Global Mental Health最新文献

{"title":"Alcohol consumption among university students in ASEAN countries: A systematic review and meta-analysis.","authors":"Mayank Kejriwal","doi":"10.1017/gmh.2025.10027","DOIUrl":"10.1017/gmh.2025.10027","url":null,"abstract":"<p><p>Alcohol consumption among university students poses significant public health challenges, especially in the Association of Southeast Asian Nations (ASEAN) region, where limited research exists. This review aims to synthesize evidence on sociodemographic factors associated with alcohol consumption among university students in ASEAN countries, assess the study quality and identify research gaps. A systematic search across nine databases was conducted in May 2024, using <i>Population, Intervention, Comparator, Outcome, Study Design and Timeframe</i> to define the inclusion criteria. Studies were assessed for quality and risk of bias using the AXIS tool. Data on sociodemographic factors were extracted, and random-effects meta-analyses were performed for frequently reported factors. Heterogeneity was measured using Cochran's Q-test and I-squared statistic, and small-study bias was tested using funnel plots and Egger's test. Fifteen cross-sectional studies involving 35,527 participants met the inclusion criteria. Gender, age and parental alcohol consumption were the most commonly studied factors. Male students had three times the odds of consuming alcohol compared to female students, a result robust to sensitivity analysis. Parental alcohol use and older age were also significantly and positively associated with alcohol consumption, with minimal heterogeneity. Most studies were of high quality, although variability in study design and geographic representation limited the generalizability of the findings. Sociodemographic factors such as gender, age and parental alcohol consumption influence alcohol use among ASEAN college students. However, cross-sectional design and limited country representation highlight the need for further robust research to inform policy and interventions.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e69"},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of group interpersonal therapy to treat depression in people living with HIV: A first evaluation of IPT dissemination in Senegal.","authors":"Hawa Abou Lam, Hélène Font, Véronique Petit, Salaheddine Ziadeh, Judicaël Malick Tine, Ibrahima Ndiaye, Ndeye Fatou Ngom, Babacar Ndiaye, Daniel Sarr, Dominique Diouf, Nathalie de Rekeneire, Antoine Jaquet, Moussa Seydi, Charlotte Bernard","doi":"10.1017/gmh.2025.10029","DOIUrl":"10.1017/gmh.2025.10029","url":null,"abstract":"<p><p>Group interpersonal therapy (IPT) was introduced to Senegal to treat depression in people living with HIV (PLWH), using a task-shifting approach. Following successful implementation at a tertiary-level hospital in Dakar, we evaluate IPT's acceptability, feasibility and benefits in primary and secondary-level suburban health facilities. We assess the impact of IPT adaptations and organizational changes and identify sustainability requirements. PLWH with depression received group IPT following the World Health Organization protocol. Acceptability, feasibility and implementation aspects were assessed quantitatively and qualitatively following specific conceptual frameworks. Depressive symptoms severity (PHQ-9) and functioning (WHODAS) were measured pre-, post-treatment and at 3-month follow-up. General linear mixed models were used to describe changes in outcomes over time. Qualitative data were analyzed thematically. Of 84 participants (median age: 45, female>50%), 81 completed group IPT. Enrolment refusal and dropout rates were 7% and 4%. Ninety-seven percent attended at least seven sessions out of eight. Depressive symptoms and functioning significantly improved by therapy's end (<i>β</i> = 12,2, CI 95% [11.6, 12.8] and <i>β</i> = 8.5, CI 95% [7.3, 9.7], respectively) with gains being sustained 3 months later (<i>p</i> = 0.94 and 0.99, respectively). Adaptations and organizational changes proved successful, but depression screening and diagnosis communication to patients remained challenging. Emerging needs included a tailored patient care pathway and confidentiality. Participants advocated for depression care integration into HIV services. Group IPT's successful implementation in various ecological and organizational contexts in Senegal indicates high acceptability and feasibility. Sustainability may be enhanced by addressing specific needs at multiple levels (individual, organizational, systemic). A comprehensive reflection on strategies to sustain and scale up group IPT is the next logical step.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e76"},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Child Depression Screening Tool in three African settings: Rwanda, Senegal and South Africa.","authors":"Sharain Suliman, Jenny Bloom, Naeem Dalal, Eric Remera, Raissa Muvunyi, Mohammed Abdulaziz, Adelard Kakunze, Ismahan Soukeyna Diop, Djena Fafa Cisse, Ndeye Awa Dieye, Britt McKinnon, Mohamadou Sall, Agnes Binagwaho, Soraya Seedat","doi":"10.1017/gmh.2025.10022","DOIUrl":"10.1017/gmh.2025.10022","url":null,"abstract":"<p><p>The unavailability of reliable, easy-to-use depression screening tools adapted for Sub-Saharan African children is a significant barrier to the treatment of childhood depression. We thus adapted the Child Depression Screening Tool (CDST) to the South African (SA), Senegalese (S) and Rwandan (R) contexts, as a tool to screen for depression in children suffering from chronic illnesses, trauma and difficulties related to COVID-19, family and community hardships. A DSM-5-based diagnostic interview and the CDST screening measure were administered to 1,001 participants aged between 7 and 16 years. The prevalence of depression ranged between 9.5 and 16.8%. It was more prevalent in youth with chronic illness and those exposed to adverse life events. Older age (R and SA), female sex (S), dislike of school (R and SA) and cannabis use (SA) were also associated with worse depression. Receiver operating characteristic analysis showed satisfactory performance (79-89%) and that sensitivity and specificity were optimized at a CDST cut-point of 5.0. The CDST is a valid tool to screen for depression in the settings assessed. If found to be suitable in other countries and settings, it may offer a clinically sound, sustainable path towards the identification of child depression in Africa.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e68"},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting competency assessments for an evidence-based brief psychological intervention with Arabic-speaking non-specialists in Switzerland.","authors":"Mahmoud Hemmo, Aemal Akhtar, Brandon A Kohrt, Gloria Pedersen, Abdul Fattah Alkamel, Chantal Martin Sölch, Alison Schafer, Julia Spaaij, Richard Bryant, Naser Morina","doi":"10.1017/gmh.2025.10023","DOIUrl":"10.1017/gmh.2025.10023","url":null,"abstract":"<p><p>The global challenge of closing the treatment gap highlights the need for innovative interventions. Problem Management Plus (PM+), developed by the World Health Organization (WHO), is an evidence-based brief psychological intervention designed to address this gap by involving non-specialist helpers. In this study, 'non-specialists' or 'helpers' are individuals without formal training in mental health, who have been trained in and have been delivering individual PM+ for more than 1.5 years. To enhance quality in mental health care, especially with non-specialists, WHO and the United Nations International Children's Emergency Fund (UNICEF) have launched the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform, an open-access resource for competency-based training. This study evaluates the acceptability and preliminary utility of EQUIP assessment tools. Thirteen helpers were assessed using the ENhancing Assessment of Common Therapeutic Factors (ENACT) and the PM+ assessment tool, culturally adapted and translated for Arabic-speaking helpers in Switzerland. The results indicate that the EQUIP tools can identify strengths and areas for improvement, provide valuable feedback for training, and thus have great potential for enhancing mental health care quality.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e72"},"PeriodicalIF":2.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare providers' experiences of community-based collaborative care for serious mental illness: a qualitative study in two integrated clinics in South Africa.","authors":"Saira Abdulla, Lesley Robertson, Sherianne Kramer, Jane Goudge","doi":"10.1017/gmh.2025.10020","DOIUrl":"10.1017/gmh.2025.10020","url":null,"abstract":"<p><p>Community-based collaborative care (CBCC) is an internationally recognised model of integrated care that emphasises multidisciplinary teamwork and care coordination. In South Africa, community psychiatry has been integrated into some primary healthcare (PHC) facilities. This study examines healthcare providers' perceptions of collaboration and its challenges in various integrated care settings. Three main components of CBCC (multidisciplinary teams, communication and case management) were explored through qualitative interviews with 29 staff members in 2 clinics. In Clinic-1, community psychiatry services operate independently in an outbuilding behind the main PHC clinic (\"co-located\"). In Clinic-2, these services are fully integrated within the PHC clinic (\"physically integrated\"). Both clinics had multidisciplinary teams, with various staff members conducting case management functions on an <i>ad hoc</i> basis. The physically integrated clinic (due to shared files, physical proximity and a facility manager with mental health experience) had greater levels of communication between the multidisciplinary team. In contrast, the co-located clinic struggled with poor management, unclear reporting structures and reinforced traditional hierarchies, limiting collaboration between the staff members. Integration does not guarantee collaboration. Improving collaboration between mental health and PHC staff requires clear roles, competent managers, CBCC endorsement from PHC clinicians, sufficient human resources and systematic communication channels, such as case review meetings.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e64"},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating implementation research outcomes for a task-sharing mental health intervention: A systematic review of the Friendship Bench.","authors":"John Patena, Deborah Adenikinju, Priyanka Lanka, Tania Hameed, Sumedha Kulkarni, Nana Osei-Tutu, Sophia Zuniga, Christina Ruan, Shivani Shenoy, Diksha Thakkar, Elizabeth Noble, Brian Angulo, Dorice Vieira, Joyce Gyamfi, Emmanuel Peprah","doi":"10.1017/gmh.2025.10025","DOIUrl":"10.1017/gmh.2025.10025","url":null,"abstract":"<p><p>Common mental disorders (CMDs) are a leading cause of burden and disability globally. Approximately 75% of those living with CMDs reside in low- and middle-income countries (LMICs), and up to 90% of those needing mental health care do not receive it. The Friendship Bench is a task-sharing mental health intervention delivered by lay health workers (LHWs) that utilizes concepts of Problem-Solving Therapy. The aim of this systematic review is to identify and evaluate the barriers and facilitators to the implementation of research outcomes of the Friendship Bench and understand its systematic uptake to narrow the CMD treatment gap. We conducted a systematic review of articles that reported on the Friendship Bench in LMICs, CMDs, implementation research outcomes, and studies that utilized experimental, observational, or qualitative study designs. We identified articles using medical subject headings and keywords from APA PsycINFO, Cochrane, CINAHL, EMBASE, Global Health, OVID, PubMed/Medline, Science Direct, Web of Science, and Google Scholar in February 2023 and again in December 2023 to capture any additional articles. We screened 641 articles, and a total of 7 articles were included in the final analysis. All studies were conducted in Zimbabwe within the past 8 years, and across all the studies, all implementation research outcomes were reported. There is strong evidence that the Friendship Bench is acceptable, appropriate, and feasible to address the CMD treatment gap in Zimbabwe. Facilitators include that the Friendship Bench is culturally adaptable, utilizes trusted LHWs, and has relatively strong community and political buy-in. Conversely, barriers include a lack of a reliable mental health system, limitations in its ability to treat more serious mental conditions, and mental health stigma. There is an opportunity to explore the application of the Friendship Bench for CMDs in other countries and as a basis for novel task-sharing interventions for other health conditions.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e65"},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress.","authors":"Beatrice Compri, Giulia Turrini, Marianna Purgato, Richard Bryant, Paula Cristobal, Josep Maria Haro, Raffael Kalisch, Vincent Lorant, David McDaid, Kerry R McGreevy, Roberto Mediavilla, Michela Nosè, A-La Park, Papoula Petri-Romão, Aurélia Roversi, Marit Sijbrandij, Andrea Tortelli, Anke Witteveen, Corrado Barbui","doi":"10.1017/gmh.2025.10024","DOIUrl":"10.1017/gmh.2025.10024","url":null,"abstract":"<p><p>Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e62"},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Rising prevalence of depression and widening sociodemographic disparities in depressive symptoms among Filipino youth: findings from two large nationwide cross-sectional surveys - CORRIGENDUM.","authors":"Joseph H Puyat, Divine L Salvador, Anna C Tuazon, Sanny D Afable","doi":"10.1017/gmh.2025.10019","DOIUrl":"10.1017/gmh.2025.10019","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1017/gmh.2025.39.].</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e55"},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A virtual intervention to support educator well-being and students' mental health in conflict-affected Ukraine: A non-randomized controlled trial.","authors":"Tara Powell, Natalia Portnytska, Iryna Tychyna, Olha Savychenko, Oksana Makarenko, Tetiana Shyriaieva, Kate Cherniavska, Jenna Muller, Rebecca Carney","doi":"10.1017/gmh.2025.10014","DOIUrl":"10.1017/gmh.2025.10014","url":null,"abstract":"<p><p>The war in Ukraine has caused widespread destruction, displacement, and distress. Educators are among those significantly affected by the conflict, facing the dual burden of educating youth directly impacted by the conflict while simultaneously dealing with their own psychological stress. This study evaluated the Psychosocial Support for Educators (PSE) program, a virtual intervention designed to improve Ukrainian educators' mental health, knowledge, and readiness to support students. A non-randomized control trial included 881 educators from three Ukrainian regions, with 572 participants in the PSE group and 309 in the control group. Surveys assessed psychosocial support knowledge, readiness, and mental health at baseline, post-intervention, and one-month follow-up. Linear mixed model analyses revealed significant improvements in the PSE group across all measures. PSE participants reported greater increases in knowledge (<i>t</i> = 2.97, <i>p</i> = .003, <i>d</i> = .38) and readiness to support students (<i>t</i> = 6.63, <i>p</i> < .001, <i>d</i> = .85), with sustained gains at follow-up. They also reported greater reductions in stress (<i>t</i> = 2.70, <i>p</i> < .01, <i>d</i> = .35), anxiety (<i>t</i> = 3.20, <i>p</i> = .001, <i>d</i> = .41), and depression (<i>t</i> = 2.00, <i>p</i> < .05, <i>d</i> = .26) compared to the control group. The findings demonstrate that PSE can effectively enhance educators' mental health and their ability to support students in conflict-affected settings, underscoring the importance of accessible, tailored mental health interventions for educators in crisis zones.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e59"},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho.","authors":"Grace H Yoon, Natalie E Johnson, Moleboheng Mokebe, Palesa Mahlatsi, Malebanye Lerotholi, Niklaus D Labhardt, Nadine Tschumi, Alastair van Heerden, Jennifer M Belus, Irene Falgas-Bague","doi":"10.1017/gmh.2025.10017","DOIUrl":"10.1017/gmh.2025.10017","url":null,"abstract":"<p><p>Behavioral treatments can help people with human immunodeficiency virus (HIV) improve their quality of life and treatment adherence. In Lesotho, where a fifth of adults live with HIV and depression and harmful alcohol use is prevalent among this group, little is known about the local suitability of established behavioral treatment strategies. We explored preferences regarding two strategies evaluated in other settings: involving phones and trusted individuals in treatment. We thematically analyzed 28 semi-structured interviews with potential service users receiving routine HIV care in the Butha-Buthe and Mokhotlong districts. Key concerns included the feasibility of phone-based treatment in rural areas and issues of limited literacy, electricity and network coverage. Others highlighted potential benefits for younger and working individuals for phone-based treatment, preferring calls over texts. Involving trusted individuals in treatment was favored, as this could foster support and accountability. Behavioral issues related to depression and alcohol use were viewed as complex, requiring face-to-face attention from trusted professionals, such as nurses and counselors, who were seen as knowledgeable and capable of maintaining confidentiality. Peer providers were not favored due to privacy concerns. These findings emphasize the need for face-to-face, confidential and health worker-led approaches for integrating behavioral treatment into HIV care in Lesotho.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e61"},"PeriodicalIF":3.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}