Journal of Pharmacy Practice and Community Medicine最新文献

{"title":"Patient’s Knowledge of Drug-Related Cost Information in Saudi Arabi","authors":"Y. Alomi, Dima Ahmad Alaskari, Malak Mohammad Almelfi, Dima Badawi","doi":"10.5530/JPPCM.2018.3.42","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.3.42","url":null,"abstract":"Objective: To explore the Patient’s Knowledge of medicines related cost information in Saudi Arabia. Methods: It is a 4-months cross-sectional survey of patient and basic knowledge of medicines. The survey consisted of two-part, demographic information and second part forty-nine questions divided into four domains. It included domain 1: Primary or essential information about patient medication, domain 2: patient information about the drug-related problem, domain 3: patient information about drug-related cost and domain 4: patient perception of medications. Medline Plus health information and DailyMed-INH elements information from National Institute of Health United State of America were used. The 5-point Likert response scale system was used. The questions were open and closed-ended. The survey distributed through social media and at 500-bed pediatrics and maternity hospital in Asir region, at ambulatory care pharmacy. The hospitals were accredited by Saudi Center for Healthcare organization (CBAHI) and Joint Commission on Hospital Accreditation from the United States of America (USA). The authors did the patients interview with electronic survey documentation. The survey was made in an electronic format and it analyzed domain three patient information about drug-related cost through survey monkey system. Results: The total responders were (614) patients with Saudi 564 (96.1%) and Non-Saudi 23 (3.9%) nationalities. The gender distribution 523 (85.2%) were females and 91 (14.8%) were males. The most type of medications used was anti-diabetic and anti-hypertension medicines, Skin medications and drugs for Respiratory Diseases. The responders showed good knowledge about drug storage at room temperature 380 (64.7%) or refrigerator 378 (64.7%), protect medication from light exposures 335 (57.56%) and how to behave with an expired medication 328 (59.85%). The patient had not adequate information about prescription prices 294 (49.83%) and imperfect knowledge about Health insurance coverage of medications 198 (32.53%). The patients showed that missing of medication knowledge led them to visit doctor clinic 114 (20%), visit the pharmacy 180 (32.4%), visit hospital emergency 40 (7.4%), hospital admission 77 (13.9%) or intensive care admission 23 (4.3%). Conclusion: The patients missed medication cost knowledge in Ministry of Health organization. Drug-related prices and medication cost awareness are demanding for Saudi patient to prevent drug-related hospital admission, patient’s shares in the drug therapy plan to choose the appropriate medications to improve patient adherence and improve clinical outcomes and patients’ quality of life. Key words: Patient, Knowledge, Medications, Cost, Ministry of Health, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82228984","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":"Healthcare professionals and Basic Knowledge of Medications in Saudi Arabia","authors":"Y. Alomi, Dima Ahmad Alaskari, Malak Mohammad Almelfi, Dima Badawi","doi":"10.5530/JPPCM.2018.3.39","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.3.39","url":null,"abstract":"Objective: To explore the Healthcare professionals and Basic Knowledge of Medications in Saudi Arabia. Methods: It is a 4-months cross-sectional survey of healthcare professionals and knowledge of medicines. The survey consisted of two-part, demographic information and second part forty-nine questions divided into four domains. It included domain one: Primary or essential information about healthcare providers medication, domain two: healthcare professionals information about the drug-related problem, domain three: healthcare professionals information about drug-related cost and domain four: Healthcare providers perception of medications. All type of healthcare professionals included in the study. Medline Plus health information and DailyMed-INH elements information from National Institute of Health United State of America were used. The survey was distributed through social media by using what’s App to more than one thousand healthcare professionals overall Kingdom of Saudi Arabia. The survey was made in an electronic format and it analyzed domain one Primary or necessary information about healthcare professionals medication through survey monkey system. Results: The total responders were (188) Healthcare professionals. Of those 177 (95.16%) were Saudi and 9 (4.84%) were non-Saudi. The gender distribution 120 (63.83%) were females and 68 (36.17%) were males. The most of Healthcare professionals were pharmacists 93 (71.54%), followed by nurses 18 (13.85%) and physicians 15 (11.54%). The most type of medications used was anti-hypertension medicines, anti-diabetic medicines, Skin medications and drugs for Respiratory Diseases. The healthcare professionals showed adequate knowledge both complete and incomplete information of the generic name of Medicines 117 (67.6%), the trade name 126 (73.7%), drug strength 128 (73.9%) and dosage form of medication 132 (76.7%). The responders showed adequate knowledge about medications with both complete information and incomplete information about drug indication 159 (85.5%), how to use medications 161 (87 %). The administration time 161 (86.55%), what to do if patient forgot one dose 133 (71.9%), the potential to adhere medication 159 (86.4%) and the time to stop drugs 148 (79.57%). The majority of responders used drug bulletin 126 (69.61%), Health practitioners 123 (67.96%), Internet 108 (59.67%) and Drug Information Center at the hospital 36 (19.89%) as sources of drug information. Conclusion: More than one-third of Healthcare professionals missed complete essential drug information knowledge. Targeting of health care professionals; with individual basic drug information courses for the healthcare professionals through drug information services is required in Saudi Arabia. Key words: Healthcare professional, Knowledge, Medications, Ministry of Health, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83805010","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":"Depression Management Physician Order: New initiatives at the Mental Hospital of Ministry of Health in Saudi Arabia","authors":"Y. Alomi, Nora Alsolami, Nada Al Qahtani, A. Rahbini","doi":"10.5530/jppcm.2018.2.29","DOIUrl":"https://doi.org/10.5530/jppcm.2018.2.29","url":null,"abstract":"The general administration of pharmaceutical care stated evidence-based pharmacy guidelines at Ministry of Health hospitals and primary healthcare centers in 2015. That has included several programs related to anticoagulation, pain management, and antibiotics. The new initiative’s project from the most significant mental hospital in Riyadh region of starting psychiatric disease drug therapy management physician order. The hospital started with a standard disease like depression. The tax force team designed the updated guidelines and approved by an official body in the hospital. The form friendly used and very important in preventing drugrelated problems and education system for healthcare staff. Key words: Depression management, Physician Oder, Ministry of Health, Saudi Arabia","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77720154","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":"Pharmacovigilance Knowledge and Perceptions Among Pharmacy, Medical and Nurse Students in University of Duhok","authors":"O. Al-lela, R. Elkalmi, Avan Saleem Salih, Diana Yaqo Yousif, Hala Wazir Ali, Narmin Oraha Shammo","doi":"10.5530/JPPCM.2018.2.16","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.2.16","url":null,"abstract":"Objective: To assess pharmacy, medical and nurse students’ knowledge of and perceptions about pharmacovigilance and reporting of adverse drug reactions (ADRs) at University of Duhok (UOD). Methods: A cross-sectional study was conducted from November 1, 2017, through January 1, 2018 using a validated self-administered questionnaire delivered to a sample of 202 students at Colleges in UOD. Results: About 42% of students indicated that they had taken courses on the concept of pharmacovigilance during their current curriculum. The mean score for knowledge about pharmacovigilance and ADR reporting was 6.98. There was a significant difference in the mean scores for knowledge about pharmacovigilance across the Colleges. About 38.6% of the respondents believed that students are competent and capable of reporting ADRs during their clerkships. The majority (67.6%) of respondents perceived that students should be taught how to report ADRs. Conclusion: The results of this study demonstrate that the majority of students in public universities have insufficient knowledge about pharmacovigilance and ADR reporting. Key words: Pharmacovigilance, Knowledge, Perception, Iraq.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81336667","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":"Cost Avoidance of Drug Information Services at the Mental Hospital in Saudi Arabia","authors":"Y. Alomi, N. Alsulami, Nada Al Qahtani, Mohamed Mashouf Al Qahtani, Fahad Abdallah Almansor","doi":"10.5530/jppcm.2018.2.23","DOIUrl":"https://doi.org/10.5530/jppcm.2018.2.23","url":null,"abstract":"Objective: To explore the cost-efficiency of drug information services at the mental hospital in Saudi Arabia. Methods: It simulation of cost efficiency of drug information center for four years and a half at a mental hospital in Saudi Arabia. It estimated cost avoidance of running drug information services. Drug information services started from answering inquiries from healthcare providers including a physician, pharmacist, and nurses. The estimated cost of using international Study Model. The value considered were the expected results of drugrelated problems sequel to drug information inquiries; if not existing drug information services and were not answered; starting from Physician visit, additional laboratory test, further treatment, hospital admission, Critical care admission to death stage. The cost estimated for each step. All value used in USA solar currency. Results: The total of drug information inquiries answered with cost avoidance reported was (1084). The total estimated cost avoidance of answered drug information inquiries was (167,623.50) USD with average cost avoidance was (154.63) USD per each inquiry. The most type inquiries estimated cost avoidance was drug dosing (117,316.50) USD followed by the drug of choice (17,960.00) USD and drug interaction (14,024.50) USD. The most estimated cost avoidance by a used references assistant to answer the question and prevent drug-related problem was Drugs.com website (118,683.50) USD, followed by Lexi comp-drug information (100,064.50) USD and prescribing guidelines in psychiatry (18,642.00) USD. The most cost avoidance related to drug information caller was physician (135,787.50) USD, pharmacist (28,624.50) USD and patients (2,342.50) USD. Conclusion: The drug information services are saving a high cost per year despite limited resources. The drug information services with different type need to expand to all departments at a Mental hospital in Riyadh city, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82365234","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":"Medical and Pharmacy Students’ Perceptions Regarding Generic Medicines in Yemen","authors":"A. Al-mohamadi, Abdulsalam M. Halboup, M. Ibrahim, M. Abdulghani, Y. Al-Worafi, Gamil Otham, Mohammed Alshakka, M. Ansari","doi":"10.5530/JPPCM.2018.2.13","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.2.13","url":null,"abstract":"Objective: The study is to evaluate Yemeni medical and pharmacy students’ knowledge and attitude regarding generic medicines. Method: A cross-sectional survey was used to collect data from final-year medical and pharmacy students at six public and private universities in Yemen. The questionnaire was distributed among the students through their course coordinators. Students were clearly informed about the objective of the study and their written consents were taken before the survey. The responses were entered in SPSS, and descriptive and inferential analyses were carried out. Results: The response rate was 60.1%. Overall the half of participants’ perception regarding generic medicine was positive. Perceptions of pharmacy students’ regarding generic medicines were better than those of the medical students. Conclusion: The present study concluded that both studied groups had insufficient knowledge about quality, safety and bioequivalence of generic medicines. The medical students showed poorer knowledge than pharmacy students which need to give more attention from educators regarding the use of generic medicines. Key words: Generic drugs, Medical students, Perception, Pharmacy students, Yemen.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78850107","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":"Analysis of Drug Information Inquires at a Mental Hospital in Saudi Arabia","authors":"Y. Alomi, Nada Al Qahtani, N. Alsulami, Mohamed Mashouf Al Qahtani, Fahad Abdallah Almansor","doi":"10.5530/JPPCM.2018.2.18","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.2.18","url":null,"abstract":"Objective: To explore the analysis of drug information inquiries at a Mental hospital in Saudi Arabia. Method: It is 4.5- years cohort analysis of drug Information centers inquiries at a 500-bed Mental hospital in Riyadh city, Saudi Arabia. All drug information centers should enter the electronic answer form of drug information inquiries. American Society of Health-System Pharmacist (ASHP) drug information model. The form consisted of questioner demographic information, questioner contact information, patient demographic data, patient diagnoses or health problems, question classification, the specific inquiry, and answer, drop list of references (Tertiary resources, secondary resources, and primary resources), and pharmacist answered demographic data. The form made through survey monkey system. The format analyzed through the Microsoft Excel sheet version 10th. Results: The total of drug information inquiries was (1088). Most of the inquiries asked by pharmacist 504 (46.32%), physician 496 (45.59%) and patients 49 (4.5%). The most type of inquiries was drug dose 272 (25%), and drug of choice 204 (16.74%), followed by drug interaction 186 (17.1%) and adverse drug reaction 172 (15.81%). The physician frequently asked about adverse drug reaction 120 (24.19%) followed by drug dosing 106 (21.37%)and drug of choice 101 (20.36%). While the pharmacist most frequently asked about drug dosing 156 (30.95%) followed by drug interaction 100 (19.84%) and drug of choice 85 (16.87%). The most type of references used to answer the question was other 416 (38.52%) and Drug.com website 263 (24.35%) followed by Medscape website 226 (20.35%) and prescribing guidelines in psychiatry book 162 (15%). Conclusion: The drug information services prove comprehensive answering of drug inquiries at a mental hospital in Riyadh city, Saudi Arabia. The drug information services need update references and more awareness to medical staff. Key words: Drug information, Inquires, Mental hospital, Ministry of Health, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73911666","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":"Bipolar Disorder Management Physician Oder: New Initiatives at the Mental Hospital of Ministry of Health in Saudi Arabia","authors":"Y. Alomi, Nora Alsolami, Nada Al Qahtani, A. Rahbini","doi":"10.5530/jppcm.2018.2.28","DOIUrl":"https://doi.org/10.5530/jppcm.2018.2.28","url":null,"abstract":"The national psychiatric pharmacy program is new system founded in the Kingdom of Saudi Arabia. The program of mental health care services at Ministry of health. The new program started with several initiatives projects including evidence named medicine guidelines. The new project of bipolar disorder management physician order was one the outcome of the program. The guidelines development through task force committee by Pharmacy department at the most prominent mental hospital, in Riyadh region in Saudi Arabia. The project prevents antipsychotic-related problems and avoids the unnecessary economic burden on the healthcare system. The new initiative’s project is new in Saudi Arabia, Gulf and Middle East counties. Key words: Bipolar Disorder, Management, Physician Oder, Ministry of Health, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87266137","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":"Patients and Healthcare Providers’ Attitudes and Perceptions of Drug-related Problems in Saudi Arabia","authors":"Y. Alomi, A. Al-Shaibani, Ghadeer Alfaisal, Njood Mohmmed Alasmi","doi":"10.5530/jppcm.2018.2.21","DOIUrl":"https://doi.org/10.5530/jppcm.2018.2.21","url":null,"abstract":"Purpose: To explore the patients and healthcare providers’ attitudes and perceptions of drug-related problems in Saudi Arabia. Methods: It is a 4-months cross-sectional survey of drug-related problem information in Saudi Arabia. The study consisted of two-part a demographic data, and second part contained the questions about the knowledge of drug-related problems, the frequent occurrence, the type of medication-induced those problems, and the resources information used about the drug-related problem. American Society of Health- System Pharmacist definitions of drug-related problems used. The 5-point Likert response scale system used. The survey distributed through social media. The questionnaire made of an electronic format, and it analyzed through survey monkey system. Results: The total responders were two hundred and one; the Saudi nationality was 188 (93.5%), and non-Saudi was 13 (6.5%) patient. The gender distribution was female 180 (89.6%), and the male was 21 (10.4%). The majority of them in age (18-44) 88% and located in Riyadh region 84 (41.8%) and Asir region 59 (29.4%). Of those 44 (22.1 %) were healthcare providers. The majority of responders showed good knowledge about medication non-compliance 150 (75.76%), and medication without indication 147 (73.1%), while an adequate revealed information of adverse drug reaction 128 (64%), and an indication without medication 124 (62%). The imperfect information found about drug interaction 75 (37.5%) and drug poisoning 89 (44.5%). The most frequent drug-related problems occurred with the patient last year at least once; it was drug noncompliance 142 (71.4%), indications without medication 100 (50%), and adverse medication events 80 (40%). The most resources information on drug-related problems used were the internet, medicine leaflet, and healthcare practitioners. Conclusion: Drug-related problems occurred at a high rate in Saudi patients. The knowledge of drug-related problems is not adequate. It is very demanding and comprehensive public education about medication and urgent implementation of the patient medications counseling program in Saudi Arabia. Key words: Patients, Healthcare providers, Attitudes, Perceptions, Drug-related problems, Saudi Arabia.","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84361594","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":"Nosocomial Infections in India: The Unaddressed Lacunae!","authors":"H. Bheemavarapu, M. Arief, Akram Ahmad, I. Patel","doi":"10.5530/JPPCM.2018.2.11","DOIUrl":"https://doi.org/10.5530/JPPCM.2018.2.11","url":null,"abstract":"A study by the international nosocomial infection control consortium found that the rates of hospital-acquired infections in India were higher than the statistics provided by the CDC (Center for Disease Control and Prevention).[1] Overcrowded hospitals with poor infrastructure, lack of basic hygiene, low healthcare professionals to patient ratio, inappropriate usage of invasive devices and antibiotics, and lack of regulation enforcement contributes to nosocomial infections-associated deaths in India. Recently, 290 children lost their lives in a tertiary referral hospital in Gorakhpur located in the northern state of Uttar Pradesh.[2] The Ministry of Health and Family Welfare of India launched an anti-microbial resistance awareness campaign known as ‘Red Line’, which encouraged people to put a stop to usage of medicines marked with a redline (antibiotics) and lacking a valid prescription from a physician.[3] In spite of awareness campaigns, the prevalence of nosocomial infections remains high in India. A recent study found 143 strains of Acinetobacter in a tertiary hospital in India, of which, 126 (88.1%) were extremely drug resistant.[4] Read more . . .","PeriodicalId":16825,"journal":{"name":"Journal of Pharmacy Practice and Community Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79097668","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}