Sexual & Reproductive Healthcare最新文献

{"title":"The understanding of dynamic birth positions for women in labor and childbirth – A hybrid concept analysis","authors":"Helena Lindgren ,&nbsp;Kerstin Erlandsson ,&nbsp;Marta Berta ,&nbsp;Osman Yimer ,&nbsp;Johanna Blomgren ,&nbsp;Christina Lundberg ,&nbsp;Tenagnework Dilnesa ,&nbsp;Michael Wells ,&nbsp;Solomon Hailemeskel","doi":"10.1016/j.srhc.2024.101039","DOIUrl":"10.1016/j.srhc.2024.101039","url":null,"abstract":"<div><div>Problem and background: The assessment of advantages and drawbacks associated with varying birthing positions has predominantly centered around medical or technical considerations and few studies have accounted for a woman’s ability to attune to her bodily instincts during labor and birth. The objective of this study was to define the concept of dynamic birth positions and its significance within the birthing process.</div></div><div><h3>Methods</h3><div>This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed and Google Scholar were searched with related terms in the theoretical phase. In the fieldwork phase, seven professionals and six mothers with the experience of dynamic birth positions were interviewed. After each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined.</div></div><div><h3>Results</h3><div>In the theoretical phase, the definition of dynamic birth positions included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results present two distinct categories that define dynamic birth positions: “Women’s choice, women’s power” and “A flow between rest and activity.” The final analysis phase of this study indicated that dynamic birth positioning is characterized by the organic progression through a variety of postures that seamlessly merge rest and activity throughout the labor and birthing process, guided by the woman’s individual preferences.</div></div><div><h3>Conclusions</h3><div>The definition of dynamic birth positions redefines birth as an evolving, dynamic journey characterized by a fluid interplay of movements and moments of rest, transcending conventional fixation on static positions.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101039"},"PeriodicalIF":1.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593395","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":"Birth satisfaction and symptoms of childbirth related PTSD among women in Iceland: A population-based study","authors":"Emma M. Swift ,&nbsp;Fjóla Guðmundsdóttir ,&nbsp;Kristjana Einarsdóttir ,&nbsp;Valgerður Lísa Sigurðardóttir","doi":"10.1016/j.srhc.2024.101037","DOIUrl":"10.1016/j.srhc.2024.101037","url":null,"abstract":"<div><h3>Background</h3><div>Given its complexity, childbirth can elicit both positive and negative psychological reactions and, in some cases, women may experience symptoms of childbirth-related post-traumatic stress disorder (CB-PTSD). Several risk factors for CB-PTSD have been identified previously, including history of mental health issues and childbirth related complications. The aim of our study was to explore the role of satisfaction with care in CB-PTSD symptoms.</div></div><div><h3>Methods</h3><div>CB-PTSD was measured with the City Birth Trauma Scale (CityBiTS), a questionnaire with 29 items distributed according to DSM-5 diagnostic criteria. A CityBiTS score &gt;28 points was defined as CB-PTSD symptoms. Birth satisfaction was measured with the Birth Satisfaction Scale-Revised (BSS-R), a self-report questionnaire. Logistic-regression was used to calculate odds ratios and 95 % confidence intervals for the association between birth satisfaction and CB-PTSD, adjusted for age, relationship status, education, income, parity, mode of birth, postpartum depression and maternal and infant health-related problems during pregnancy and birth.</div></div><div><h3>Results</h3><div>Of 600 participants, 34 (5.7 %) indicated symptoms of CB-PTSD. When adjusted for socio-demographic and pregnancy and birth-related factors, birth satisfaction was independently associated with symptoms of CB-PTSD. For each additional point on the BSS-R, the odds of having CB-PTSD symptoms decreased by 16%. Support during labor and birth, effective communication and shared decision making were factors significantly associated with CB-PTSD symptoms.</div></div><div><h3>Discussion</h3><div>Increased satisfaction with care was strongly associated with less symptoms of CB-PTSD. Emphasizing sense of control with support, effective communication and shared decision making may significantly improve the overall experience for women and possibly reduce CB-PTSD symptoms.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101037"},"PeriodicalIF":1.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514381","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":"Workplace intervention among pregnant hospital employees − a cluster randomised trial evaluating sick leave","authors":"Jane Lauridsen ,&nbsp;Pernille Pedersen ,&nbsp;Anne-Mette Hedeager Momsen ,&nbsp;Mette Lausten Hansen ,&nbsp;Ane Marie Thulstrup ,&nbsp;Rikke Damkjær Maimburg","doi":"10.1016/j.srhc.2024.101038","DOIUrl":"10.1016/j.srhc.2024.101038","url":null,"abstract":"<div><h3>Objective</h3><div>Sick leave during pregnancy is common and associated with strenuous working conditions and multiple occupational exposures. The aim of this study was to evaluate the effect of midwifery facilitation of sessions with pregnant employees and managers focusing on work adjustment, to reduce discomfort and occupational risks.</div></div><div><h3>Methods</h3><div>A cluster randomised controlled trial was conducted. Hospital employees were randomised to intervention or reference. The intervention group received midwifery support in addition to the standard hospital pregnancy policy provided to the reference group. Outcomes were pregnancy-related sick leave and general sick leave. Intention-to-treat analysis was performed with mixed-effect models.</div></div><div><h3>Results</h3><div>Sick leave was similar between the intervention and reference groups, and 51 % of pregnant employees did not take any days of full pregnancy related sick leave, while approximately 21 % took more than 30 days. Group differences in mean estimates for partial sick leave were −0.5 (CI −2.3;1.3) days. Differences in full sick leave was 1.2 (CI −2.9;5.2) days, and 0.6 (CI −1.0;2.1) days for general sick leave.</div></div><div><h3>Conclusion</h3><div>Midwifery support as an add-on to usual pregnancy policy did not decrease sick leave during pregnancy compared to usual practice in a study population of Danish healthcare professionals. Midwifery support tailored towards the specific work environment may perhaps provide better results.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101038"},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677992","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":"Association between quality of antenatal care service utilisation and adverse birth outcomes among adolescent women in 22 Sub-Saharan African countries. A mixed-effects multilevel analysis","authors":"Tadesse Tolossa ,&nbsp;Lisa Gold ,&nbsp;Eric HY Lau ,&nbsp;Merga Dheresa ,&nbsp;Julie Abimanyi-Ochom","doi":"10.1016/j.srhc.2024.101036","DOIUrl":"10.1016/j.srhc.2024.101036","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the association between the quality of antenatal care (ANC) service utilisation and adverse birth outcomes among adolescent women in Sub-Saharan Africa (SSA).</div></div><div><h3>Methods</h3><div>A two-level mixed-effects model was employed using the recent Demographic Health Survey (DHS) data from 22 SSA countries. Both bivariable and multivariable multilevel analyses were conducted to assess the association between individual and community level factors with adverse birth outcomes. The results of the fixed effects model were interpreted in the form of adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs).</div></div><div><h3>Results</h3><div>In SSA, 23.5 % of adolescent mothers experienced adverse birth outcomes. This study found that receiving high quality ANC was associated with a 28 % reduction in the likelihood of adverse birth outcomes (AOR = 0.72, 95 % CI: 0.63, 0.83). Among the individual-level factors, middle-aged adolescence (AOR = 1.23, 95 % CI: 1.11, 1.36), being a female newborn (AOR = 1.15, 95 % CI: 1.05, 1.26), single marital status (AOR = 0.87, 95 % CI: 0.78, 0.96) and higher educational status (AOR = 0.83, 95 % CI: 0.74, 0.93) were significantly associated with adverse birth outcomes. From the community-level variables, women from Eastern Africa had positive significant association with adverse birth outcomes (AOR = 1.30, 95 % CI: 1.15, 1.46).</div></div><div><h3>Conclusions</h3><div>Nearly one-fourth of adolescent women in SSA experienced at least one type of adverse birth outcome. Low quality of ANC was significantly associated with adverse birth outcomes. Policymakers need to consider a comprehensive, essential, and minimal package of ANC to enhance the quality of ANC, which is crucial for better adolescent birth outcomes.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101036"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425792","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":"Condom non-use among adolescents: Prevalence and associated factors among school-going adolescents from 58 countries","authors":"Nazifa Nawal Huda ,&nbsp;Rashawan Raziur Rouf ,&nbsp;Md Shajedur Rahman Shawon","doi":"10.1016/j.srhc.2024.101035","DOIUrl":"10.1016/j.srhc.2024.101035","url":null,"abstract":"<div><h3>Objectives</h3><div>Studies in several resource-limited settings have investigated the prevalence and potential factors associated with condom non-use among adolescents, showing inconsistent and varied findings, owing to methodological inconsistencies. Thus, this study aimed to investigate the prevalence and associated factors of condom non-use among a global sample of adolescents and their differences based on sex and region.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study using the 2009–2018 Global School-based Health Survey data from 58 countries which included 183,100 adolescents aged 12–15 years. Random-effects <em>meta</em>-analysis was used to estimate the overall and regional pooled prevalence of condom non-use. Multilevel mixed-effect logistic regressions were used to investigate the correlates of condom non-use.</div></div><div><h3>Results</h3><div>Overall, 26.2% of the total sample reported being sexually active and of these, 27.6% did not use condoms during last intercourse, with boys reporting higher than girls (27.9% vs. 25.6%). The prevalence of condom non-use was the highest in the African region (29.2%) and the lowest in the South-East Asia region (21.1%). There were variations in prevalence across countries, regions, and sex. Female gender, older age, loneliness, suicidal ideation, being bullied, parental support and supervision, truancy, smoking, illicit drug use, early sexual initiation, and having multiple sex partners were associated with condom non-use. There was evidence of heterogeneity of correlates across regions and sex.</div></div><div><h3>Conclusions</h3><div>In this analysis, we found variations in the prevalence and associated factors of condom non-use among adolescents by sex and region. These findings can shape effective sexual health initiatives and improve resource distribution across regions.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101035"},"PeriodicalIF":1.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376412","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":"Examining the impact of an online educational video on the contraceptive knowledge, awareness and choices of young women living in rural and remote Australia","authors":"Danielle Mazza,&nbsp;Jessica R Botfield,&nbsp;Jessie Zeng,&nbsp;Claudia Morando-Stokoe,&nbsp;Noushin Arefadib","doi":"10.1016/j.srhc.2024.101034","DOIUrl":"10.1016/j.srhc.2024.101034","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether an online educational video, tailored to young women living in rural and remote areas, increases their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC).</div></div><div><h3>Study Design</h3><div>A single group pre-post survey design, in which participants completed the pre-video survey (S1), watched the 13-min video, then completed a survey immediately after (S2) and 6  months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression.</div></div><div><h3>Results</h3><div>A total of 153 participants watched the video and completed S1 and S2; 56 % of these completed S3. Prevideo (S1) 33 % of participants were unaware of LARC methods. Only 3 % rated their knowledge about every method as high. Knowledge improved immediately post video (S2) for all methods (aOR 12.5, 95 % CI 5.2 to 29.8) and LARC methods (aOR 7.9, 95 % CI 4.3 to 11.8). Overall method preference for LARC increased from 23.5 % (n = 36) at S1 to 48 % (n = 74) at S2. Likelihood of using a LARC increased at S2 (aOR 2.1, 95 % CI 1.5 to 2.9). The overall proportion of participants using a LARC increased from 18 % at S1 to 21 % at S3, however, this increase was not significant (p = 0.3).</div></div><div><h3>Conclusion</h3><div>Our findings underscore the effectiveness of tailored online educational videos in enhancing contraceptive knowledge and preference for LARCs amongst young women living in rural and remote areas. However preference did not translate into uptake, suggesting that structural and other barriers may be prominent.</div></div><div><h3>Implications</h3><div>This study emphasises the need for a multifaceted approach to facilitating young womens’ access to effective methods of contraception, including LARC. Efforts to promote knowledge should be coordinated with place-based initiatives and policies that directly address the structural barriers to accessing critical sexual and reproductive health services unique to women in rural and remote areas.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101034"},"PeriodicalIF":1.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395846","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":"Investigating the associations between early labour onset symptoms and self-diagnosed labour onset in a cohort study of primiparas","authors":"Hanna Gehling,&nbsp;Loukia M. Spineli ,&nbsp;Mechthild M. Gross","doi":"10.1016/j.srhc.2024.101033","DOIUrl":"10.1016/j.srhc.2024.101033","url":null,"abstract":"<div><h3>Objective</h3><p>The early recognition of possible labour onset symptoms may be pivotal to identifying the beginning of early labour and are usually recognised by the birthing women themselves. The present study illustrates the interrelationship among five labour-onset symptoms and explores the association of these labour-onset symptoms with the self-diagnosed labour onset of primiparas.</p></div><div><h3>Methods</h3><p>A prospective cohort study on a sample of 69 primigravida in Giessen, Germany, expecting spontaneous onset of labour at term. The participants filled in a diary from ≥37 + 0 weeks gestation until self-diagnosed labour onset. Descriptive, bivariate and inferential analysis explored association of labour onset symptoms with self-diagnosed labour onset while accounting for maternal and newborn characteristics.</p></div><div><h3>Results</h3><p>Self-diagnosed labour onset was positively associated with all symptoms and clinical characteristics, apart from irregular pain and maternal weight and age. Moreover, regular pain was negatively correlated with irregular pain; having regular pain increased the odds of self-diagnosed labour onset substantially (OR: 10.18, 95 % CI: 2.39–66.27), followed by gastrointestinal symptoms (OR: 2.07, 95 % CI: 0.40–13.10) and emotional symptoms (OR: 2.05, 95% CI: 0.30–13.98).</p></div><div><h3>Conclusion</h3><p>Being the initiator of intrapartum care without any birth experience, primiparas are prone to experiencing dissatisfaction in care and may enter professional care too late or too early. The present study showed that regular pain may signify primiparas to self-diagnose labour onset within 24 h and indicate early labour symptoms that may be relevant for a self-diagnosed labour onset.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101033"},"PeriodicalIF":1.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000880/pdfft?md5=209b96674188a4d56f33a7802f6bf7bc&pid=1-s2.0-S1877575624000880-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229067","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":"Overuse of intrapartum CTG monitoring in low-risk women in Norway","authors":"Kristin Jerve Aanstad ,&nbsp;Are Hugo Pripp ,&nbsp;Rebecka Dalbye ,&nbsp;Aase Devold Pay ,&nbsp;Anne Cathrine Staff ,&nbsp;Anne Kaasen ,&nbsp;Ellen Blix","doi":"10.1016/j.srhc.2024.101032","DOIUrl":"10.1016/j.srhc.2024.101032","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101032"},"PeriodicalIF":1.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000879/pdfft?md5=6ea504f0052b44efaea62ee30c94692b&pid=1-s2.0-S1877575624000879-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157844","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":"The conclusion of CTG overuse is not justified","authors":"Jørg Kessler ,&nbsp;Sindre Grindheim ,&nbsp;Johanne Kolvik Iversen","doi":"10.1016/j.srhc.2024.101031","DOIUrl":"10.1016/j.srhc.2024.101031","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101031"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147057","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":"Hysterectomy and medical financial hardship among U.S. women","authors":"Biplab Kumar Datta ,&nbsp;Ashwini Tiwari ,&nbsp;Yara H. Abdelgawad ,&nbsp;Ruhun Wasata","doi":"10.1016/j.srhc.2024.101019","DOIUrl":"10.1016/j.srhc.2024.101019","url":null,"abstract":"<div><h3>Objective</h3><p>Hysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, which<!--> <!-->may cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t.</p></div><div><h3>Methods</h3><p>Using data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity.</p></div><div><h3>Results</h3><p>While the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts.</p></div><div><h3>Conclusions</h3><p>Our results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"42 ","pages":"Article 101019"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088934","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}