Journal of Public Health Management and Practice最新文献

{"title":"Communication Disparities and Trusted Sources of COVID-19 Information in Massachusetts School Districts.","authors":"Anna L Thompson, Bradley S Davis, Augusta Rohrbach, Jonathan M Davis, Paola Sebastiani, Alice M Tang","doi":"10.1097/PHH.0000000000002052","DOIUrl":"10.1097/PHH.0000000000002052","url":null,"abstract":"<p><strong>Context: </strong>The COVID-19 pandemic led to the closure of prekindergarten to grade 12 schools and an inequitable return to full-time in-person learning.</p><p><strong>Objective: </strong>To explore how ethnic and racial differences across school districts in Massachusetts correlate with parents' attitudes, beliefs, and trusted sources of information about COVID-19 and mitigation strategies.</p><p><strong>Design: </strong>An electronic survey was distributed by school administrators to parents and guardians in November and December 2021 using existing school district contact lists and established methods of communication (email in 2 school districts; email and text message in 1 district).</p><p><strong>Setting: </strong>Three school districts in Massachusetts (Chelsea, Medford, and Somerville).</p><p><strong>Participants: </strong>Parents of prekindergarten to grade 12 school students attending public schools.</p><p><strong>Main outcome measures: </strong>Parental attitudes and beliefs regarding mitigation strategies for COVID-19 (surveillance testing, masking, and vaccination); trusted information sources about COVID-19; preferred methods of communication from schools.</p><p><strong>Results: </strong>A total of 1496 survey responses were analyzed. Chelsea respondents were predominantly Hispanic/LatinX (88%); Medford and Somerville were predominantly White/non-Hispanic (80% and 68%, respectively). Testing, masks, and vaccination were supported by >80% of parents/guardians across districts. However, there were statistically significant differences between school districts regarding participation in testing programs, implications of a child testing positive, vaccination of young children, communication preferences, and trusted sources of information.</p><p><strong>Conclusions: </strong>Although primarily focused on COVID-19, these results highlight opportunities for public health personnel and school administrators to work directly with parents and guardians in their school districts to improve communication strategies and be a trusted source of information for a variety of public health issues.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"291-304"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156371","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":"Updated National and State-Specific Prevalence of Congenital Cytomegalovirus Infection, United States, 2018-2022.","authors":"Chelsea S Lutz, Mark R Schleiss, Karen B Fowler, Tatiana M Lanzieri","doi":"10.1097/PHH.0000000000002043","DOIUrl":"10.1097/PHH.0000000000002043","url":null,"abstract":"<p><strong>Context: </strong>Congenital cytomegalovirus (cCMV) infection is the most common infectious cause of birth defects and the leading non-genetic cause of sensorineural hearing loss in the United States. Prior national cCMV infection prevalence estimates were based on one multi-site screening study conducted between 2007 and 2012 and were not adjusted for sociodemographic characteristics, such as maternal race and ethnicity or age.</p><p><strong>Objective: </strong>This study sought to estimate national and state-specific prevalence of cCMV infection in the United States, adjusted for maternal race and ethnicity and maternal age group, by pooling estimates from published studies.</p><p><strong>Design: </strong>We searched PubMed for U.S. cCMV newborn screening studies conducted between 2003 and 2023. From included studies, we abstracted maternal race and ethnicity- and age group-stratified cCMV prevalence to estimate strata-specific pooled prevalence. We obtained strata-specific weights from live birth data.</p><p><strong>Main outcome measure: </strong>Estimated adjusted national and state-specific prevalence estimates from 2018 to 2022.</p><p><strong>Results: </strong>Four studies (conducted 2004-2005, 2008, 2007-2012, and 2016-2021) were included for data abstraction. Overall, infants born to non-Hispanic Black (9.3 [8.2-10.5] per 1000) or non-Hispanic American Indian and Alaska Native (8.5 [2.1-33.2] per 1000) mothers had the highest cCMV prevalence. The estimated race and ethnicity-adjusted prevalence was 4.6-4.7 per 1000 live births nationally and ranged from 3.9 to 6.5 per 1000 across states from 2018 to 2022. Southern states and Alaska consistently had the highest cCMV prevalence. The estimated maternal age group-adjusted prevalence was 4.3-4.4 per 1000 live births nationally and ranged from 3.8 to 5.1 per 1000 across states from 2018 to 2022.</p><p><strong>Conclusions: </strong>States with larger proportions of racial and ethnic minorities had higher estimated prevalence of cCMV infection compared to states with larger proportions of White persons. These estimates may be useful for informing cCMV surveillance at the jurisdiction level and developing tailored, culturally relevant education and prevention strategies for persons at higher risk.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"234-243"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134217","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":"Experiences and Lessons Learned From Surging the Governmental Public Health Workforce During the COVID-19 Pandemic.","authors":"Katie Morrison Lee, Alyssa Bosold, Cindy Alvarez, Oluwatosin O Dada, Deborah S Porterfield","doi":"10.1097/PHH.0000000000002051","DOIUrl":"10.1097/PHH.0000000000002051","url":null,"abstract":"<p><strong>Context: </strong>During the COVID-19 pandemic, the United States relied on the public health workforce to control the spread of COVID-19 while continuing to provide foundational public health services. Facing longstanding staffing shortages, state, tribal, local, and territorial (STLT) public health agencies (PHAs) used various strategies and supports to surge the workforce in response to the pandemic.</p><p><strong>Objectives: </strong>The study explored (1) the types of strategies and supports STLT PHAs used to surge the public health workforce during the pandemic, (2) assessments of surge strategies and supports, and (3) approaches to using the range of surge strategies available.</p><p><strong>Design: </strong>We conducted 27 semi-structured interviews in 2023 and performed thematic analysis.</p><p><strong>Participants: </strong>Interviewees included STLT public health officials, leaders of organizations that directly supported the COVID-19 workforce surge, and public health workforce experts indirectly involved in the workforce surge.</p><p><strong>Results: </strong>To surge the workforce, interviewees relied on partnerships, staffing agencies, the National Guard, the Centers for Disease Control and Prevention Foundation's COVID-19 Corps, the Medical Reserve Corps, and other strategies. Interviewees valued strategies that rapidly engaged staff and volunteers at no cost to their PHA and flexible funding from the federal government to support surge efforts but noted shortcomings in the strategies and supports available. Interviewees described using multiple strategies simultaneously but noted challenges in implementing these strategies due to inadequate planning and insufficient staff and resources.</p><p><strong>Conclusion: </strong>The study underscores the need for STLT PHAs to establish mechanisms to surge the workforce as part of ongoing planning for emergency preparedness. Focus areas include building administrative and hiring capacity within STLT PHAs and sustaining partnerships and contractual agreements that helped fill staffing gaps during the pandemic. To support efforts to build workforce capacity to meet future surge management needs, STLT PHAs should consider creative solutions to attract and retain staff, as well as opportunities to engage students in public health work.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"283-290"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156372","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":"Local Supports to Break the Cycle: A Description of Intersectional Interventions to Address Adverse Childhood Experiences and Drug Overdose.","authors":"Amie C Myrick, Camille A Adams, Laura J Cremer, Nicole Filion, Stephanie Haddad, Caroline Snyder, April Wisdom","doi":"10.1097/PHH.0000000000002042","DOIUrl":"10.1097/PHH.0000000000002042","url":null,"abstract":"<p><strong>Context: </strong>Adverse childhood experiences (ACEs), substance use disorders (SUDs), and overdose are interconnected issues impacting individuals and communities at multiple levels of the social ecology and across generations. Few studies describe approaches that intentionally and simultaneously address these issues.</p><p><strong>Program: </strong>This paper examines activities of 15 sites across the country that were designed to simultaneously prevent ACEs, SUD, and overdose. This paper describes the work at the intersection as well as gaps and opportunities. Describing ways to implement intersectional programming may assist other organizations in taking similar steps in their communities.</p><p><strong>Implementation: </strong>From December 2020 through July 15, 2023, funded sites received technical assistance from the National Association of County and City Health Officials and the Centers for Disease Control and Prevention for 18 months to support the implementation, adaptation, and/or expansion of evidence-based programs to address ACEs, SUD, and overdose.</p><p><strong>Evaluation: </strong>Activities were coded to identify intersectional interventions that addressed ACEs, SUD, and overdose. Most of the ACEs prevention strategies and overdose prevention priority areas/guiding principles from which communities could choose were represented. Most activities were implemented with caregivers and families and addressed ACEs through interventions to lessen harm or to promote social norms. Primary prevention and coordination of resources were the most used overdose prevention priority area/guiding principle.</p><p><strong>Discussion: </strong>It is possible to address the intersection of ACEs, SUD, and overdose on a local level. Opportunities to further address the intersection include incorporating more secondary and tertiary prevention strategies, expanding economic supports, and increasing the work focused on equity.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"227-233"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548303","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":"National Public Health Accreditation: Now Is the Time.","authors":"Paul Kuehnert, Kaye Bender","doi":"10.1097/PHH.0000000000002099","DOIUrl":"10.1097/PHH.0000000000002099","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"155-156"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886313","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":"How Business and Public Health Can Work Better Together.","authors":"Emma Dewhurst, Bethany Kuerten","doi":"10.1097/PHH.0000000000002116","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002116","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"31 2","pages":"337-338"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025310","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":"Leveraging Media Monitoring to Inform Targeted Health Communications for Adolescents, Older Adults, and LGBTQ+ People.","authors":"Erika Bonnevie, Sierra Smith, Maddie Kapur, Joe Smyser, Brian C Castrucci","doi":"10.1097/PHH.0000000000002132","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002132","url":null,"abstract":"<p><strong>Objective: </strong>This manuscript assesses how media monitoring can guide the tailoring of public health communications for adolescents, older adults, and LGBTQ+ individuals, addressing their unique mental health challenges.</p><p><strong>Design: </strong>The study employed a thematic analysis of publicly available digital and social media data.</p><p><strong>Setting: </strong>Research was conducted using media monitoring platforms, with a focus on conversations relevant to specific groups within the United States.</p><p><strong>Participants: </strong>The dataset included millions of public posts relevant to mental health issues among adolescents, older adults, and LGBTQ+ communities, collected over a one-year period. Main Outcome Measures: Key themes and patterns within mental health discussions were identified.</p><p><strong>Results: </strong>Discussions around the \"youth mental health crisis\" were prominent, with 25% of adolescent-related posts reflecting this sentiment, often highlighting the impact of social media and academic pressures. For older adults, themes of loneliness and financial struggles were recurrent, with discussions showing a lack of practical support and resources. In LGBTQ+ conversations, there was an emphasis on the challenges of discrimination and identity-related misconceptions, with 28% of the mentions relating to mental health crises involving suicide or self-harm. These discussions underscored the critical need for inclusive and affirmative support tailored to the unique challenges faced by these groups.</p><p><strong>Conclusions: </strong>Media monitoring provides essential insights that can improve public health messaging by identifying trending mental health discussions and sentiments. By acknowledging and addressing the specific needs and challenges of specific population groups, public health communicators can develop more effective strategies that not only highlight problems but also offer clear, actionable solutions to promote better mental health outcomes and support. This approach is crucial for adapting health communications to the evolving landscape of media and public discourse, ensuring that messages are both relevant and supportive.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524631","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":"A Breath of Fresh Air: Pilot Testing Electronic Case Reporting for Public Health Surveillance of Occupational Lung Diseases in Wisconsin.","authors":"Paul D Creswell, Sara Mader, Komi K S Modji, Katherine E McCoy","doi":"10.1097/PHH.0000000000002147","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002147","url":null,"abstract":"<p><strong>Context: </strong>Public health surveillance plays a crucial role in evaluating disease risk and providing timely evidence to policymakers and the public. However, surveillance of many occupational diseases is limited by existing surveillance infrastructure, which is heavily dependent on laboratory tests.</p><p><strong>Objective: </strong>The present pilot study compared case data for 3 occupational lung diseases (ie, silicosis, asbestosis, and farmer's lung disease) from electronic case reports (eCR) with existing hospital discharge data in the state of Wisconsin to see if eCR-which sends health records directly from clinics when specific criteria are met-provided previously undetected cases of these reportable diseases.</p><p><strong>Design: </strong>Case data for 3 reportable occupational lung diseases were pulled from eCR records within the Wisconsin Electronic Disease Surveillance System. In this retrospective cross-sectional study, a unique identifier was used to match eCR cases to hospital discharge data.</p><p><strong>Setting and participants: </strong>This study was conducted using administrative data at a state health department to compare data systems and assess the utility of eCR for occupational health surveillance.</p><p><strong>Main outcome measures: </strong>The number and percentage of matched and unmatched cases were calculated to assess the overlap of the 2 data systems. For eCR cases, the median number of years since diagnosis was also assessed.</p><p><strong>Results: </strong>The percentage of eCR cases that could not be matched to hospital discharge data ranged from 55% to 81.2%, depending on the disease of interest. The median length of time since diagnoses for eCR cases was multiple years, suggesting that most had long been missing from existing surveillance.</p><p><strong>Conclusions: </strong>This study suggests that eCR creates new potential in occupational health surveillance. eCR was found to provide previously undetected cases of occupational lung disease at a state health department and stands to improve the timeliness of case reporting as well.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528129","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":"Content Analysis of Social Determinants of Health Accelerator Plans Using Artificial Intelligence: A Use Case for Public Health Practitioners.","authors":"Kelli DePriest, John Feher, Kailen Gore, LaShawn Glasgow, Clint Grant, Peter Holtgrave, Karen Hacker, Robert Chew","doi":"10.1097/PHH.0000000000002148","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002148","url":null,"abstract":"<p><strong>Context: </strong>Public health practice involves the development of reports and plans, including funding progress reports, strategic plans, and community needs assessments. These documents are valuable data sources for program monitoring and evaluation. However, practitioners rarely have the bandwidth to thoroughly and rapidly review large amounts of primarily qualitative data to support real-time and continuous program improvement. Systematically examining and categorizing qualitative data through content analysis is labor-intensive. Large language models (LLMs), a type of generative artificial intelligence (AI) focused on language-based tasks, hold promise for expediting content analysis of public health documents, which, in turn, could facilitate continuous program improvement.</p><p><strong>Objectives: </strong>To explore the feasibility and potential of using LLMs to expedite content analysis of real-world public health documents. The focus was on comparing semiautomated outputs from GPT-4o with human outputs for abstracting and synthesizing information from health improvement plans.</p><p><strong>Design: </strong>Our study team conducted a content analysis of 4 publicly available community health improvement plans and compared the results with GPT-4o's performance on 20 data elements. We also assessed the resources required for both methods, including time spent on prompt engineering and error correction.</p><p><strong>Main outcome measures: </strong>Accuracy of data abstraction and time required.</p><p><strong>Results: </strong>GPT-4o demonstrated abstraction accuracy of 79% (n = 17 errors) compared to 94% accuracy by the study team for individual plans, with 8 instances of falsified data. Out of the 18 synthesis data elements, GPT-4o made 9 errors, demonstrating an accuracy of 50%. On average, GPT-4o abstraction required fewer hours than study team abstraction, but resource savings diminished when accounting for time for developing prompts and identifying/correcting errors.</p><p><strong>Conclusions: </strong>Public health professionals who explore the use of generative AI tools should approach the method with cautious curiosity and consider the potential tradeoffs between resource savings and data accuracy.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504839","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":"Minnesota Public Health Corps: A Qualitative Assessment of AmeriCorps' Members Experiences.","authors":"Henry Stabler, Chelsey Kirkland, Jaclyn Frank, Rachel Price, Jonathon Leider","doi":"10.1097/PHH.0000000000002145","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002145","url":null,"abstract":"<p><strong>Context: </strong>Long-standing gaps in public health capacity exist due to extensive workforce shortages, particularly in governmental public health (GPH); these gaps were worsened during and after the COVID-19 pandemic. In response, the federal government established Public Health AmeriCorps (PHA), which supported the integration of AmeriCorps members in public health systems. Minnesota Public Health Corps (MNPHC) prioritized placing members in GPH agencies to increase GPH capacity. Initial evaluation results (2022-2023) suggest that program members were well-integrated into agencies. This article reports on the contextual information offered by MNPHC members throughout their service, including the specific programs and activities members implemented, to better explain how members were successful at extending agencies' capacity.</p><p><strong>Objectives: </strong>Activities, challenges, and successes of members during their service are described to better explain how members were successful at extending their sites' capacity.</p><p><strong>Design: </strong>Descriptive qualitative methods using data reported each month by 60 members.</p><p><strong>Setting: </strong>GPH agencies with at least one AmeriCorps member.</p><p><strong>Participants: </strong>MNPHC members and GPH agencies.</p><p><strong>Intervention: </strong>MNPHC members at GPH agencies across Minnesota who implemented service plans.</p><p><strong>Main outcome measure: </strong>Outcomes of interest included salient themes within MNPHC members' (1) activities, (2) encountered challenges and barriers, (3) successes.</p><p><strong>Results: </strong>MNPHC members implemented public health activities that helped bolster the capacity at host sites. The most common activities were related to public health communications, community engagement, and data analysis. Reported successes were largely concerned with progress made on the different activities being implemented by members. Members also reported few challenges; however, most reported challenges related to common issues encountered in public health, such as difficulty working with community partners or finding available data.</p><p><strong>Conclusions: </strong>MNPHC offers a compelling model that provides support to the GPH workforce while also offering those considering a career in GPH an opportunity to experience a range of public health activities.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504850","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}