological distress include subjective emotionality, broad-spectrum affective variability and non-psychiatric aetiology. Antecedents include demographic and medical history factors, as well as social and psychological factors. Consequences include adverse maternal-neonatal outcomes, negative attitudes, avoidance behaviours and relational dysfunction.</p><p><strong>Conclusion: </strong>This study provides a conceptual clarification of pregnancy psychological distress by distinguishing it from broader prenatal conditions. This elucidated concept establishes the necessary foundation for informing the development of targeted midwifery-led assessments and care, thereby bridging the gap between theory and clinical practice.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"104626"},"PeriodicalIF":2.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280675","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":"Understanding the expectations and experiences of women during facility-based childbirth in Eastern Uganda: What do women want during childbirth?","authors":"Isaac Byonanebye, Annette Namugaya, Rose Chalo Nabirye, David Mukunya, Julius N Wandabwa, Sarah Racheal Akello, Proscovia Nabachenje, Ivan Lume, Joshua Epuitai","doi":"10.1016/j.midw.2025.104548","DOIUrl":"10.1016/j.midw.2025.104548","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, an increase in facility-based childbirth is associated with provision of care that may not align with the expectations of women. The study was conducted to explore expectations of women regarding intrapartum care and whether these expectations aligned with their experiences of care during a facility-based childbirth.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted among women who had given birth. We conducted 18 in-depth interviews to explore women's expectations, and preferences during childbirth. Women were also interviewed to explore their childbirth experiences, especially to determine whether their experience of care matched their expectations.</p><p><strong>Results: </strong>We identified two themes: 1) What women want during intrapartum care and 2) What women received during intrapartum care. Most women prioritised maternal and neonatal survival during intrapartum care. Secondly, women wanted services to be available during childbirth. These included availability of adequate medicines, supplies, and healthcare providers. Thirdly, women who were scheduled for caesarean sections yearned for labour pain relief and postoperative pain relief after birth. Lastly, women wanted respectful maternity care and to give birth in clean facilities. Women who desired for positive birth outcomes including normal births noted that those expectations were met even among those who had caesarean births. Participants noted that medicines and supplies were available for them except for some supplies that were required for caesarean section. Women were surprised to receive respectful care despite hearsay stories of mistreatment in facilities, while the facilities were seen to be clean and hygienic. Although women desired pain relief for labour and postoperative pain, they perceived inadequate pain relief during and after operation.</p><p><strong>Conclusion: </strong>Women had low expectations of care. Women's expectations were focussed on the bare minimum of maternal and neonatal survival. Women's expectations for availability of medicines, and optimal pain relief were not adequately met during childbirth. Addressing all the expectations of women during childbirth may promote positive childbirth experience, satisfaction and skilled birth attendance.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"104548"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804428","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 co-designed conceptual educational framework for midwives to train Indigenous traditional birth attendants in low resource settings of remote Papua New Guinea.","authors":"Sara David, Michelle A Kelly, Yvonne Hauck, Zoe Bradfield","doi":"10.1016/j.midw.2025.104547","DOIUrl":"10.1016/j.midw.2025.104547","url":null,"abstract":"<p><strong>Problem: </strong>In remote Papua New Guinea there are few midwives or functioning health facilities, and high perinatal mortality. Indigenous traditional birth attendants carry the burden of caring for women and newborns.</p><p><strong>Background: </strong>Midwives training and developing traditional birth attendants rely on ad-hoc approaches to the education they provide, drawing from their own knowledge and skills.</p><p><strong>Aim: </strong>Develop a culturally sensitive conceptual educational framework as a guide for midwives to train and supervise traditional birth attendants in low-resource settings.</p><p><strong>Methods: </strong>Seven-step approach: 1) Establish trust and respect; 2) Identification of the need; 3) Ethical considerations; 4) Needs analysis; 5) Contextual considerations; 6) Theoretical framework; 7) Practice standards.</p><p><strong>Findings: </strong>The Yamen Traditional Birth Attendant Conceptual Educational Framework guides midwives to train and supervise traditional birth attendants to strengthen maternal and newborn healthcare in low-resource settings through pre-service education and community development. Four adult, cross-cultural learning principles were identified: cultural sensitivity, strategic issues, previous experience, evidence-based practice. Expected outcomes include increased knowledge, skills, attitudes, and critical thinking of traditional birth attendants.</p><p><strong>Discussion: </strong>Training and supervision of traditional birth attendants by midwives is recommended for low-resource settings of Papua New Guinea to foster strong partnerships between communities and health facilities and improve perinatal safety.</p><p><strong>Conclusion: </strong>A co-designed, culturally sensitive education framework is presented with the potential to strengthen maternal and newborn services in low-resource settings by linking traditional birth attendants to midwives in formal health services. Further research is needed to articulate the role, scope of work and key learning competencies.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"104547"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817103","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":"Shared learning and reflections from the MuM study: An online antenatal music programme for maternal wellbeing co-designed by midwives, music therapists and women with lived experience.","authors":"Tríona McCaffrey, Pui Sze Cheung, Kyriaki Pantelidou, Cathy McGlynn, Laoise FitzGerald, Mairéad Morales, Noelle O'Riordan, Anna Papyan, Sylvia Murphy-Tighe","doi":"10.1016/j.midw.2025.104560","DOIUrl":"10.1016/j.midw.2025.104560","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"104560"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817104","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":"Effects of breastfeeding during pregnancy on maternal and newborn health and breast milk composition: Meta-analysis.","authors":"Ozlem Sinan, Döndü Kurnaz","doi":"10.1016/j.midw.2025.104550","DOIUrl":"10.1016/j.midw.2025.104550","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is essential health behavior for the health of the mother and child. The duration of breastfeeding often affects the likelihood of overlapping between breastfeeding and subsequent pregnancies.</p><p><strong>Aim: </strong>This meta-analysis evaluated the effects of breastfeeding during pregnancy on maternal and newborn health outcomes and the composition of breast milk based on previous studies.</p><p><strong>Methods: </strong>The study protocol was developed, and the article was written following the PRISMA guidelines. The screening was conducted in September 2024, and the study was registered with PROSPERO. A comprehensive search was performed using PubMed, Google Scholar, the Cochrane Library, EBSCO, Embase, the National Thesis Center, and the TR Index. The methodological quality of the included studies was assessed using the JBI quality assessment tools. Data were pooled through meta-analysis, and a GRADE evidence profile was generated.</p><p><strong>Findings: </strong>The meta-analysis revealed that breastfeeding during pregnancy did not significantly affect birth weight, the incidence of miscarriage, preterm labor, or pregnancy complications. However, it was associated with an increased incidence of low birth weight and intrauterine growth retardation. Regarding breast milk composition, breastfeeding during pregnancy did not change the total protein or lactose content but resulted in a reduction in fat content. Subgroup analyses indicated that the effects of breastfeeding during pregnancy on maternal and newborn health were influenced by the level of development of the country in which the studies were conducted.</p><p><strong>Key conclusions: </strong>Breastfeeding during pregnancy may impact breast milk composition and maternal and neonatal health.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"104550"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812188","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":"Transforming breastfeeding outcomes: The power of antenatal breastmilk expression, a retrospective cohort study in Ireland","authors":"Gemma McMonagle ,&nbsp;Elaine Mooney ,&nbsp;Kristian Mallon ,&nbsp;Amanda McCloat ,&nbsp;Roisin Lydon ,&nbsp;Lynne Cunningham ,&nbsp;Marla Kennedy ,&nbsp;Roisin Lennon ,&nbsp;Margaret McLoone","doi":"10.1016/j.midw.2025.104625","DOIUrl":"10.1016/j.midw.2025.104625","url":null,"abstract":"<div><h3>Background</h3><div>Antenatal breast milk expression is safe and effective in diabetic women at low risk of complications. Antenatal breast milk expression is associated with higher breastfeeding rates at birth and postpartum.</div><div>Aim. This research aimed to evaluate the impact of antenatal breast milk expression on breastfeeding outcomes in an Irish cohort.</div></div><div><h3>Methods</h3><div>Mothers were offered antenatal breast milk expression support packs at 36 weeks' gestation if they met one or more criteria: insulin dependent diabetic; elective section; multiparity pregnancy; previous feeding issues; or planned separation. Women at risk of complications were excluded. Data was extracted from maternity records of women who gave birth between November 2022 - April 2023 at a regional hospital. Chi-square (χ2) or Fisher’s exact tests and Independent <em>t</em>-tests or Mann-Whitney U tests compared differences in categorical and continuous data respectively.</div></div><div><h3>Findings</h3><div>Of mothers who received antenatal breast milk expression support packs (<em>n</em> = 63), 76.2 % (<em>n</em> = 48) expressed antenatal colostrum and 70.8 % (<em>n</em> = 34) brought colostrum to hospital. Most mothers who expressed antenatal colostrum also exclusively breastfeeding at birth (95.8 %, <em>n</em> = 46; χ2(1) = 13.237, <em>p</em> &lt; 0.001), timepoint 2: &lt;48 h post birth (89.6 %, <em>n</em> = 43; χ2(1) = 4.495, <em>p</em> = 0.034) and at discharge (75 %, <em>n</em> = 36; χ2(1) = 6.300, <em>p</em> = 0.012).</div></div><div><h3>Conclusion</h3><div>Antenatal breast milk expression was high when provided with a support pack. Antenatal breast milk expression had a positive impact on initiation and continuation of breastfeeding in this cohort. Therefore, a longitudinal intervention to assess exclusive breastfeeding duration is warranted.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104625"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233027","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":"Strengthening Philippine midwifery curricula with planetary health competencies: A call for action","authors":"Artemio M. Gonzales Jr.,&nbsp;Arnold Jann L. Cariaso","doi":"10.1016/j.midw.2025.104619","DOIUrl":"10.1016/j.midw.2025.104619","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104619"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212983","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":"Investigation of the validity and reliability of the Turkish version of the Comprehensive Breastfeeding Knowledge Scale","authors":"Merve Yazar Renkyorgancı ,&nbsp;Emel Ege ,&nbsp;Emine Geçkil ,&nbsp;Jennifer Abbass-Dick ,&nbsp;Cindy-Lee Dennis","doi":"10.1016/j.midw.2025.104624","DOIUrl":"10.1016/j.midw.2025.104624","url":null,"abstract":"<div><h3>Objective</h3><div>This study was conducted to test the validity and reliability of the Turkish version of the Comprehensive Breastfeeding Knowledge Scale.</div></div><div><h3>Method</h3><div>This methodological study was carried out between July 1, 2023, and May 1, 2024, in the Department of Obstetrics and Gynecology at a university hospital. Approvals were obtained from the original scale author, the ethics committee, the institution where data were collected, and the participants. The study sample comprised 350 participants, including 200 primiparous pregnant women and 150 postpartum women. For validity, the Content Validity Ratio (CVR) and Content Validity Index (CVI) were used to assess language and content validity, and Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to evaluate construct validity. For reliability, item analyses were conducted, and the Intraclass Correlation Coefficient (ICC) and Paired t-Test were used to determine test-retest reliability, while Cronbach’s alpha coefficient was employed to assess internal consistency.</div></div><div><h3>Results</h3><div>Of the women who participated in the study, 57.1 % were pregnant and 42.9 % were in the postpartum period. Among the participants, 39.7 % were between the ages of 18 and 25, 38.9 % were high school graduates, and 51.4 % had received breastfeeding education. EFA results revealed that the scale maintained a three-factor structure consistent with the original scale, the items were distributed across the factors in a similar manner, factor loadings ranged from 0.50 to 0.65, and the explained variance was 37.3 %. The CFA results indicated excellent model fit with a chi-square/df ratio of 1.912, and good fit indices, including GFI (0.904), RMSEA (0.051), and CFI (0.894).</div></div><div><h3>Conclusion</h3><div>The findings of this study demonstrate that the Turkish version of the Comprehensive Breastfeeding Knowledge Scale is a valid and reliable measurement tool for assessing breastfeeding knowledge among primiparous pregnant and postpartum women. The scale can be utilized in descriptive studies evaluating breastfeeding knowledge and in experimental studies aimed at improving breastfeeding knowledge, as a pre-test and post-test assessment tool.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104624"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251913","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":"Cross-cultural adaptation and validation of the “AprendeLact” questionnaire to Portuguese","authors":"Cristian Martín-Vázquez ,&nbsp;Agueda Cervera-Gasch ,&nbsp;Rosa María Dos Santos Moreira ,&nbsp;Marta Arias-Crespo ,&nbsp;Cláudia Patricia Da Costa Brás ,&nbsp;Cristina Liébana-Presa","doi":"10.1016/j.midw.2025.104621","DOIUrl":"10.1016/j.midw.2025.104621","url":null,"abstract":"<div><h3>Background</h3><div>Breast milk is the optimal nourishment a mother can provide for her child. Although many mothers aspire to breastfeed, such efforts necessitate support and guidance from qualified healthcare professionals.</div></div><div><h3>Aim</h3><div>Translation and Cross-Cultural Adaptation of the “AprendeLact” Questionnaire on Breastfeeding Knowledge into Portuguese</div></div><div><h3>Methods</h3><div>A cross-sectional validation study involving translation, content validity, test-retest reliability, and internal consistency was conducted. Descriptive and bivariate analyses were performed on sociodemographic variables and questionnaire outcomes. Fifty-seven undergraduate nursing and postgraduate maternal and obstetric health students from the Coimbra School of Nursing were randomly selected through cluster sampling.</div></div><div><h3>Findings</h3><div>The results demonstrated high internal consistency (Kuder–Richardson formula 20 [KR-20] = 0.87) and excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.899). The average score achieved was 12.246 ± 5.23 points. The highest-scoring item was number 6, related to “colostrum,” while the lowest-scoring item was number 5, which assessed the “utility of the e-lactancia website.”</div></div><div><h3>Conclusions</h3><div>The “AprendeLact” questionnaire was cross-culturally adapted and validated into Portuguese for undergraduate nursing and postgraduate maternal and obstetric health students. Findings revealed limited breastfeeding knowledge among the students, particularly regarding practical aspects. Factors associated with higher levels of knowledge included being female, being in the final years of a bachelor’s degree, participating in clinical placements related to breastfeeding, attending training activities, engaging in breastfeeding support groups, or having been breastfed as a child.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104621"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206909","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}