Answer:
shoulder impegment syndrome
Explanation:
Shoulder pain caused by friction of the connective tissue (tendon) in the shoulder blade.
Impingement syndrome is caused by inflammation due to repetitive movements of the shoulder. Injuries and advanced age are also other causes.
The pain may be constant and increase with movements to lift or reach an object.
Rest, medications, and physical therapy may be helpful
10. What are the health-related fitness components?
Peter has a vitamin deficiency, a skin problem, brain damage, and a chronic liver problem due to his chronic substance abuse of which drug?
A. Nicotine
B. Cocaine
C. Alcohol
D. Heroin
Answer:
1. alcohol 2. they contain tar, like traditional cigarettes
Explanation:
1. for him to have chronic liver problems it has to travel through the liver, alcohol is the leading cause of liver problems
2.e-cigarettes do not contain tar because it is an electrical product which is one factor of why they are not harmful
A lot of people are known to often abuse substances. Peter's issue is due too Alcohol.
Chronic alcohol use is known to affect the brain. A lot of studies has shown that excessive alcohol use and damaged brain function leads to dementia, deficits in learning and memory, mental disorders, etc.The act of drinking alcohol can also lead to vitamin deficiency. It can cause deficiencies in vitamin A, C, D, E, K, and B.
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How is physical performance enhanced through the development of muscular strength and muscular endurance?
Answer:
As muscles become stronger, physical performance is improved. Improving muscular strength and muscular endurance gives the body the ability to work, exercise or play more often, with more power and for longer periods of time. Muscles act as tiny furnaces that burn fat.Explanation:
Muscular strength improves the ability to lift heavier weights, while muscular endurance enhances the capacity to sustain repeated muscle contractions.
The development of muscular strength and muscular endurance plays a crucial role in enhancing physical performance across various activities, from sports to daily life.
These components of fitness are fundamental for improved athletic performance and overall functional movement.
Muscular strength refers to the maximum amount of force a muscle or muscle group can exert against resistance in a single effort.
By increasing muscular strength, individuals can generate more force during movements like lifting, pushing, or pulling.
This translates into improved performance in activities such as weightlifting, sprinting, and high-intensity exercises.
The ability to lift heavier weights, for instance, allows athletes to optimize their training and achieve better results.
Muscular endurance, on the other hand, pertains to the muscle's capacity to sustain contractions over an extended period.
Developing muscular endurance enables individuals to perform repetitive or sustained activities without experiencing fatigue as quickly. This is particularly beneficial for endurance sports like running, cycling, or swimming, where the ability to maintain muscle function over an extended duration is key to success.
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You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should:________.
a. administer high-concentration oxygen.
b. monitor for signs of inadequate respiration.
c. be prepared to treat for shock if he also has a high fever.
d. treat the patient as any other 52-year-old with chest pain.
What are some mental effects of stress
Answer:
Depression.
Anxiety
Irritability
The prevailing explanation for the relationship between stress and illness has been that increased levels of stress result in a decrease in the immune system's ability to protect the body from illness. On the other hand, it is possible that people who are experiencing stress engage in more health-damaging behaviors, this leads us to a greater likelihood of illness. This different explanation of the relationship demonstrates the importance of __________.
Answer: ruling out rival hypothesis
Explanation:
To rule out rival hypothesis suggests that to exclude the possible explanation for a specific claim. This suggests that before confirming or believing something one has to ensure that other explanation for a specific claim has been disproved to become sure for a specific claim.
According to the given situation, the stress and illness relationship is required to be derived. The increased level of stress and illness is responsible for the decrease in immunity is ruled out by the fact that people due to stress indulge or engage in health damaging behaviors. This is responsible for illness.
Aurora is a neuropsychologist focused on mapping certain reward circuits in the brain. She is not concerned about how her work might be used to change behavior but instead she is just trying to further knowledge about these circuits for the sake of knowledge. Aurora's research can be described as:
Answer:
Basic research
Explanation:
Basic research can also be referred to as fundamental research. This type of research is done to generate or increase scientific knowledge base. It seeks to generate new theories, principles and ideas, which is not necessarily applied, but can form the basis of scientific development.
In other words, basic research is mostly theoretical, with the purpose of increasing the understanding or explanation of a behavior or phenomenon, without seeking problem solving.
Therefore Aurora's research can be described as basic research.
What are the steps used when performing CPR?
While giving cardiopulmonary resuscitation (CPR), it is important to make sure the area is secure for you and the victim, then check to see whether they are responsive by tapping them lightly and yelling, "Are you okay?"
Thus, in CPR, call all emergency services or ask someone else to do so if the victim is not responding. Start the chest compressions by putting the heel of one hand on the victim's center chest, interlacing the other hand on top, and applying a forceful, rapid pressure at a pace of 100–120 compressions per minute.
After 30 compressions, tilt the victim's head back, lift their chin, and cover their mouth with yours while sealing their nose to provide two rescue breaths. Until assistance arrives, keep performing cycles of 30 compressions and two rescue breaths.
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Explain a strategy that you can use to ensure that your own personal beliefs and preconceptions don’t get in the way of your job response?
Answer:
A good strategy is: an organizational and tolerant culture in the workplace
Explanation:
A good strategy is. Having an organizational and tolerant culture at work, this means, what is work must be done at work and what corresponds to our personal values and beliefs, are only ours; But we must be willing to be receptive and share our beliefs and values with others as long as the occasion for it arises in a social setting.
Now, we must be tolerant and very respectful of the opinions and beliefs of others, we must not turn our work into a place of religious and philosophical competences.
To avoid personal beliefs interfering with job performance, a strategy is to practice empathy, open-mindedness, and self-reflection.
Explanation:A strategy to ensure that personal beliefs and preconceptions don't interfere with job performance is to practice empathy and open-mindedness. This involves actively listening to others, considering different perspectives, and being willing to change one's opinion based on new information. Additionally, self-reflection and self-awareness are important to recognize and challenge any biases or assumptions.
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When one is performing a box-to-box plyometric drop jump, in order to generate sufficient force in a limited amount of time (< 200 ms), which muscle fibers are bypassed through the principle of selective recruitment?
Answer:
Muscle Fibers Type I
Explanation:
Muscle fibers in the body are classified based on how they produce energy or generate force. The Muscle Fibers type I, type I C, type IIC, type IIAC, type IIA, type IIA and type IIX are generally classified as being either slow-twitch or fast-twitch.
Muscle Fibers Type I is generally a slow twitch fiber. They can provide their own source of energy and can sustain force for an extended period of time, but they are not able to generate a significant amount of force.
However, the activation threshold is quite low, this means that while they get recruited first when a muscle contracts, they are unable to generate the amount of force necessary for the specific activity. They are, therefore, bypassed through the principle of selective recruitment and the fast-twitch muscle fibers are engaged.
Rofonzo is a 36 year old recently divorced primigravida at 30 weeks gestation. She weighs 120 pounds with a BMI of 22 which indicates a normal height to weight proportion. Rofonzo's health history is negative for chronic health problems. She is an active career woman who experiences a moderate to sometimes severe level of stress with her job. Her diet consists of a lot of fast foods to "save time" especially when she has to eat on the run or while working. Rofonzo was diagnosed with mild preeclampsia. When the diagnosis is explained, she states that her mother and one of her sisters had a blood pressure problem when they were pregnant.
How should the nurse explain preeclampsia to Rofonzo?
Answer:
Preeclampsia can be defined as the condition in which pregnant women faces hypertension which develops after 20 weeks of pregnancy. Preeclampsia can affect multisystem of the body and is characterized by spasms of the blood vessels (vasospastic) that makes difficulty in the dilation of increased bood produced during pregnancy.
She may experience a number of signs and symptoms that may escalate and worsen as the progression of the disease progresses from mild to severe. The only solution is getting her baby, but it has been found that a number of treatment methods are effective in managing the disease's progress until it is time for her baby to be born.
This is the way nurse can explain Rofonzo about preeclampsia.
If ya could answer these questions about the reproductive system. I'm honestly to lazy to answer them myself.
1. Describe the function of the ovaries and testes.
2. Summarize the purpose of the Uterus.
3. Explain the functions of the cervix.
4. Define gametes and explain why they are essential to reproduction.
Answer:
Ovaries:
shelter and protect the eggs a female is born with until they are ready for useproduce estrogen release eggs (ovulation)Testes
Produce and store spermCreate testosterone and androgensChild bearing. "The uterus performs multiple functions and plays a major role in fertility and childbearing. This organ is able to change in shape as muscles tighten and relax to make it possible to carry a fetus"
The Cervix produces cervical mucusDuring pregnancy, the cervix closes to help keep the fetus in the uterus until birth during labor the cervix dilatesGametes: a mature sexual reproductive cell, as a sperm or egg, that unites with another cell to form a new organism.
They area literally what come together to make the baby, without them, there is no baby
Also, this took me like ten minutes lol. Maybe just do your own work.
A new mother brings in her 6‐month‐old baby for not being able to keep his eyes together when
looking to the left. On examination, both of his eyes appear in alignment (conjugate) when
looking to the right. However, when looking to the left, the baby's left eye stays in the forward
gaze position, while the right continues on with full adduction to the left. The eyes appear to be
out of alignment (dysconjugate). Which cranial nerve (CN) is responsible for the dysfunction in
looking left?
) The left oculomotor nerve (CN III)
b) The right abducens nerve (CN VI)
c) The right trochlear nerve (CN IV)
d) The right oculomotor nerve (CN III)
e) The left trochlear nerve (CN IV)
f) The left abducens nerve (CN VI)
Answer: f) The left abducens nerve (CN VI)
Explanation:
The correct response is the left abducens nerve (CN VI), since the left abducens nerve (CN VI) pushes the left eye outwards towards the left. The muscle's paresis or weakness can create the baby's inability to move the left eye outwards to the left.
The right oculomotor nerve (CN III) is wrong as this nerve pushes the right eye upwards, upwards and inwards, upwards and outwards, downwards and outwards.
The right trochlear nerve (CN IV) is wrong as this nerve travels downwards and inwards the right eye.
The right nerve abducens (CN VI) is incorrect as this nerve pushes the right eye outwards to the right.
The left oculomotor nerve (CN III) is wrong as this nerve pushes the left eye inwards, upwards and inwards, upwards and outwards and downwards and outwards.
The left trochlear nerve (CN IV) is incorrect, as this nerve pushes the left eye downwards and inwards.
Hence, the correct option is f) The left abducens nerve (CN VI).
What kind of infection does Ray have? What medication does Ray's doctor prescribe for treatment? Ray's doctor diagnoses him with a infection of the ear called otomycosis. The doctor prescribes Ray an for treatment.
Can you explain more of the question? Ray has an ear infection, so he gets treated. What is the question?
Answer:
1- fungal 2-anti-infective
Explanation:
The vital signs for a client with a possible head injury were, on admission: blood pressure 128/72 mm Hg, pulse 90 beats/min, and respirations 66 breaths/min. Which vital sign assessment conducted four hours later most likely indicates the presence of increased intracranial pressure (ICP)?
A. Blood pressure 172/68 mm Hg, pulse 42 beats/min, respirations 10 breaths/min
B. Blood pressure 160/90 mm Hg, pulse 112 beats/min, respirations 16 breaths/min
C. Blood pressure 130/72 mm Hg, pulse 50 beats/min, respirations 24 breaths/min
D. Blood pressure 100/70 mm Hg, pulse 120 beats/min, respirations 30 breaths/min
Answer: The correct answer to the question is option A
Blood pressure 172/68 mm Hg, pulse 42 beats/min, respirations 10 breaths/min
Explanation: Increased intracranial pressure can simply be defined as the increase/rise in the pressure within the brain and the structures sorrounding the brain.
Increased intracranial pressure can be caused by alot of things which includes trauma to the head,bleeding into the brain and it's sorrounding structure,build-up of fluid in the brain, inflammation/swelling of the brain or brain tissues,tumour or mass growing in the brain or its sorrounding structures which can either be benign (non-cancerous) or malignant (cancerous).
One of the symptoms of increased intracranial pressure is rise in blood pressure,this rise in blood pressure happens so that the body can compensate for the increased pressure and as well increase the cerebral perfusion pressure (CPP),as the pressure continues,there is decrease blood flow to the brain,cushing reflex(the nervous system way of responding to increased ICP) will set in which will reduce the heart rate(bradycardia) and also reduce respiratory rate or make it irregular.
This vital signs in option A is indicative of increased intracranial pressure.
At rest,a healthy human has a normal ICP level of 7-10mmHg
The nurse is providing discharge education about how to avoid joint stress for a client hospitalized with an acute exacerbation of rheumatoid arthritis. Which statement by the client demonstrates the teaching has been effective?
a) I need to start carrying heavy items with my arms, instead of my hands."
b) I will be able to return to my job as a medical transcriptionist.""
c) I can still sit and knit while watching television."
d) I will sit on a tall kitchen stool instead of standing when I am preparing meals."
e) When I go to bed at night I should use a pillow under my knees."
Answer:
Two options apply here, and they are:
a) I need to start carrying heavy items with my arms, instead of my hands.
d) I will sit on a tall kitchen stool instead of standing when I am preparing meals
Explanation:
Rheumatoid arthritis is a disease that makes joints become painful or swollen. It has no cure, but the level of growth can be slowed by medications.
Carrying heavy items on the arms instead of the hand, helps take stress off the joints in the hands.
In the lower body, sitting helps take pressure off the joints.
Knitting is not advisable, because stress on the joints can be caused by steady movements. Placing pillows under kness would not help avoid joint stress because there is a chance of having joint contracture.
So, when the client makes any of the statements in option (a) and (d), the nurse clearly understands the teaching has been effective.
Olga and Boris Mikhailov come to an outpatient clinic with their five-year-old daughter, Anya. The receptionist gathers information during the initial history. Olga and Boris were born in Russia and they have lived in the country for 8 years. They are both employed full time and speak English well. Anya was born in this county and she is fluent in Russian and English. Olga states that Anya is basically healthy. She experienced a viral illness a couple of months ago, but she quickly recovered. Anya is at the clinic for her 5-year-old check-up for kindergarten.
Answer:
The missing statement in question is;
According to Erickson, in what stage of development is Anya?
Explanation:
According to Erikson theory, Anya is in Initiative v Guilt stage.
Erikson theory is related to the different psychosocial developments that happen in complete human cycle through his life span. There are eight stages from birth till adulthood.
One of them is Initiative v Guilt, which is the third stage. This is related to children where they tend to assert themselves more often
One purpose of the BON’s position statements and guidelines is to provide
Answer:
guidance to nurses with regard to carrying out orders from Physician Assistants (PAs).
Explanation:
It should be understood that the Physician assistance, PAs may provide medical aspects of care, including ordering or prescribing medications and treatments, as delegated by a physician consistent with laws, rules and regulations.
It should be noted also that a physician is not required to be present at all times at the location where the PA is providing care and orders are not required to be countersigned by the physician.
Therefore, a nurse may carry out or execute these orders. And , the nurse must seek clarification if he/she believes the order or treatment is inaccurate, non-efficacious or contraindicated, by consulting with the PA and physician as appropriate.
In conclusion, BON simply means Board of Nursing.
Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant? "
a) Inspect the site for thrombophlebitis.
b) Discontinue the IV solution.
c) Check the infusion rate.
d) Dispose of the disconnected IV set.
A
Explanation
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Preeti discovers that her roommate Shari recently experimented with methamphetamine. Preeti, worried about her roommate, informs Shari that there are risks associated with methamphetamine use, such as the induction of symptoms associated with _________.
a. psychosis
c. bipolar disorderb. obsessive compulsive disorder
d. generalized anxiety disorder
Answer: Psychosis---A
Explanation: According to research, Over time, methamphetamine abuse has been found to have many negative effect leading to firstly, Addiction which is compulsive drug engagement and use which have a ripple effect in disorganizing the functional and molecular changes in the brain. followed by display of psychotic symptoms such as confusion, paranoia, hallucinations etc lasting for months and even longer years even when such person involved has withdrawn.
Preeti, is worried about her roommate, Shari because she knows that that there are risks associated with methamphetamine use, such as the induction of symptoms associated with Psychosis
Final answer:
Chronic methamphetamine abuse is associated with the induction of symptoms akin to a. psychosis, including hallucinations and delusions, similar to those seen in schizophrenia.
Explanation:
Preeti is correct to be concerned about her roommate Shari's use of methamphetamine, as it is associated with a range of serious health risks. One of the major risks associated with chronic methamphetamine abuse is the induction of symptoms associated with psychosis. These can include paranoia, visual and auditory hallucinations, delusions, and the sensation of insects crawling under the skin. Methamphetamine abuse can lead to psychotic features that are similar to those seen in schizophrenia, a debilitating mental illness characterized by difficulties in differentiating between reality and imagination, as well as disordered thoughts and perceptions. Furthermore, methamphetamine is neurotoxic, causing damage to dopamine and serotonin neurons in the central nervous system, which impacts brain structure and function.
What is not a typical symptom of influenza?
Answer:
There are many NOT typical symptoms of influenza, since the typical ones are very pathognomonic.
Those that are not typical could become:
that the patient feels animated, not very fatigued, with excess energy and absence of fever, insstinal constipation.
Explanation:
The symptoms, unlike the signs, are what the patient perceives ... That is why we do not clarify other factors such as dyspnea or fever, since that would become a SIGN and not a SYMPTOM.
Instead, the sign is a factor that appears and is perceived by the medical professional through some technique or thanks to some prior knowledge.
Answer:
See explanation below for answer.
Explanation:
Influenza, also called Flu is a common viral infection that can be deadly, especially in high-risk groups. It attacks the lungs, nose and throat.
People at high risk include:
Young children, older adults, pregnant women, and people with chronic disease or weak immune systems.Symptoms include:
fever, chills, muscle aches, cough, congestion, runny nose, headaches, and fatigue.It should be noted that not everyone with flu will have a fever.
1. Which is NOT a benefit of warming up? A. Your heart has time to adjust to exercise B. You will perform better C. Chance of injury is increased D. Your muscles work better when they are warm
Answer:
C. Chance of injury is increased.
1. There are 3 examples of non-specific immune responses to exterior barriers. Which of the following is NOT one of them? Immersive Reader
hair
Skin surfaces
saliva & mucus
Digestive juices
Answer:
Immersive reader hair.
Explanation:
Non specific immune responses is the defence system from birth and it protects against all antigens.
This involves barriers that keep harmful substances from entering the body. It includes:
Skin surfaces
Mucus and saliva
Digestive juices
Cough reflex
Enzymes in tear.
Encouragement and appropriate praise should be given to hyperactive clients to help them increase their feelings of self-esteem. When they have acted appropriately, what is the best statement for the nurse to make in an effort to let them know of their improvement?
Options are not provided. The complete question is as following:
Encouragement and appropriate praise should be given to hyperactive clients to help them increase their feelings of self-esteem. When they have acted appropriately, what is the best statement for the nurse to make in an effort to let them know of their improvement?
1. "You behaved well today."
2. "I knew you could behave."
3. "Everyone likes you better when you behave like this."
4. "Your behavior today was much better than it was yesterday."
Answer: 1. "You behaved well today."
Explanation:
Hyperactive behaviour generally refers to excessive movement, being easily distracted, impulsivity, loss of attention, aggressiveness and similar behaviour. Typical habits may include talking too much, wandering, and fidgeting or running continuously.
Behavior therapy may help with hyperactivity disorder replace negative habits and actions with positive ones.
Praising the pateint will raise positivity in the pateint and increase their feelings of self-esteem, so the suitable statment for the patient is "You behaved well today."
The statement "You behaved well today" is more powerful to make th epateint belive that what he did is good and will encourage him to do well in future as well.
Hence the correct answer is 1. "You behaved well today."
There is considerable variation by country in the distribution of causes of deaths among adults in the typical reproductive ages, with deaths due to which of the following being common in low-income countries and rare in high-income countries?
Infectious Disease
Viral disease
accidents
Answer:
Infectious diseases
Explanation:
Infectious diseases are cause by pathogens. These pathogens are micro-organisms(microbes) and can’t be seen by the naked eye except through varying types of microscope. These pathogenic microorganisms are divided into 4 which include Bacteria, Fungi, Virus and Protozoa.
These infectious diseases are high in low-income countries because a low economy is a characteristic of a developing or underdeveloped country. These countries are usually characterized by Poverty, poor education, low health knowledge, poor infrastructure which encourages and supports the prevalence of infectious diseases.
Complete each statement to identify the form of asexual reproduction.
During_______
a new plant grows from parts of the parent plant.
During_______
a cell divides to produce a new, genetically identical cell.
During vegetative propagation, a new plant grows from parts of the parent plant.
During mitosis, a cell divides to produce a new, genetically identical cell.
Explanation:
Both vegetative propagation and mitosis are methods of asexual reproduction followed by various organisms. In both the methods, only a single parent is involved in the reproduction of new daughter cells.
Vegetative reproduction is the asexual reproduction in plants with the formation of a new plant from the existing structures of the parent plant. These structures include rhizomes, bulbs, tubers etc.
Mitosis is a type of cell division which leads to the formation of genetically identical daughter cells similar to their parents. This occurs due to replication of the chromosome which then splits to form two identical daughter cells each with the complete set of chromosomes.
Answer:
During vegetative propagation, a new plant grows from parts of the parent plant.
During binary fission, a cell divides to produce a new, genetically identical cell.
Explanation:
Got it right
According to the Standards of Nursing Practice, Board Rule 217.11, LVNs have a "directed" scope of practice. Mention an appropriate nursing practice supervisor for the LVN
LVNs have a "directed" scope of practice and their nursing practice supervisor can be an RN, APRN, physician, dentist, or podiatrist.
Explanation:
According to the Standards of Nursing Practice, LVNs (Licensed Vocational Nurses) have a "directed" scope of practice as defined by the Texas Board of Nursing in Rule 217.11. This means that LVNs are under the supervision and direction of a registered nurse (RN), advanced practice registered nurse (APRN), physician, dentist, or podiatrist.
An appropriate nursing practice supervisor for the LVN would be an RN, APRN, physician, dentist, or podiatrist who oversees and guides the LVN's work. They provide guidance, and support, and ensure that the LVN is practicing within their defined scope of practice and following the Standards of Nursing Practice.
In summary, the appropriate nursing practice supervisor for an LVN depends on the healthcare setting and the specific situation, but it is generally an RN, APRN, physician, dentist, or podiatrist who supervises and directs the LVN's work.
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According to the Standards of Nursing Practice, Board Rule 217.11, Licensed Vocational Nurses (LVNs) have a 'directed' scope of practice.
LVNs must practice under the supervision of a healthcare professional with a more advanced scope of practice. Appropriate nursing practice supervisors for LVNs include the following:
Registered Nurse (RN): RNs have a broader and more advanced scope of practice compared to LVNs and can provide the necessary supervision.
Advanced Practice Registered Nurse (APRN): This includes Nurse Practitioners (NPs), Clinical Nurse Specialists (CNS), Nurse Anesthetists (CRNA), and Nurse Midwives (CNM), all of whom have specialized training and can supervise LVNs.
Physician (MD or DO): Medical Doctors (MDs) or Doctors of Osteopathic Medicine (DOs) are qualified to oversee the practice of LVNs, ensuring that patient care aligns with medical standards.
Physician Assistant (PA): PAs can also supervise LVNs as they work under the supervision of physicians and have extensive medical training.
The supervision provided by these professionals ensures that LVNs perform their duties safely and in accordance with established medical protocols and ethical standards.
A nurse observes a few small, yellow nodules on the cervix of a client during the speculum exam. They are not painful or odorous, and a thin, clear discharge is present. The nurse recognizes that these are most indicative of what type of condition?a) Nabothian cysts
b) Columnar epithelium
c) Chlamydia infection
d) Cervical eversion
Describes the distribution of sodium and potassium between cells and body fluids
Answer:
Refer below.
Explanation:
The distribution of sodium and potassium between cells and body fluids are:
K+ mainly in the cells, Na+ in the body fluids.
Answer:
The distribution and balance of sodium and potassium between cells and tissue fluids is by means of a pump that requires ATP, that is, it is ATP dependent, and generates a countergrade of the minerals by balancing them, three sodium molecules are taken for two of potassium
Explanation:
These pumps are activated at necessary and punctual times, they are not constantly active.
Being a countergrade means that you need energy to go against the spontaneous gradient of the membrane, to overcome it and achieve balance.
The sodium potassium pumps are FUNDAMENTAL for cell life since without them the cells could suffer from hyper or hypoteonicity of the concentrations of these minerals, thus generating serious failures and cell death.
What are some ways to stay safe from corona virus??
Answer:
Wash your hands, social distance (no leaving the house for unnecessary reasons and no visiting friends or family members), wear a mask if you must go out in public.
Explanation: