Maternal and Child Nutrition最新文献

{"title":"Perceptions of Underlying Factors and Consequences of Childhood Malnutrition and Care-Seeking Behaviour for Children Under 5 Years With Acute Malnutrition: A Qualitative Study in Rural Bangladesh.","authors":"Md Abdul Alim, Bibi Marium, Benjamin Guesdon, M Munirul Islam, Caroline Antoine, Mehedi Hasan Anik, Stefaan De Henauw, Tahmeed Ahmed, Souheila Abbeddou","doi":"10.1111/mcn.70030","DOIUrl":"https://doi.org/10.1111/mcn.70030","url":null,"abstract":"<p><p>Acute Malnutrition affects 45 million children under five globally, with Bangladesh contributing more than 1.7 million cases. While community-based management of acute malnutrition (CMAM) guidelines in Bangladesh exist, they primarily emphasise nutritional counselling and face challenges in coverage and implementations. It is important to understand barriers to CMAM uptake and implementation. This study aims to explore the perceptions of acute malnutrition's underlying factors and consequences among parents, healthcare providers, and policymakers, alongside parents' care-seeking behaviours for under-five children with acute malnutrition. Conducted in areas with and without CMAM programs, the research follows a phenomenological design with thematic analysis of focus group discussions (FGDs) and key informant interviews (KIIs). Thirty FGDs with parents, 28 KIIs with healthcare providers, and 16 KIIs with policymakers were conducted. Identified causes of acute malnutrition included infections, diseases, lack of awareness about nutritious foods, supernatural beliefs, poverty, and inadequate care and feeding practices. Consequences included stunted growth, impaired mental development, and increased illness risk. Although parents acknowledged the urgency of treating acute malnutrition, they sought care at healthcare facilities regardless of illness. Factors influencing care-seeking behaviour were inability in problem prioritisation, transportation cost and availability, healthcare access, wage loss, and out-of-pocket expenses. Despite awareness of acute malnutrition's underlying factors and consequences, parental care-seeking remains limited. The study recommends integrating acute malnutrition guidelines with communicable disease programs, implementing targeted social and behavioural change programs, addressing superstitions, fostering collaboration with traditional healers strengthening social safety nets, and empowering women in healthcare decision-making.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70030"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expenditures on Strengthening Large Scale Breastfeeding Counseling Programs in Bangladesh, Ethiopia, and Vietnam.","authors":"Tina G Sanghvi, Rick Homan, Tuan Nguyen, Zeba Mahmud, Marina Nersesyan, Patricia Preware, Edward A Frongillo, Roger Mathisen","doi":"10.1111/mcn.70031","DOIUrl":"https://doi.org/10.1111/mcn.70031","url":null,"abstract":"<p><p>Timely support given to breastfeeding mothers can result in life-saving benefits for both mothers and infants. Progress in achieving results from existing efforts to improve breastfeeding practices can be accelerated with adequate investments in effective interventions. We aimed to document expenditures incurred by three diverse programs in Bangladesh, Ethiopia, and Vietnam that demonstrated improved breastfeeding outcomes. Based on expenditure records, we retrospectively calculated annual and per participant expenditures. The results represent the incremental financial needs of strengthening existing efforts in low- and middle-income countries to inform budget planning. The programs reached between 400,000 to 1.2 million pregnant women, infants, and mothers annually at an average expenditure of USD 0.55 to 1.90 per woman and infant. The largest proportion of expenditures were incurred for training frontline workers and delivering interpersonal communication or counseling. These ranged from 73.4% of total expenditures in Bangladesh to 63.9% in Ethiopia and 55.1% in Vietnam. Management and administration expenditures ranged from 13.3% and 19.6% across countries; the range in expenditures for planning and strategy development was 2.5%-9.9%; for materials development and production was 1.1%-15.1%; and for monitoring was 1.7%-18.7%. The results show that existing cadres of facility and community workers can deliver effective breastfeeding counseling on a large scale with substantial economies of scale. Budgetary needs will differ by country due to delivery system strengths and weaknesses, pre-existing coverage, and demand for counseling services. The study provides a basis for realistic budget estimates for strengthening breastfeeding counseling in large-scale programs.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70031"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet, Fruit and Vegetable Intake, and Nutritional Status in Fiji: A Scoping Review.","authors":"Fusta Azupogo, Sonja Y Hess, Anasaini Moala Silatolu, Deanna K Olney","doi":"10.1111/mcn.70023","DOIUrl":"https://doi.org/10.1111/mcn.70023","url":null,"abstract":"<p><p>Increasing fruit and vegetable (F&V) intake is essential for transitioning toward healthier, more sustainable diets. To design effective intervention programmes to promote F&V intake, it is crucial to understand intake levels and dietary patterns across different demographic groups as well as populations' nutritional status. We conducted a scoping review to summarise scientific evidence on the diet, F&V intake and nutritional status of the Fijian population. In January 2023, we searched PubMed for relevant literature. Studies were eligible if they were published in English since 2012 (for dietary intake and nutritional status) or since 2002 (for F&V) and met predefined inclusion criteria. We identified 163 articles reporting on diet, 47 on F&V intake and 95 on nutritional status. After further review and confirmation that articles met inclusion criteria, data were extracted from 16 articles on diet, 8 on F&V and 13 on nutritional status. The scoping review revealed a shift in Fiji from traditional foods to processed, unhealthy foods, high salt intake and poor dietary diversity. F&V intake was low, with only a quarter of adults and adolescents consuming the recommended daily servings. Approximately 7% of children under-five were stunted, and 8% were overweight. At least 25% of adolescents were overweight or obese, whereas 10% were underweight. Over 30% of adults were obese, and at least 25% were overweight. Overweight/obesity was higher in females and Indigenous Fijians; underweight higher among Indo-Fijian adolescents, especially males. Strengthening population-wide efforts to promote healthy lifestyles and dietary habits is crucial to address these issues.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70023"},"PeriodicalIF":2.8,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Cash Transfer Programmes Affect Child Anaemia? Results From a Meta-Analysis.","authors":"James Manley, Harold Alderman","doi":"10.1111/mcn.70026","DOIUrl":"https://doi.org/10.1111/mcn.70026","url":null,"abstract":"<p><p>Childhood anaemia is common and debilitating. Nutrition-specific policies are effective for addressing anaemia in many contexts but less is known about nutrition-sensitive policies such as cash transfers. We reviewed over 4000 studies and gathered 26 estimates of the effect of cash transfer programmes on childhood haemoglobin and anaemia. Overall, neither the impact of cash on haemoglobin (0.065 d/L, CI [-0.054, 0.184]) nor on anaemia prevalence (-0.092, CI [-1.227, 1.042]) were significant. While cash on its own had basically a null effect, programmes that provided cash in combination with other interventions such as behaviour change communication or nutritional supplements were more successful. The impact of social protection on haemoglobin and anaemia is surprisingly understudied compared to height, on which a previous study found well over 100 impacts of cash transfer programmes. Overall impacts of cash transfer programmes on haemoglobin and anaemia are weak: evidence is inconclusive at best. Cash transfer programmes are more successful in combination with other programmes providing education and/or nutritional supplements.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70026"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional Associations Between Exposure to Commercial Milk Formula Marketing, Beliefs About Its Use, and Socioeconomic Position Among Pregnant Women and Mothers in the UK.","authors":"Martha Athanasiadou, Florence Sheen, Andrea D Smith, Clare Llewellyn, Rana Conway","doi":"10.1111/mcn.70022","DOIUrl":"https://doi.org/10.1111/mcn.70022","url":null,"abstract":"<p><p>International provisions are in place to restrict marketing practices that idealise the use of commercial milk formula (CMF) and discourage breastfeeding. In high-income countries, women of lower socioeconomic position (SEP) are less likely to breastfeed. This study aimed to characterise the nature of exposure to CMF marketing in the UK, the extent to which women hold positive beliefs about CMF and examine the relationship between exposure to CMF marketing, holding positive beliefs about CMF and SEP. Data on these topics were collected for 1052 pregnant women and mothers of children under 18 months of age between February 2020 and February 2021. Participants were assigned a 'CMF marketing score' according to the number of locations where they recalled seeing advertisements, engaging with companies or receiving promotional activity. The extent to which women held positive beliefs about CMF ('CMF positivity score') was determined by level of agreement with 17 statements. Principal component analysis, analyses of covariance and regression analyses were applied. Every woman reported exposure to CMF marketing from multiple channels. CMF marketing score did not vary across SEP groups (p = 0.342). Women of lower and middle SEP held stronger CMF positive beliefs than women of higher SEP, including 'Breastfeeding and formula feeding provide a baby with the same health benefits' (p < 0.005). CMF marketing score was not associated with CMF positivity score. Marketing suggesting CMF provides benefits similar to, or greater than, breastfeeding should be restricted to help mitigate current inequalities in infant feeding practices.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70022"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions, Causes and Treatment of Severe Acute Malnutrition, Mbuji-Mayi, Kasai-Oriental, Democratic Republic of the Congo.","authors":"Julien Ntaongo Alendi, Marie-Claire Muyer, Cécile Salpeteur, Steve Botomba, Jean Baptiste Mayavanga, Aimée Mupuala, Florence Mbiya Muadi, Samuel Mampunza, Léon Quénéet, Marlène Camrrubi, Carine Magen Fabregat","doi":"10.1111/mcn.70024","DOIUrl":"https://doi.org/10.1111/mcn.70024","url":null,"abstract":"<p><p>The effective management of severe acute malnutrition (SAM) is contingent upon the perceptions of the affected communities, and preferred therapeutic pathways, object of the present research. A qualitative survey collected 54 semistructured individual interviews, 10 focus groups, and 6 direct observations in Mbujimayi town, Kasaï Oriental province, Democratic Republic of Congo. The deductive approach was used to analyse the data. Cultural and religious beliefs, as well as lived experience, influence perceptions of SAM. The latter is perceived as a shameful disease, a curse, or divine punishment by communities. Food insecurity and poverty following the bankruptcy of Bakwanga diamond Mining (MIBA), then food taboos, women's heavy workloads, poor childcare practices, low birth spacing and lack of access to drinking water were the main causes perceived. Traditional healers are the primary source of care and consider SAM resulting from curses or witchcraft, needing special preparations. Religious leaders regard SAM as a spiritual illness requiring prayers even if modern medicine is administered. Some families turn to prayer, hoping for a therapeutic convocation of the sacred, or self-medication. Modern medicine is the final recourse, frequently combined with the other modalities. For health workers, SAM is linked to nutritional and socioeconomic factors which must be addressed with modern medicine including RUTF. Community awareness and access to education for women is needed to change perceptions. Nutrition programmes would benefit of co-designing their communication and behaviour change strategies with key influential community members of therapeutic pathways of children suffering from SAM.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70024"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assurance and Quality Improvement in Maternal, Infant, Young Child and Adolescent Nutrition Service Provision in Five Countries","authors":"Kavita Sethuraman,&nbsp;Sujata Bose,&nbsp;Jessica Escobar-DeMarco,&nbsp;Edward A. Frongillo","doi":"10.1111/mcn.13772","DOIUrl":"10.1111/mcn.13772","url":null,"abstract":"<p>Greater efforts are needed to better integrate nutrition services focused on the first 1000 days into health systems. Key constraints to large-scale impact include the scale of coverage, intensity and quality of nutrition services. But there is little understanding to date on what quality comprises in the context of maternal, infant, young child and adolescent nutrition (MIYCAN) services. This qualitative assessment presents findings from five countries (Bangladesh, Burkina Faso, Cambodia, Ethiopia, and India) where Alive and Thrive (A&amp;T) addressed the quality of MIYCAN services to understand the quality frameworks used, components addressed and factors that can improve the quality of MIYCAN services. The methodology consisted of reviewing programme documents and conducting purposive key informant interviews (<i>n</i> = 30) with A&amp;T country staff and stakeholders involved with MIYCAN service provision supported by A&amp;T technical assistance (TA). Countries used either health-system-level quality assurance (QA), largely systems strengthening, or facility-level continuous quality improvement (QI) that used an iterative process to improve service quality. Joint pilot interventions supported by A&amp;T and respective country governments demonstrated that implementing QA/QI to improve MIYCAN services was feasible. Common QA/QI activities included improving nutrition standards of care, harmonising training materials, changing how services were delivered, altering counselling from didactic to dialogue-oriented and promoting the strategic use of data to address service provision challenges and identify solutions. Factors that facilitated QA/QI included working jointly with the government. The findings suggest that there are common principles that can guide the development of future MIYCAN programmes with similar objectives.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702083","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":"Mapping Stakeholders in Mexico's Maternal and Child Health Network: A Net-Map Approach.","authors":"Mónica Ancira-Moreno, Cecilia Pérez Navarro, Elizabeth Hoyos-Loya, Isabel Omaña-Guzmán, Soraya Burrola-Méndez, Sonia Hernández-Cordero","doi":"10.1111/mcn.70020","DOIUrl":"https://doi.org/10.1111/mcn.70020","url":null,"abstract":"<p><p>Maternal and child health care consists of providing quality care for the dyad mother-child, starting with prenatal care, early postpartum, and monitoring the growth and development of children during their first 1000 days of life. Maternal and child malnutrition remains a critical public health concern in Mexico, and it is still far from reaching the Global Nutrition Targets, particularly those corresponding to stunting, low birth weight, anemia, and exclusive breastfeeding by 2030. The objectives of this study were to: (1) identify the actors involved in decision-making regarding programs or policies for maternal and child malnutrition prevention and care in Mexico; (2) Identify the themes and institutions in which the actors are involved; and (3) Analyze the information by emphasizing the roles of the relevant actors, their influence, and power in working toward the improvement of maternal and child health and nutrition. We used the actor mapping or Net-Map methodology developed by the International Food Policy Research Institute and the World Bank. The Mapping was conducted through individual interviews with key informants related to or involved with maternal and child health and nutrition topics in Mexico (n = 19 in the first stage; n = 15 in the second stage). Several actors are involved in maternal and child health and nutrition in Mexico. However, the decision-making power remains at the government or supranational organizations level, with little intervention from organized civil society. Working networks must be strengthened at all levels to further enhance the actions that are being or may be implemented.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70020"},"PeriodicalIF":2.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Feeding Practices in Guinea: Implications for Infant Dietary Diversity.","authors":"Teresa R Schwendler, Kathleen L Keller, Leif Jensen, Muzi Na, Mohamed L Fofana, Mamady Daffé, Hermine Sankhon, Stephen R Kodish","doi":"10.1111/mcn.70017","DOIUrl":"https://doi.org/10.1111/mcn.70017","url":null,"abstract":"<p><p>The aim of this study was to assess the extent to which specific feeding styles may be associated with the diets of infants aged 6-9 months in Guinea. This study was designed to have multiple, iterative phases with methodological triangulation. During Phase 1 of data collection, direct observations (n = 10) were used to develop a tailored tool for Phase 2, during which 72 meal observations were conducted among infants aged 6-9 months to define caregiver feeding styles. Specific behaviours underlying established feeding styles were recorded at the level of the intended bite. Following each observation, infant diet diversity scores (DDS), or the number of food groups consumed in the previous 24 h, were collected. During Phase 3, we interviewed 34 caregivers to understand the drivers of their feeding styles. Caregiver feeding styles were determined using cluster analysis of observed behaviours and a linear regression was used to explore the relationship between feeding style and infant DDS. Textual data from interviews were thematically analysed to explain the drivers of feeding style. Caregivers were characterized as those using forceful (n = 12), responsive (n = 52) or uninvolved (n = 8) feeding styles. Our study found that responsive feeding was not associated with a higher DDS when controlling for child age in months. The most salient factors shaping feeding style in this setting included perception around infant and young child developmental stage, food refusals and trust in infant cues. Overall, food insecurity may need to be addressed in addition to feeding styles to improve DDS.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70017"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formative Research for the Development and Implementation of a Smartphone Application to Report Breaches to the International Code of Marketing of Breast-Milk Substitutes in Mexico.","authors":"M Unar-Munguía, M Ceballos-Rasgado, P J Mota-Castillo, A Santos-Guzman, V Aureoles-García, V H Moran, M Sachse Aguilera, K Markwell","doi":"10.1111/mcn.70014","DOIUrl":"https://doi.org/10.1111/mcn.70014","url":null,"abstract":"<p><p>Almost 40 years after the adoption of the International Code of Marketing of Breast-Milk Substitutes ('the Code') in Mexico, noncompliance persists. In other countries, smartphone applications for reporting Code noncompliance have proven effective. This study aimed to identify key features for the design of a public health surveillance app to monitor Code breaches and the barriers and facilitators to its use by parents and stakeholders. Semi-structured interviews (n = 34) and focus groups (n = 14) with key stakeholders (n = 81), including parents and caregivers, health care personnel, representatives of academia, civil society organizations and government entities, were conducted between August and December 2023. Transcripts were analysed in MAXQDA 20 software using grounded theory 'lite', which emphasizes the construction of categories and concepts to explore and structure participant perspectives. Four categories were constructed from the coding process: (a) knowledge and perspectives about the Code; (b) attitudes towards reporting Code breaches and any subsequent repercussions; (c) stakeholders perspectives on monitoring the Code and (d) perspectives on the app. Mexican stakeholders supported the development of an app and associated website to monitor the Code, indicated a willingness to report breaches, and believed that a national committee and state bodies should oversee surveillance and monitoring activities of the Code. Adapting legal measures with appropriate sanctions and making infractions public were recommended. Developing an app assisted with artificial intelligence could aid the establishment of a national monitoring system for the Code, make infractions public, promote societal participation, and drive regulatory changes for commercial milk formula marketing.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70014"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}