Musculoskeletal Drug Therapy for Geriatric Patients

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Author :
Publisher : CRC Press
ISBN 13 : 9780789008244
Total Pages : 89 pages
Book Rating : 4.0/5 (82 download)

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Book Synopsis Musculoskeletal Drug Therapy for Geriatric Patients by : James W Cooper

Download or read book Musculoskeletal Drug Therapy for Geriatric Patients written by James W Cooper and published by CRC Press. This book was released on 2000-06-14 with total page 89 pages. Available in PDF, EPUB and Kindle. Book excerpt: How can we safely and effectively treat musculoskeletal disorders in this fast-growing population? Musculoskeletal Drug Therapy for Geriatric Patients is an essential reference for pharmacists, physicians, and nurses who plan treatment for elderly patients suffering from post-menopausal osteoporosis, osteoarthritis, rheumatoid arthritis, and gout or hyperuricemia. The medical cost of these common ailments is staggering: osteoporosis alone causes more than 1.5 million fractures each year with annual costs to the health system of approximately $14 billion. The human cost--in pain, disfigurement, restricted movement, and lost work--is incalculable. Today pioneering research is being done, and new drugs have become available to alleviate patients’suffering. Musculoskeletal Drug Therapy for Geriatric Patients offers detailed discussions of the newest drug treatments and recent findings on older medications. For example, many authorities agree that acetominophen should be frontline therapy of degenerative arthritis in the elderly, yet the most common adverse drug reaction of geriatric patients in long-term care is for NSAID gastropathy. This book suggests safer options, including the newest COX-2 inhibitors and disease-modifying anti-rheumatic drugs. Musculoskeletal Drug Therapy for Geriatric Patients offers clear strategies for the assessment and treatment of these painful, debilitating disorders in the elderly. Including tables and charts that comprehensively list test results, Musculoskeletal Drug Therapy for Geriatric Patients provides solid advice on the issues of medical management of these common diseases. This valuable book examines specific issues, including: the newest COX-2 inhibitors and how they work the evaluation, diagnosis, and management of osteoporosis osteoarthritis and its drug therapy a scholarly assessment of geriatric rheumatoid arthritis and its treatment. dosage, contraindications, and possible negative effects of various medications determining the need for chronic prophylactic therapy in patients with gout or hyperuricemia Although none of these musculoskeletal diseases can yet be cured, effective drug therapy can keep them in check. Musculoskeletal Drug Therapy for Geriatric Patients will help you give your patients the most powerful new treatments with the fewest side effects, thereby improving their quality of life.

Musculoskeletal Drug Therapy for Geriatric Patients

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Author :
Publisher : CRC Press
ISBN 13 : 9780789007896
Total Pages : 108 pages
Book Rating : 4.0/5 (78 download)

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Book Synopsis Musculoskeletal Drug Therapy for Geriatric Patients by : James W Cooper

Download or read book Musculoskeletal Drug Therapy for Geriatric Patients written by James W Cooper and published by CRC Press. This book was released on 2000-07-10 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: How can we safely and effectively treat musculoskeletal disorders in this fast-growing population? Musculoskeletal Drug Therapy for Geriatric Patients is an essential reference for pharmacists, physicians, and nurses who plan treatment for elderly patients suffering from post-menopausal osteoporosis, osteoarthritis, rheumatoid arthritis, and gout or hyperuricemia. The medical cost of these common ailments is staggering: osteoporosis alone causes more than 1.5 million fractures each year with annual costs to the health system of approximately $14 billion. The human cost--in pain, disfigurement, restricted movement, and lost work--is incalculable. Today pioneering research is being done, and new drugs have become available to alleviate patients’suffering. Musculoskeletal Drug Therapy for Geriatric Patients offers detailed discussions of the newest drug treatments and recent findings on older medications. For example, many authorities agree that acetominophen should be frontline therapy of degenerative arthritis in the elderly, yet the most common adverse drug reaction of geriatric patients in long-term care is for NSAID gastropathy. This book suggests safer options, including the newest COX-2 inhibitors and disease-modifying anti-rheumatic drugs. Musculoskeletal Drug Therapy for Geriatric Patients offers clear strategies for the assessment and treatment of these painful, debilitating disorders in the elderly. Including tables and charts that comprehensively list test results, Musculoskeletal Drug Therapy for Geriatric Patients provides solid advice on the issues of medical management of these common diseases. This valuable book examines specific issues, including: the newest COX-2 inhibitors and how they work the evaluation, diagnosis, and management of osteoporosis osteoarthritis and its drug therapy a scholarly assessment of geriatric rheumatoid arthritis and its treatment. dosage, contraindications, and possible negative effects of various medications determining the need for chronic prophylactic therapy in patients with gout or hyperuricemia Although none of these musculoskeletal diseases can yet be cured, effective drug therapy can keep them in check. Musculoskeletal Drug Therapy for Geriatric Patients will help you give your patients the most powerful new treatments with the fewest side effects, thereby improving their quality of life.

Selected Health Conditions and Likelihood of Improvement with Treatment

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Author :
Publisher : National Academies Press
ISBN 13 : 0309670950
Total Pages : 319 pages
Book Rating : 4.3/5 (96 download)

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Book Synopsis Selected Health Conditions and Likelihood of Improvement with Treatment by : National Academies of Sciences, Engineering, and Medicine

Download or read book Selected Health Conditions and Likelihood of Improvement with Treatment written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-07-12 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers' compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don't result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.

The Management of Pain in Older People

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Author :
Publisher : John Wiley & Sons
ISBN 13 : 9780470065488
Total Pages : 226 pages
Book Rating : 4.0/5 (654 download)

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Book Synopsis The Management of Pain in Older People by : Patricia Schofield, PhD, RGN

Download or read book The Management of Pain in Older People written by Patricia Schofield, PhD, RGN and published by John Wiley & Sons. This book was released on 2007-04-04 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book will enable readers to understand the principles underpinning the management of pain which a particular emphasis upon the care of the older adult. The chapters will explore concepts that are recognised to be involved in the pain experience but each author will then add their own unique perspective by applying the principles to their specialist area of practice and the care of the older adult. It is structured to include the aims and outcomes of the chapter at the beginning so that readers can track their progress, and provides chapter outlines and further reading suggestions foir this unique topic area.

Pain Management and the Opioid Epidemic

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Author :
Publisher : National Academies Press
ISBN 13 : 0309459575
Total Pages : 483 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Pain Management and the Opioid Epidemic by : National Academies of Sciences, Engineering, and Medicine

Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Pain-Wise

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Author :
Publisher : Hatherleigh Press
ISBN 13 : 1578264103
Total Pages : 201 pages
Book Rating : 4.5/5 (782 download)

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Book Synopsis Pain-Wise by : David Kloth, M.D.

Download or read book Pain-Wise written by David Kloth, M.D. and published by Hatherleigh Press. This book was released on 2011-11-22 with total page 201 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chronic pain doesn't have to be a life sentence with this accessible guide to pain management and treatment—from identifying your problem areas to finding the right specialist Suffering from chronic pain can be incredibly isolating and frustrating. Visiting doctor after doctor can leave you feeling as if there is no treatment for your pain. If you or a loved one is suffering from chronic pain, this book can be a first step to understanding treatments that can help manage pain. Though doctors have tried to treat patients in pain throughout history, more recently, focused training and certification in pain medicine has resulted in the emergence of a new specialty designed to help people suffering from chronic pain. Pain-Wise also includes expert advice on: • Identifying what parts of your body are in pain, using a simple anatomy guide • How to choose a pain specialist that is right for you • Getting the most out of your doctor’s visits • Basic explanations of common interventional pain management techniques • How to follow-up on treatment Written by three doctors with years of experience in pain management, Pain-Wise is a patient’s guide to simplifying the confusing and often overwhelming process of finding treatment for chronic pain. It will teach you the basics of how pain works, explain different interventional pain therapies in layman’s terms, and help you find a doctor that can manage, and potentially relieve, your chronic suffering.

Fundamentals of Geriatric Pharmacotherapy

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Author :
Publisher : ASHP
ISBN 13 : 158528436X
Total Pages : 684 pages
Book Rating : 4.5/5 (852 download)

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Book Synopsis Fundamentals of Geriatric Pharmacotherapy by : Lisa C. Hutchison

Download or read book Fundamentals of Geriatric Pharmacotherapy written by Lisa C. Hutchison and published by ASHP. This book was released on 2015-03-01 with total page 684 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the number of older patients surge, so too will the medication management challenges pharmacists and other healthcare providers face with this population. Providing care for these often complex cases means not only staying on top of new medications and therapies, but dealing with a wide range of other issues as well. Now in its second edition, Fundamentals of Geriatric Pharmacotherapy, by Lisa C. Hutchison and Rebecca B. Sleeper, offers the full support you need to provide the most effective medication management and therapeutic decisions. This text is unique, not only as a comprehensive overview of major issues in geriatric pharmacotherapy and a core textbook for students, but as a resource for all healthcare professionals who treat elderly patients. Covering all major topics and issues, the second edition provides the most current information and proven strategies in one comprehensive guide, including associated issues that impact therapy, such as the coordination of care across multiple venues and caregivers. Inside this edition, you will find: Summarized treatment guidelines Evidence-based reviews Recommendations for the frail elderly Case studies and clinical pearls Key points, terms, and definitions Self-assessment questions Extensively referenced New chapters on Palliative and Hospice Care and Infections and Antimicrobial Stewardship The demands of an aging population mean that a greater understanding of geriatric pharmacotherapy is now essential for all healthcare providers. Written by practicing geriatric specialists, Fundamentals of Geriatric Pharmacotherapy provides all the detailed information and practical guidance you need.

Pharmacological Considerations in Gerontology

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Author :
Publisher : Springer Publishing Company
ISBN 13 : 082612772X
Total Pages : 335 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Pharmacological Considerations in Gerontology by : Abimbola Farinde, PhD, PharmD

Download or read book Pharmacological Considerations in Gerontology written by Abimbola Farinde, PhD, PharmD and published by Springer Publishing Company. This book was released on 2019-12-04 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: Underscores the complexity of prescribing drugs for older adults while providing state-of-the-art guidelines for safe patient care An evidence-based, quick-access reference for adult gerontology nurse practitioners and related healthcare providers, this text describes a holistic, patient-centered approach to prescribing drugs to older adults. Comprehensive yet concise writing distills timely guidance on the complexities of safely prescribing to this unique population. This book opens with physiologic changes and assessment considerations for older adults, followed by a discussion of pharmacokinetics and pharmacodynamics, then a final section on guidelines for drug selection, drug interactions, and multimorbidities. Each chapter presents information in a consistent, easy-to-read template. Patient Care Pearls alert readers to crucial information and relevant case studies with examples of inappropriate medical prescribing provide context for drug delivery. Key points and chapter summaries help reinforce information. Additional features include the provision of guidelines for psychotropic medications in LTC facilities, special considerations for frail older adults, and the role of pharmacists as a resource for other practitioners. Key Features: Decision-making guidance on prescribing practices in varied settings Discusses in depth physiological considerations including multimorbidity and polypharmacy Presents Beer’s Criteria and its implications Guidelines for psychotropic medications in LTC facilities Special considerations for frail older adults Patient Care Pearls, case studies, key points, and chapter summaries

Drug-Induced Headache

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Author :
Publisher : Springer Science & Business Media
ISBN 13 : 3642733271
Total Pages : 174 pages
Book Rating : 4.6/5 (427 download)

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Book Synopsis Drug-Induced Headache by : Hans-Christoph Diener

Download or read book Drug-Induced Headache written by Hans-Christoph Diener and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.

Geriatric Rehabilitation

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Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 032354455X
Total Pages : 350 pages
Book Rating : 4.3/5 (235 download)

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Book Synopsis Geriatric Rehabilitation by : David X. Cifu

Download or read book Geriatric Rehabilitation written by David X. Cifu and published by Elsevier Health Sciences. This book was released on 2018-01-20 with total page 350 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rehabilitation of the geriatric patient poses a unique set of challenges and conditions often not seen in younger patients, but which are common among older adults. This quick, practical resource helps physiatrists and other members of the rehabilitation team overcome these challenges, covering the wide range of topics necessary to provide the highest level of care to this rapidly increasing population. Presents practical guidance on arthritis and joint replacement, polypharmacy and mobility, swallowing dysfunction, nutritional recommendations, psychiatric and cognitive disorders, assistive technology, and more. Covers the physiologic changes and epidemiology of aging, osteoporosis and fragility fractures, fall prevention and intervention, and prevention of hospital-acquired deconditioning. Consolidates today’s available information on geriatric rehabilitation into one convenient resource.

Handbook of Pain Relief in Older Adults

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Author :
Publisher : Springer Science & Business Media
ISBN 13 : 1592596681
Total Pages : 330 pages
Book Rating : 4.5/5 (925 download)

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Book Synopsis Handbook of Pain Relief in Older Adults by : F. Michael Gloth III

Download or read book Handbook of Pain Relief in Older Adults written by F. Michael Gloth III and published by Springer Science & Business Media. This book was released on 2003-12-17 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive assessment of the clinical, psychological, legal, and cultural aspects of dealing with unnecessary pain in the elderly. The authors explore pharmacotherapy (nonopioids, opioids, and adjuvants), interventional strategies, the role of rehabilitation in managing pain in seniors, and the problems of pain management in long-term care. Supplementary features include continuing medical education (CME) certification, a CME posttest and evaluation to be completed and submitted for credit, and an appendix of analgesics that details starting oral doses, maximum daily oral doses, and special considerations for the elderly. 6.5 AMA/PRA category 1 CME credits with completion of included test.

Geriatric Emergency Medicine

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Author :
Publisher : Cambridge University Press
ISBN 13 : 1107677645
Total Pages : 383 pages
Book Rating : 4.1/5 (76 download)

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Book Synopsis Geriatric Emergency Medicine by : Joseph H. Kahn

Download or read book Geriatric Emergency Medicine written by Joseph H. Kahn and published by Cambridge University Press. This book was released on 2014-01-16 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.

Guccione's Geriatric Physical Therapy E-Book

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Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0323610153
Total Pages : 736 pages
Book Rating : 4.3/5 (236 download)

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Book Synopsis Guccione's Geriatric Physical Therapy E-Book by : Dale Avers

Download or read book Guccione's Geriatric Physical Therapy E-Book written by Dale Avers and published by Elsevier Health Sciences. This book was released on 2019-10-24 with total page 736 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering a comprehensive look at physical therapy science and practice, Guccione’s Geriatric Physical Therapy, 4th Edition is a perfect resource for both students and practitioners alike. Year after year, this text is recommended as the primary preparatory resource for the Geriatric Physical Therapy Specialization exam. And this new fourth edition only gets better. Content is thoroughly revised to keep you up to date on the latest geriatric physical therapy protocols and conditions. Five new chapters are added to this edition to help you learn how to better manage common orthopedic, cardiopulmonary, and neurologic conditions; become familiar with functional outcomes and assessments; and better understand the psychosocial aspects of aging. In all, you can rely on Guccione’s Geriatric Physical Therapy to help you effectively care for today’s aging patient population. Comprehensive coverage of geriatric physical therapy prepares students and clinicians to provide thoughtful, evidence-based care for aging patients. Combination of foundational knowledge and clinically relevant information provides a meaningful background in how to effectively manage geriatric disorders Updated information reflects the most recent and relevant information on the Geriatric Clinical Specialty Exam. Standard APTA terminology prepares students for terms they will hear in practice. Expert authorship ensures all information is authoritative, current, and clinically accurate. NEW! Thoroughly revised and updated content across all chapters keeps students up to date with the latest geriatric physical therapy protocols and conditions. NEW! References located at the end of each chapter point students toward credible external sources for further information. NEW! Treatment chapters guide students in managing common conditions in orthopedics, cardiopulmonary, and neurology. NEW! Chapter on functional outcomes and assessment lists relevant scores for the most frequently used tests. NEW! Chapter on psychosocial aspects of aging provides a well-rounded view of the social and mental conditions commonly affecting geriatric patients. NEW! Chapter on frailty covers a wide variety of interventions to optimize treatment. NEW! Enhanced eBook version is included with print purchase, allowing students to access all of the text, figures, and references from the book on a variety of devices.

Handbook of Assessment in Clinical Gerontology

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Author :
Publisher : Academic Press
ISBN 13 : 0080959725
Total Pages : 753 pages
Book Rating : 4.0/5 (89 download)

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Book Synopsis Handbook of Assessment in Clinical Gerontology by : Peter A. Lichtenberg

Download or read book Handbook of Assessment in Clinical Gerontology written by Peter A. Lichtenberg and published by Academic Press. This book was released on 2010-08-20 with total page 753 pages. Available in PDF, EPUB and Kindle. Book excerpt: New trends in mental healthcare practice and a rapid increase in the aged population are causing an explosion in the fields of clinical gerontology and geropsychology today. This comprehensive second edition handbook offers clinicians and graduate students clear guidelines and reliable tools for assessing general mental health, cognitive functioning, functional age, psychosocial health, comorbidity, behavior deficits, and more. Psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning are addressed in full, and a wide range of conditions and disorders common to this patient population are covered. Each chapter provides an empirical review of assessment instruments, assessment scales in their totality, a review of how these instruments are used with and adapted for different cultural groups, illustration of assessments through case studies, and information on how to utilize ongoing assessment in treatment and/or treatment planning. This combination of elements will make the volume the definitive assessment source for clinicians working with elderly patients. The most comprehensive source of up-to-date data on gerontological assessment, with review articles covering: psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning Consolidates broadly distributed literature into single source, saving researchers and clinicians time in obtaining and translating information and improving the level of further research and care they can provide Chapters directly address the range of conditions and disorders most common for this patient population - i.e. driving ability, mental competency, sleep, nutrition, sexual functioning, demntias, elder abuse, depression, anxiety disorders, etc Fully informs readers regarding conditions most commonly encountered in real world treatment of an elderly patient population Each chapter cites case studies to illustrate assessment techniques Exposes reader to real-world application of each assessment discussed

Principles of Geriatric Critical Care

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Author :
Publisher : Cambridge University Press
ISBN 13 : 1316613895
Total Pages : 245 pages
Book Rating : 4.3/5 (166 download)

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Book Synopsis Principles of Geriatric Critical Care by : Shamsuddin Akhtar

Download or read book Principles of Geriatric Critical Care written by Shamsuddin Akhtar and published by Cambridge University Press. This book was released on 2018-10-25 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides coverage of the issues surrounding geriatric critical care, emphasising assessment and treatment.

Cancer and Aging

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Author :
Publisher : Karger Medical and Scientific Publishers
ISBN 13 : 3318023078
Total Pages : 179 pages
Book Rating : 4.3/5 (18 download)

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Book Synopsis Cancer and Aging by : M. Extermann

Download or read book Cancer and Aging written by M. Extermann and published by Karger Medical and Scientific Publishers. This book was released on 2013-01-18 with total page 179 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer is clearly an age-related disease. Recent research in both aging and cancer has demonstrated the complex interaction between the two phenomena. This affects a wide spectrum of research and practice, anywhere from basic research to health care organization. Core examples of these close associations are addressed in this book. Starting with basic research, the first chapters cover cancer development, mTOR inhibition, senescent cells altering the tumor microenvironment, and immune senescence affecting cancer vaccine response. Taking into account the multidisciplinarity of geriatric oncology, several chapters focus on geriatric and oncologic aspects in patient assessment, treatment options, nursing and exercise programs. The book is rounded off by a discussion on the impact of the metabolic syndrome illustrating the interactions between comorbidity and cancer and a chapter on frailty.This book provides the reader with insights that will hopefully foster his or her reflection in their own research and practice to further the development of this most exciting field. Given the aging of the population worldwide and the high prevalence of cancer, it is essential reading not only for oncologists and geriatricians but for all health practitioners.

Chart Supplement, Pacific

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Author :
Publisher :
ISBN 13 :
Total Pages : 324 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Chart Supplement, Pacific by :

Download or read book Chart Supplement, Pacific written by and published by . This book was released on 2010 with total page 324 pages. Available in PDF, EPUB and Kindle. Book excerpt: