Journal of Health Organization and Management最新文献

{"title":"A novel approach to prioritizing health technology investments using integrated AI-based ranking model.","authors":"Yaşar Gökalp, Serkan Eti, Hasan Dinçer, Serhat Yüksel","doi":"10.1108/JHOM-05-2024-0190","DOIUrl":"https://doi.org/10.1108/JHOM-05-2024-0190","url":null,"abstract":"<p><strong>Purpose: </strong>Health technologies are an issue that directly affects the sustainability and quality of health services. Due to budget constraints, it is not financially possible for businesses to apply comprehensive improvement strategies to all these criteria. In this case, it is possible for businesses to implement more priority strategies. Accordingly, the main purpose of this study is to evaluate the important performance indicators of health technology investments.</p><p><strong>Design/methodology/approach: </strong>Firstly, with the help of the artificial intelligence system, a decision matrix is established. Secondly, spherical fuzzy total order of preference decision-making trial and evaluation laboratory methodology is taken into consideration for weighting the criteria. Thirdly, emerging seven countries are ranked by using spherical fuzzy MultiAtributive Ideal-Real Comparative Analysis (MAIRCA).</p><p><strong>Findings: </strong>The findings demonstrate that the criteria of health policies and research and development are defined as the most significant factor in this regard. China and Turkey are also found to be the most successful emerging countries with respect to the performance of health technology investments.</p><p><strong>Originality/value: </strong>The main contribution of this study is that a novel decision-making model is generated by integrating artificial methodology into the spherical fuzzy sets.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956641","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}

{"title":"The missing links of value congruence: evidence from the Thai healthcare workforce.","authors":"Decha Dechawatanapaisal","doi":"10.1108/JHOM-09-2024-0367","DOIUrl":"https://doi.org/10.1108/JHOM-09-2024-0367","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate possible factors, such as trust in management and shared vision, that influence value congruence and its mediating effect on work engagement. It also explores how resilience, functioning as a moderator, could change the nature of the links between value congruence and its determinants.</p><p><strong>Design/methodology/approach: </strong>Data were collected through an online survey from 301 healthcare employees in Thailand. Hypotheses were tested and analyzed using confirmatory factor analysis, structural equation modeling and bootstrapping procedures.</p><p><strong>Findings: </strong>The results reveal that value congruence mediates the positive impacts of trust in management and shared vision on work engagement. Trust in management and shared vision translate into higher levels of value congruence, more so when employees are highly resilient.</p><p><strong>Practical implications: </strong>The findings suggest that healthcare administrators should design interventions to cultivate trustworthy leadership behaviors in daily operations while improving communication of the organization's overarching vision and objectives to help employees internalize and seamlessly integrate its core values into their own professional identities.</p><p><strong>Originality/value: </strong>Despite the extensive research on value congruence and its outcomes, little is known about its development. This study makes a valuable contribution by addressing these missing links, particularly in hospital settings. It also highlights how resource management explains the ways in which resilience in practice influences employees' value congruence at work.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956240","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}

{"title":"Navigating the COVID-19 crisis: a study of healthcare leadership response in India and the USA.","authors":"Jallavi Panchamia, Yogita Abichandani, Ridhi Arora","doi":"10.1108/JHOM-09-2024-0383","DOIUrl":"https://doi.org/10.1108/JHOM-09-2024-0383","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic has reignited the debate on effective leadership during a crisis. The study examined healthcare leaders' experiences, challenges and responses amid the COVID-19 crisis in India and the USA.</p><p><strong>Design/methodology/approach: </strong>Thematic analysis culminated in developing a thematic framework that encapsulates the behavior of operational healthcare leaders in India and the USA to illustrate how they responded to the global pandemic. Twelve hospital leadership experiences were collected through in-depth Interviews.</p><p><strong>Findings: </strong>The study highlighted comparable experiences and leadership responses from the USA and India. Thematic framework induced from three themes and eight sub-themes to illustrate how leaders handled unknown challenges of the pandemic, which they countered with increased accountability as a leader, extended need-based networking with inevitable experience of self-role distance, leading to their pragmatic approach and reinforcement of self-belief.</p><p><strong>Research limitations/implications: </strong>The study findings provide a way forward for revisiting existing crisis management frameworks and cross-cultural leadership theories in terms of behavioral aspects integration with the technical or operational aspects of crisis management.</p><p><strong>Practical implications: </strong>Healthcare leaders aiming to rebuild hospital systems would benefit from the study by incorporating identified skills such as coping with emotional labor, self-role distance, perseverance, pragmatic approach, networking with extended stakeholders, and extra-role behaviors into training and mentoring programs.</p><p><strong>Originality/value: </strong>Using a thematic analysis approach, the study's two-country research design identified a homogeneous leadership response despite a distinct countrywide context.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956642","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}

{"title":"The trends of patient engagement in a co-production healthcare services: a insights from a bibliometric analysis.","authors":"Bagus Nuari Harmawan, Sofia Al Farizi","doi":"10.1108/JHOM-03-2024-0123","DOIUrl":"https://doi.org/10.1108/JHOM-03-2024-0123","url":null,"abstract":"<p><strong>Purpose: </strong>Co-production improves the quality of healthcare services by prioritizing patient-centred care and ensuring optimal implementation. Current patient participation research have primarily concentrated on the co-production stages, despite patient participation being the central emphasis of its implementation. A study conducted analysed four specific attributes of patient participation, with patient engagement specifically emphasizing the interactions between patients and healthcare workers. Several studies have concluded that the interaction between the two actors is inefficient. This article examines current study trends concerning patient participation and identifies knowledge gaps from these studies.</p><p><strong>Design/methodology/approach: </strong>This study used bibliometric analysis. This study used VOSviewer software for bibliometric analysis. The Scopus database contained 398 publications about patient participation in co-production in healthcare, which served as the basis for the analysis.</p><p><strong>Findings: </strong>The study on patient engagement in a co-production context for healthcare had grown fast in recent years. Patient-centred approach and patient-centred care were two important things in patient engagement. Several factors influenced the implementation of patient engagement: attitude, ability, awareness, responsibility and knowledge. It is still uncommon to do research on the measurement of output and results from patient engagement implementation. Studies on instruments for measuring these two factors, particularly in a quantitative manner, are still few.</p><p><strong>Research limitations/implications: </strong>Various recommendations have been put forward for additional investigation. Firstly, further examination of outcome measurement in patient engagement is necessary, given the lack of decisive instruments available. Secondly, examining the most influential factors on patient engagement in co-production in healthcare. Thirdly, a more thorough analysis is needed regarding the dimensions of co-production, considering that some dimensions overlap, such as the activation and empowerment dimensions, which are really carried out during engagement. The researcher acknowledges the inherent limitations of bibliometric studies, including the dependence on the Scopus databases for extracting data and the choice of search phrases. Furthermore, conducting a systematic literature review may be necessary to thoroughly examine and delineate the research topics, methodologies and outcomes of this study.</p><p><strong>Originality/value: </strong>This study updates us on patient engagement study trends and establishes a framework for implementing patient engagement in healthcare services.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915968","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}

{"title":"The effect of lean leadership on workload and job satisfaction: the moderating effect of workload and gender.","authors":"Mustafa Nal, Erhan Dag, Yasar Demir","doi":"10.1108/JHOM-08-2024-0330","DOIUrl":"https://doi.org/10.1108/JHOM-08-2024-0330","url":null,"abstract":"<p><strong>Purpose: </strong>The first aim of this study is to determine the effect of lean leadership on the workload and job satisfaction of healthcare workers, and the second aim is to reveal the moderating role of workload and employee gender in this relationship.</p><p><strong>Design/methodology/approach: </strong>In this study, we created a comprehensive model to determine the effect of lean leadership on the workload and job satisfaction of healthcare employees and to reveal the moderating role of workload and employee gender in this relationship. We collected 1,207 valid questionnaires among Turkish health workers.</p><p><strong>Findings: </strong>The results indicate that: (1) Lean leadership reduces perceived workload, (2) Lean leadership increases job satisfaction, (3) Workload moderates the effect of lean leadership on job satisfaction and (4) Employee gender moderates the effect of lean leadership on job satisfaction and workload. These findings have provided theoretical and practical suggestions for reducing the workload and increasing the job satisfaction of healthcare employees. Finally, we will make some suggestions for the future.</p><p><strong>Research limitations/implications: </strong>As with other studies, there are some limitations in this study. The data used in this study were collected in Turkey. Turkish culture has a more collectivist culture than Western countries (Koksal 2011). In addition, the research was carried out with the participation of health employees. Due to Turkish cultural characteristics and the characteristics of health services, the generalization of research results may be limited. Therefore, it is recommended that the research be repeated across different cultures and different sectors to determine whether our results are culture-specific, sector-specific or generalized.</p><p><strong>Practical implications: </strong>Healthcare managers can reduce the perception of employees' workload by showing lean leadership behavior. Healthcare managers can increase their job satisfaction by valuing employees, inviting them to participate in business processes and providing them with the resources they need.</p><p><strong>Social implications: </strong>In order to maintain and increase health workers' job satisfaction, we recommend that health managers should ensure fair job sharing. In addition, health managers should take into account that female employees are more sensitive about the workload.</p><p><strong>Originality/value: </strong>This research is the first study to examine the effect of lean leadership behavior on healthcare professionals' workload perception and job satisfaction. Therefore, it offers important theoretical and practical implications.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856008","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}

{"title":"Meaningful organizational routines in primary healthcare: influencing factors and their consequences for routine enactment.","authors":"Mattias Jacobsson, Malin Näsholm","doi":"10.1108/JHOM-10-2023-0317","DOIUrl":"10.1108/JHOM-10-2023-0317","url":null,"abstract":"<p><strong>Purpose: </strong>Based on the well-known risks associated with deviating from established routines in primary healthcare and the positive consequences of upholding them, the purpose of this study is to increase the understanding of the role of meaningfulness in the enactment of organizational routines.</p><p><strong>Design/methodology/approach: </strong>The study is based on 24 semi-structured interviews with three different professional categories in primary healthcare in Sweden. The data were analyzed using thematic analysis on a latent level, combined with a two-factor model as sensitizing concepts.</p><p><strong>Findings: </strong>Differences are identified between factors that reduce meaninglessness (called \"sufficiency factors\") and those that enable meaningfulness (called \"meaningfulness factors\"). Nine sufficiency factors and six meaningfulness factors explain what makes organizational routines perceived as meaningful by the different professional groups. A two-factor matrix is developed that highlights the intricate challenges associated with routine enactment based on these factors.</p><p><strong>Originality/value: </strong>The study is unique in that it is the first to integrate research on organizational routines and meaningfulness. However, understanding meaningful organizational routines is not only essential because it is an overlooked area in both of these two streams of research but also because of its clear, practical relevance in the primary healthcare setting.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"39 9","pages":"16-35"},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915966","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}

{"title":"Resilience in local Finnish health systems: how are leaders' approaches to change manifested in organisational crisis responses?","authors":"Soila Karreinen, Kristiina Janhonen, Laura Kihlström, Henna Paananen, Marjaana Viita-Aho, Liina-Kaisa Tynkkynen","doi":"10.1108/JHOM-06-2024-0257","DOIUrl":"10.1108/JHOM-06-2024-0257","url":null,"abstract":"<p><strong>Purpose: </strong>Local health systems form the basis for health system resilience. Leaders' standpoints are crucial in advancing resilience capacities and change. This study analysed how local health system leaders' approaches to change reflect health system resilience capacities. Furthermore, we explored what triggers and hinders change during a crisis.</p><p><strong>Design/methodology/approach: </strong>The data consist of purposively sampled interviews with 14 local Finnish health system leaders during the COVID-19 pandemic. Using abductive content analysis, examples of resisting, absorbing, adapting and transforming were identified. Contextual triggers and hindrances for the initiation of change processes were analysed to support understanding of health system resilience capacities at the local level.</p><p><strong>Findings: </strong>Resilience capacities were manifested by doing standard things faster (absorption), engaging in collaborative reflections (adaptation) and reforming organisational boundaries and services (transforming). \"Resisting\" leaned on varied levels of reflection, with mixed responses. Triggers and hindrances varied situationally and highlighted the roles of a changing operational environment, existing practices and the social dimension (e.g. building a shared understanding).</p><p><strong>Originality/value: </strong>Leaders' standpoints and their approaches to change are rarely the focus of attention in system-centred conceptualisations of health system resilience. Leaders' awareness of their approaches to change can affect organisational responses and health system resilience. This should be more clearly acknowledged in theoretical frameworks, leadership training, preparedness planning and crisis governance. Health system resilience capacities form intertwined, nonlinear processes that are reshaped throughout a crisis. Analysis of resistance can enrich the understanding of local-level processes.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":"39 9","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877679","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}

{"title":"Effect of relation or effect of investment? Procedural justice and physician authority as factors shaping the well-being of patients.","authors":"Tomasz Prusiński, Stanisław Burdziej, Michał Główczewski","doi":"10.1108/JHOM-03-2024-0091","DOIUrl":"https://doi.org/10.1108/JHOM-03-2024-0091","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to determine the predictive power of two relational factors, procedural justice and legitimacy, against the well-being of patients receiving medical care.</p><p><strong>Design/methodology/approach: </strong>The study sample consisted of 590 patients in treatment for somatic conditions in hospital outpatient clinics. The study was conducted in a correlational scheme. Subjects evaluated their relationship with their chosen doctor. In order to verify the hypotheses, SEM was carried out.</p><p><strong>Findings: </strong>The relationship effect was noted. Procedural justice was a significant and positive predictor of psychological well-being, while distributive justice, i.e. time and money invested by the patient in their treatment, was not. The perceived legitimacy of the doctor was not a significant predictor of the psychological well-being of their patient. The relationship between the experience of procedural justice and psychological well-being was serially mediated by patients' perceived physician legitimacy and perceived life satisfaction.</p><p><strong>Originality/value: </strong>Relational factors shape treatment outcomes operationalized by patients' subjective sense of well-being. Fair patient handling is a predictor of positive treatment outcomes.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814586","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}

{"title":"Employee voice in healthcare: a systematic review.","authors":"Leah Hague, Michael Barry, Paula K Mowbray, Adrian Wilkinson, Ariel Avgar","doi":"10.1108/JHOM-11-2023-0353","DOIUrl":"https://doi.org/10.1108/JHOM-11-2023-0353","url":null,"abstract":"<p><strong>Purpose: </strong>We aim to advance our understanding by examining voices related to employees' own interests and associated outcomes for employees and healthcare organizations. Patient safety reviews do not explore contextual factors such as organizational or professional cultures and regulatory environments in depth, and arguments for overcoming barriers to voice in health are underdeveloped. The research has largely developed in separate literature (various subdisciplines of management and the health field), and we outline the divergent emphases and opportunities for integration with the aim of investigating all relevant contextual factors and providing guidance on best practice informed by multiple disciplines.</p><p><strong>Design/methodology/approach: </strong>A systematic approach was taken to gathering and reviewing articles, and coding and reporting are in line with the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Rethlefsen <i>et al</i>., 2021).</p><p><strong>Findings: </strong>We identified a range of facilitators, barriers and outcomes of employee interest voice at different levels (organizational, leadership, team or individual) in a healthcare context. We identify various theoretical, methodological and knowledge gaps, and we suggest several ways in which these can be addressed in future research efforts.</p><p><strong>Practical implications: </strong>We make multiple contributions to both theory and practice, including highlighting the importance and implications of integrating disciplinary approaches, broadening context, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of healthcare voice and to shifting management focus to include all forms of employee voice in healthcare for the benefit of staff and patients.</p><p><strong>Originality/value: </strong>We make multiple contributions to both theory and practice including highlighting the importance of integrating disciplinary approaches, broadening context to include employee interest issues, improving research design and exploring under-researched samples and topics. This information is essential in providing a more comprehensive model of health care voice and to shifting management focus to take a more inclusive view of employee voice in healthcare for the benefit of staff as well as patients.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807419","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}

{"title":"Stakeholder management and financial sustainability in philanthropic hospitals.","authors":"Antônio Ronaldo Madeira de Carvalho, Gérson Tontini","doi":"10.1108/JHOM-07-2024-0286","DOIUrl":"https://doi.org/10.1108/JHOM-07-2024-0286","url":null,"abstract":"<p><strong>Purpose: </strong>This paper explores how the maturity of social relationship management in philanthropic hospitals affects community engagement as well as economic and financial support.</p><p><strong>Design/methodology/approach: </strong>The research is based on a sample of 121 philanthropic hospital organizations located in Brazil, answered by hospital managers. Using structural equation modeling, this study examines how the hospital's maturity in managing community relations influences both the community's engagement with the hospital and its economic and financial support. The model is related to the maturity of community relationship management (technology, process, people, strategy and organizational culture), community engagement (interactivity, social presence and loyalty) and community economic and financial support.</p><p><strong>Findings: </strong>The results reveal that community involvement positively impacts economic and financial support, but there is no positive and direct correlation between the maturity of community relationship management and economic and financial support. As hospitals mature in management practices, community involvement in economic and financial support tends to decrease. Nevertheless, effective community engagement remains crucial for economic and financial support. The study emphasizes the need for structured relationship management within philanthropic hospitals and the implementation of effective strategies for community involvement.</p><p><strong>Originality/value: </strong>This study introduces a new model for evaluating the maturity of hospital-community relationship management.</p>","PeriodicalId":47447,"journal":{"name":"Journal of Health Organization and Management","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819387","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}