Kelly A Kimball, Christopher B Roecker, Katie Hoyt
{"title":"Impostor phenomenon among US chiropractic students.","authors":"Kelly A Kimball, Christopher B Roecker, Katie Hoyt","doi":"10.7899/JCE-19-10","DOIUrl":"https://doi.org/10.7899/JCE-19-10","url":null,"abstract":"<p><strong>Objective: </strong>Impostor phenomenon is expressed by feelings of self-doubt and the belief that one is unintelligent. The purpose of this research was to describe the prevalence of impostor phenomenon among students enrolled in a doctor of chiropractic program and to evaluate for any differences in the rates of impostor phenomenon between males and females.</p><p><strong>Methods: </strong>We performed an anonymous cross-sectional, online survey of all students enrolled in the doctor of chiropractic program at 2 campuses of 1 chiropractic college. We reported the point prevalence of impostor phenomenon and used χ2 to evaluate the differences in impostor phenomenon among males and females. We also evaluated for between-group differences for 4 other demographic factors believed to influence impostor phenomenon.</p><p><strong>Results: </strong>We received 406 survey responses (34% response rate). Impostor phenomenon was reported in 39% of students responding to our survey. Approximately 46% of all females and 32% of all males met the criteria for impostor phenomenon, and females had significantly higher rates of impostor phenomenon (p = .005). The following variables were not associated with impostor phenomenon: year in which students were enrolled; marital status; whether chiropractic was their first career; and type of clinical experience the student encountered.</p><p><strong>Conclusion: </strong>Our findings demonstrate that over a third of students enrolled in a doctor of chiropractic program met the criteria for impostor phenomenon, and females were significantly more likely to experience impostor phenomenon. The results from this survey are similar to those reported in other healthcare educational settings.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"209-214"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528442/pdf/i1042-5055-35-2-209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38474357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine A Major, Kara D Burnham, Kathryn A Brown, Chad D Lambert, Jenny M Nordeen, Leslie A K Takaki
{"title":"Evaluation of an online case-based learning module that integrates basic and clinical sciences.","authors":"Christine A Major, Kara D Burnham, Kathryn A Brown, Chad D Lambert, Jenny M Nordeen, Leslie A K Takaki","doi":"10.7899/JCE-20-3","DOIUrl":"https://doi.org/10.7899/JCE-20-3","url":null,"abstract":"<p><strong>Objective: </strong>Case-based online modules can be created to integrate basic science and clinical science knowledge. An integrated module was designed, implemented, and evaluated for student performance and perception.</p><p><strong>Methods: </strong>Five faculty members from both basic science and clinical education departments developed an integrative, online, case-based learning module. The case involved a patient with facial asymmetry, and the student was led to a diagnosis of Bell's palsy. Material on Bell's palsy was presented in an integrated module in addition to traditional lecture for a fall cohort of students and was presented only in traditional lecture format to a winter cohort of students. Both cohorts were given the same 5 multiple-choice questions on Bell's palsy as part of a midterm exam, and the scores of these test questions were compared between cohorts. A 13-question, mixed-methods survey was given to the fall cohort to determine their perceptions of the module and their learning.</p><p><strong>Results: </strong>Multiple-choice test question performance was equivalent between cohorts for the Bell's palsy questions (fall 2018: mean = 3.68, SD = 0.99; winter 2019: mean = 3.51, SD = 0.92). Perception survey responses indicated that students felt positively about the integrated module and that it was applicable and helpful with improving, reinforcing, and integrating basic science and clinical knowledge.</p><p><strong>Conclusion: </strong>This study provides evidence that case-based integrated modules are perceived favorably by students and result in similar exam question performance. They can be a useful tool to help students connect information throughout the chiropractic curriculum.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"192-198"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528434/pdf/i1042-5055-35-2-192.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38791863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Harnessing the Web: How Chiropractic Education Survives and Thrives During the COVID-19 Pandemic: Chiropractic Educators Research Forum (CERF), December 5, 2020.","authors":"","doi":"10.7899/JCE-20-27","DOIUrl":"https://doi.org/10.7899/JCE-20-27","url":null,"abstract":"<p><p>This conference was convened by the Chiropractic Educators Research Forum (CERF) on December 5, 2020. This meeting provided a forum for the presentation of scholarly works in chiropractic education theory and practice. This conference specifically focused on research related to chiropractic education during the COVID-19 pandemic. During the December 2020 CERF meeting, presenters and panelists took an in depth look at how programs worked to meet program objectives, graduation requirements, accreditation, and other activities during the COVID-19 pandemic.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"222-228"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528439/pdf/i1042-5055-35-2-222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25566804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Craig Moore, Stephney Whillier, Martha Funabashi, Diana De Carvalho, Jon Adams, Matthew Fernandez, Rosemary Giuriato, Michael Swain
{"title":"Chiropractic student diagnosis and management of headache disorders: A survey examining self-perceived preparedness and clinical proficiency.","authors":"Craig Moore, Stephney Whillier, Martha Funabashi, Diana De Carvalho, Jon Adams, Matthew Fernandez, Rosemary Giuriato, Michael Swain","doi":"10.7899/JCE-20-11","DOIUrl":"https://doi.org/10.7899/JCE-20-11","url":null,"abstract":"<p><strong>Objective: </strong>To explore the self-perceived preparedness and clinical proficiency in headache diagnosis and management of Australian chiropractic students in senior years of study.</p><p><strong>Methods: </strong>Australian chiropractic students in the 4th (n = 134) and 5th year (n = 122) of 2 chiropractic university programs were invited to participate in an online cross-sectional survey. Descriptive analyses were conducted for all variables. Post hoc analyses were performed using simple linear regression to evaluate the relationship between self-perceived preparedness and correctness of headache diagnosis and management scores.</p><p><strong>Results: </strong>Australian chiropractic students in senior years demonstrated moderate overall levels of self-perceived preparedness and proficiency in their ability to diagnose and manage headache disorders. Final-year students had a slightly higher self-perceived preparedness and proficiency in headache diagnosis and management compared to those students in the 4th year of study. There was no relationship between self-perceived preparedness and correctness of headache diagnosis and management for either 4th- or 5th-year chiropractic students.</p><p><strong>Conclusion: </strong>Our findings suggest that there may be gaps in graduate chiropractic student confidence and proficiency in headache diagnosis and management. These findings call for further research to explore graduate chiropractic student preparedness and proficiency in the diagnosis and management of headache disorders.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"229-241"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528441/pdf/i1042-5055-35-2-229.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25393502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of videos to teach basic science concepts in a doctor of chiropractic training program.","authors":"Kathryn M Shaw, Ali Rabatsky","doi":"10.7899/JCE-17-17","DOIUrl":"https://doi.org/10.7899/JCE-17-17","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the effectiveness of teaching biochemical concepts by video in a doctor of chiropractic training program.</p><p><strong>Methods: </strong>Students in a biochemistry class were taught the Krebs cycle through a video exercise and glycolysis in a traditional lecture format. They received a review of both concepts and were tested. Test performance was examined. Students answered a questionnaire following the exercise.</p><p><strong>Results: </strong>There were no significant differences in test performance on the topic learned by the video exercise. However, students felt that both lecture and review were more effective learning tools than video.</p><p><strong>Conclusion: </strong>Despite the results of other authors, our students preferred traditional didactic lecture with review rather than video. With no difference in test scores observed, the role of videos in our basic science course remains unclear, perhaps only used as an occasional supplement. These results were not expected, given the often-preferred use of technology by current learners.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"205-208"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528438/pdf/i1042-5055-35-2-205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38381303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephney Whillier, Reidar P Lystad, Joyce El-Haddad
{"title":"Team-based learning in neuroanatomy.","authors":"Stephney Whillier, Reidar P Lystad, Joyce El-Haddad","doi":"10.7899/JCE-19-25","DOIUrl":"https://doi.org/10.7899/JCE-19-25","url":null,"abstract":"<p><strong>Objective: </strong>Team-based learning (TBL) is an active learning method in which student teams participate in individual work, teamwork, and the application of learned concepts to problem solving. It has been widely adopted in the education of health professions. The aim of this study was to assess whether TBL in tutorials would be beneficial to students' assessed knowledge and subjective sense of satisfaction as compared to traditional modes of teaching.</p><p><strong>Methods: </strong>In 2018, TBL was introduced into the tutorials of a clinically oriented undergraduate course of neuroanatomy, and its benefits in improving student grades and satisfaction were assessed. The Welch 2 sample t test was used for group differences in continuous variables, and Pearson's χ2 test with Yates' continuity correction was used for group differences in dichotomous variables. Linear modeling was used to look for group differences while adjusting for significant baseline characteristics.</p><p><strong>Results: </strong>Our study found that in comparison to more traditionally delivered teaching, TBL did not improve grades or alter overall satisfaction. A post hoc pairwise comparison of satisfaction among lectures, tutorials, and practical classes showed that students appeared to be most dissatisfied with the TBL.</p><p><strong>Conclusion: </strong>Analysis of our methods, results, student comments, and the literature indicate that the length of the tutorials, at 1 hour, was too short to conduct TBL to the standards required. In addition, there is an imperative to persist in preparing students for a different knowledge-transfer paradigm, and it takes a few iterations to improve the approach and application of this method of teaching.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"184-191"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528444/pdf/i1042-5055-35-2-184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38672040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivian T Ly, Brian C Coleman, Christopher M Coulis, Anthony J Lisi
{"title":"Exploring the application of the Charlson Comorbidity Index to assess the patient population seen in a Veterans Affairs chiropractic residency program.","authors":"Vivian T Ly, Brian C Coleman, Christopher M Coulis, Anthony J Lisi","doi":"10.7899/JCE-20-1","DOIUrl":"https://doi.org/10.7899/JCE-20-1","url":null,"abstract":"<p><strong>Objective: </strong>Chiropractic trainees require exposure to a diverse patient base, including patients with multiple medical conditions. The Veterans Affairs (VA) Chiropractic Residency Program aims for its doctor of chiropractic (DC) residents to gain experience managing a range of multimorbid cases, yet to our knowledge there are no published data on the comorbidity characteristics of patients seen by VA DC residents. We tested 2 approaches to obtaining Charlson Comorbidity Index (CCI) scores and compared CCI scores of resident patients with those of staff DCs at 1 VA medical center.</p><p><strong>Methods: </strong>Two processes of data collection to calculate CCI scores were developed. Time differences and agreement between methods were assessed. Comparison of CCI distribution between resident DC and staff DCs was done using 100 Monte Carlo simulation iterations of Fisher's exact test.</p><p><strong>Results: </strong>Both methods were able to calculate CCI scores (n = 22). The automated method was faster than the manual (13 vs 78 seconds per patient). CCI scores agreement between methods was good (κ = 0.67). We failed to find a significant difference in the distribution of resident DC and staff DC patients (mean p = .377; 95% CI, .375-.379).</p><p><strong>Conclusion: </strong>CCI scores of a VA chiropractic resident's patients are measurable with both manual and automated methods, although automated may be preferred for its time efficiency. At the facility studied, the resident and staff DCs did not see patients with significantly different distributions of CCI scores. Applying CCI may give better insight into the characteristics of DC trainee patient populations.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"199-204"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528440/pdf/i1042-5055-35-2-199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38807451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian J Gleberzon, Robert Cooperstein, Christopher Good, Christopher Roecker, Charles Blum
{"title":"Developing a standardized curriculum for teaching chiropractic technique.","authors":"Brian J Gleberzon, Robert Cooperstein, Christopher Good, Christopher Roecker, Charles Blum","doi":"10.7899/JCE-20-2","DOIUrl":"10.7899/JCE-20-2","url":null,"abstract":"<p><strong>Objective: </strong>This is a report of the results of 4 facilitated workshops aimed at developing a standardized chiropractic technique curriculum.</p><p><strong>Methods: </strong>Workshops were held at research conferences during 2014, 2016, 2018, and 2019. Participants were tasked with developing recommendations for diagnostic and therapeutic procedures appropriate for chiropractic technique programs.</p><p><strong>Results: </strong>For diagnostic procedures, there was general agreement among participants that chiropractic programs should include diagnostic imaging, postural assessment, gait analysis, palpation (static, motion, and joint play/springing), global range of motion, and evidence-based orthopedic/neurological tests. No consensus could be reached with respect to chiropractic x-ray line marking (spinography) nor heat sensing instruments, and there was only partial consensus on leg length assessment. For therapeutic procedures, all participants agreed that the following should be included: high-velocity, low amplitude spinal and extremity manipulation, adjustments assisted by hand-held instruments, drop tables, flexion-distraction tables, and pelvic blocks. There was unanimous support for teaching mobilization of the spine and peripheral joints, as well as for manual and instrument-assisted soft tissue therapies. There were some overarching issues: participants strongly preferred assessment methods known to be reliable and valid and therapeutic procedures known to be safe and effective. Where evidence was lacking, they insisted that diagnostic and therapeutic methods at minimum have face validity and biological plausibility. However, they cautioned against applying aspects of evidence-based care too rigidly.</p><p><strong>Conclusions: </strong>Despite differing views on chiropractic terminology, philosophy, and scope of practice, participants' opinions were similar regarding diagnostic and therapeutic procedures that ought to be included in chiropractic technique programs.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"249-257"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528435/pdf/i1042-5055-35-2-249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25565105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatima Ismail, Naomi Booysen, Christopher Yelverton, Cynthia Peterson
{"title":"Characteristics of chiropractic patients treated at the University of Johannesburg chiropractic student clinic and relevance to the educational process.","authors":"Fatima Ismail, Naomi Booysen, Christopher Yelverton, Cynthia Peterson","doi":"10.7899/JCE-19-29","DOIUrl":"10.7899/JCE-19-29","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the demographic and descriptive information of new patients presenting to an educational institution-based chiropractic student clinic in South Africa that could then be used to draw comparisons to other international chiropractic student clinics and local practices.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of all new patient files from January 1, 2016, to July 31, 2016. The variables extracted were age, health profiles, number of musculoskeletal complaints, treatment protocol, and number of treatments that patients received for the initial complaint. Data were analyzed using cross-tabulations and multidimensional χ2 tests.</p><p><strong>Results: </strong>There were 865 files reviewed. Most patients were aged between 20 and 24 years. Lumbar and pelvic complaints were most common (42.2%), followed by the cervical spine (28%). Lumbar (18.8%) and cervical (16.8%) biomechanical conditions, followed by lumbar myofascial pain syndrome (7.6%), were the most common problems. Musculoskeletal conditions were reported in 99% of cases. The majority (80%) of patients received 9 or fewer treatments for their initial complaint. Manipulation was used in 93.9% of cases, followed by mobilization (8.8%), interferential current (23.5%), and dry needling (19.1%).</p><p><strong>Conclusions: </strong>Data gathered suggest that there are some general similarities with international training institutions. There are also differences between the study sample and international institutions and South African private chiropractic practice. The dissimilarities were a younger patient population, a lower number of treatment visits, and low exposure to nonmusculoskeletal conditions. These differences may affect the breadth of student education and require further investigation.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"215-221"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528433/pdf/i1042-5055-35-2-215.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38707427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bruce L Shotts, Igor Himelfarb, Greg L Crawford, Justin Harding, Andrew R Gow
{"title":"Practice analysis and changes to the Chiropractic Board of Clinical Nutrition diplomate exam.","authors":"Bruce L Shotts, Igor Himelfarb, Greg L Crawford, Justin Harding, Andrew R Gow","doi":"10.7899/JCE-19-16","DOIUrl":"https://doi.org/10.7899/JCE-19-16","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of this study was to report results of the practice analysis survey and to provide insights into the average levels of performance and the importance of professional tasks executed by chiropractic nutritionists. In addition, this study informs the chiropractic community of the changes made to the Chiropractic Board of Clinical Nutrition diplomate exam.</p><p><strong>Methods: </strong>Seventy-eight practicing chiropractic nutritionists responded to the practice analysis survey. Their responses were analyzed, and conclusions about frequency and importance of performance tasks were reached. A panel of subject matter experts provided a qualitative review of the survey responses. The quantitative and qualitative analyses of the survey responses indicated that minor changes to the test plan were needed.</p><p><strong>Results: </strong>Descriptive statistical techniques were employed to analyze the survey responses. The qualitative panel suggested reducing the number of domains on the nutrition exam from 7 to 6 by combining Laboratory and Nutrition-Specific Testing and Imaging and Other Special Studies domains. Additionally, the panel decided on the final distribution of weights combining the quantitative results with qualitative perspectives.</p><p><strong>Conclusion: </strong>The practice analysis is a first step in the definition of the skills required for practicing chiropractic nutritionists. The analysis becomes one of the references and a decision-making tool used by the board for developing and administrating quality assessments.</p>","PeriodicalId":44516,"journal":{"name":"Journal of Chiropractic Education","volume":"35 2","pages":"171-183"},"PeriodicalIF":0.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528437/pdf/i1042-5055-35-2-171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38477955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}