Journal of Pediatric Psychology最新文献

{"title":"Longitudinal psychological well-being in caregivers of young children with cleft lip and/or palate.","authors":"Nicola M Stock, Debora Blaso, Paul White, Laura Shepherd, Bruna Costa, Karine Edme, Richa Aspland, Matthew Hotton","doi":"10.1093/jpepsy/jsaf029","DOIUrl":"10.1093/jpepsy/jsaf029","url":null,"abstract":"<p><strong>Objective: </strong>Caregivers of children with chronic conditions can experience psychological distress and an impact on quality of life (QoL). Cleft lip and/or palate (CL/P) is one of the most common congenital conditions worldwide. Utilizing data extracted from The Cleft Collective cohort studies in the United Kingdom, this study investigated longitudinal psychological well-being in caregivers of young children with CL/P, to inform screening practices and early intervention.</p><p><strong>Methods: </strong>Baseline (post-diagnosis) and 5-year questionnaire data were extracted for 525 caregivers (342 biological mothers, 183 fathers/partners). Outcome measures included the PedsQL-Family Impact Module, the Perceived Stress Scale, and the Hospital Anxiety and Depression Scale.</p><p><strong>Results: </strong>QoL significantly improved from T1 (post-birth) to T2 (5 years) as reported by mothers and fathers/partners. At T2, scores on all measures were aligned with, or more favorable than, norms. A minority continued to report clinically significant levels of distress at 5 years. Predictors of poorer outcomes on all measures included a less positive life orientation, more negative appraisals of CL/P, less favorable baseline scores, lower healthcare satisfaction, and prior mental health conditions. Outcomes were also less favorable for caregivers of children with combined cleft lip and palate compared to other cleft types. Reductions in negative appraisals of CL/P were significantly associated with improved QoL over time.</p><p><strong>Conclusions: </strong>QoL and psychological well-being in caregivers is generally positive at 5 years. A minority experienced poorer outcomes and routine assessment by a multidisciplinary team is therefore recommended. Targeting early negative appraisals may help to facilitate long-term caregiver adjustment.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric long COVID: relationships with premorbid history of anxiety or depression and health-related quality of life.","authors":"Ellen Henning, Rashelle Musci, Sara B Johnson, Cindy Villatoro, Laura A Malone","doi":"10.1093/jpepsy/jsaf034","DOIUrl":"10.1093/jpepsy/jsaf034","url":null,"abstract":"<p><strong>Objective: </strong>Up to 25% of youth may develop long COVID following COVID-19 infection. Mood changes are commonly reported; however, few studies use validated measures. This study describes prevalence of self-reported anxious and depressive symptoms among youth with long COVID. We also examined the association of these symptoms with prior mental health diagnosis and health-related quality of life.</p><p><strong>Methods: </strong>We conducted a retrospective study of pediatric patients (n = 139) evaluated in a pediatric post-COVID-19 rehabilitation clinic who met criteria for long COVID. Patients were included if they completed the Pediatric Quality of Life Inventory (PedsQL), the Multidimensional Anxiety Scale for Children, second edition (MASC 2), and/or the Children's Depression Inventory, second edition (CDI 2). Relationships between prior anxiety or mood disorder and current depressive and anxious symptoms were assessed using chi-square tests. Relationships between depressive and anxious symptoms and health-related quality of life were examined using multiple linear regression.</p><p><strong>Results: </strong>Almost 40% of patients had elevated scores for anxious or depressive symptoms. Prior anxiety or mood disorder diagnosis was associated with higher scores. Depression scores, and specifically the Ineffectiveness subscale, were inversely associated with PedsQL scores.</p><p><strong>Conclusions: </strong>Prevalence of anxious and depressive symptoms in this clinical sample was high. Screening measures for mood and anxiety overlap with physical symptoms of long COVID and use of collateral information is recommended. The relationship between the Ineffectiveness subscale and the PedsQL warrants further investigation to evaluate if they assess the same domain or if negative perception of abilities contributes to health-related quality of life.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Breaking barriers, centering community voices, and advancing equitable diabetes care for Black and Latine families-lessons from the TEAM intervention.","authors":"Vinkrya N Ellison, Kishan R Desai, Angelica R Eddington, Kristoffer S Berlin","doi":"10.1093/jpepsy/jsaf040","DOIUrl":"10.1093/jpepsy/jsaf040","url":null,"abstract":"","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"399-401"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and satisfaction of a mindfulness-based healthy eating and stress management program targeting economically marginalized families in a pilot trial.","authors":"Sisi Chen, Jiying Ling, Reese Buhlman, Sophia Tadavich, Tsui-Sui Annie Kao","doi":"10.1093/jpepsy/jsaf010","DOIUrl":"10.1093/jpepsy/jsaf010","url":null,"abstract":"<p><strong>Objectives: </strong>To inform and improve future program development, particularly with economically marginalized families, this study aimed to examine the acceptance and satisfaction of a mindfulness-based healthy eating and stress management program among participating parents and daycare teachers in a pilot trial.</p><p><strong>Methods: </strong>A mixed-methods study was conducted to evaluate a 14-week mindfulness-based program implemented with 107 English-speaking Head Start children (ages 3-5 years) and their parents. The program included a school-based mindful eating curriculum, a home-based parent component to promote mindful eating and reduce parental stress, and a bridging activity connecting home practice with school learning. Quantitative evaluation data were collected from 84 parents (Mage = 30.12 years) and 12 teachers (Mage = 43.92 years) via Qualtrics. Semistructured interviews were conducted with 20 parents (Mage = 31.55 years). Descriptive statistics and thematic analysis were used to analyze data.</p><p><strong>Results: </strong>Both quantitative (95.2%) and qualitative data demonstrated overall satisfaction with the entire program. About 83%-92% of teachers and 85% of parents considered the school-based curriculum to be satisfactory and acceptable. About 88%-100% of parents were satisfied with the Facebook private group and parent meetings. Approximately 91% of parents found the child letters helpful in connecting and translating school learning into mindful practices at home.</p><p><strong>Conclusions: </strong>Results demonstrate high levels of acceptance and satisfaction with the mindfulness-based program among economically marginalized families and daycare teachers. Findings provide several key implications for future interventions to incorporate a mindful eating curriculum into daycare routines, proactively connect home practices with school learning to enhance the interactive influence between children and parents, and form a virtual peer support community through social media platforms and group meetings.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"402-411"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, validation, and item bias assessment of the Self-Care Inventory-Short-Form among racially and income-diverse adolescents living with type 1 diabetes and their caregivers.","authors":"Vinkrya N Ellison, Kristoffer S Berlin, Kishan R Desai, Kasey R Harry, Corey T Jackson, Mary E Keenan-Pfeiffer, Jessica L Cook, Rachel L Ankney, Kimberly L Klages, Katherine A Semenkovich, Tiffany M Rybak, Gabrielle G Banks, Kathryn Sumpter, Angelica R Eddington","doi":"10.1093/jpepsy/jsaf022","DOIUrl":"10.1093/jpepsy/jsaf022","url":null,"abstract":"<p><strong>Objective: </strong>Youth with type 1 diabetes and their families engage in complex health behaviors to help manage blood glucose levels and to reduce the risk of serious health complications. Given well-documented health disparities in pediatric diabetes, rapid and equitable assessment of diabetes self-care can help identify potential areas where support is needed. This purpose of this study was to (a) develop a short-form of the Self-Care Inventory-Revised (SCI-R) and (b) evaluate validity, reliability, and differential item functioning (DIF) across several socio-illness-demographic variables of the full and short-form SCI-R.</p><p><strong>Methods: </strong>Participants were 181 adolescent-caregiver dyads from the Predicting Resiliency in Youth with Type 1 Diabetes (PRYDE) study who completed a 15-item version of the SCI-R. Adolescents (age: M = 14.64, SD =1.70, range 12-18 years), identifying as female (n = 92), male (n = 92), Black/AA (57%), and/or White (43%), also completed diabetes-specific measures of stress and Health-related Quality of Life (T1D-HRQoL). Youths' most recent hemoglobin A1c (HbA1c) values were extracted from their medical records.</p><p><strong>Results: </strong>Initial items selected based on the six highest factor loadings of 15 were evaluated using DIF analyses. The final 6-item youth and caregiver SCI-SF6 totals correlated with HbA1c, stress, and T1D-HRQoL. They were invariant across participant dyads at the scalar level (root mean squared error of approximation =.077, 90% CI: .056-.098; comparative fit index =.971, standardized root mean square residual = .0490). DIF analyses failed to reject the null hypothesis for item bias factor loadings or item thresholds across age, family income, HbA1c, racial category, gender, and illness duration.</p><p><strong>Conclusions: </strong>The results support initial evidence of equitable assessment, measurement invariance, validity, and reliability for SCI-SF6 across important socio-illness-demographic variables.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"420-432"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minority stress, mental health, and substance use in transgender youth: the moderating role of positive affect.","authors":"Benjamin Parchem, Johnny Berona, Claire A Coyne, Judith T Moskowitz, Yee-Ming Chan, Diane Ehrensaft, Robert Garofalo, Marco A Hidalgo, Johanna Olson-Kennedy, Stephen M Rosenthal, Amy C Tishelman, Diane Chen","doi":"10.1093/jpepsy/jsaf018","DOIUrl":"10.1093/jpepsy/jsaf018","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationships between gender minority stressors and mental health outcomes among transgender and gender diverse (TGD) youth and explore the moderating role of positive affect.</p><p><strong>Method: </strong>Baseline data of 315 TGD youth (ages 12-20 years old) from the Trans Youth Care-United States study comprised the analytic sample. Youth completed three subscales of the Gender Minority Stress and Resilience Measure for Adolescents (GMSR-A; nondisclosure of gender identity/gender history, negative future expectations, and internalized transphobia), Beck Depression Inventory-II (BDI-II), Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2), Alcohol, Smoking and Substance Involvement Screen Test (ASSIST), and the NIH Toolbox Positive Affect survey. Regression analyses using the Hayes PROCESS macro assessed moderation effects.</p><p><strong>Results: </strong>Gender minority stressors were associated with more symptoms of depression (r = 0.29 to 0.42) and anxiety (r = 0.32 to 0.42) and were not significantly associated with substance use (r = -0.01 to 0.10). Positive affect was negatively associated with gender minority stressors (r = -0.19 to -0.24) and mental health/substance use outcomes (r = -0.16 to -0.63). Positive affect significantly buffered the association between nondisclosure of gender identity and depressive symptoms (ΔR2 = 0.02) and protected against the impact of internalized transphobia on anxiety symptoms (ΔR2 = 0.01).</p><p><strong>Conclusions: </strong>Positive affect is a promising modifiable protective factor that buffers the negative impact of gender minority stress on the mental well-being of TGD youth. Adapting existing positive emotion interventions for TGD youth is an indicated future direction for research and clinical practice.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"412-419"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: The Journal of Pediatric Psychology remains committed to advancing pediatric psychology science.","authors":"Avani C Modi, Kurt A Freeman, Cecelia Valrie, Marisa E Hilliard, Eleanor R Mackey, Katie A Devine, Susan Wood","doi":"10.1093/jpepsy/jsaf037","DOIUrl":"10.1093/jpepsy/jsaf037","url":null,"abstract":"","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"387"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating representativeness: recruitment for a virtual family-based intervention focused on the transition from pediatric to adult diabetes care†.","authors":"Madeleine C Suhs, Alexander O'Donnell, Julia Ellis, Jill Weissberg-Benchell, Michael A Harris, Jaclyn L Papadakis","doi":"10.1093/jpepsy/jsaf023","DOIUrl":"10.1093/jpepsy/jsaf023","url":null,"abstract":"<p><strong>Objective: </strong>Recruiting representative samples of youth for behavioral health interventions is challenging yet necessary to translate research into practice and eliminate health disparities. Transition-aged youth with type 1 diabetes (T1D) represent a vulnerable population; not enough attention is given to their inclusion in behavioral health interventions. Behavioral Family Systems Therapy for Diabetes Transition (BFST-DT) is an intervention aimed at improving transition readiness and is currently being pilot tested. The objectives of this study are to (1) evaluate the representativeness of the enrolled sample based on demographic and medical characteristics and (2) evaluate recruitment communication preferences.</p><p><strong>Methods: </strong>Thirty adolescents (Mage = 16.57 years) with T1D and their caregiver(s) were recruited from a large urban hospital. Demographic and medical variables were collected via electronic medical record. Research staff recorded recruitment details about communication attempts and methods and reasons for participation decline.</p><p><strong>Results: </strong>Those who enrolled in the intervention had more insulin pump usage than the recruitment population. Those who enrolled communicated primarily over email, while those who declined preferred phone. The length of time before a participation decision was communicated was similar between the enrolled and declined groups at about 6 weeks. The main reason for declining to participate was lack of interest.</p><p><strong>Conclusions: </strong>Recruitment strategies were mostly effective in recruiting a representative sample of adolescents with T1D. Findings have implications for recruiting populations that are challenging to engage in intervention research. Future research should prioritize the stratification of historically underrepresented groups during recruitment.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"433-441"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of the TEAM pilot trial with African American and Latino families.","authors":"Ashley M Butler, Marisa E Hilliard, Krystal Christopher, Marissa Baudino, Charles Minard, Lefkothea Karaviti","doi":"10.1093/jpepsy/jsaf001","DOIUrl":"10.1093/jpepsy/jsaf001","url":null,"abstract":"<p><strong>Objective: </strong>We adapted the empirically supported Family Teamwork intervention protocol to support collaborative parent involvement in type 1 diabetes (T1D) management among African American and Latino parents of children with T1D. This randomized pilot study aimed to evaluate feasibility and acceptability of the Type 1 Diabetes Empowerment and Management (TEAM) intervention.</p><p><strong>Methods: </strong>African American and Latino parents (n = 59; 65% recruitment rate) of youth (ages 5-10 years, M = 8.9 ± 1.6 years; 59% female, M hemoglobin A1c 9.0% ± 1.9%) with diabetes duration of ≥1 year and who were fluent in English and not planning to leave the geographic area were recruited and randomized 3:1 to the TEAM intervention (n = 44) or usual diabetes care alone (n = 15). The intervention consisted of six group-based sessions co-led by a study interventionist and a trained parent leader, plus five phone calls with the parent leader. Secondary outcomes included psychosocial questionnaires and HbA1c at baseline and 12 months post-baseline.</p><p><strong>Results: </strong>Participants attended a mean of 2.1 ± 2.0 (33%) TEAM intervention sessions. Acceptability ratings (5-point scale) among parents who completed ≥1 session (n = 28) were high: helpfulness (4.5 ± 0.75), encouraged new perspectives (4.5 ± 0.58), enjoyment (4.4 ± 0.70), learned new information/skills (4.3 ± 0.70), prompted change to diabetes management (4.6 ± 0.69), and positive impact on family (4.5 ± 0.69). Qualitative interviews (n = 35) indicated positive perspectives about emotional and informational support and suggestions for adding child intervention components. Pre-post data completion rates were 92% for questionnaires.</p><p><strong>Conclusions: </strong>Despite feasibility challenges, the TEAM intervention was acceptable among parents who attended sessions. Reducing barriers to session attendance may be warranted to impact psychosocial and clinical outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04053504.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"388-398"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay between pain and disease activity: personal models of pain beliefs and emotional representations in children and young people with juvenile idiopathic arthritis in a UK nationwide prospective inception cohort.","authors":"Danielle C Mountain, Stephanie Shoop-Worrall, Lis Cordingley, Sarah Peters, Janet E McDonagh, Coziana Ciurtin, Gavin Cleary, Rebecca R Lee, Kimme Hyrich, Daniela Ghio","doi":"10.1093/jpepsy/jsaf024","DOIUrl":"https://doi.org/10.1093/jpepsy/jsaf024","url":null,"abstract":"<p><strong>Objectives: </strong>Juvenile idiopathic arthritis (JIA) is a group of childhood-onset inflammatory rheumatic conditions characterized by pain as one of the most common and distressing symptoms. This cross-sectional study aimed to investigate whether relationships between reported pain and disease activity in JIA affected beliefs about pain, known as \"personal models.\"</p><p><strong>Methods: </strong>187 out of a possible 363 participants with JIA who completed questionnaires about function and pain perception were recruited through the Childhood Arthritis Prospective Study (CAPS). A pre-selected pain score threshold and validated disease activity score cut-offs were used to assign the participants into four groups: low pain/low disease, low pain/high disease, high pain/low disease, and high pain/high disease. Multivariable linear regressions examined associations between the groups and their \"personal models.\"</p><p><strong>Results: </strong>Compared to participants with low pain/low disease, those with high pain/high disease and those with high pain/low disease were more likely to sense greater threat, have more negative emotional representations, and perceive less control over their pain. Participants with low pain/high disease had similar pain beliefs compared to those with low pain/low disease.</p><p><strong>Conclusion: </strong>This is the first study to compare \"personal models\" of pain in JIA. Children and young people who experience high pain severity regardless of disease activity perceived high pain threat, low controllability, and negative emotional representations. This highlights the importance of considering and addressing personal models of pain at diagnosis, especially those who present high levels of pain.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}