{"title":"Patient-perceived barriers and enablers to adherence to physiotherapist prescribed self-management strategies","authors":"K. Peek, M. Carey, L. Mackenzie, R. Sanson-Fisher","doi":"10.15619/nzjp/46.3.03","DOIUrl":"https://doi.org/10.15619/nzjp/46.3.03","url":null,"abstract":"The objectives of this study were to describe patient-reported adherence to physiotherapist-prescribed self-management strategies; and the perceived barriers and enablers to adherence to each strategy. Patients attending physiotherapy private practices (n=4) were observed during their consultation. Patients prescribed one or more self-management strategies received a follow-up telephone interview within 10-14 days of the observed consultation and were asked to self-report their level of adherence and their perceived barriers and/or enablers to each prescribed strategy. Results indicated that patients (n=108) reported receiving 177 strategies and being fully adherent to 36% (95% CI: 29-44%) of these strategies. Patient-reported adherence barriers (n=113) and enablers (n=172) were coded using a modified version of the World Health Organisation five dimensions of adherence. Frequently reported barriers included social/economic-related (n=52; 46%) such as being too busy, and patient-related (n=29; 26%) including being too tired/lack of motivation. Frequently reported enablers included therapy-related (n=71; 41%) such as “the strategy was easy to complete”, and condition-related (n=45; 26%) including “that the strategy helped to manage symptoms”. Thus, patient adherence may be aided by ensuring that: the strategy is less complex; it does not cause pain; it isn’t time consuming; and it leads to an improvement in condition-related symptoms. Peek, K., Carey, M., Mackenzie, L., Sanson-Fisher, R. (2018). Patient-perceived barriers and enablers to adherence to physiotherapist prescribed self-management strategies. New Zealand Journal of Physiotherapy 46(3): 105-112. doi:10.15619/NZJP/46.3.03","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42519273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Lord, Olivia Isbey, S. Del-Din, L. Rochester, Lynne M. Taylor
{"title":"Discerning the contribution of balance and mobility to ambulatory activity in community-dwelling octogenarians: A preliminary report","authors":"S. Lord, Olivia Isbey, S. Del-Din, L. Rochester, Lynne M. Taylor","doi":"10.15619/NZJP/46.3.05","DOIUrl":"https://doi.org/10.15619/NZJP/46.3.05","url":null,"abstract":"Adults are encouraged to maintain levels of physical activity throughout their life span. This study describes gait performance and ambulatory activity (as a key component of physical activity) in 15 community-dwelling octogenarians and examines the association between activity measured continuously for 5 days with a tri-axial accelerometer and clinical measures of balance and functional mobility. Outcomes represented macro features of ambulatory activity and included volume, pattern and variability of activity. Micro gait outcomes were derived from each walking bout and represented 14 discrete spatio-temporal characteristics of gait. Participants walked a median of 9,294 steps/day (range 5,121-18,231). For macro outcomes, the strongest associations were established for Timed up and Go (TUG) single and dual task times and mean bout length (rs = -.66, p = 0.006, and -.68, p = 0.005 respectively; Spearman’s rho), and TUG dual task and accumulation of walking bouts (alpha) (α) (rs = -.67, p = 0.006). For micro outcomes, there was a positive correlation between step velocity and the Activities Balance and Confidence Scale (rs = .67 p = 0.006), and a negative correlation between step velocity and TUG single task (rs = .71, p = 0.003). TUG dual task showed a positive association with step time asymmetry (rs = .65 p = 0.008) and swing time asymmetry (rs = .66, p = 0.004). For this group of active octogenarians, associations between ambulatory activity and functional mobility were stronger than for balance. Lord, S., Isbey, O., Del-Din, S., Rochester, L., Taylor, L. (2018). Discerning the contribution of balance and mobility to ambulatory activity in community-dwelling octogenarians: A preliminary report. New Zealand Journal of Physiotherapy 46(3): 133-138. doi:10.15619/NZJP/46.3.05","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44414297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Latissimus dorsi avulsion, with coupled teres major injury, in a professional football goalkeeper: case report","authors":"Mathew Prior, J. Collins, R. Pope","doi":"10.15619/nzjp/46.3.06","DOIUrl":"https://doi.org/10.15619/nzjp/46.3.06","url":null,"abstract":"Significant upper limb injuries are rare in professional football [soccer]. Latissimus dorsi avulsion injury is particularly rare in sport of all types, with limited published information informing optimal management. A 35 year-old male professional football goalkeeper sustained, via a non-contact ball throwing mechanism, a latissimus dorsi avulsion and partial teres major tendon tear during competitive matchplay. He undertook a conservative rehabilitation programme, emphasising progressive mechanical loading, in order to return to full function and competition. The player successfully returned to unrestricted training at 32 days post-injury and returned to play at 38 days post-injury. At 12 months post-injury he had suffered no injury recurrence and remains playing at the same competition level. Latissimus dorsi avulsion is an uncommon injury, with accurate diagnosis requiring both a high level of clinical suspicion coupled with diagnostic imaging. Despite the severity, this injury may be amenable to conservative management in even elite athletes with high functional demands. The following case outlines such a management approach successfully utilised with a professional football goalkeeper. Prior, M., Collins, J., Pope, R. (2018). Latissimus dorsi avulsion, with coupled teres major injury, in a professional football goalkeeper: case report. New Zealand Journal of Physiotherapy 46(3): 139-146. doi:10.15619/NZJP/46.3.06","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44323501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early mobilisation of patients in the acute hospital setting following aneurysmal subarachnoid haemorrhage – a survey of current physiotherapy practice","authors":"S. Hernandez, P. Thomas, A. Udy, C. Hodgson","doi":"10.15619/NZJP/46.3.04","DOIUrl":"https://doi.org/10.15619/NZJP/46.3.04","url":null,"abstract":"Aneurysmal subarachnoid haemorrhage is a catastrophic form of stroke. There is very limited literature to guide physiotherapists on the type and timing of mobility interventions that should be provided during the acute phase. The aim of this study was to determine the current practices of physiotherapists in early mobilisation of patients with aneurysmal subarachnoid haemorrhage. A purposedesigned electronic survey was distributed to 71 physiotherapists in hospitals that specialise in the management of aneurysmal subarachnoid haemorrhage throughout Australia and New Zealand. A response rate of 80% was obtained (n=57). Prior to the aneurysm being repaired, the most common practice reported by physiotherapists was not to mobilise patients (41%). Once the aneurysm was repaired, mobility goals increased with >80% of physiotherapists reporting goals of sitting on the edge of the bed or step transferring to a chair day one post repair. Physiotherapists reported that vasospasm, delayed cerebral ischaemia, recent further bleed, hypotension or the use of high level of noradrenaline would prevent them from mobilising patients. Only four respondents reported that they had a mobilisation protocol for aneurysmal subarachnoid haemorrhage patients at their hospital. Further research is required into the safety, timing and efficacy of early mobilisation practices in the management of aneurysmal subarachnoid haemorrhage patients. Hernandez, S., Thomas, P., Udy, A., Hodgson, C. (2018). Early mobilisation of patients in the acute hospital setting following aneurysmal subarachnoid haemorrhage – a survey of current physiotherapy practice. New Zealand Journal of Physiotherapy 46(3): 113-132. doi:10.15619/NZJP/46.3.04","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41663023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What helps or hinders clinicians in their decision-making processes when using or prescribing mHealth apps in practice? An exploratory study","authors":"Claire Hempel, A. Sezier, Gareth Terry","doi":"10.15619/NZJP/46.2.04","DOIUrl":"https://doi.org/10.15619/NZJP/46.2.04","url":null,"abstract":"Recent advancement and use of technology in healthcare has led to a rapid growth and availability of mobile health applications (mHealth apps) in clinical practice. This proliferation has led to growing concern over the unregulated nature of this new industry. The expectation that clinicians abide by the rule ‘do no harm’ has also raised concerns regarding the maintenance of client safety and questions as to how clinicians navigate this tension and how mHealth apps are being used in clinical practice. This research investigated what helps and hinders the use and prescription of mHealth apps in allied health clinical practice. Using a qualitative descriptive methodology, an exploratory study was conducted utilising a mixed methods approach. The twelve participants consisted of 11 physiotherapists and an occupational therapist. Thematic analysis was used to analyse data. Two themes were constructed from the data: (1) Deflection of professional responsibility and (2) Dependence on the physiotherapy toolbox and evidence based practice. This research established basic understanding of the acceptability and use of mobile technology in allied health practice. Results demonstrated a poor use of mHealth apps and a preference for a certain kind of evidence-based technique in clinical practice. Clinicians also voiced a lack of knowledge and confidence in their own skills or judgements in relation to mHealth apps, with many admitting to relying on recommendations by colleagues, professional bodies and clients. Hempel, C., Sezier, A., Terry, G. (2018) What helps or hinders clinicians in their decision-making processes when using or prescribing mHealth apps in practice? An exploratory study. New Zealand Journal of Physiotherapy 46(2): xx-xx. doi:10.15619/NZJP/46.2.04","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44930038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Hale, K. Bryant, Aimee L. Ward, A. Falloon, A. Montgomery, Brigit Mirfin-Veitch, K. Tikao, S. Milosavljevic
{"title":"Organisational views on health care access for hauā (disabled) Māori in Murihiku (Southland), Aotearoa New Zealand: A mixed methods approach","authors":"L. Hale, K. Bryant, Aimee L. Ward, A. Falloon, A. Montgomery, Brigit Mirfin-Veitch, K. Tikao, S. Milosavljevic","doi":"10.15619/NZJP/46.2.03","DOIUrl":"https://doi.org/10.15619/NZJP/46.2.03","url":null,"abstract":"We report and discuss the findings of a survey of a range of health care providers serving hauä (disabled) Mäori in the Murihiku (Southland) region of Aotearoa New Zealand. To explore hauä Mäori access to health services, we used a mixed methods approach beginning with a quantitative survey and followed by qualitative interviews. Twenty-nine (58%) completed surveys were returned and we interviewed representatives from 15 organisations. We found all organisations were disability accessible in the physical sense, but were less accessible from a cultural perspective. There appeared a misunderstanding between what could be deemed a non-racial, human rights approach of respect for all people, no matter the ethnicity (“We treat everyone who walks through the door the same”) and the importance of tikaka (customary Mäori practice), for services provided for Mäori. The most significant proposal resulting from this research was for organisations to have a local, trusted, cultural advisor to regularly discuss and review Mäori clients. Individually, health facilities that provide services to Mäori should evaluate their cultural awareness, service access and promotion, health information, and service effectiveness. This paper provides insights and suggestions to health organisations, such as physiotherapy services, on how they can improve their service accessibility to hauä Mäori. Hale, L., Bryant, K., Ward, A., Falloon, A., Montgomery, A., Mirfin-Veitch, B., Tikao, K., & Milosavljevic, S. (2018). Organisational views on health care access for hauä (disabled) Mäori in Murihiku (Southland), Aotearoa New Zealand: A mixed methods approach. New Zealand Journal of Physiotherapy 46(2): 51-66. doi:10.15619/NZJP/46.2.03","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43672529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aishwarya Grime, S. Daines, L. Pringle, L. Heang, D. C. Ribeiro
{"title":"The within-day reliability of scapular and shoulder EMG measurements in asymptomatic individuals during shoulder abduction","authors":"Aishwarya Grime, S. Daines, L. Pringle, L. Heang, D. C. Ribeiro","doi":"10.15619/nzjp/46.2.02","DOIUrl":"https://doi.org/10.15619/nzjp/46.2.02","url":null,"abstract":"The purpose of this study was to assess the within-day reliability of scapular and shoulder surface electromyography (sEMG) measurements during shoulder abduction. Twenty asymptomatic individuals performed 10 repetitions of shoulder abduction, which was then retested 10 minutes later. sEMG was used to record the activity of upper and lower trapezius; anterior, middle and posterior deltoids; supraspinatus; infraspinatus; and serratus anterior muscles. Muscle activation was expressed as a percentage of maximum voluntary isometric contraction (MVIC). The intraclass correlation coefficient (ICC) and standard error of measurement (SEM) were used to assess within-day reliability for concentric and eccentric phases of shoulder abduction. For the concentric phase, ICC values ranged from 0.87 to 0.98 and SEM values from 8.6% to 18.9% MVIC. For the eccentric phase, ICC values ranged from 0.65 to 0.97, and SEM values from 9.8% to 24.4% MVIC. In asymptomatic individuals, EMG measurements of the scapular and shoulder muscles during the concentric phase of shoulder abduction had excellent reliability, and for the eccentric phase, had good to excellent reliability depending on the analysed muscle. These findings provide valuable information on reliability of sEMG for assessing muscle activity of scapular and shoulder muscles. Grime, A., Daines, S., Pringle, L., Heang, L., & Ribeiro, D.C. (2018). The within-day reliability of scapular and shoulder EMG measurements in asymptomatic individuals during shoulder abduction. New Zealand Journal of Physiotherapy 46(2): 67-72. doi:10.15619/NZJP/46.2.02","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42423670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An online fitness to practise specific module alters physiotherapy students’ health knowledge, perceptions and intentions","authors":"K. Lo, A. Cracknell, R. Hopmans, S. Maloney","doi":"10.15619/nzjp/46.2.05","DOIUrl":"https://doi.org/10.15619/nzjp/46.2.05","url":null,"abstract":"Health professional students experience fitness to practise (FTP) issues but commonly do not seek help. Strategies to support students’ FTP in preparation for clinical placement are warranted. This article adds further insights into curriculum to support students’ FTP. The purpose of the study was to gain insight into students’ perception, levels of confidence, knowledge, understanding and help-seeking intentions regarding FTP issues and their supports. Year 3 and 4 Bachelor of Physiotherapy students provided open-ended responses regarding the impact of undertaking an education module to increase their awareness of FTP issues and associated support systems. After completing the module, students were more confident to define FTP, able to identify support systems and more likely to seek help for FTP issues. They were less likely to self-manage FTP issues although this was not statistically significant. After viewing the curriculum students increased their awareness of where to seek help from 52/68 (77%) to 50/50 (100%). Students also increased their understanding of what to do if a peer had an FTP issue from 31/68 (45%) to 46/50 (92%). The factors that both facilitate and discourage help-seeking behaviour were discussed. An FTP specific module altered students’ perceptions, levels of confidence, knowledge and understanding regarding FTP issues. It also increased students’ intentions to seek help. Strategies to support students’ FTP issues were described with discussion of strategies to improve the FTP specific module. Lo, K., Cracknell, A., Hopmans, R., & Maloney, S. (2018). An online fitness to practise specific module alters physiotherapy students’ health knowledge, perceptions and intentions. New Zealand Journal of Physiotherapy 46(2): 79-87. doi:10.15619/NZJP/46.2.05","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48837922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physiotherapists in cardiac and pulmonary rehabilitation","authors":"Sarah Mooney, Sarah Rhodes","doi":"10.15619/NZJP/46.2.01","DOIUrl":"https://doi.org/10.15619/NZJP/46.2.01","url":null,"abstract":"We report and discuss the findings of a survey of a range of health care providers serving hauä (disabled) Mäori in the Murihiku (Southland) region of Aotearoa New Zealand. To explore hauä Mäori access to health services, we used a mixed methods approach beginning with a quantitative survey and followed by qualitative interviews. Twenty-nine (58%) completed surveys were returned and we interviewed representatives from 15 organisations. We found all organisations were disability accessible in the physical sense, but were less accessible from a cultural perspective. There appeared a misunderstanding between what could be deemed a non-racial, human rights approach of respect for all people, no matter the ethnicity (“We treat everyone who walks through the door the same”) and the importance of tikaka (customary Mäori practice), for services provided for Mäori. The most significant proposal resulting from this research was for organisations to have a local, trusted, cultural advisor to regularly discuss and review Mäori clients. Individually, health facilities that provide services to Mäori should evaluate their cultural awareness, service access and promotion, health information, and service effectiveness. This paper provides insights and suggestions to health organisations, such as physiotherapy services, on how they can improve their service accessibility to hauä Mäori. Hale, L., Bryant, K., Ward, A., Falloon, A., Montgomery, A., Mirfin-Veitch, B., Tikao, K., & Milosavljevic, S. (2018). Organisational views on health care access for hauä (disabled) Mäori in Murihiku (Southland), Aotearoa New Zealand: A mixed methods approach. New Zealand Journal of Physiotherapy 46(2): 51-66. doi:10.15619/NZJP/46.2.03","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48252910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring student fitness to practise in physiotherapy – Strategies from the coalface","authors":"K. Lo, Heather Curtis, A. Cracknell","doi":"10.15619/nzjp/45.2.02","DOIUrl":"https://doi.org/10.15619/nzjp/45.2.02","url":null,"abstract":"Health professionals have high rates of burnout. Their work satisfaction is also affected by supervising students with fitness to practise (FTP) issues. FTP issues include those regarding clinical competence, professionalism and physical and/or mental health. Strategies to support health professional clinical educators are warranted but have not yet been documented. This project investigated insights into strategies that support the supervision of students with FTP issues. Participants included approximately 45 attendees at the Personally Arranged Learning Session (PeArL) at the Australian Physiotherapy Association (APA) Conference Melbourne, October 2013 and approximately 20 attendees at the Clinical Education Managers Australia and New Zealand (CEMANZ) meeting in April 2015. Clinical educators discussed peer-assisted learning and buddy systems to support clinical educators and students. There was a preference indicated for feed-forward mechanisms to support student learning needs. Educators valued faculty staff as important supports particularly when supervising students with mental health concerns. Mentoring for clinical educators was also encouraged to help support staff new to the educator role. The importance of teamwork and regular breaks from clinical education were discussed. Clinical education managers discussed the inherent requirements of physiotherapy courses including strategies to flag and support students with FTP issues. Strategies to support clinical educators when supervising students with FTP issues were described.","PeriodicalId":52167,"journal":{"name":"New Zealand Journal of Physiotherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44912576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}