Sexual and Reproductive Health Matters最新文献

{"title":"Menstrual health outcomes and associations with depression and anxiety in Spain: a cross-sectional study.","authors":"Andrea García-Egea, Tomàs López-Jiménez, Uxune Apalategi-Gómez, Maria José Fernández-Domínguez, Carmen Rodríguez-Domínguez, Vinita Mahtani-Chugani, Anna Berenguera, Laura Medina-Perucha","doi":"10.1080/26410397.2026.2702119","DOIUrl":"10.1080/26410397.2026.2702119","url":null,"abstract":"<p><p>This study analysed the relationship between menstrual health and self-reported depression and anxiety in women and people who menstruate (PWM) (≥18 years) in Spain, from a critical gender perspective. An online survey was used to collect data in 32 healthcare centres in 2023. Descriptive and ordinal logistic regression models were performed with 1,404 participants. Menstrual bleeding of over 80 ml was associated with higher odds of more severe depression (aOR = 1.61; 95% CI: 1.45-1.79; <i>p</i> < 0.001) and anxiety (aOR = 1.67; 95% CI: 1.35-2.06; <i>p</i> < 0.001). Higher menstrual pain intensity was also linked to higher odds of more severe depression (aOR =  2.05; 95% CI: 1.82-2.31; <i>p</i> < 0.001) and anxiety (aOR = 1.82; 95% CI: 1.43-2.30; <i>p</i> < 0.001). A higher frequency of premenstrual symptoms was associated with increased odds for more severe depression (aOR = 14.54; 95% CI: 10.73-19.70; <i>p</i> < 0.001) and anxiety (aOR = 12.95; 95% CI: 9.10-18.44; <i>p</i> < 0.001). In addition, higher reports of menstrual taboo, stigma and discrimination were associated with higher odds of more severe depression (aOR = 2.23; 95% CI: 1.81-2.76; <i>p</i> < 0.001) and anxiety (aOR = 2.34; 95% CI: 1.91-2.87; <i>p</i> < 0.001). Reports of more severe depression (aOR = 2.50; 95% CI: 1.65-3.78; <i>p</i> < 0.001) and anxiety (aOR =  2.55; 95% CI: 1.70-3.83; <i>p</i> < 0.001) increased with the severity of menstrual poverty. Greater impact on social participation during menstruation was strongly associated with higher odds of more severe depression (aOR = 7.41; 95% CI: 4.90-11.191; <i>p</i> < 0.001) and anxiety (aOR = 6.69; 95% CI: 5.22-8.59; <i>p</i> < 0.001). Sociodemographic factors may mediate the menstrual-mental health relationship. Our study sheds light on the interplay between menstrual and mental health in our context, from a gender and social health inequities perspective.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2702119"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond reproductive rights: implementing the Africentric reproductive justice framework in sexual and reproductive health and rights litigations in Africa.","authors":"Moses Mulumba, Jessica Oga, Nimrod Muhumuza","doi":"10.1080/26410397.2025.2570579","DOIUrl":"10.1080/26410397.2025.2570579","url":null,"abstract":"<p><p>This paper analyses emerging trends in judicial approaches to sexual and reproductive health and rights (SRHR) in Africa, arguing for a paradigm shift from the conventional rights-based framework that emphasises \"choice\" to an Africentric Reproductive Justice framework (ARJ). It employs a qualitative research design, combining a literature review with an in-depth analysis of eight purposively selected SRHR court cases from African countries and the United States to examine how recent judicial decisions reflect a growing integration of reproductive rights with broader social justice issues. The proposed ARJ framework is grounded in the reproductive justice theory, incorporating conceptual principles of decoloniality and Africentrism, which emphasises amplifying positive African narratives, leveraging African-based judicial institutions, involving civil society organisations, and empowering African individuals to engage with judicial systems for reproductive justice. This approach addresses intersectionality, race, class, gender, and socioeconomic status in SRHR issues in Africa. The findings demonstrate that African courts are increasingly balancing competing rights and interests in culturally sensitive ways, reflecting an evolving understanding of reproductive justice in African contexts. This paper concludes by arguing that achieving genuine reproductive justice necessitates moving beyond the \"right to choice\". It requires deconstructing enduring structural barriers and addressing historical injustices perpetuated by colonial legacies, and the ARJ framework, rooted in decolonial principles, presents a holistic, context-specific approach towards achieving equitable SRHR for all individuals on the continent.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2570579"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12692456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of short interpregnancy intervals in high-income countries: a systematic review.","authors":"J Dunne, D Foo, J Jancey, G Pereira, B Kefale, D G Belay, G Dhamrait, A T Gebremedhin, K B Mruts, S D Nyadanu, A Roy, G A Tessema","doi":"10.1080/26410397.2025.2545699","DOIUrl":"10.1080/26410397.2025.2545699","url":null,"abstract":"<p><p>Short interpregnancy intervals (IPIs) of <6-18 months are associated with adverse maternal and child outcomes. This study aimed to identify the individual, relationship, community, and societal factors that influence short IPIs in high-income countries. A comprehensive search was undertaken in CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, Ovid/PsycINFO, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar for articles published in English from 1st January 1990 to 26th October 2023. Studies were included if they reported an effect estimate of at least one determinant of pregnancy spacing in a high-income country. The quality of the included studies was assessed using the Johanna Briggs Institute Critical Appraisal Tool and Cochrane Risk Assessment Tool. Multi-level factors at the individual, relationship, community, and societal level were systematically identified through the socio-ecological model. This study is registered with PROSPERO (CRD42020176311). Of 2005 unique articles, 220 were identified for full-text review, and 55 met the inclusion criteria representing a total of 27,103,055 women from 13 high-income countries. All the included studies were deemed to be of moderate to high quality. Most of the studies reported determinants of short IPI at the individual level, with non-use of contraception the most common reported factor. Peer influence was a factor at the relationship level, and access to health care and reproductive services were impactful at the community and societal levels, respectively. Future research and efforts should support the development and implementation of policies and practices that support optimum pregnancy spacing from a comprehensive socio-ecological position.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2545699"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from focus groups with trans and gender-diverse people with endometriosis: stories you tell, stories you don't.","authors":"Maddalena Giacomozzi, Jasmine Brazelton, Khushi Jeswani, Donna Ruumpol, Petra Verdonk, Annemiek Nap","doi":"10.1080/26410397.2025.2562682","DOIUrl":"10.1080/26410397.2025.2562682","url":null,"abstract":"<p><p>Endometriosis is a chronic condition characterised by cyclic pain symptoms that often significantly affect health-related quality of life. Predominantly framed as a \"woman's condition\", current research overlooks the experiences of transgender and gender-diverse (TGD) individuals with endometriosis. This jeopardises the right to health for a community that faces historically rooted social and health disparities. This study aims to explore the embodied relationship between gender and endometriosis symptoms among TGD people living with endometriosis. A secondary objective is to examine the accessibility and competence of healthcare systems in addressing the needs of this community. The methodology included two focus group discussions conducted across four focus groups (4 × 2). Fourteen participants representing diverse gender identities, various stages of endometriosis and ages, were recruited online from nine countries across three continents, forming a heterogeneous group. Reflexive thematic analysis identified 15 codes and 7 clusters. The results were organised into themes, following the four embodiment epidemiological notions. Participants reported their gender self-perception and endometriosis symptoms to be interrelated and mutually influential. Feelings of disconnection and alienation were prevalent, particularly during life events such as menarche. Due to mistrust and experiences of discrimination, many TGD individuals withhold critical information during medical consultations. TGD people with endometriosis have unique health needs, e.g. how to combine gender-affirming and endometriosis care, and they are often concerned about future employability. Overall, the study underscores the urgent need to improve healthcare for TGD individuals with endometriosis as a matter of health justice.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2562682"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12548068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health policy challenges in Lebanon's healthcare system: on sexual and reproductive health and rights.","authors":"Faysal El Kak, Sohayla El Fakahany, Tamar Kabakian-Khasholian, Stephen McCall, Ghada Saad","doi":"10.1080/26410397.2025.2525600","DOIUrl":"10.1080/26410397.2025.2525600","url":null,"abstract":"<p><p>Lebanon's healthcare system has demonstrated remarkable resilience amidst ongoing political and economic turbulence. Yet, the critical domain of Sexual and Reproductive Health and Rights (SRHR) remains underserved. This commentary analyses the systemic barriers, policy deficiencies, and urgent needs that shape SRHR within Lebanon's healthcare landscape. Despite the country's commitments to international frameworks like the ICPD and CEDAW, SRHR policies are hindered by political fragmentation, societal conservatism, and insufficient prioritisation. These challenges translate into inadequate and inconsistent family planning services, a lack of comprehensive sexuality education, inadequate maternal healthcare, and significant obstacles in accessing essential services, especially for marginalised communities such as refugees, women, and youth. Lebanon's \"Vision 2030\" health strategy, while ambitious in scope, offers only limited engagement with SRHR, which leaves systemic inequities unaddressed. Renewed episodes of violence and displacement further strain the healthcare system and deepen the disparities faced by vulnerable groups. The reliance on temporary, NGO-led initiatives to fill gaps in service provision underscores a broader policy paralysis and inconsistent resource allocation, which together prevent the sustainable integration of SRHR into national health frameworks. This commentary calls for a gender-sensitive, inclusive healthcare policy that positions SRHR as a foundational pillar of public health, gender justice, and social equity. Achieving this requires concerted efforts among government agencies, NGOs, and international partners to overhaul existing frameworks and address structural barriers.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2525600"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising to the challenge: lessons learnt from the Global Women's Research Society (GLOW) conference for women's and newborn health in the context of global crises.","authors":"Clara Calvert, Sagarika Kaushal, Aduragbemi Banke-Thomas, Zeina Jamaluddine, Brian Matovu, Jennifer Riches, Robert Ssekitoleko, Wendy Graham, Rosemary Townsend","doi":"10.1080/26410397.2025.2525656","DOIUrl":"10.1080/26410397.2025.2525656","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2525656"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The end-of-treatment process in medically assisted reproduction: a qualitative study of healthcare professionals' views.","authors":"Federica Bonazza, Lidia Borghi, Sara Molgora, Elena Vegni, Daniela Leone","doi":"10.1080/26410397.2025.2494412","DOIUrl":"10.1080/26410397.2025.2494412","url":null,"abstract":"<p><p>In the medically assisted reproduction (MAR) pathway, one of the most complex phases is the end of the treatment. Unlike other medical contexts, there is no biological endpoint in the MAR setting. This absence makes the decision to end MAR treatment extremely challenging for both patients and healthcare professionals. Accordingly, our research aimed to examine the process related to the end of MAR treatment, as devised by healthcare professionals. Our sample included physicians, biologists, and psychologists aged <i>≥</i>18 years with specialised training in assisted reproduction. Data were collected through four focus groups (in February-May 2023), focusing on the topic of the end of treatment (EoT) and its definition. Data were collected and analysed according to the principles of Grounded Theory. The findings shed light on the attributes and components related to the end of the treatment process. The central category \"the end of treatment\" consists of a definition of what is considered the end of treatment and the associated decision-making process. In the phase leading up to the EoT, the process is influenced by contextual and proximal factors, which interact and influence each other. To cope with and manage the EoT, healthcare providers adopt spontaneous strategies that lead to positive or negative outcomes. End-of-treatment management is a key facet of clinical practice. This contribution increased knowledge about EoT and highlighted healthcare professionals' perspectives, which should be considered for the implementation of best practice points and respect for patients' rights to the highest attainable standard of mental and physical health.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2494412"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Few rights, great threats, endless struggles: setbacks and resistance in the last decade of fights for legal abortion in Brazil.","authors":"Nathália Machado Cardoso, Mariana Pércia Namé de Souza Franco, Luiza Magalhães Cadioli, Ana Flávia Pires Lucas d'Oliveira, Elisabeth Meloni Vieira","doi":"10.1080/26410397.2025.2555050","DOIUrl":"10.1080/26410397.2025.2555050","url":null,"abstract":"<p><p>This commentary analyses the state of legal abortion in Brazil over the past decade, contextualising the increasing restrictions and political disputes surrounding the issue within broader anti-gender offensives. While Brazilian law permits abortion only in limited cases - rape, risk to the pregnant person's life, and anencephaly - access to these rights has been consistently undermined, particularly amid the strengthening of far-right political forces. We explore how moral arguments and conservative discourses - often framed through the notion of \"gender ideology\" - have been mobilised to roll back sexual and reproductive rights, resulting in significant institutional and legislative setbacks, including attempts to criminalise legal abortion practices. In contrast, the commentary highlights forms of resistance led by feminist movements, progressive lawmakers, and the judiciary, such as mass protests, strategic litigation, and efforts to socially decriminalise abortion. Furthermore, it addresses the role of strategic ignorance in perpetuating state inaction and the importance of academic research in illuminating these dynamics and resisting the erosion of rights. The struggle for reproductive justice in Brazil is ongoing, marked by both persistent threats and collective resistance.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2555050"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effects of a multi-level intervention on young women's contraceptive use: sexual and reproductive health results of a cluster-randomised factorial-design study in Tshwane, South Africa.","authors":"Ilene S Speizer, Courtney P Bonner, Laura Nyblade, Jacqueline Ndirangu, Alexandra Minnis, Khatija Ahmed, Tracy L Kline, Felicia A Browne, Brittni Howard, Wendee M Wechsberg","doi":"10.1080/26410397.2026.2696689","DOIUrl":"10.1080/26410397.2026.2696689","url":null,"abstract":"<p><p>In South Africa, adolescent girls and young women (AGYW) are engaged in early, condomless, and unprotected (from pregnancy) sex, which puts them at risk of unintended pregnancies and sexually transmitted infections. At the individual, interpersonal, and structural levels, AGYW experience barriers to their access to and use of contraception and condoms. This study employed a cluster-randomised factorial design to examine the impact of a multi-level intervention on contraceptive use behaviours among 802 women ages 16-24 in Tshwane, South Africa. The two intervention components were the Young Women's Health CoOp (YWHC), an intervention to increase participants' knowledge and skills, and a stigma and discrimination (S&D) reduction training at the facility level. Study facilities were randomised into the four study arms: YWHC only; S&D only; both YWHC and S&D; and control (standard of care). The study demonstrated that AGYW in the YWHC arm (RRR: 2.45; 95% CI: 1.05-5.70, <i>p</i> = 0.038) and those in the YWHC and S&D arm (RRR: 3.65; 95% CI: 1.56-8.50, <i>p</i> = 0.003) were more likely to have started a contraceptive method than to remain a non-user compared to those in the control arm over the 9-month follow-up period. However, those in the S&D training-only arm had lower odds of adopting a method over the follow-up period (OR: 0.63; 95% CI: 0.41-0.97, <i>p</i> = 0.037). These results demonstrate the importance of supporting AGYW with tailored messaging in a safe environment as part of sexual and reproductive health services.<i>DOI: 10.1080/26410397.2026.2696689</i>.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2696689"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a comprehensive measure of reproductive coercion and abuse for global use: a Delphi study.","authors":"Desireé LaGrappe, Angela Taft, Leesa Hooker, Laura Tarzia, Kristina Edvardsson","doi":"10.1080/26410397.2026.2652218","DOIUrl":"10.1080/26410397.2026.2652218","url":null,"abstract":"<p><p>Reproductive coercion and abuse describes controlling behaviours to undermine another person's reproductive autonomy, predominantly affecting women and gender minorities with pregnancy capacity. Debate exists about how this form of gender-based violence should be measured and whether available measures developed over a decade ago adequately capture current conceptual understandings. To address this, our study aimed to develop a comprehensive measure of reproductive coercion and abuse for global population-level use. A modified e-Delphi technique was used to determine consensus on measurement items generated from pre-existing literature and formative qualitative research. Global experts (<i>n</i> = 30) with research, clinical, and/or lived expertise were recruited from low- to middle- and high-income countries and asked to rate items against COSMIN criteria. Participants represented 15 countries and five global regions (Africa, Asia, Europe, North America, Oceania). They suggested 12 new items in addition to the 62 candidate items. Consensus was not reached on 17 of 74 items. After incorporating final feedback, 59 items were selected for future pilot testing. The Delphi panel did not reach consensus on structure of response options or how to ask about intent. Experts agreed measuring the distinct interpersonal relationships in which reproductive coercion and abuse can occur is important. We developed a robust set of new items to measure reproductive coercion and abuse within multi-country comparative studies that fills a measurement gap in sexual and reproductive health. With future psychometric evaluation, the measure will enable more sensitive, specific, and consistent prevalence estimates across contexts, critical to inform practice and policy locally and globally.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2652218"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13206697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}