ISI is excited to announce that we’ve expanded our insurance options to cater to all different types of health insurance requirements and now, we will be introducing the World Elite plan, which is ACA-compliant and available for purchase for international students at select universities! The plan is available in three levels: World Elite Plus, World Elite 250, and World Elite 450.
Benefits include:
The plan uses the optional UnitedHealthcare Global Network allowing students to choose their doctors, hospitals, and clinics. Additionally, the plan uses the Optum Rx pharmacy network so students don’t have to pay first to get reimbursed. Whenever students visit an in-network provider, the doctor, hospital, clinic or pharmacy will directly bill the insurance company for the service
Since this plan will only be available for specific universities, we recommend that you visit our School Requirements section to learn more about which plan will work for your college or university!If you’re unsure about what plan option is suitable for your specific needs, please contact our customer service team. Our licensed insurance agents are more than happy to guide you with your insurance questions and concerns.
We are pretty much familiar with the word “friend”. A friend is usually the one you met for the first time at school or with whom you established a relationship simply by living in the building next door.
Welcoming a friend into our lives should bring us joy and happiness, but a friendship goes much further than having a confidant with whom you can rely on, take photos or even travel with. According to several studies, friends not only contribute to improving our social life, but they can also help us in multiple ways. How is this possible? Studies have shown that friendships can bring different benefits to our mental health, let’s take a look at some of them:
Reduce stress
According to a study carried out by a recognized university in Canada, secreting oxytocin during a pleasant moment such as a dinner or a conversation causes us to experience relief and well-being.
Friends will always have your back in case you need to talk to somebody or just want to take a break from work or daily life responsibilities, because most of the time they are the ones who come to our rescue when we are feeling stressed out due to personal and/or family issues.
Improve your self-confidence
Friends can help us see situations from a different perspective, they can give us sincere and accurate advice that can impact our way of thinking or even notice details and/or options that we had not considered previously.
There are several psychological studies that affirm that friendships always strengthen trust and raise self-esteem because it favors communication and helps personal development.
Helps to deal with health problems
Unfortunately, no one is exempt from getting ill, and that usually deteriorates our body and our mental health at the same time. Psychological studies have shown that social support is important and can have a positive effect when fighting an illness, in addition to that, friends can help make it more bearable and can even speed up our recovery.
They will make you a better person
Friends are always there to bring out the best in us, they always push us to be better. If you don’t feel good about yourself or you’re having troubles with something, send a message or give your friends a call, because they can help you get through difficult times.
According to a study, it is the same friends who motivate you to look for an eating plan to maintain a healthy relationship with food or who always invite you to practice sports and/or outdoor activities that involve the physical movement of your body.
Our friends are our antidepressants
It is proven that friendship can mitigate the symptoms of disorders such as anxiety and depression, a conclusion that is also corroborated by psychologist Pedro Agustín Garzón: “People who are alone, who do not live with others, do not relate, that is, they have low social interaction, live less and may have greater psychological difficulties.”
A stronger heart
In addition to exercising, identifying risk factors and having a healthy diet, a good friend also protects our cardiovascular health.This is demonstrated by a study carried out by Duke University (United States), which concluded that 50% of adults who had died from cardiovascular problems did not have close friends, while 85% of survivors had long term friendships.
Now that you know some of the physical and psychological benefits of friendship, share with us in the comments who your best friend is and send them a message to let them know how important they are to you.
References:
https://www.vidaysalud.com/el-poder-de-los-amigos-y-su-efecto-en-tu-salud/
Sight is one of our most precious senses and it is important to make sure our sight is sharp and healthy. One way to take care of it is to have regular sight tests.
Sight tests are essential for detecting and monitoring a variety of eye conditions, including:
How often should you get tested for eye acuity?
Most adults should get tested for eye acuity every two years. However, you may need to get tested more often if you have any of the following risk factors:
What happens during a sight acuity test?
During an eye acuity test, you will be asked to sit in front of a chart with letters or symbols of different sizes. You will then be asked to cover one eye and read the smallest letters or symbols that you can see with the other eye. The process will then be repeated with the other eye.
Your eye doctor will use the results of your eye acuity test to determine your prescription for glasses or contact lenses, if necessary. They will also use the results to monitor your vision over time and detect any changes.
Most student plans do not include coverage for sight acuity tests, eyeglasses, or contact lens prescriptions. That is why we have made a plan available that you can use if you want to have supplementary vision coverage while you are residing in the U.S.
The Ameritas Vision plan includes the following benefits:
You can review the plan and apply for it here: https://www.internationalstudentinsurance.com/dental-vision-insurance/
Making sure your sight is healthy is fundamental for your daily life activities and you would want to have the right coverage if you are looking to get eyeglasses or contact lenses. Our customer service team can always be contacted if you have any questions.
The FDA Approved an Over-the-Counter Birth Control Pill!
What does that mean for international students?
Recently, the United States Food and Drug Administration (FDA) authorized the US’s first “over-the-counter” birth control pill called “Opill.” “Over-the-counter” refers to medications that can be purchased at a pharmacy without a prescription from a doctor. THIS IS BIG NEWS! Keep reading to learn why.
Prior to this authorization, in order for someone to obtain a prescription for birth control, they would typically have had to take the following steps:
Since birth control is considered preventative medication, and an appointment to get this medication would also fall under the preventive or wellness category, many international student insurance plans would not have covered this doctor visit. In addition, they also might not cover the cost of the preventative prescription medication.
However, with this new authorization, these are the steps someone would need to take in order to obtain the Opill birth control pill:
A price hasn’t been announced for the Opill yet, but HRA Pharma, the pill’s manufacturer, is receiving a lot of pressure from various entities to make sure the medication is affordable without insurance coverage (since most insurance plans don’t cover or discount over-the-counter medications). They anticipate announcing a price in the coming months, with the Opill being available in early 2024.
However, currently there are twelve states, plus Washington, DC, that do require insurance companies to cover over-the-counter contraceptives. You can see the list of states here, and always double check your insurance policy to understand your benefits. You can also call our customer service if you ever have questions about how your plan works!
Another important thing to note about this new Opill is that it is a progesterone-only birth control pill. Many currently prescribed birth control pills are combination progesterone-estrogen pills, but studies have found that progesterone-only has fewer side effects and is thus safer to take independently, without the direction of a doctor.
As they say in the news, this is a developing story, so the actual details and processes of how it will all work may shift and change over the next few months. We will do our best to update you on the major announcements related to this exciting approval!
For additional reading on this topic:
International students who participate in sports are at a greater risk of injury because they are constantly pushing their bodies to the limit and are more likely to be involved in accidents. If they practice sports frequently, it is important for international students to have sports insurance.
When choosing a sports insurance plan, you must consider the type of sports you will be participating in. There are four main categories of sports: organized sports, extreme/adventure sports, contact sports, and recreational, leisure, or fitness sports.
Organized Sports
Organized sports, as defined in insurance terms, usually include intercollegiate, interscholastic, intramural or club sport participation. If your sport requires organized practices or events, if you have a coach, or if you signed up for the sports through your school, it is most likely an organized sport. This definition does not include semi-professional and professional sports, which are usually in their own category, and in general are not covered by most international student or travel medical plans.
Organized sports are typically covered by international student insurance plans, but there is a maximum limit per injury. For example, the Student Secure Budget plan covers organized sports up to $3,000 per injury, while the Student Secure Select and Elite plans cover organized sports up to $5,000 per injury. You need to purchase an additional rider on this plan to get organized sports coverage. The Student Secure offers coverage for a wide variety of school-sanctioned sports, from basketball and football to rodeo and surfing.
It is important to note that not all organized sports are covered by every insurance plan. Some plans may exclude certain sports, such as contact sports or extreme sports. It is important to read the fine print of your insurance plan carefully to make sure that the sports you participate in are covered.
Extreme/Adventure Sports
Extreme sports, also known as adventure sports, are activities perceived as having a high level of inherent danger. These activities often involve speed, height, a high level of physical exertion, and, in most cases, highly specialized gear. These kinds of activities are often undertaken for thrill seeking, and thus can expose the participant to abnormal risk that exceeds even that of organized sports.
Extreme/adventure sports are not typically covered by international student insurance plans. However, there are some plans that offer limited coverage for extreme/adventure sports, or there may be an additional rider that can be added to the plan for an additional cost.
If you are planning to participate in extreme/adventure sports, it is important to carefully consider your insurance options. You may want to purchase a separate insurance policy that specifically covers these types of sports.
If you are an international student interested in practicing extreme sports, we have some options for you:
The Atlas Travel plan includes coverage for all extreme sports that are not excluded specifically in the policy. Excluded sports include base jumping, bobsleigh, cave diving, cliff jumping, mountaineering at elevations of 4,500 meters or higher, racing by any animal or motorized Vehicle or BMX and whitewater rafting. On the contrary, two of the extreme sports that the Atlas Travel plan does cover are snow skiing and snowboarding, as long as they don’t violate the authority laws and stay inbound.
The Patriot Travel plan is another example of a plan that offers an Adventure Sports rider. Sports covered under the rider are limited to the following: abseiling, BMX, bobsledding, bungee jumping, canyoning, caving, hot air ballooning, jungle zip lining, parachuting, paragliding, parascending, rappelling, skydiving, spelunking, wildlife safaris and windsurfing.
Contact Sports
Contact sports are also not typically covered by international student insurance plans. These sports involve physical contact between players, which increases the risk of injury. However, there may be an exception if the sport is sanctioned by your school.
For example, the Student Secure Budget and Select plans cover all organized sports, even if they are considered contact sports. However, if you are planning to participate in a contact sport that is not sanctioned by your school, you may want to purchase a separate insurance policy that specifically covers these types of sports.
Recreational, Leisure, or Fitness Sports
Some sports don’t fit into any of these categories. If you practice a sport to keep fit or just for fun, it would be considered into another category called Recreational, Leisure, or Fitness sports. Recreational, leisure, or fitness sports are typically covered by international student insurance plans. These sports are not considered to be as dangerous as organized sports, extreme/adventure sports, or contact sports.
However, it is important to read the fine print of your insurance plan carefully to make sure that the sports you participate in are covered. Some plans may exclude certain sports, such as sports that involve the use of motorized vehicles.
Tips for Choosing a Sports Insurance Plan
When choosing a sports insurance plan, there are a few things you should keep in mind:
Having sports insurance can give you peace of mind knowing that you are protected in case of an injury. It is an important consideration for any international student who participates in sports.
Community mental health is a mix of actions that have the goal of improving mental health on a community or social level, tackling health problems and their determining factors in a comprehensive way.
Taking action in building a community of mental health awareness is important because we are all responsible for taking care of and supporting each other. We may not always live and be part of a culture where institutions for mental health exist or where not all parts of the population benefit from them. Therefore, we must create these conditions instead of waiting for them to happen.
Mental Health
Mental health is a person’s emotional, psychological, and social well-being. And it has an effect on every aspect of a person’s life, including how they think, feel, and act. Also, it affects the way a person handles stress, the choices that they make, and how they relate to others. Emotional wellness is the ability to be aware of our feelings and accept them. It means having an optimistic approach through challenges and change. Being emotionally well doesn’t necessarily mean that you’re happy all the time, but rather, that you’re self-aware and able to shift as a way to feel better.
Risk and Safety Factors
There are a number of factors that can determine a person’s state of mental health, or that of a group, or even anticipate mental health disorders.Two of these are known as risk and safety factors, and both can be split into three categories:
Risk Factors | ||
Personal | Social | Socioeconomic |
Examples: -Genetics and perinatal conditions -Physical health issues -Traumatic life experiences | Examples: -Lack of a support network (family, school, neighborhood or work) -Isolation (due to migration, discrimination, etc.) | Examples: -Poverty and inequity -Unemployment -Geography (where you live and your current living situation) -Education level |
Safety Factors | ||
Personal | Social | Socioeconomic |
Examples: -Emotional assertiveness -Resilience -Agency and autonomy | Examples: -Stable and sufficient support network -Healthy dynamics on relationships (work, family, partners) | Examples: -Available services such as health, quality food, housing and green areas -Job opportunities |
Identifying both factors is a good first step for community mental health assessment and prevention.
You may have figured out by this point that most of the risk factors can be taken care of if a community is prepared to carry out small actions that will have a bigger role in the long run.
Take action!
Here are some ideas for concrete actions that you can start or suggest within your own community, whether it’s your school, college or university, neighborhood, family, group of friends, clubs you belong to, etc. You can even promote these actions by starting them yourself and teaching others to replicate them as well. Remember being part of the change you’d like to see is key.
Practice affection, assertive communication, breathing exercises throughout the day, meditation and other fulfilling spiritual activities. If it’s possible, get counseling and/or psychotherapy.
Create clubs for recreational activities such as arts and crafts (music, band, painting, dancing, movie club), gardening (you could learn about sustainable crops and how to plant them, or just gardening to embellish your surroundings or the city that you live in) and cultural events with topics the community might be interested in.
Create exercise groups; the options are endless: you can go for a walk or a bike ride, organize a yoga class, pilates, etc.
Look out for those in your community who might need an extra hand with their day to day activities, and volunteer so everyone can take turns when it comes to helping and contributing. These could be older generations or those with special needs, such as people living with a physical, mental or social disadvantage.
Promote awareness for having healthy surroundings. Noise is one of the most common stress factors. It makes us lack concentration, interferes with our sleep schedule, makes us become irritable and constantly nervous. Take careful consideration when playing loud music, beeping your horn, screaming, and talking loud for a long period of time, etc. Think twice and think of others!
Form groups for emotional support where you can practice emotional assertiveness and acceptance. You don’t necessarily need a professional to be there, it’s more than enough to be an active listener. Try to avoid judging and exude empathy for others.
These are some ideas you can start implementing now. If they already exist in your community, spread awareness and start incorporating them more regularly. Remember, you have agency and are capable of transforming your surroundings little by little, step by step!
Singing is a universal human activity that has been enjoyed for centuries. It is a way to express ourselves, connect with others, and simply have fun. But did you know that singing can also be good for your health?
Here are some therapeutic effects from singing:
If you’re looking for a way to improve your health, singing is a great option. It’s a fun, easy way to get exercise and enjoy the benefits of music. So grab a songbook and start singing!
Energy drinks are a type of non-alcoholic drink that offer us a better physical and mental performance as they provide that extra shot of energy that we sometimes need. Whether it’s for final exams season, athletic activities, or when we have an overwhelming amount of work or a hectic travel itinerary.
This extra shot of energy is mostly the result of the high concentrations of caffeine and sugar that energy drinks contain, among other ingredients that have become popular in the market of energy drinks, such as vitamins and natural ingredients like ginseng and guaraná. However, the reality is that some of these natural ingredients lack specific scientific evidence regarding their supposed properties.
In this blog, we analyze the effects of energy drinks on the body, as well as their effectiveness in relation to what they promise, and the possible risks that regular consumption of these drinks entails.
These drinks can enhance our alertness, and on a physical level, they increase blood pressure, heart rate, and respiratory rate, granting that extra shot of energy and alertness that we might need.
The most common substance in energy drinks is caffeine, which is the most consumed psychoactive substance worldwide. But the problem itself is not the caffeine, it’s the amount we consume. Depending on the brand and the size of the container, the caffeine concentration of an energy drink can vary from 80 mg to 160 mg and even more.
It is true that caffeine increases our mental performance, and when it’s consumed before practicing sports, caffeine could improve our performance and endurance during prolonged activities. However, excessive caffeine consumption can cause dehydration as it has a diuretic effect. In addition, it can also cause various problems such as changes in the sleep cycle, irritability, nervousness or anxiety. Ironically, it is also believed that in some cases, it can cause problems with retaining information or focusing.
In addition to caffeine, energy drinks may contain large amounts of sugar, which can also affect our health. It is a fact that sugar is a source of energy that the body synthesizes, but the risks of excessive sugar consumption outweigh the benefits that an energy drink could provide. It is important to note that sugar is linked to several health problems such as type-2 diabetes, overweight, and cavities.
The amount of ingredients vary depending on the brand and the size of the container, but to give you a general idea, energy drinks usually contain around 11 grams of sugar per 100ml. So, we could estimate that the amount of sugar in a 250 ml to 500 ml energy drink can range from 30 to 60 grams, which would be the equivalent of about 12 coffee spoons of sugar. Therefore, an energy drink of 500 ml would exceed the daily sugar intake that is considered safe for human consumption, according to the World Health Organization (WHO).
Nowadays, it is easy to find sugar-free alternatives, which contain sweeteners instead. While it is true that the sugar-free versions are relatively healthier and there are no known adverse effects, the research on regular consumption of sweeteners is limited. Therefore, it is not known for sure what the adverse effects of having energy drinks on a regular basis could be. Some sources infer that they could have negative effects on our intestinal microbiota.
Among the other active ingredients of energy drinks, it is normal to find taurine, which is an amino acid that can naturally be found in meat, fish, dairy products, eggs, nuts, and legumes.
Taurine has many functions such as regulating the functioning of the cardiovascular system and the central nervous system. However, the amounts of taurine found in energy drinks are much higher than what we can find naturally in food. On the other hand, the studies that have been performed on the consumption of taurine, have not shown that it actually improves physical and mental performance. Therefore, we can conclude that taurine and its energy boosting effects are marketing strategies.
As mentioned, energy drinks normally include vitamins, which are mostly of type B, such as vitamin B3 and B6. These vitamins do contribute to energy and mental performance, and reduce tiredness and fatigue. The advantage of type B vitamins is that the risk of overdose is very unlikely. If we take more than the body needs, the excess will be naturally eliminated through physiological processes.
Regarding the natural ingredients that energy drinks contain, such as ginseng and guaraná; these are considered active ingredients that produce a biological effect in our body, like caffeine does. But despite the popularity of these ingredients, the information available regarding their effectiveness in combination with all other ingredients of energy drinks is quite limited. In the long run, it could be a risk as active ingredients will cause a reaction in the body, which then could cause side effects or even negatively react with medications. For example, ginseng is contraindicated in people with heart problems, high blood pressure, and anxiety.
Guarana, on the other hand, naturally contains caffeine, which could increase the caffeine levels in an energy drink and be counterproductive if these drinks are consumed excessively.
When we consume energy drinks in excess, the cardiovascular system is the most affected as blood pressure can dangerously raise, which increases the risk of suffering a heart attack or a stroke. Excess of energy drinks could also cause irregular heart rhythm which will increase the risk of having lethal arrhythmias.
Lastly, it is important to point out the effects of these drinks if they are combined with alcohol, which is a common practice nowadays. Mixing these drinks with alcohol can be dangerous as the effects that energy drinks can have on the body and nervous system could mask the effects of alcohol, and this could lead to a higher alcohol intake. By mixing these drinks with alcohol, confusing signals are sent to the nervous system and because of this, dangerous levels of alcohol could be reached.
Having said this, we can conclude that more research is needed on the effects and possible risks of energy drinks, and the active ingredients they contain. The consumption of these drinks should be moderate and it is important to be aware of the possible risks that they imply.
Sources:
As soon as countries in Asia started opening back up after COVID, I went into full planning mode. My husband and I had postponed our honeymoon yet another year because we wanted to maximize our time abroad without having to spend precious vacation days in a hotel room quarantining. Once January 2023 came around, we started our adventure through Southeast Asia visiting Japan and then making our way to the Philippines.
However, after spending years hearing nothing but coronavirus this and that, you often forget there are other diseases out there. Unfortunately, while traveling to one of the islands of the Philippines, I started feeling very sick. By the time we reached our hotel, I knew something was very wrong as the pain on my abdomen wouldn’t subside. Finding myself sick, in a country where I didn’t know the language nor how the healthcare system worked, was daunting to say the least.
Doing the job I do day in and day out, however, I’m luckier than most as it has prepared me for situations like this and most importantly to have an insurance plan to cover my medical expenses. Before our trip, I bought a Patriot Travel International Lite plan to cover my spouse and I in case the unexpected happened. From this experience, I gained a few nuggets of wisdom:
Documents? Check!
When we entered Japan, we were asked to present our travel insurance documents. Being the diligent insurance agent that I am and having heard others’ experiences while traveling, I purchased an insurance plan ahead of time. I also read my insurance documents and downloaded my documents to my phone to have on hand.
Looking back, I don’t recall reading anywhere that Japan would ask for proof of insurance but I am glad I was prepared for this question.
Did you know? – When you purchase an insurance plan through ISI, you’ll be issued an ID card as well as a visa letter. The visa letter is an official document that can be presented to an embassy, consulate or at a port of entry and it highlights the most important benefits of your plan.
As I work with insurance plans every day, I had a pretty good idea how to use my plan and what I would be covered for. However, normal people usually don’t spend their days reading through insurance documents! A simple phone call to the insurance company will help you verify your benefits. They can explain to you how to use your plan abroad and how to locate a doctor or clinic. I was able to contact the international phone line before going to the clinic and they informed me what my coverage would be.
Use Online Tools
Every insurance plan offered through ISI gives you access to an online portal where you can find providers, file your claims, extend your coverage and much more. I was able to locate a clinic in their international provider search and after going to the clinic, I took a picture of the documents and receipts the doctor gave me and uploaded my claim to the myIMG portal offered through our Patriot International plan. I’ve been able to follow up on my claim right online and upload any documentation that was missing.
Did you know? – You can find international providers right through your account when you buy a Patriot International plan. Create your account before your trip and access the international provider search here.
Bring Extra Cash
In this day and age, many places accept credit cards or bank transfers. As convenient as that sounds, if you’re visiting remote locations, cash is still needed for day-to-day transactions. My husband and I were in El Nido, Palawan, a beautiful yet remote island of the Philippines. One of the days, there was a whole island outage and thus, ATMs didn’t work.
On top of that the clinic did not accept card payments. Thankfully, we had extra cash that we could use to pay for my visit to the clinic as well as prescription medication. Generally, for minor conditions like mine, you will be expected to pay out-of-pocket and then file a claim for reimbursement. For major conditions that may require emergency procedures or life-saving treatment, you or the hospital can contact the insurance company to arrange direct billing.
After a quick recovery, we were able to finish our backpacking trip through Southeast Asia. I am very lucky I have the training to handle situations like this one in a country on the other side of the world where I did not speak the language.
At ISI, we recommend the plans we do because we know that the unexpected can happen at any time and we have personal experience with them. To learn more about a specific plan, our team of licensed insurance agents is here to assist you!
Yessica Pacheco is the Director of Customer Service at ISI. She’s originally from Colombia but has lived in the United States since 2005. She has had the opportunity to travel through Latin America, Europe and Asia. Her interest in education and international studies along with her experience in bilingual customer service led her to EIC. When not in the office, you’ll find her immersed in a good book or with her dogs at the beach.
When I hear the term “altitude sickness” I begin picturing an intrepid explorer, strapped into climbing gear who is covered in puffy skier jacket clinging to the side of a mountain while snow falls from above.
My imagination is painting a picture of a very outdoorsy, adventurer who climbs mountains. My imagination doesn’t include a picture of myself as a tourist, strapped into a giant backpack and pulling my wheeled luggage through an airport. But it should.
Here’s the truth: anyone can experience altitude sickness. All it takes nowadays is a plane ride to be in a completely new place in the world. And if the place you’re traveling to has a higher elevation than what your body is accustomed to, you may find yourself experiencing altitude-sickness.
What is the cause of Altitude Sickness?
The pressure of the air that surrounds us is called barometric or atmospheric pressure. When visiting higher altitudes, this pressure drops and there is less oxygen available.
People that live somewhere located at a moderately high altitude will become accustomed to the air pressure. However, when traveling to a place at a higher altitude than your norm, your body will need time to adjust to the change in pressure.
Any time that you go over 8,000 feet you can be at risk for altitude-sickness. Some people find themselves more prone to altitude-sickness than others, and how your body reacts can be unique to you. It is wise to keep in mind the classic identifiers of altitude-sickness, so that you can be prepared if your condition worsens. Headaches, shortness of breath, and nausea are all classic signs of altitude sickness.
Altitude sickness, also called Mountain Sickness, has 3 levels:
Are certain people more prone to Altitude-Sickness than others?
No, anyone can develop altitude sickness no matter how fit, unfit, young, old, healthy or unhealthy they may be. While there are no specific illnesses that make you more likely to develop altitude sickness, there are people who are more likely to do poorly, for example:
Treating Altitude-Sickness
If your symptoms persist or are more severe, or if mild symptoms don’t go away and in fact get worse, it is advised that you get to a lower elevation as quickly as possible and seek immediate medical attention.
Can Altitude-Sickness Be Prevented?
I was a tourist in a city that is around 7,300 feet in elevation, which is well under the 8,000-foot elevation limit that I mentioned earlier, but I found my sinuses and throat were incredibly dry, I was short of breath and excessively exhausted while doing very little.
My condition was fairly mild, falling in the first level, AMS, and I did find myself acclimating slowly, but it’s something to keep in mind during your travels. The last thing you want on your vacation, or while attending a new school, is to find yourself needing medical care.
Sources: