Pub Date : 2022-02-16DOI: 10.1080/02739615.2021.2013222
T. Wilaisakditipakorn, C. Ievers-Landis, S. Malay, Kimberly Burkhart, S. Ibrahim, Shanna Kralovic, Elizabeth A. Diekroger
ABSTRACT Children with neurodevelopmental disorders commonly have sleep problems and higher screen time compared with their typically developing peers. Relationships of their media use to sleep are unknown during the COVID-19 pandemic. Seventy-five caregivers/parents of children ages 5–12 years with neurodevelopmental disorders completed surveys during the pandemic, reporting average child media use of 3.35 hours/day (SD = 0.36) and sleep duration of 9.22 hours (SD = 1.27). Media use duration was not significantly related to any sleep outcomes in the total sample. Unexpectedly, in subgroup analyses with COVID-19 exposure/distress variables, greater media use duration significantly related to less sleep-related impairment (p = .012) and disturbance (p = .0004). Clinical implications are that media use/sleep plans should be individually tailored for these at-risk children.
{"title":"Sleep and media use among children with neurodevelopmental disorders during the COVID-19 pandemic","authors":"T. Wilaisakditipakorn, C. Ievers-Landis, S. Malay, Kimberly Burkhart, S. Ibrahim, Shanna Kralovic, Elizabeth A. Diekroger","doi":"10.1080/02739615.2021.2013222","DOIUrl":"https://doi.org/10.1080/02739615.2021.2013222","url":null,"abstract":"ABSTRACT Children with neurodevelopmental disorders commonly have sleep problems and higher screen time compared with their typically developing peers. Relationships of their media use to sleep are unknown during the COVID-19 pandemic. Seventy-five caregivers/parents of children ages 5–12 years with neurodevelopmental disorders completed surveys during the pandemic, reporting average child media use of 3.35 hours/day (SD = 0.36) and sleep duration of 9.22 hours (SD = 1.27). Media use duration was not significantly related to any sleep outcomes in the total sample. Unexpectedly, in subgroup analyses with COVID-19 exposure/distress variables, greater media use duration significantly related to less sleep-related impairment (p = .012) and disturbance (p = .0004). Clinical implications are that media use/sleep plans should be individually tailored for these at-risk children.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"385 - 407"},"PeriodicalIF":0.9,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45977527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-03-12DOI: 10.1080/02739615.2022.2041419
Bethany Forseth, Kelsey M Dean, Megan Murray, Haley J Killian, Dana Bakula, Rebecca E Swinburn Romine, Kandace Fleming, Christie A Befort, Keisha M England, Rohit Bhagat, Maheen Bangash, Meredith L Dreyer Gillette, Eve-Lynn Nelson, Ann M Davis
To examine the early impact of the COVID-19 pandemic on rural parental stress and family behaviors, parents who participated in a 2nd-4th grade pediatric obesity intervention completed a survey in May 2020. Parents (N=77) experienced 7.8±2.7 events on the COVID-19 Exposure and Family Impact Scales (CEFIS) with an average impact of 2.5±0.5, with many parents reporting moderate stress (73%). Parental stress was predictive of personal well-being getting 'worse' while loss of income events were predictive of family routines getting 'better.' Professionals working with rural families may want to assess for these factors when promoting positive changes in family health behaviors.
{"title":"The impact of COVID-19 on rural treatment-seeking families with children with overweight or obesity.","authors":"Bethany Forseth, Kelsey M Dean, Megan Murray, Haley J Killian, Dana Bakula, Rebecca E Swinburn Romine, Kandace Fleming, Christie A Befort, Keisha M England, Rohit Bhagat, Maheen Bangash, Meredith L Dreyer Gillette, Eve-Lynn Nelson, Ann M Davis","doi":"10.1080/02739615.2022.2041419","DOIUrl":"https://doi.org/10.1080/02739615.2022.2041419","url":null,"abstract":"<p><p>To examine the early impact of the COVID-19 pandemic on rural parental stress and family behaviors, parents who participated in a 2<sup>nd</sup>-4<sup>th</sup> grade pediatric obesity intervention completed a survey in May 2020. Parents (N=77) experienced 7.8±2.7 events on the COVID-19 Exposure and Family Impact Scales (CEFIS) with an average impact of 2.5±0.5, with many parents reporting moderate stress (73%). Parental stress was predictive of personal well-being getting 'worse' while loss of income events were predictive of family routines getting 'better.' Professionals working with rural families may want to assess for these factors when promoting positive changes in family health behaviors.</p>","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 3","pages":"300-315"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540603/pdf/nihms-1799440.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.1080/02739615.2021.2016407
M. Stearns, C. Ievers-Landis, C. McCrae, S. Simon
ABSTRACT Without the structure and schedule of traditional activities such as in-person school and socialization, evidence is emerging of pediatric sleep changes during the COVID-19 pandemic. A narrative review was conducted of the sleep literature during the pandemic for preschoolers, school-aged children, and adolescents. Changes in sleep and risk and protective factors for sleep heath during the COVID-19 pandemic are reviewed along with real-life clinical case examples for each developmental period. Given the high rates of pediatric sleep disturbance, clinicians, researchers, and policymakers should refine screening strategies and facilitate referrals for behavioral interventions to support sleep health during pandemics and other natural disasters.
{"title":"Sleep across childhood during the COVID-19 pandemic: a narrative review of the literature and clinical case examples","authors":"M. Stearns, C. Ievers-Landis, C. McCrae, S. Simon","doi":"10.1080/02739615.2021.2016407","DOIUrl":"https://doi.org/10.1080/02739615.2021.2016407","url":null,"abstract":"ABSTRACT Without the structure and schedule of traditional activities such as in-person school and socialization, evidence is emerging of pediatric sleep changes during the COVID-19 pandemic. A narrative review was conducted of the sleep literature during the pandemic for preschoolers, school-aged children, and adolescents. Changes in sleep and risk and protective factors for sleep heath during the COVID-19 pandemic are reviewed along with real-life clinical case examples for each developmental period. Given the high rates of pediatric sleep disturbance, clinicians, researchers, and policymakers should refine screening strategies and facilitate referrals for behavioral interventions to support sleep health during pandemics and other natural disasters.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"408 - 430"},"PeriodicalIF":0.9,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45787819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-06DOI: 10.1080/02739615.2021.2000413
S. Uygun, Nedime Tuğçe Bilbay
ABSTRACT The aim of our study was to investigate the psychometric properties of the Turkish adaptation of the Epworth Sleepiness Scale for children and adolescents (ESS-CHAD). We evaluated internal consistency, test−retest reliability, construct validity, and criterion validity of the ESS-CHAD in the sample of 145 children with a mean age of 14.58 (±1.44), consisting of 53.1% females. Confirmatory factor analysis showed an 8-item unidimensional structure of the scale. Cronbach’s alpha was 0.74; the correlation coefficients for test−retest reliability and criterion validity were 0.96 and 0.85, respectively (p’s< .05). Our study presented the first evidence to establish the validity and reliability of the ESS-CHAD for Turkish children aged 12 − 18 years.
{"title":"Psychometric evaluation of the Turkish adaptation of the Epworth sleepiness scale for children and adolescents","authors":"S. Uygun, Nedime Tuğçe Bilbay","doi":"10.1080/02739615.2021.2000413","DOIUrl":"https://doi.org/10.1080/02739615.2021.2000413","url":null,"abstract":"ABSTRACT The aim of our study was to investigate the psychometric properties of the Turkish adaptation of the Epworth Sleepiness Scale for children and adolescents (ESS-CHAD). We evaluated internal consistency, test−retest reliability, construct validity, and criterion validity of the ESS-CHAD in the sample of 145 children with a mean age of 14.58 (±1.44), consisting of 53.1% females. Confirmatory factor analysis showed an 8-item unidimensional structure of the scale. Cronbach’s alpha was 0.74; the correlation coefficients for test−retest reliability and criterion validity were 0.96 and 0.85, respectively (p’s< .05). Our study presented the first evidence to establish the validity and reliability of the ESS-CHAD for Turkish children aged 12 − 18 years.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"235 - 249"},"PeriodicalIF":0.9,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45414329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-04DOI: 10.1080/02739615.2021.2002695
A. Vassilopoulos, M. Swartz, S. Paranjape, K. Slifer
ABSTRACT Cystic fibrosis (CF) increases risk for mental health symptoms. This study evaluated patient and caregiver screening for anxiety and depression symptoms as related to pulmonary function (PF) and health-care utilization (HCU). Participants included adolescents, young adults (AYAs; N = 119) and their caregivers (N = 104). AYA depression symptoms correlated with number of hospitalizations (NOH; r = 0.194, p = .035) and length of stay (LOS; r = 0.198, p = .031). AYA LOS correlated with caregiver depression (r = 0.230, p = .019) and anxiety (r = 0.339, p < .001) symptoms. Caregiver anxiety symptoms (sr2 = 0.044), depression symptoms (sr2 = 0.039), and AYA PF (sr2 = 0.193) predicted HCU. Psychosocial screening and intervention are recommended for standard care.
{"title":"Adolescent and caregiver mental health, pulmonary function, and healthcare utilization in pediatric cystic fibrosis","authors":"A. Vassilopoulos, M. Swartz, S. Paranjape, K. Slifer","doi":"10.1080/02739615.2021.2002695","DOIUrl":"https://doi.org/10.1080/02739615.2021.2002695","url":null,"abstract":"ABSTRACT Cystic fibrosis (CF) increases risk for mental health symptoms. This study evaluated patient and caregiver screening for anxiety and depression symptoms as related to pulmonary function (PF) and health-care utilization (HCU). Participants included adolescents, young adults (AYAs; N = 119) and their caregivers (N = 104). AYA depression symptoms correlated with number of hospitalizations (NOH; r = 0.194, p = .035) and length of stay (LOS; r = 0.198, p = .031). AYA LOS correlated with caregiver depression (r = 0.230, p = .019) and anxiety (r = 0.339, p < .001) symptoms. Caregiver anxiety symptoms (sr2 = 0.044), depression symptoms (sr2 = 0.039), and AYA PF (sr2 = 0.193) predicted HCU. Psychosocial screening and intervention are recommended for standard care.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"199 - 212"},"PeriodicalIF":0.9,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45459931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-04DOI: 10.1080/02739615.2021.2001337
Roohi Y. Kharofa, Kristin M W Stackpole, Catherine Anthony, Rebekah Moorhead, R. Siegel
ABSTRACT During the COVID-19 shutdown, our pediatric weight management center instituted telemedicine and expanded educational content on Facebook. The aims of this study were to assess telemedicine utilization and social media engagement (optional). We performed a retrospective chart review and examined Facebook posts. During the first 6 weeks of the pandemic, 129 patients completed a telemedicine visit (52 non-completers). Completers were less likely to be Medicaid-insured (OR 0.252). Families engaged most with Facebook exercise content (avg. views: 449). Further analysis is necessary to determine how to make telemedicine accessible for low-income families and to determine if social media engagement improves anthropometric outcomes.
{"title":"Pediatric weight management amid the COVID-19 pandemic: a natural telemedicine experiment","authors":"Roohi Y. Kharofa, Kristin M W Stackpole, Catherine Anthony, Rebekah Moorhead, R. Siegel","doi":"10.1080/02739615.2021.2001337","DOIUrl":"https://doi.org/10.1080/02739615.2021.2001337","url":null,"abstract":"ABSTRACT During the COVID-19 shutdown, our pediatric weight management center instituted telemedicine and expanded educational content on Facebook. The aims of this study were to assess telemedicine utilization and social media engagement (optional). We performed a retrospective chart review and examined Facebook posts. During the first 6 weeks of the pandemic, 129 patients completed a telemedicine visit (52 non-completers). Completers were less likely to be Medicaid-insured (OR 0.252). Families engaged most with Facebook exercise content (avg. views: 449). Further analysis is necessary to determine how to make telemedicine accessible for low-income families and to determine if social media engagement improves anthropometric outcomes.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"431 - 442"},"PeriodicalIF":0.9,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42264171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-04DOI: 10.1080/02739615.2021.2007771
Emily M. Steiner, L. Dahlquist
ABSTRACT This study examined how intolerance of uncertainty and having a child with food allergy relate to protective parenting. Eighty mothers of children with food allergy and 78 mothers of healthy children completed questionnaires assessing intolerance of uncertainty and parenting style. Mothers then rated vignettes of hypothetical parenting situations in terms of perceived uncertainty, threat, and negative affect and reported their likely parenting response. Results indicated that mothers’ affective and cognitive appraisals mediated the association between intolerance of uncertainty and protective parenting. Findings suggest that maternal intolerance of uncertainty and child health status may increase the risk of protective parenting.
{"title":"Intolerance of uncertainty and protective parenting: the mediating role of maternal appraisals and the moderating role of child health status","authors":"Emily M. Steiner, L. Dahlquist","doi":"10.1080/02739615.2021.2007771","DOIUrl":"https://doi.org/10.1080/02739615.2021.2007771","url":null,"abstract":"ABSTRACT This study examined how intolerance of uncertainty and having a child with food allergy relate to protective parenting. Eighty mothers of children with food allergy and 78 mothers of healthy children completed questionnaires assessing intolerance of uncertainty and parenting style. Mothers then rated vignettes of hypothetical parenting situations in terms of perceived uncertainty, threat, and negative affect and reported their likely parenting response. Results indicated that mothers’ affective and cognitive appraisals mediated the association between intolerance of uncertainty and protective parenting. Findings suggest that maternal intolerance of uncertainty and child health status may increase the risk of protective parenting.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"263 - 284"},"PeriodicalIF":0.9,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42485391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-03DOI: 10.1080/02739615.2021.2005599
Hannah Morris, D. Tumin, R. Kroeger, Cierra Buckman
ABSTRACT Using the 2016–2018 National Survey of Children’s Health, we examined whether children with parents in same-sex versus different-sex couples had different levels of access to a medical home. We found that relative to children with parents in different-sex couples, children with parents in same-sex couples had 31% lower odds of having access to a medical home, 36% lower odds of having a usual place to go for health care, and 29% lower odds of receiving family-centered care. Results suggest less access to care consistent with the medical home criteria for children with parents in same-sex versus different-sex couples.
{"title":"Medical home access among children of parents in same-sex couples","authors":"Hannah Morris, D. Tumin, R. Kroeger, Cierra Buckman","doi":"10.1080/02739615.2021.2005599","DOIUrl":"https://doi.org/10.1080/02739615.2021.2005599","url":null,"abstract":"ABSTRACT Using the 2016–2018 National Survey of Children’s Health, we examined whether children with parents in same-sex versus different-sex couples had different levels of access to a medical home. We found that relative to children with parents in different-sex couples, children with parents in same-sex couples had 31% lower odds of having access to a medical home, 36% lower odds of having a usual place to go for health care, and 29% lower odds of receiving family-centered care. Results suggest less access to care consistent with the medical home criteria for children with parents in same-sex versus different-sex couples.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"51 1","pages":"250 - 262"},"PeriodicalIF":0.9,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48887454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-03DOI: 10.1080/02739615.2021.2004146
Rebecca M. Warwick, Daniel E Shumer
ABSTRACT Modern transgender and non-binary (TGNB) pediatric health care originated in the 1990s. This patient population is adversely affected by minority stress, victimization, mental health disparities, and barriers to health care With improving social and cultural support for TGNB identities and favorable evidence for affirming social and medical interventions, the need for pediatric gender services clinics has grown. Gender-affirming care requires collaboration between social and medical entities, including school personnel, community services, medical providers, and mental health professionals, which is best served within a multidisciplinary treatment model of care. This article provides an overview of the components within multidisciplinary pediatric gender clinics.
{"title":"Gender-affirming multidisciplinary care for transgender and non-binary children and adolescents","authors":"Rebecca M. Warwick, Daniel E Shumer","doi":"10.1080/02739615.2021.2004146","DOIUrl":"https://doi.org/10.1080/02739615.2021.2004146","url":null,"abstract":"ABSTRACT Modern transgender and non-binary (TGNB) pediatric health care originated in the 1990s. This patient population is adversely affected by minority stress, victimization, mental health disparities, and barriers to health care With improving social and cultural support for TGNB identities and favorable evidence for affirming social and medical interventions, the need for pediatric gender services clinics has grown. Gender-affirming care requires collaboration between social and medical entities, including school personnel, community services, medical providers, and mental health professionals, which is best served within a multidisciplinary treatment model of care. This article provides an overview of the components within multidisciplinary pediatric gender clinics.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"52 1","pages":"91 - 115"},"PeriodicalIF":0.9,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46496823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-02DOI: 10.1080/02739615.2021.1993228
C. Lynn, E. Lyons, E. Muther
ABSTRACT Cystic fibrosis (CF) is an inherited, life-limiting chronic health condition that impacts many organ systems including the lungs, pancreas, liver, intestines, and reproductive organs. Given the various organ systems impacted, treatments can be complex, burdensome, and time consuming. In addition, the stress and emotional impact of CF on caregivers as well as patients is significant. This paper describes delivery of psychosocial care across developmental stages in the largest pediatric CF center in the country. The focus will be on goals of care as well as assessment and intervention strategies. Furthermore, clinical informatics and next steps also will be discussed.
{"title":"Delivery of cystic fibrosis psychosocial care across developmental stages","authors":"C. Lynn, E. Lyons, E. Muther","doi":"10.1080/02739615.2021.1993228","DOIUrl":"https://doi.org/10.1080/02739615.2021.1993228","url":null,"abstract":"ABSTRACT Cystic fibrosis (CF) is an inherited, life-limiting chronic health condition that impacts many organ systems including the lungs, pancreas, liver, intestines, and reproductive organs. Given the various organ systems impacted, treatments can be complex, burdensome, and time consuming. In addition, the stress and emotional impact of CF on caregivers as well as patients is significant. This paper describes delivery of psychosocial care across developmental stages in the largest pediatric CF center in the country. The focus will be on goals of care as well as assessment and intervention strategies. Furthermore, clinical informatics and next steps also will be discussed.","PeriodicalId":46607,"journal":{"name":"Childrens Health Care","volume":"52 1","pages":"70 - 90"},"PeriodicalIF":0.9,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43613032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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