Jbi Evidence Implementation最新文献

{"title":"Introducing multidisciplinary ward rounds in Malawi: a best practice implementation project.","authors":"Beverley Johnson, Clare Bennett, Judith Carrier, Dianne Watkins, Chimwemwe Mula, Raphael Kazidule, Pricilla Salley, Miloslav Klugar, Jitka Klugarová","doi":"10.1097/XEB.0000000000000443","DOIUrl":"10.1097/XEB.0000000000000443","url":null,"abstract":"<p><strong>Introduction: </strong>The Royal College of Physicians (RCP) and the Royal College of Nursing (RCN) in the United Kingdom advocate the use of structured multidisciplinary team (MDT) ward rounds since they can enable safe, effective, improved care and enhanced staff satisfaction.</p><p><strong>Objectives: </strong>This project sought to implement best practices for MDT ward rounds in a male medical ward in a hospital in Malawi.</p><p><strong>Methods: </strong>The project was conducted in line with the JBI Evidence Implementation Framework. A baseline audit of MDT ward rounds was conducted with six staff members. Audit criteria consisted of ten best practices, as recommended by JBI, the RCP, and the RCN. Stakeholder meetings were held to review the baseline audit results and highlight areas of non-compliance. JBI's Getting Research into Practice (GRiP) tool was used to identify barriers to compliance with best practices, and a follow-up audit was conducted to determine changes in practice.</p><p><strong>Results: </strong>The results only showed improvement for one criterion, which rose from 33% to 100% (n=6) where nurses attended the ward round.</p><p><strong>Conclusions: </strong>This study demonstrated some challenges in evidence implementation projects and how these can, in part, be overcome. While the results only demonstrated improvement for one criterion, this paper shows how audits can be used to promote best practice, which in this case resulted in nurses being more involved in ward rounds, improvements in MDT communication, enhanced nurse inclusion in decision-making and, consequently, patient care.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A233.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"S35-S43"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project.","authors":"Mariana Davies Ribeiro Bersaneti, Renata Desordi Lobo, Thais Bianca Brandão, Regina Claudia Silva Souza, Vanessa de Brito Poveda","doi":"10.1097/XEB.0000000000000413","DOIUrl":"10.1097/XEB.0000000000000413","url":null,"abstract":"<p><strong>Objectives: </strong>This project aimed to promote evidence-based practices relat. ed to the oral health of critically ill patients in an intensive care unit in Brazil.</p><p><strong>Introduction: </strong>The oral hygiene of patients on mechanical ventilation is an essential component of nursing care quality, and well-defined guidelines ensure appropriate care. Mechanical ventilation is associated with the risk of ventilator-associated pneumonia, which can increase mortality, length of stay, time on mechanical ventilation, and hospital costs.</p><p><strong>Methods: </strong>This project was guided by the JBI Evidence Implementation Framework, which consists of seven stages: (1) identification of the area of practice to be changed, (2) involvement of change agents, (3) context assessment and readiness for change, (4) review of practices against evidence-based audit criteria, (5) implementation of practice changes, (6) reassessment of practices using a follow-up audit, and (7) consideration of the sustainability of changes in practice.</p><p><strong>Results: </strong>Four audit criteria were developed to evaluate compliance with best practices. In the follow-up audit, Criteria 1, 2, and 3 obtained compliance of ≥ 80%. Thus, for Criterion 1, all the patients on mechanical ventilation for more than 24 hours were evaluated by the oral medicine team, resulting in 100% compliance. For Criterion 2 on appropriate oral hygiene measures, a compliance rate of 80% was achieved. For Criterion 3, 39 professionals (90.7%) participated in educational activities related to the oral health protocol for critically ill patients, obtaining 90.7% compliance. For Criterion 4 regarding patients being evaluated before receiving any oral health care, improvement was low (only 50%), revealing the need for further improvement.</p><p><strong>Conclusion: </strong>This best practice project improved the professional practice of nursing staff and increased compliance with best practices for the oral health of critically ill patients.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A175.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"4-13"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic investigations in adults with suspected stroke-improvement of door-to-imaging time: a best practice implementation project.","authors":"Petra Šedová, Radim Líčeník, Tahir Ismail, Hasan Muhammad Khaled, Miloslav Klugar, Abanoub Riad, Jitka Klugarová","doi":"10.1097/XEB.0000000000000497","DOIUrl":"10.1097/XEB.0000000000000497","url":null,"abstract":"<p><strong>Objectives: </strong>This evidence implementation project aimed to assess and improve compliance with evidence-based neuroimaging criteria for adult patients with suspected stroke.</p><p><strong>Introduction: </strong>Stroke is the second leading cause of mortality and severe disability, requiring timely and accurate diagnosis. Clinical guidelines recommend brain imaging within 60 minutes of hospital arrival for suspected stroke patients. This project involved hospitals in North West Anglia NHS Foundation Trust, UK, serving 850,000 people with over 800 admissions annually.</p><p><strong>Methods: </strong>The JBI Evidence Implementation Framework was used to guide this project. JBI software, the Practical Application of Clinical Evidence System (PACES), as well as JBI's Getting Research into Practice (GRiP) approach, were used to conduct the audit and implementation phases. The project followed three stages: (1) implementation planning, (2) baseline assessment and implementation, and (3) impact evaluation. Three audit criteria were used to represent best practices for diagnosing suspected stroke patients.</p><p><strong>Results: </strong>The baseline audit revealed low compliance with the first criterion, with only 2.9% (1/35) of patients receiving a CT head scan within 1 hour of admission. In the follow-up audit, compliance improved to 45.2% (14/31). The other two criteria, diagnosis by a trained health care professional and baseline ECG assessment, had already achieved 100% compliance in the baseline audit.</p><p><strong>Conclusions: </strong>Compliance with evidence-based neuroimaging criteria improved after implementing targeted educational strategies and training. The rate of CT scans conducted within 1 hour increased, although door-to-imaging times remain suboptimal compared with achievable benchmarks of ≤ 20 minutes. Ongoing education and training are crucial for sustaining high compliance and improving stroke patient outcomes.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A324.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"S27-S34"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and sustainability of best practice guidelines: a tale of three hospitals.","authors":"Peiwei Qin, Haixia Wang, Zhenhui Tao, Wenxin Zhang, Juan Wang, Peifen Ma","doi":"10.1097/XEB.0000000000000486","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000486","url":null,"abstract":"<p><strong>Objective: </strong>This study explores factors that affect the sustainable implementation of best practice guidelines (BPGs) and provides a basis for developing corresponding action strategies to promote project sustainability.</p><p><strong>Methods: </strong>Using the NHS (National Health Service) questionnaire scoring system, surveys were conducted among nurses who implemented BPGs in three hospitals in China. Data were analyzed using statistical analysis. We adhered to the STROBE guidelines for cross-sectional studies.</p><p><strong>Results: </strong>The average total score was 85.18/100, while the average scores of the process dimension, staff dimension, and organization dimension were 25.85, 45.88, and 13.45, respectively. The average score of the three dimensions was 83.12%, 87.56%, and 81.52%, respectively. This means that the three dimensions of the NHS SM had high scores and the implemented BPGs had a high likelihood of being sustained. The sustainable implementation of guidelines involves three factors: project characteristics, staff dimensions, and organizational environment.</p><p><strong>Conclusion: </strong>Important factors that influence project sustainability include the clinical value of the project, a supportive environment provided by human resources and project infrastructure, and the degree of cooperation between interprofessional teams.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A305.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain assessment and management in patients with dementia in Taiwan: a best practice implementation project.","authors":"Shwu-Feng Tsay, Cheng-Yu Chang, Jui-Yuan Su, Sing Shueh Hung, Pei-Fan Mu","doi":"10.1097/XEB.0000000000000481","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000481","url":null,"abstract":"<p><strong>Introduction: </strong>The lack of a consistent and effective assessment tool for older adults with dementia in home care in Taiwan, and the inability of home care nurses to provide pharmacological and non-pharmacological pain management, may affect the quality of life of patients with dementia.</p><p><strong>Objectives: </strong>The aim of this project was to promote evidence-based practices for pain assessment and management of patients with dementia living in the community.</p><p><strong>Methods: </strong>The project followed the JBI Evidence-based Healthcare Model and the seven-phase JBI Evidence Implementation Framework. Eight audit criteria were used, representing best practice recommendations. Through a Getting Research into Practice (GRiP) analysis, we identified three barriers to changing practice and implemented improvement strategies. A follow-up audit was conducted to measure changes in compliance.</p><p><strong>Results: </strong>This project was conducted in five home care institutions. Fourteen home care nurses and 109 patients with dementia participated in the project. The follow-up audit showed that compliance rates had improved significantly. Specifically, the compliance rate increased from 14.29%, 1.83%, 1.83% to 100% for Criteria 1-3, respectively. For Criteria 4-8, compliance increased from 0% to 100%. In addition, the average score of the home care nurses' perceptions of pain care for patients with dementia increased from 44.29 points before the intervention to 82.86 points, and all 14 home care nurses achieved a score of 100 points in the Objective Structured Clinical Examination scenario-based exercises, which was a good learning outcome.</p><p><strong>Conclusions: </strong>Leadership, knowledge-sharing, learning-by-doing teaching strategies, and open communication were key factors in the successful implementation of this study.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A294.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition as therapy - the role of dietitian counseling: a best practice implementation project.","authors":"Paulina Weglarz, Agata Skop-Lewandowska, Robert Prill, Tina Poklepović Peričić, Tereza Vrbová, Jitka Klugarová, Wiktoria Leśniak, Małgorzata M Bala","doi":"10.1097/XEB.0000000000000479","DOIUrl":"https://doi.org/10.1097/XEB.0000000000000479","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this best practice implementation project was to improve dieticians' professional practice and dietary care through the use of counseling strategies.</p><p><strong>Introduction: </strong>Improving the design and implementation of evidence-based practice depends on successful behavior change interventions. This requires an appropriate method for designing the interventions and then analyzing the targeted behavior. Behavior change techniques (BCTs) have been demonstrated to improve the patient-dietitian relationship and patient treatment outcomes.</p><p><strong>Methods: </strong>This evidence-based quality improvement project used the JBI Evidence Implementation Framework to identify gaps in clinical practice and barriers to changing practice. We recruited 20 dietitians and conducted a baseline audit to determine their level of knowledge of BCTs, the extent to which they applied BCTs in their practice, and barriers to using BCTs. To address the identified barriers, a 5-hour training session was conducted by a dietitian with psychological training. A follow-up audit was then conducted to measure improvements in compliance with best practice.</p><p><strong>Results: </strong>The baseline audit revealed that 80% of participants used some of the targeted counseling strategies. The most common barriers were lack of guidance on the use of BCTs or insufficient knowledge of BCTs. The follow-up audit revealed that 93% of participants used some counseling strategies, representing a 13% improvement from baseline.</p><p><strong>Conclusions: </strong>Applying BCTs is a challenge in dietary practice. The results indicate that education about these techniques is needed. As the next step, we suggest disseminating the relevant recommendations among dietitians in Poland and providing education about the use of these methods.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A289.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-disciplinary advance care planning in oncology and palliative care amidst a pandemic: a best practice implementation project.","authors":"Felix Muehlensiepen, Henrikje Stanze, Susann May, Kerstin Stahlhut, Carolin Helm, Hassan Tarek Hakam, Małgorzata M Bała, Tina Poklepović Peričić, Tereza Vrbová, Jitka Klugarova, Robert Prill","doi":"10.1097/XEB.0000000000000445","DOIUrl":"10.1097/XEB.0000000000000445","url":null,"abstract":"<p><strong>Introduction: </strong>Advance care planning (ACP) ensures that patients receive medical care aligned with their values, goals, and preferences, especially regarding end-of-life decisions in serious chronic illnesses.</p><p><strong>Objective: </strong>This project aimed to introduce and promote evidence-based ACP in oncology and palliative care at a midsized hospital near Berlin, Germany, during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This project was guided by the JBI Evidence Implementation Framework and used a mixed methods audit cycle. A baseline audit was conducted using qualitative interviews and workshops with representatives from all the health care disciplines involved in oncology and palliative care at the hospital. The findings were compared with eight best practice recommendations. Targeted strategies aimed at the key stakeholders involved in ACP practice were then implemented. Finally, a semi-quantitative questionnaire was used in a follow-up audit with the same participants as in the baseline audit.</p><p><strong>Results: </strong>The baseline audit revealed a high level of familiarity with the concept of ACP. However, there was a lack of a uniformly accepted definition and understanding of ACP among the health care professionals, leading to a lack of coordination in task distribution. The follow-up audit revealed improvements with regard to education and training in ACP (Criterion 1: 50% to 100%) and organizational support to facilitate ACP conversations (Criterion 3: 87.5% to 100%). Other audit criteria compliance rates remained unchanged.</p><p><strong>Conclusion: </strong>Clinical education and team-based process analysis can facilitate ACP implementation across disciplines in oncology and palliative care facilities. However, the project did not succeed in implementing lasting changes in clinical processes and best practice ACP due to the COVID-19 pandemic. Such an endeavor would demand considerable resources and time, both of which were constrained during the pandemic.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A236.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"345-355"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FAME in implementation: adopting evidence into practice.","authors":"Yan Hu, Lei Xu","doi":"10.1097/XEB.0000000000000472","DOIUrl":"10.1097/XEB.0000000000000472","url":null,"abstract":"","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":"22 4","pages":"335-337"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two audit and feedback approaches: descriptive analysis of personal and contextual dynamics.","authors":"Maria Pagano, Irene Cappadona, Francesco Corallo, Davide Cardile, Augusto Ielo, Giangaetano D'Aleo, Maria Cristina De Cola, Placido Bramanti, Rosella Ciurleo","doi":"10.1097/XEB.0000000000000428","DOIUrl":"10.1097/XEB.0000000000000428","url":null,"abstract":"<p><strong>Introduction: </strong>Audit and feedback (A&F) is a systematic intervention that can be used to improve the quality of health care. The EASY-NET Network Project proposes an innovative A&F model.</p><p><strong>Aim: </strong>This study aimed to describe the newly proposed A&F model. An analysis was conducted, examining the participants' attitudes and their individual and interpersonal mechanisms to understand how they influence the work context and vice versa.</p><p><strong>Methods: </strong>Two A&F models were compared, involving emergency and rehabilitation health workers, who were divided into two groups. The classic A&F model was compared with a new model, using a desk audit followed by interactive feedback. Communication training was provided to the audit team by psychologists before commencement of the project. The experimental group underwent psychological screening using two standardized tools (COPE-NVI and ProQoL) to evaluate personal and relational dynamics using the context-mechanism-outcome (CMO) paradigm.</p><p><strong>Results: </strong>The exchange of ideas among health professionals is more effective when using face-to-face feedback than written feedback. The COPE-NVI and ProQoL questionnaires highlighted the difficulties experienced by health care professionals in implementing effective coping strategies to deal with stressful events.</p><p><strong>Conclusions: </strong>Identifying signs of stress in health care workers is essential for improvement strategies to be implemented and for establishing new, optimal conditions. Remote feedback makes it possible to overcome logistical barriers and, in the future, this method can be used for inter-organizational collaboration.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A203.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"384-395"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborative implementation science: a Can-SOLVE CKD case example.","authors":"Selina Allu, Mary Beaucage, Maoliosa Donald, Manuel Escoto, Joanne Kappel, Louise Morrin, Steven D Soroka","doi":"10.1097/XEB.0000000000000435","DOIUrl":"10.1097/XEB.0000000000000435","url":null,"abstract":"<p><strong>Abstract: </strong>Research is critical for uncovering new and effective therapies for better health outcomes, yet there remains a significant lag between identifying evidence-based interventions and implementing them into practice. Research teams can often be experienced in evidence generation, but less so in evidence implementation, underscoring the need for more customized tools to support them in this latter step. The implementation stage can be especially challenging given how strategies must be tailored to the unique end users and contexts of a given intervention. Therefore, our patient-oriented kidney research network sought to create an \"Implementation Toolkit\" and \"Pathway to Implementation\" guide to help research teams and their operational and clinical partners in implementing their interventions. Importantly, the tools were created using input and feedback from diverse groups, including patient partners, implementation science experts, researchers, operational leaders, and policymakers, all of whom play role in supporting the implementation of health interventions. Our tools are widely applicable to diverse teams, regardless of the intervention or innovation being implemented.</p><p><strong>Spanish abstract: </strong>http://links.lww.com/IJEBH/A214.</p>","PeriodicalId":48473,"journal":{"name":"Jbi Evidence Implementation","volume":" ","pages":"418-421"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}