International Emergency Nursing最新文献

{"title":"Awareness level related to spinal cord injury among emergency healthcare providers in Jordan","authors":"Ahmad Al-Mawahreh ,&nbsp;Hekmat Al-Akash ,&nbsp;Nabeel Al-Yateem ,&nbsp;Fatma Refaat Ahmed ,&nbsp;Roqia Saleem Awad Maabreh ,&nbsp;Mahmoud Al-Hussami ,&nbsp;Khaldoun Hamdan ,&nbsp;Ahmad Rajeh Safain","doi":"10.1016/j.ienj.2025.101742","DOIUrl":"10.1016/j.ienj.2025.101742","url":null,"abstract":"<div><h3>Objective</h3><div>The study aims to evaluate the awareness of spinal cord injuries among emergency healthcare providers in Jordan, due to rising incidents from traffic accidents and other medical conditions.</div></div><div><h3>Methodology</h3><div>A 20-item structured questionnaire was used to assess the knowledge and self-reported practices of emergency healthcare providers dealing with spinal cord injuries.</div></div><div><h3>Results</h3><div>Among 144 participants, the overall mean awareness level related to Spinal Cord Injuries (SCI) was 16.19/20 ± 5.01. Among those, only 44.4 % of the participants were found to have a “good” knowledge level, while 55.6 % lacked adequate management knowledge for SCI. However, 59.7 % reported high first response rates. Many providers were unfamiliar with immediate spinal stabilization and proper handling methods. Self-reported practice correlated with knowledge acquisition.</div></div><div><h3>Conclusion and Recommendations</h3><div>There is a need for educational and training programs to improve competencies in managing spinal cord injuries, which can enhance patient outcomes and reduce socio-economic burdens. Addressing educational gaps can lead to more effective emergency response strategies in Jordan.</div></div><div><h3>Prevalence to clinical practice</h3><div>The study enhances understanding of spinal cord injuries and suggests improving emergency healthcare services in Jordan through regular training, simulation-based learning, and continuous professional development. Future research should evaluate the effectiveness of these interventions.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101742"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999337","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":"When the adrenaline wears off: A suryomentaram-informed self-efficacy perspective for supporting emergency nurses after resuscitation care","authors":"Elia Firda Mufidah ,&nbsp;Novita Toding ,&nbsp;Lutfi Isni Badiah ,&nbsp;Rizky Andana Pohan","doi":"10.1016/j.ienj.2026.101780","DOIUrl":"10.1016/j.ienj.2026.101780","url":null,"abstract":"","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101780"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327893","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":"Secondary traumatic stress in emergency room nurses: A cross-sectional study","authors":"Mary Frazier","doi":"10.1016/j.ienj.2026.101767","DOIUrl":"10.1016/j.ienj.2026.101767","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency room nurses care for patients during the worst times in their lives: motor vehicle accidents, violence, rape, trauma, death, etc. Continuous exposure puts nurses at risk for secondary traumatic stress (STS): the negative emotional, psychological, and/or physical reaction experienced by someone who had an indirect exposure to trauma. This can impair a nurse’s ability to cope, increase levels of anxiety/depression, and intention to leave the profession.</div></div><div><h3>Methods</h3><div>Using a cross-sectional design, 169 nurses completed a survey between February – June 2023. Data were collected using a demographic form, Secondary Traumatic Stress Scale, Brief-COPE Inventory, and a Visual Analog Scale for Perceived Stress.</div></div><div><h3>Results</h3><div>159/169 (94%) participants scored at least mild STS, with over 55% experiencing severe levels of STS. Four relationships were significant when compared to reported STS level: education level (<em>p</em> = 0.004), avoidant coping (<em>p</em> &lt; 0.001), emotion-focused coping (<em>p</em> &lt; 0.001), and change in perceived stress (<em>p</em> &lt; 0.001). The relationship between STS and experience, hospital trauma level, shift worked, and employment status were not significant (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Nurses experience severe levels of STS, putting them at high risk of negative effects. Hospitals should introduce the concept of STS during nursing orientation: descriptions of what STS may look like, measuring current stress levels, and identify coping strategies. By identifying signs of STS early, nurses may be able to implement coping strategies before the emotional, physical, or psychological toll gets to be overwhelming.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101767"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167388","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":"The association between mode of arrival, presence of medical referral, and outcomes in patients presenting to the emergency department with chest pain: A historical cohort study","authors":"Sheizaf Gefen ,&nbsp;Eugene Feigin ,&nbsp;Tomer Ziv-Baran","doi":"10.1016/j.ienj.2026.101753","DOIUrl":"10.1016/j.ienj.2026.101753","url":null,"abstract":"<div><h3>Background</h3><div>Chest pain is a common reason for emergency department (ED) visits, yet the impact of arrival mode and medical referral status on hospital admission and clinical outcomes remains unclear. This study evaluated their influence on ED patients with chest pain.</div></div><div><h3>Methods</h3><div>A retrospective cohort study analyzed adults presenting with chest pain between January 2022 and June 2024. Patients were categorized as self-arrival without referral (SA), self-arrival with medical referral (MR), or arrival via emergency medical services (EMS). Primary outcome was hospital admission; secondary outcomes included 30-day mortality, prolonged length of stay (LOS), heart-related diagnoses, and readmission rates.</div></div><div><h3>Results</h3><div>Among 12,164 ED visits, hospital admissions were highest in the EMS group (29.9 %) compared to SA (21.0 %) and MR (17.1 %; p &lt; 0.001). After adjustment, EMS and SA groups had greater odds of admission (adjusted ORs: 1.66 and 1.54, respectively; p &lt; 0.001). EMS patients had the highest 30-day mortality (0.8 %), prolonged LOS (43.0 %), and readmission rates (8.0 %). Heart-related diagnoses at discharge were lowest in the MR group (21.7 % vs. 32.0 % in SA; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Medical referral was associated with lower admissions and better outcomes. Optimizing community-based diagnostics may improve triage and reduce ED burden.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101753"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025053","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":"Emergency department care for early pregnancy loss: A scoping review of patient experiences and compassionate clinical practices in the United States","authors":"Kayleigh Gregory,&nbsp;Christian Tayiwoh Amambua,&nbsp;Megan Jaskowiak,&nbsp;Caitlin Jeanmougin","doi":"10.1016/j.ienj.2026.101763","DOIUrl":"10.1016/j.ienj.2026.101763","url":null,"abstract":"<div><h3>Background</h3><div>Early pregnancy loss (EPL), including miscarriage and ectopic pregnancy, affects a significant proportion of pregnancies and often leads patients to seek urgent care in the emergency department (ED). Despite this, the quality of care received varies and individuals often have negative experiences. This scoping review provides a comprehensive overview of published research examining ED care for EPL, specifically focusing on patient experiences and compassionate clinical practices.</div></div><div><h3>Methods</h3><div>The PRISMA-ScR checklist was utilized for the review. A literature search was performed to identify studies on individuals’ health care experiences in the ED setting following EPL, with particular attention paid to compassionate or empathetic care and the practices used to provide it. Searches were conducted in PubMed, PsychInfo, SocINDEX, and CINAHL. Four reviewers independently screened the records.</div></div><div><h3>Results</h3><div>Of the 89 records reviewed, 15 studies met the inclusion criteria.<!--> <!-->Themes emerging from the literature include an urgent need for improved education for ED healthcare professionals on accurate diagnosis, empathetic communication, and evidence-based management of EPL, standardized care protocols, and trauma-informed approaches tailored to reproductive loss.</div></div><div><h3>Conclusion</h3><div>Findings from the review can inform future efforts to redesign ED practices to support patient-centered EPL care, particularly as EDs remain the primary site for EPL management in the United States.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101763"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221566","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":"The predictive power of job content, subjective workload, and job burnout on cognitive failures in nurses working in emergency departments","authors":"N. Parizad ,&nbsp;P. Nazmi ,&nbsp;K. Hosseingholipour ,&nbsp;Z. Abedi","doi":"10.1016/j.ienj.2026.101746","DOIUrl":"10.1016/j.ienj.2026.101746","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive failure is a complex issue in the nursing work environment. This study aimed to examine the extent to which job content, perceived subjective workload, and job burnout predict cognitive failures among nurses working in the emergency departments (EDs).</div></div><div><h3>Methods</h3><div>In this descriptive cross-sectional study, 255 nurses from EDs of selected hospitals in Iran were selected using quota sampling in 2024. Data were collected using questionnaires on demographics, the Cognitive Failures Questionnaire (CFQ), the NASA Task Load Index (NASA-TLX) questionnaire, the Maslach Burnout Inventory (MBI), and the Job Content Questionnaire (JCQ). Data were analyzed with SPSS version 26.0 using descriptive statistics, Pearson correlation coefficient, and linear regression.</div></div><div><h3>Results</h3><div>Correlation analyses revealed that cognitive failures among ED nurses are significantly associated with several factors. Specifically, cognitive failures were positively correlated with job content (r = 0.38, p &lt; 0.001) and perceived subjective workload (r = 0.60, p &lt; 0.001), and negatively correlated with job burnout (r = −0.37, p &lt; 0.001). Linear regression analysis indicated that job content and perceived subjective workload together explain 38 % of the variance in cognitive failure scores, highlighting their predictive role.</div></div><div><h3>Conclusion</h3><div>The complex and challenging conditions in EDs can lead to cognitive failures among nurses. Implementing strategies such as reducing environmental stressors, ensuring adequate nursing staff, and providing psychological support is essential to mitigate these cognitive failures.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101746"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174153","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":"“Make the best use of resources in organizations and society at large”—Professionalś experiences of the Collaborative Health Care model","authors":"Jenny Hallgren ,&nbsp;Maria Klingberg ,&nbsp;Maria Karlsson ,&nbsp;Catharina Gillsjö","doi":"10.1016/j.ienj.2026.101775","DOIUrl":"10.1016/j.ienj.2026.101775","url":null,"abstract":"<div><h3>Background</h3><div>Collaborative Health Care (CHC) is an integrated health care model in Sweden in which municipal and regional health care resources are coordinated to provide fast, coherent, and seamless health care in patients’ homes.</div></div><div><h3>Aim</h3><div>Explore registered nurses’ experiences of working within the Collaborative Health Care model.</div></div><div><h3>Methods</h3><div>A qualitative, inductive design was used and was reported in accordance with the COREQ checklist. Semi-structured individual interviews were conducted via video with eight registered nurses—six women and two men aged 27–65 years—with experience working in the CHC health care model. The interviews lasted between 40 and 105 min and were recorded and transcribed verbatim.</div></div><div><h3>Results</h3><div>The findings consist of three categories, divided into nine subcategories and illustrated by quotes. The CHC is experienced as a work model in progress, spurring initial feelings of anxiety and frustration. Working in the health care model is described as challenging due to uncontrolled increase in workload, complex assessments, and limited knowledge about the patient. Participants found CHC to be beneficial in several ways for patients and their relatives, for health care professionals, for participating organizations, and for society at large.</div></div><div><h3>Conclusion</h3><div>Implementing an integrated health care model like CHC can initially be experienced as challenging. Health care professionals can experience initial feelings of frustration and anxiety, since the usual workload may be affected by unexpected assignments, requiring knowledge to conduct complex, and sometimes novel, assessments. Working in CHC is a learning process resulting in increased competence. Participants found CHC to be beneficial in several ways, making the most out of resources in organizations and society at large to provide coordinated integrated care to patients in their homes.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101775"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258846","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":"The effect of the BREATHe paramedic – paramedic mobile game on nursing and paramedic students’ competence development – A quasi-experimental study","authors":"Hanna-Mari Ylitalo ,&nbsp;Petri Roivainen ,&nbsp;Heli-Maria Kuivila ,&nbsp;Jonna Juntunen ,&nbsp;Kristina Mikkonen ,&nbsp;Sari Pramila-Savukoski","doi":"10.1016/j.ienj.2026.101778","DOIUrl":"10.1016/j.ienj.2026.101778","url":null,"abstract":"<div><h3>Background</h3><div>Mobile games are emerging as powerful tools for learning. There is a lack of understanding of their potential in nursing and paramedic competence development.</div></div><div><h3>Aim</h3><div>The study aimed to test the effectiveness of the BREATHe Paramedic mobile game in enhancing paramedic competence among nursing and paramedic students.</div></div><div><h3>Design</h3><div>A quasi-experimental study.</div></div><div><h3>Participants</h3><div>Nursing and paramedic students (n = 36) from Finland.</div></div><div><h3>Methods</h3><div>The study was conducted in the spring of 2024 to examine the impact of the BREATHe Paramedic mobile game on nursing and paramedic students’ self-assessed paramedic competence and objective learning outcomes. To measure self-assessed competence, the Global Rating Scale for the Assessment of Paramedic Clinical Competence, using a Likert scale, was employed. Additionally, the study explored students’ attitudes, satisfaction, and overall experiences with the game.</div></div><div><h3>Results</h3><div>According to students’ self-assessments, the BREATHe Paramedic mobile game significantly improved all measured areas (p &lt; 0.05), including e.g. situational awareness, patient assessment and decision-making. Regarding objective data, statistically significant improvement was found in medication management competence (p = 0.024). Most of the students were satisfied with the game. The mobile game increased students’ motivation to learn and improved their skills, but it also raised some challenges, such as technical implementation and getting feedback.</div></div><div><h3>Conclusion</h3><div>The study showed that the BREATHe paramedic mobile game can promote paramedic competence development, as indicated by students’ self-evaluations. Objective data supported the overall findings; however, it revealed a statistically significant difference only in medication management competence. The mobile game’s feedback system should be improved, and further research is needed to understand how to maximise the benefits of mobile games in paramedic education and continuous learning in working life.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"85 ","pages":"Article 101778"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322413","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":"From uncertainty to confidence: Standardizing team approach to physical restraint (TAPR) for safer emergency care. A pre-post intervention quality improvement project","authors":"Jonathan Garcia,&nbsp;Hannah Butler,&nbsp;Kristin Boggs,&nbsp;Jocelyn Yanez","doi":"10.1016/j.ienj.2026.101743","DOIUrl":"10.1016/j.ienj.2026.101743","url":null,"abstract":"<div><h3>Background</h3><div>Managing violent and disruptive patients in emergency care remains a critical challenge, placing both staff and patient at risk. A multidisciplinary team developed the Team Approach to Physical Restraint (TAPR) intervention to offer a collaborative, role-based framework for safely managing these situations through interdisciplinary coordination.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate TAPR’s effectiveness in promoting safety and team-based preparedness in the emergency department.</div></div><div><h3>Methods</h3><div>A pre- and post-intervention survey design was used to assess the impact of TAPR among emergency department clinicians across multiple roles. The survey included 8 pre-interventions and 12 post-interventions, utilizing Likert-type scales to measure outcomes related to role clarity, perceived injury prevention, confidence in protocol use, and overall effectiveness. Descriptive statistics were used to analyze participant responses.</div></div><div><h3>Results</h3><div>Following the intervention, 92.5 % of participants reported clarity and applicability in role assignments. Additionally, 77.5 % believed TAPR reduced the likelihood of injuries during restraints, and 90% expressed confidence in initiating the protocol. Overall, 87.5 % agreed that TAPR effectively reduced risks during violent patient encounters.</div></div><div><h3>Conclusion</h3><div>TAPR enhanced preparedness, improved interprofessional collaboration and increased staff confidence in managing violent patients. These findings suggest that TAPR may serve as standardized approach for promoting safety and consistency in emergency care environments.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101743"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924839","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":"Turkish validity and reliability of the parental competence questionnaire in the paediatric hospital emergency setting (ECP-U)","authors":"Aylin Kurt ,&nbsp;Fatma Dinç ,&nbsp;Emine Güneş Şan ,&nbsp;Ahmet Butun ,&nbsp;Meltem Catalbas Acarsoy","doi":"10.1016/j.ienj.2025.101716","DOIUrl":"10.1016/j.ienj.2025.101716","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study is to conduct Turkish validity and reliability study of the parental competence questionnaire in the paediatric hospital emergency setting.</div></div><div><h3>Methods</h3><div>This study is a descriptive, cross-sectional, correlational and methodological study. Participants were 624 parents with children aged 0–14 who presented to the paediatric emergency department between December 2023 and July 2024. The study was carried out in the emergency department of three hospitals in three different regions of Turkey. The data were collected by using the “demographic information form” and “parental competence questionnaire in the paediatric hospital emergency setting”, “state and trait anxiety inventory”, and “parental stress questionnaire”. Explanatory and confirmatory factor analysis, Horn’s parallel analysis, Catell’s scree test, Cronbach’s ordinal alpha coefficients and Pearson correlation were used in the data analysis.</div></div><div><h3>Results</h3><div>The mean age of the mothers included in the study was 34.63 ± 6.94, and the mean age of the fathers was 37.88 ± 7.83. The scale consisted of 18 items and three sub-dimensions: emotional management and expression, social support, and parental agency, explaining 60 % of the total variance. It was determined that the Cronbach’s ordinal alpha coefficients of the scale factors were greater than 0.745. There is a negative correlation between the parental stress questionnaire, the state and trait anxiety inventory, and the parental competence questionnaire in the paediatric hospital emergency setting.</div></div><div><h3>Conclusions</h3><div>According to the results of this study, the parental competence questionnaire in the paediatric hospital emergency setting is a valid and reliable measurement tool for the Turkish population.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101716"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570977","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}