Child and Adolescent Mental Health最新文献

{"title":"Technology matters: AI-driven tools in children's mental healthcare: perspectives from young people and parents","authors":"Zoë Firth,&nbsp;Christine Aicardi,&nbsp;Stephen Oram,&nbsp;Nicholas Cummins,&nbsp;Alice Wickersham,&nbsp;Helen L. Fisher,&nbsp;Johnny Downs","doi":"10.1111/camh.70045","DOIUrl":"10.1111/camh.70045","url":null,"abstract":"<p>Artificial intelligence may be able to improve the efficiency, accuracy and predictiveness of mental health assessments, and public perspectives are crucial to ensuring these tools are implemented with fairness and accountability. We developed an artificial intelligence-driven tool to automatically analyse parents' speech data, which if successful could be implemented in children and young people's mental health assessments. To engage stakeholders with this project, we worked with a science fiction writer to produce two stories about possible futures of our tool, which we discussed in workshops with young people and parents. Here, we summarise key themes arising from this novel method of engaging the public in mental health research, and highlight considerations for clinicians and researchers creating novel technologies for children and young people's mental healthcare.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"244-247"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Reimagining environmental health for children – integrating longitudinal, genetic, and cross-cultural perspectives","authors":"Suci Nora Julina Putri,&nbsp;M. Eval Setiawan,&nbsp;Riza Amalia,&nbsp;Herul Wahyudin","doi":"10.1111/camh.70038","DOIUrl":"10.1111/camh.70038","url":null,"abstract":"<p>This article highlights the importance of a multidisciplinary approach in understanding the environmental impacts on children's mental health, emphasizing the integration of longitudinal designs, genetic methodologies, and cross-cultural validation. Longitudinal research is essential to identify temporal relationships and sensitive developmental periods, while methods such as Mendelian randomization can help disentangle environmental effects from unmeasured genetic and social confounding factors. Cross-cultural validation is also crucial to ensure the global relevance of findings and to support equitable public health policies. This article advocates for more comprehensive research to better understand modifiable environmental factors that promote children's mental well-being.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"252-253"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Debts and experienced financial scarcity: associations with nonsuicidal self-injury and suicidality in adolescents at risk for psychopathology","authors":"Susan J. Ravensbergen,&nbsp;Nita G.M. de Neve-Enthoven,&nbsp;Diandra C. Bouter,&nbsp;Wilco W. van Dijk,&nbsp;Witte J.G. Hoogendijk,&nbsp;Nina H. Grootendorst-van Mil","doi":"10.1111/camh.70065","DOIUrl":"10.1111/camh.70065","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As adolescents transition to increased independence, they may also begin to encounter financial difficulties, including debt, which may contribute to psychological distress. While financial difficulties and experienced financial scarcity have been well-documented contributors to suicidality in adults, their impact on adolescent populations remains underexplored. The current study aims to elucidate the relationship between late adolescents' own debts or their experienced financial scarcity and the prevalence of self-harm, including both nonsuicidal self-injury (NSSI) and suicidality (suicidal ideation/attempt).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the first follow-up measurement (T1) of a population-based high-risk cohort in the Netherlands were utilized. For the present study, adolescents (<i>n</i> = 650, mean age at T1 = 17.9 years) provided self-reported data on unsecured debts, experienced financial scarcity, NSSI and suicidality. Hierarchical logistic regression analyses were conducted to examine the associations between these variables, adjusting for potential confounding factors, including individual, sociodemographic, and socioenvironmental influences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The presence of unsecured debts was associated with an increased prevalence of suicidality (adjusted OR = 1.94, <i>p</i> = .046), but not with NSSI (<i>p</i> = .068). In contrast, greater experienced financial scarcity was associated with a higher prevalence of both NSSI (adjusted OR = 1.09, <i>p</i> = .004) and suicidality (adjusted OR = 1.15, <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results underscore the importance of addressing financial difficulties, particularly debts and experienced financial scarcity, in adolescents at-risk for NSSI and suicidality. Interventions aimed at mitigating the effects of financial strain – such as financial education or support programs – may be important in reducing the risk of self-harm in this population. Further research is needed to explore the efficacy of early intervention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"198-207"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Matters: Between hope and cynicism – competing narratives and the moral economy of child and adolescent psychiatry","authors":"Jordan Sibeoni,&nbsp;Anne Revah-Levy","doi":"10.1111/camh.70104","DOIUrl":"10.1111/camh.70104","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Child and Adolescent Mental Health Services (CAMHS) are currently marked by a paradox: growing public recognition of youth mental health difficulties coincides with increasingly fragile and underresourced services. Beyond organisational strain, the field is shaped by competing narratives about its mission and limits (hopeful progressivism which emphasises innovation, early intervention and developmental plasticity; on the other, defensive pessimism which foregrounds chronicity, clinical realism and institutional constraint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 <h3> Aims</h3>\u0000 <p>To examine how these competing narratives operate within CAMHS and to articulate an alternative orientation capable of supporting ethical clinical practice.</p> </section>\u0000 \u0000 <section>\u0000 <h3> Materials &amp; Methods</h3>\u0000 <p>A conceptual and narrative analysis drawing on medical humanities and social sciences perspectives, in particular the concept of moral economy, illustrated by a clinical vignette.</p> </section>\u0000 \u0000 <section>\u0000 <h3> Results</h3>\u0000 <p>Hopeful progressivism and defensive pessimism function as moral postures that distribute responsibility, legitimacy and emotional labour within institutions, with hope and cynicism operating as institutional currencies. Although seemingly opposed, both positions risk obscuring the structural determinants of care and relocating difficulties onto clinicians or families.</p> </section>\u0000 \u0000 <section>\u0000 <h3> Discussion</h3>\u0000 <p>Rather than choosing between optimism and cynicism, CAMHS may benefit from holding these narratives in productive tension through a dialogical, reflexive approach that re-centres families and re-politicizes the conditions of care.</p> </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conslusion</h3>\u0000 \u0000 <p>A form of realistic hope, grounded in developmental temporality and attentive to material conditions is essential to ethical and clinically meaningful care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"248-251"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to ‘Short Research Article: Independent association between household income and family adversity and bipolar disorder in adolescence and young adulthood—a registry-data study in the Basque Country’","authors":"","doi":"10.1111/camh.70095","DOIUrl":"10.1111/camh.70095","url":null,"abstract":"<p>Mar-Barrutia, L., Larrañaga, I., Chart-Pascual, J. P., Zorrilla, I., Abejas-Diez, D., Gomez-Prieto, A., Mar, J., &amp; Gonzalez-Pinto, A. (2025). Short Research Article: Independent association between household income and family adversity and bipolar disorder in adolescence and young adulthood - a registry-data study in the Basque Country. <i>Child and Adolescent Mental Health</i>, <i>30</i>(4), 392–396. https://doi.org/10.1111/camh.12780</p><p>The author, Juan Pablo Chart-Pascual, should be linked to affiliation 5 as well. The correct details for the byline are:</p><p>Lorea Mar-Barrutia^1,2, Igor Larrañaga^3,4, Juan Pablo Chart-Pascual^1,2,<b>5</b>, Iñaki Zorrilla^1,2,5,6, Daniel Abejas-Diez^1,2, Alba Gomez-Prieto¹, Javier Mar^3,4,7 &amp; Ana Gonzalez-Pinto^1,2,5,6</p><p>¹Psychiatry Service, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain</p><p>²Bioaraba Health Research Institute Vitoria-Gasteiz, Spain</p><p>³Kronikgune Institute for Health Services Research, Barakaldo, Spain</p><p>⁴Research Unit, Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Arrasate-Mondragón, Spain</p><p>⁵UPV/EHU – University of the Basque Country, Vitoria-Gasteiz, Spain</p><p>⁶CIBERSAM, CIBER en Salud Mental, Madrid, Spain</p><p>⁷Biodonostia Health Research Institute Donostia-San Sebastian, Spain</p><p>We apologize for this error.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do Artificial Intelligence chatbots respond to questions from adolescent personas about their eating, body weight or appearance?","authors":"Florence Sheen,&nbsp;Bethany Mullarkey,&nbsp;Gemma L. Witcomb,&nbsp;Marie-Christine Opitz,&nbsp;Ellen Maloney,&nbsp;Saffron M. Baldoza,&nbsp;Hannah J. White","doi":"10.1111/camh.70047","DOIUrl":"10.1111/camh.70047","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Body image and eating behaviours are common areas of concern for early adolescents. Artificial Intelligence (AI) interactions are becoming commonplace, including with chatbots that provide human-like communication. Adolescents may prefer using chatbots to anonymously ask sensitive questions, rather than approaching trusted adults or peers. It is unclear how chatbots answer such questions. We explored how chatbots would respond to eating, weight or appearance-related queries from adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Ten fictitious adolescent personas and scripts were created to facilitate conversations with ChatGPT and Claude.AI. Personas asked questions about eating, body weight and/or appearance, presenting as ‘curious’, ‘worried’ or ‘having a potential eating disorder’. Conversation outputs were analysed using reflexive thematic analysis to explore the content of chatbot responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were identified: (1) Live a ‘healthy’ adolescent lifestyle; (2) Eat ‘healthily’; (3) Promoting regular physical activity; (4) Seek support; (5) Focus on you. Advice was often framed within societal ideals relating to eating, body weight and/or appearance. Chatbots signposted to trusted adults and healthcare professionals for support, but not to regulated resources (e.g., NHS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Framings around eating, weight and/or appearance may be problematic for adolescents with eating disorder symptomatology. A lack of prompting for further information or signposting to regulated support means vulnerable adolescents may receive unhelpful information or not reach adequate support. Understanding how AI could be supportive and/or unhelpful to adolescent users presenting with eating, body or appearance-related concerns is important. Findings can inform policy regulating AI chatbots' communications with adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"176-185"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Debate: Conversational AI and young people's mental health – friend or foe? – more than a ‘good or bad’ story: a self-determination theory approach to conversational AI and adolescent well-being","authors":"Laure Dedecker,&nbsp;Yuhui Olivia Chen,&nbsp;Gaëlle Vanhoffelen,&nbsp;Laura Vandenbosch,&nbsp;Lara Schreurs","doi":"10.1111/camh.70109","DOIUrl":"10.1111/camh.70109","url":null,"abstract":"<p>The rapid adoption of conversational AI among adolescents has sparked growing debate about its implications for development and well-being. This article applies a Self-Determination Theory lens to explore how and under which conditions adolescents' conversational AI usage supports or frustrates their basic psychological needs for competence, relatedness, and autonomy. Conversational AI may enhance competence through learning assistance, relatedness through emotional and relational support, and autonomy through increased independence. At the same time, it may also promote the risk of superficial competence, displace human relationships, and constrain authentic autonomy. Overall, the role conversational AI plays in adolescents' development is unlikely to be universally positive or negative for all adolescents, but instead depends on how, why, and in which context these technologies are used, highlighting the need for nuanced research and developmentally sensitive design.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"235-237"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Ambient voice technology in CAMHS - from documentation relief to outcome-accountable implementation.","authors":"Yu-Hui Huang, Lien-Chung Wei","doi":"10.1111/camh.70119","DOIUrl":"10.1111/camh.70119","url":null,"abstract":"<p><p>Ambient voice technology has been proposed as a promising approach to reduce documentation burden in child and adolescent mental health services and neurodevelopmental settings. In response to Dineley and colleagues' discussion of responsible implementation and evidence gaps, this letter argues that ambient voice technology should be evaluated as a care-pathway intervention rather than merely as a note-generation tool. We emphasize the importance of outcome-accountable implementation, including measurement of documentation time, clinician cognitive load, note correction burden, error severity, therapeutic alliance, patient and carer experience, equity, and downstream care decisions. Particular attention is needed in multilingual, family-based, and neurodevelopmental consultations, where multispeaker attribution, atypical speech, and culturally specific expressions of distress may challenge automated systems. Ambient voice technology should protect clinical reasoning, preserve uncertainty, and remain subject to auditable human oversight. Its value in CAMHS should be judged by safety, equity, experience, and meaningful clinical improvement.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in Practice: A pilot randomised trial on smartphone and social media abstinence - effects on sleep quality and psychological wellbeing in adolescents.","authors":"Emma C Sullivan, Scott A Cairney, Lisa-Marie Henderson","doi":"10.1111/camh.70118","DOIUrl":"10.1111/camh.70118","url":null,"abstract":"<p><p>There is growing concern that smartphones and social media (S/SM) disrupt adolescent sleep, wellbeing and cognition, yet causal evidence from robust interventions is limited. To assess the acceptability of a total 21-day S/SM detox, we conducted a preregistered (https://osf.io/79zd2) pilot randomised controlled trial with 82 adolescents aged 13-18 years from UK schools. Participants were randomly assigned to a total S/SM detox (N = 26), total S/SM detox with access to a basic 'brick' phone (N = 26) or a business-as-usual control (N = 30). Pre-and post-intervention measures of sleep, wellbeing and cognition were collected using surveys, wearables and cognitive tasks. Retention was high, with 13% attrition across groups. At 21-days, one or both detox groups showed tentative improvements in sleep duration, daytime sleepiness, depressive symptoms, perceived stress and working memory relative to the controls, however, these changes were not maintained at a 2-month follow-up. Open-ended post-detox reflections encompassed a range of both positive and negative experiences, with reported challenges including boredom, functional reliance on smartphones and fear of missing out. Nevertheless, 83% endorsed the need for government action. Digital detoxes appear feasible for generating causal evidence; however, they can also pose functional challenges to young people. Fully powered trials should address these challenges, potentially via more targeted intervention approaches (e.g. switching off the internet on smartphones, particularly at bedtime).</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health contacts and referrals of children and young people in England, 2016-2021: An epidemiological study and comparison of young people who have received protective and care interventions and their peers.","authors":"Barry Coughlan, Julia Mannes, Nicole Marshall, Tessa Morgan, Tamsin J Ford, Francesca Crozier-Roche, David Graham, Taliah Drayak, Jack Smith, Luke Geoghegan, Matt Woolgar, Rick Hood, Robbie Duschinsky","doi":"10.1111/camh.70116","DOIUrl":"https://doi.org/10.1111/camh.70116","url":null,"abstract":"<p><strong>Background: </strong>In England, 18% of children and young people (CYP) experience clinical levels of mental health difficulties. CYP who are involved in children's social care, either receiving in-home care (i.e. child protection plans; CPP) or out-of-home care (i.e. children looked after; CLA), may experience higher prevlance than peers. Less is known about actual contacts with mental health services. This study aimed to provide an account of the contacts with mental health services for children with and without CPP and CLA, and reasons for referral.</p><p><strong>Methods: </strong>Data were extracted from NHS Digital for all CYP in England in contact (e.g. through referral, appointment, support) with mental health services between April 2016 and March 2021, and included sociodemographic information, CPP or CLA status and referral reason.</p><p><strong>Results: </strong>In total, 1,984,827 CYP were in contact with mental health services. The most common referral reasons were anxiety (13%), 'in crisis' (10%) and depression (7%). Contacts tended to increase each year for all groups. Overall, CPP and CLA were between 2 and 3 times more likely to be in contact with mental health services compared to peers. However, this represented between 9% and 18% of CPP and CLA.</p><p><strong>Conclusion: </strong>The findings suggest that there are wide discrepancies between mental health needs and contacts with services. CPP and CLA have particularly high levels of unmet need. While these data indicate escalating demand, service contacts have not increased significantly, suggesting an increased threshold for access in a stretched clinical service.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}