Leadership in Health Services最新文献

{"title":"Interactions between the context of a health-care organisation and failure: the situational impact of failure on organisational learning","authors":"Stijn Horck","doi":"10.1108/lhs-04-2024-0036","DOIUrl":"https://doi.org/10.1108/lhs-04-2024-0036","url":null,"abstract":"Purpose\u0000This study aims to explore how health-care organisations learn from failures, challenging the common view in management science that learning is a continuous cycle. It focuses on understanding how the context of a health-care organisation and the characteristics of failure interact.\u0000\u0000Design/methodology/approach\u0000Systematically collected empirical studies that examine how health-care organisations react to failures, both in terms of learning and non-learning, were reviewed and analysed. The key characteristics of failures and contextual factors are categorised at the individual, team, organisational and global level.\u0000\u0000Findings\u0000Several factors across four distinct levels are identified as being susceptible to the situational impact of failure. In addition, these factors can be used in the design and development of innovations. Taking these factors into account is expected to stimulate learning responses when an innovation does not succeed. This enhances the understanding of how health-care organisations learn from failure, showing that learning behaviour is not solely dependent on whether a health-care organisation possesses the traits of a learning organisation or not.\u0000\u0000Originality/value\u0000This review offers a new perspective on organisational learning, emphasising the situational impact of failure and how learning occurs across different levels. It distinguishes between good and bad failures and their effects on a health-care organisation’s ability to learn. Future research could use these findings to study how failures influence organisational performance over time, using longitudinal data to track changes in learning capacity.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"30 21","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816961","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":"Engaging leadership in health care during the COVID-19 pandemic and followers’ engagement and quality of care","authors":"Bogdan Oprea, Daniela Ionescu-Avram, Iuliana Armas, Eugen Avram","doi":"10.1108/lhs-02-2024-0022","DOIUrl":"https://doi.org/10.1108/lhs-02-2024-0022","url":null,"abstract":"Purpose\u0000Investigating the role of leadership during the COVID-19 pandemic in maintaining the well-being and performance of the medical personnel, as frontline workers, is of major importance. The aim of this study was to investigate the relationships between engaging leadership in health care during COVID-19 pandemic and followers’ work engagement and performance and to test the mediating role of followers’ basic psychological need satisfaction in these relationships.\u0000\u0000Design/methodology/approach\u0000A cross-sectional study was conducted on a sample consisting of 200 health-care employees. Data were collected starting with May 2020 and ending with November 2020, during the COVID-19 pandemic. Participants reported on the engaging leadership of their direct supervisor and on their own psychological need satisfaction, work meaningfulness, work engagement and quality of care.\u0000\u0000Findings\u0000The positive association between engaging leadership and followers’ work engagement was fully mediated by followers’ basic needs satisfaction. The relationship between engaging leadership and followers’ quality of patient care was not supported. Work meaningfulness did not mediate the link between engaging leadership and followers’ engagement.\u0000\u0000Practical implications\u0000By meeting followers’ needs for autonomy, competence and relatedness, engaging leaders can stimulate followers’ work engagement during outbreaks and other similar crises. Managers in health care may maintain a high level of followers’ work engagement during crises if they adopt an engaging leadership style.\u0000\u0000Originality/value\u0000The study investigated for the first time the role of meeting the psychological needs of health-care workers by leaders during a health-care crisis.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"15 15","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661418","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":"Leadership style, change management and job performance of health information management practitioners in tertiary hospitals in South-East, Nigeria","authors":"Bashir Ademola Adeyemi, C. Ebegbetale, Ibrahim Olanrewaju Showemimo","doi":"10.1108/lhs-03-2024-0026","DOIUrl":"https://doi.org/10.1108/lhs-03-2024-0026","url":null,"abstract":"\u0000Purpose\u0000Managing patients’ health information is one of the building blocks of the health system and the adoption of health information technologies like electronic health records (EHRs) is expected to reduce the various challenges in keeping and accessing quality health-care data that aid decision-making among medical practitioners. This study aims to investigate how leadership styles and change management affected the job performance of health information management practitioners on their adoption of EHRs in tertiary hospitals in Nigeria.\u0000\u0000\u0000Design/methodology/approach\u0000The study used primary data collected using a Likert scale questionnaire from 117 health information management officers and health information technicians in selected tertiary hospitals in South-Eastern Nigeria. The data were analysed using bivariate correlation and multiple regression techniques of inferential statistics.\u0000\u0000\u0000Findings\u0000The analyses revealed that transformational leadership style, transactional leadership style and change management had significant positive influence on the job performance of health information management practitioners. However, laissez-faire leadership style did not show any significant positive influence. A further analysis showed that the combined effects of leadership styles and change management were also affirmed to significantly influence the adoption of EHRs for quality health-care delivery in Nigerian tertiary hospitals.\u0000\u0000\u0000Originality/value\u0000The study contributes to health information management and the need to understand how leadership styles and change management can influence the adoption of EHRs. However, there is no adequate research that examined the role of leadership style and change management in influencing the job performance of Nigerian HIM practitioners regarding their usage of EHRs in tertiary hospitals in Nigeria.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"90 26","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141664115","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":"Leadership dynamics in nursing: a comparative study of paternalistic approaches in China and Pakistan","authors":"Samyia Safdar, Shazia Faiz, Namra Muabark","doi":"10.1108/lhs-03-2024-0028","DOIUrl":"https://doi.org/10.1108/lhs-03-2024-0028","url":null,"abstract":"\u0000Purpose\u0000This study aims to examine the impact of nurses’ paternalistic leadership style on performance, in the presence of underlying mechanisms, i.e. self-efficacy as a mediator in the high-power distance societies, namely, China and Pakistan, based on social exchange theory. Both healthcare sectors have seen several behavioral advancements in recent years. To improve things, even more, behavioral elements such as the influence of leadership styles, personality traits and so on have become more important. However, leadership styles, particularly paternalistic leadership, have received little attention in this field and need to be highlighted along with the mediating and moderating effects.\u0000\u0000\u0000Design/methodology/approach\u0000Data were collected from public and private sector hospitals in China and Pakistan using a 6-week time lag technique. Firstly, 356 Chinese and 411 Pakistani nurses were surveyed about their perceptions of power distance, self-efficacy and paternalistic leadership. Their managers were called six weeks later for a dyadic response to provide feedback on nurses’ performance. For confirmatory factor analysis, AMOS 22 and for regression analysis, SPSS 22 was used.\u0000\u0000\u0000Findings\u0000According to the study's findings, nurses in both countries perform well when led by a paternalistic leader. Furthermore, self-efficacy explains the relationship between paternalistic leaders and nurses’ performance. The moderated-mediation result also supported the importance of power distance.\u0000\u0000\u0000Originality/value\u0000This study highlights the kind of nursing leadership which is beneficial in high-power-distance societies and leads to better performance. According to this research, paternalistic leadership improves nurses’ performance in both China and Pakistan. As a result, this study will be useful in high-power-distance societies, where hospital administrators can ensure that paternalism is implemented in leadership, thereby improving nurse performance.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"104 13","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666487","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":"Health and social care leaders’ and employees’ perceptions of remote leadership and the associated factors","authors":"Anja Terkamo-Moisio, Elsa Paronen, A. Häggman-Laitila, Johanna Lammintakanen","doi":"10.1108/lhs-01-2024-0010","DOIUrl":"https://doi.org/10.1108/lhs-01-2024-0010","url":null,"abstract":"Purpose\u0000The purpose of this study was to describe health and social care leaders’ and employees’ perceptions of remote leadership and the associated factors.\u0000\u0000Design/methodology/approach\u0000A total of 45 leaders and 177 employees from one Finnish health and social care organization completed an electronic questionnaire between October and November 2020. The questionnaire included questions related to background information, along with structured and open-ended questions addressing remote leadership and the associated factors. The collected quantitative data was analyzed with statistical methods, while inductive content analysis was used to analyze the qualitative data.\u0000\u0000Findings\u0000Remote leadership emerged as a developing form of leadership that was part of everyday life at a regional health and social care organization. However, it was also considered by some as a distanced and authoritarian form of leadership that reduced communication to a one-way flow of information. Remote leadership and digitalization in health and social care were generally perceived positively, especially among higher educated participants and those working mainly in a remote context. However, digitalization was also perceived as a burden and remote leadership as a source of uncertainty at work, especially among lower educated participants and those who worked mainly in traditional contexts.\u0000\u0000Originality/value\u0000This study expands the little-researched area and provides insights that can be used to further develop remote leadership and the related education.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675663","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":"The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil.","authors":"Lorena G Barberia, Gilmar Masiero, Iana Alves de Lima, Luciana Santana, Tatiane C Moraes de Sousa","doi":"10.1108/LHS-01-2024-0008","DOIUrl":"10.1108/LHS-01-2024-0008","url":null,"abstract":"<p><strong>Purpose: </strong>Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil.</p><p><strong>Design/methodology/approach: </strong>Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders' management and public health experience increase the duration of tenure.</p><p><strong>Findings: </strong>States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency.</p><p><strong>Research limitations/implications: </strong>Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary's tenure are difficult to separate and analyze separately.</p><p><strong>Practical implications: </strong>This study provides empirical insights into what factors drive health leader turnover during major health emergencies.</p><p><strong>Social implications: </strong>During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders' duration in one of the world's largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover.</p><p><strong>Originality/value: </strong>To the best of the authors' knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world's largest public health systems.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":"511-525"},"PeriodicalIF":1.7,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332199","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":"Do health-care institutions perform better under leaders with medical or non-medical backgrounds? A scoping review.","authors":"Shazwani Mohmad, Kun Yun Lee, Pangie Bakit","doi":"10.1108/LHS-11-2023-0084","DOIUrl":"10.1108/LHS-11-2023-0084","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.</p><p><strong>Design/methodology/approach: </strong>A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords \"performance,\" \"impact,\" \"physician,\" \"medical,\" \"doctor,\" \"leader,\" \"healthcare institutions\" and \"hospital.\" Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.</p><p><strong>Findings: </strong>A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (<i>n</i> = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.</p><p><strong>Practical implications: </strong>While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.</p><p><strong>Originality/value: </strong>The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders' background.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 5","pages":"142-156"},"PeriodicalIF":1.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162677","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":"Global research trends in nursing leadership from 1985 to 2022: a bibliometric analysis.","authors":"Changchang Chen, Xutong Zheng, Wenjie Chen, Hezi Mu, Man Zhang, Hongjuan Lang, Xuejun Hu","doi":"10.1108/LHS-09-2023-0074","DOIUrl":"https://doi.org/10.1108/LHS-09-2023-0074","url":null,"abstract":"<p><strong>Purpose: </strong>Developing nursing leadership has become a key policy priority to achieve universal health coverage. This study aims to explore the current status, developing trends and research frontiers in the field of nursing leadership.</p><p><strong>Design/methodology/approach: </strong>In total, 1,137 articles and reviews on nursing leadership from 1985 to 2022 were retrieved from the Web of Science Core Collection database. Trends of publications, journals, countries/regions, institutions, documents and keywords were visualized and analyzed using Microsoft Excel and CiteSpace software.</p><p><strong>Findings: </strong>Nursing leadership research showed an overall increase in number despite slight fluctuations in annual publications. The USA was the leading country in nursing leadership research, and the University of Alberta was the most productive institution. The <i>Journal of Nursing Management</i> was the most widely published journal that focused on nursing leadership, followed by the <i>Journal of Nursing Administration</i>. Keyword analysis showed that the main research hotspots of nursing leadership are improvement, practice and impact of nursing leadership.</p><p><strong>Originality/value: </strong>This article summarizes the current state and frontiers of nursing leadership for researchers, managers and policy makers, as well as follow-up, development and implementation of nursing leadership. More research is needed that focuses on the improvement, practice and impact of nursing leadership, which are cyclical, complementary and mutually reinforcing. Longitudinal and intervention studies of nursing leadership, especially on patient prognosis, are also particularly needed.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892799","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":"Effect of authentic leadership on nurses' stress, burnout, presenteeism during COVID-19.","authors":"Preeadashnie Pillay, Caren Brenda Scheepers, Rick Diesel","doi":"10.1108/LHS-10-2023-0082","DOIUrl":"https://doi.org/10.1108/LHS-10-2023-0082","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who are working with COVID-19-positive patients. Burnout leads to decreased productivity and manifests as emotional exhaustion, depersonalisation (cynicism) and low personal accomplishment (professional efficacy). Authentic leadership is built on a humanistic value system, which is the core value of nurses and other health-care professionals. This study therefore used authentic leadership as the independent variable.</p><p><strong>Design/methodology/approach: </strong>A cross-sectional quantitative research method was adopted by distributing validated online questionnaires to 1,334 nurses in a private pathology laboratory and 241 questionnaires were analysed with 93.4% female respondents. Multiple linear regression model testing was conducted.</p><p><strong>Findings: </strong>Multiple regression analyses showed statistically significant negative correlations between authentic leadership and emotional exhaustion, cynicism, job stress and job-stress-related presenteeism, and a positive correlation between authentic leadership and professional efficacy.</p><p><strong>Practical implications: </strong>This study provides empirical data to encourage organisations to focus on developing authentic leaders to decrease nurses' burnout, job stress and presenteeism. The health-care sector should strive to create an environment where nurses are valued and their talent is recognised to increase employee engagement and commitment.</p><p><strong>Originality/value: </strong>There were two contributions in this study: first, to determine whether there is a relationship between authentic leadership job stress and job-stress-related presenteeism. Second, to determine whether there is a relationship between authentic leadership and the three sub-constructs of burnout.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858956","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":"Excellence in healthcare: nurturing servant leadership, fostering collaborative culture and promoting social sustainability in the UAE - strategies for transformation.","authors":"Divya Upadhyay","doi":"10.1108/LHS-01-2024-0012","DOIUrl":"https://doi.org/10.1108/LHS-01-2024-0012","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the healthcare sector of the United Arab Emirates (UAE) to explore the significance of servant leadership and collaborative culture in fostering social sustainability. The primary objective of this paper is to investigate how servant leadership and a collaborative culture contribute to social sustainability in health care in the UAE. With a focus on promoting well-being within healthcare organizations, the paper aims to uncover the synergies between servant leadership, collaborative culture, and social sustainability.</p><p><strong>Design/methodology/approach: </strong>This paper conducted a multilayer literature review of existing literature on servant leadership, collaborative culture and social sustainability in health care, both globally and specifically in the UAE context, and a conceptual model was proposed.</p><p><strong>Findings: </strong>Servant leadership proves to be a culturally pertinent and effective leadership model within the UAE due to its alignment with cultural values, emphasis on community support, and the robust health-care system that contributes to individual well-being. This combination establishes a solid foundation for fostering a healthy and sustainable society.</p><p><strong>Research limitations/implications: </strong>Limitations and implications are discussed. The current research has not identified the boundary conditions under which servant leadership and collaborative culture may be more or less effective. This could involve exploring industry-specific influences or contextual factors. Theoretical and practical implications are discussed.</p><p><strong>Originality/value: </strong>The research seeks to unravel the interconnections between servant leadership, collaborative culture and social sustainability. To the best of the author's knowledge, none of the studies have explored the interrelationships of these constructs, particularly in the UAE context.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854074","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}