A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
A
Abbreviations & Acronyms
Browse our comprehensive list of abbreviations of NHS Terms.
Abuse
a violation of an individual’s harm and civil rights by any other person or persons. Abuse may consist of single or repeated acts. It may be physical, verbal or psychological, it may be an act of neglect or an omission to act, or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which he or she has not consented, or cannot consent. Abuse can occur in any relationship and may result in significant harm, or exploitation of the person subjected to it
Accident & Emergency (A&E)
A 24 hour walk-in service provided by an acute hospital for conditions that need immediate medical attention to save a life or to prevent permanent damage to health, for example, a serious accidental injury or a heart attack.
Acute Care
The treatment of patients who need specialised medical or surgical care, or who need care for a brief but severe period of illness. This includes conditions that are the result of disease or serious accidents and while recovering from surgery. (See also Secondary Care)
Acute Hospital
A large hospital located in a city centre that provides acute care facilities and services
Allied Health Professional
See therapist.
Ambulatory Care
Ambulatory care is a patient focused service where some conditions may be treated without the need for a hospital stay. Ambulatory care is provided by a range of staff including doctors, nurses and therapists who can offer the same specialist assessment, treatment and care that is received on a hospital ward. Patients can often return to their own home, even if further treatment is required on another day. Ambulatory care can also prevent patients with long term conditions such as diabetes, respiratory conditions and angina from getting into a crisis and reduce the need for hospital admission. This is achieved through active management, such as vaccination, help with self-care, case management and lifestyle changes.
B
Better Care
Health and social care services work together to provide better support at home and earlier treatment in the community to prevent people needing urgent care in hospital or early admission into care homes. more inormation can be found here
Being open
Open communication pf patient safety incidents that result in harm or death of a patient while receiving healthcare.
C
Cardiac
Relating to the heart.
Care Act
The Care Act is a new law about care and support for adults in England that came into effect in April 2015. Visit the East Riding of Yorkshire Council for more information.
Care Home
Also known as a residential home, which provides accommodation, meals and personal care (such as help with washing and eating) for people who can no longer live independently. The majority of care homes are run by private companies but some are managed by local authorities. See also Nursing Homes).
Care or Case Management
Patients with complex needs such as a serious disability or long term condition are identified and supported by skilled health and/or social care workers in an integrated care pathway.
Care Model
A set of guidelines and principles for an entire health and/or social care service or services within one or more organisation. Care models help to improve patient care by:
- defining responsibility and authority for individuals working within the service/s
- providing continuity of care
- supporting individual care pathways.
There are many types of models of care, for example, patient-focused, primary care, family-centred and chronic.
Care Pathway
Detailed guidance for management of a patient with a specific condition based on best practice and clinical guidelines. Care pathways improve the continuity and co-ordination of care across different disciplines and sectors, particularly when a patient’s condition is complex. A care pathway covers first contact with the NHS or Local Authority, takes in all the different stages of their treatment or care and ends when the treatment is completed. Also known as a Patient Pathway.
Care Plan
A care plan is an agreement between a patient and their health professional (or social services) to help individuals manage their health day to day. It can be a written document or something recorded in patient notes.
Carer
A carer is anyone who cares, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction cannot cope without their support.
Chemotherapy
Treatment of disease by chemical substances commonly used to treat cancers.
Chronic disease
See Long Term Condition.
Chronic Heart Disease
A general term covering one or more specific diseases of the heart which are long term conditions affecting a patient’s life and do not respond to treatment.
Chronic Obstructive Pulmonary Disease (COPD)
A Long Term Condition that is a persistent or recurring respiratory disease affecting the lungs and the heart, leaving people with difficulty in breathing.
Clinical
Observation and treatment of disease and other illness in patients in order to heal.
Clinical Commissioning Group (CCG)
NHS organisations with a statutory responsibility for planning health services and meeting the health needs of local populations. They often cover the same or a similar area as the Local Authority. They Commission (buy) health and care services including the majority of planned care, rehabilitation care, urgent and emergency care, most community health services, mental health and learning disability services. The governing body includes GPs, a nurse, a hospital consultant, executive officers and Local Authority officers for public health and social care.
CCG Council of Members
A CCG Council of Members consists of a representative from each GP practice in the CCG area. Members have responsibility to represent the health needs of their patients and the views of their GP practice. Each member GP practice has a vote for major CCG decisions which is proportional and determined by their total registered patients.
Commissioning
A continuous cycle of activities that is focused on planning and buying healthcare provision. Activities within this cycle include:
- understanding local information about the health needs of the population to tailor services to that need
- using national and local research evidence about best practice
- seeking views from local GPs and other clinical professionals, partner organisations and the local population about what services should be made available and how they should be organised
- ensuring services are safe, good quality and value for money
- as well as contract negotiation, target setting, providing incentives and monitoring providers of local services.
Commissioner
An organisation with responsibility for assessing the needs of service users, arranging or buying services to meet those needs from service providers in either the public, private or voluntary sectors, and assuring itself as to the quality of those services.
Community Beds/ Wards
An inpatient ward within a community hospital that offers care and rehabilitation to individuals that are temporarily unwell due to surgery or illness.
Community Care
Care or support provided by social services departments and the NHS to assist people in their day-to-day living.
Community Health Services
Treatment provided to people outside of hospitals, for example at the GP practice or via community nurses and therapists, together with preventative services such as immunisation, screening or health promotion.
Community Hospitals
Local hospitals serving relatively small populations providing a range of clinical services but not equipped to handle emergency admissions on a 24 hour 7 days a week basis. Some community hospitals also offer community beds.
Community Hub or Locality Hub
A centre that brings together primary and community services (and often social services) on a single site or virtually through multi-disciplinary teams (MDTs) to provide more convenient patient access. Health, social care and voluntary and private sector services work together to provide a seamless service which may include services such as GP and dental services, community nursing, physiotherapy, outpatient clinics and minor injury services.
Community Matron
A community matron is a case manager with advanced level clinical skills and expertise in dealing with patients with complex long term conditions. This is a senior nurse role with responsibility for planning, managing, delivering and coordinating care for patients with highly complex needs living in their own homes and communities.
Culture
Learned attitudes, beliefs and values that define a group or groups of people.
D
Data loss
There is no simple definition of a serious data loss incident. What may at first appear to be of minor importance may, on further investigation, be found to be serious and vice versa. Any incident involving the actual or potential loss of personal information that could lead to identify fraud or have other significant impact on individuals should be considered as serious.
Deep Dive
A deep dive is an extensive review into a subject area. The deep dives are an opportunity for key people to work collaboratively and examine performance, quality and safety matters in detail. Actions that arise from the deep dives are followed up and reported at agreed meetings so that progress is maintained.
Dementia
Umbrella term for a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. Dementia is caused when the brain is damaged by an accident, disease or a stroke. A person with dementia will gradually deteriorate as it is a progressive condition.
Dermatology
Branch of medicine concerned with the skin and its diseases.
Diabetes
A condition characterised by a raised concentration of glucose in the blood due to a deficiency in the production and/or action of insulin, a pancreatic hormone.
Diagnostics
Procedures to identify a disease or condition, e.g. blood tests, x-rays, endoscopies and MRI scans.
Dietitian
A professional therapist who applies the science of nutrition to the feeding of groups and individuals in health and disease. Their primary role is to advise and educate both patients and other professionals
Duty of Candour
A statutory requirement to ensure health care providers operate in a more open and transparent way. The regulation requires an NHS body to:
- Make sure it acts in a open an transparent way with relevant persons in relation to care and treatment provided to people who use services in carrying on a regulated activity
- Tell the relevant person in person as soon as reasonably practicable after becoming aware that a “notifiable safety incident” has occurred, and provide support to them in relation to the incident, including when giving the notification
- Provide an account of the incident which, to the best of the health service body’s knowledge, is true of all the facts the body knows about the incident as at the date of the notification.
- Advise the relevant person what further enquiries the health service body believes are appropriate
- Offer an apology
- Follow this up by giving the same information in writing, and providing an update on the enquiries
- Keep a written record of all communication with the relevant person
Due Diligence
Due diligence is the term used to describe the performance of an investigation of a business or person.
E
Elective (planned) care
Planned assessment and treatment of non-urgent medical conditions such as orthopaedic treatment (e.g. a knee replacement). At present this may require a hospital outpatient visit, diagnostic tests and possibly an operation. An elective care pathway is the planned journey patients take from referral to treatment and recovery.
Emergency care
Treatment given to individuals that have suffered e.g. a serious accident or a heart attack, who need immediate medical attention to save their life or to prevent permanent.
End of life care
Care provided to someone at the end of their life. The difference between end of life care and palliative care is that someone receiving palliative care may have an incurable condition but will live for many years whereas end of life care is only provided to someone who terminally ill and in the last few weeks of their life.
Endoscopy
Examination of the inside of the body to spot any abnormalities that might need treating. Done using a flexible pipe like instrument with a tiny camera and light on the end called an endoscope. The most common endoscopic procedures look down the throat, stomach, and portions of the intestine.
F
Falls prevention service
A team that specialises in working with individuals who have an increased risk of having a fall, due to their age or poor condition of health. Things that the falls service do include offering physiotherapy to strengthen muscles, advising on and providing assistive equipment and footwear and making a referral to a hospital consultant for specialist assessment where appropriate.
Five Year Forward View
The NHS Five Year Forward View was published on 23 October 2014 and sets out a vision for the future of the NHS and how it needs to change over the next five years if it is to close the widening gaps in the health of the population, quality of care and the funding of services. It has been developed by the partner organisations that deliver and oversee health and care services including NHS England, Public Health England, Monitor, Health Education England, the Care Quality Commission and the NHS Trust Development Authority. A copy is available in Easy Read and audio.
Foundation Trust (FT)
NHS hospitals that are run as independent, public benefit corporations, controlled and run locally. Foundation Trusts have increased freedoms from government regulations regarding their options for investment in and delivery of services.
G
GP (General Practitioner)
A medical doctor who provides primary care and specialises in family medicine.
Gynaecology
Relating to the branch of medicine which deals with women’s reproductive organs.
H
Healthcare professional
Doctor, dentists, nurse, pharmacist, optometrist, allied healthcare professional or registered alternative healthcare practitioner
Health Prevention
Consists of actions taken to prevent the onset of disease and health problems, as opposed to treating disease. See also health promotion.
Health promotion
Services that raise awareness about health hazards and encourage people to have better health by doing such things as stopping smoking, spotting early signs of diseases and eating healthily. Health promotion services also target audiences with key messages, for example, encouraging teenagers to have safe sex and vulnerable people individuals to get the ‘flu jab during winter.
Hospital at home
A care model that aims to improve a patient’s quality of life and prevent hospital admissions by allowing them to be safely cared for in their own home. The care is provided by a specialist multi-disciplinary team who are set up to work just like a community ward team. Also known as a virtual ward.
Hospital in-reach
A team that contains nursing, therapy and social care workers. They identify patients in hospital that could be discharged home earlier with the right care planning and support then take care of the individual until they regain independence once more or are placed in a suitable care environment such as a care home.
Hospice
Offer supportive care to people in the final phase of a terminal illness and focuses on comfort and quality of life, rather than cure. Hospices receive some funding from the NHS and local authority but are usually run by a charity and also rely on charitable donations.
Human Resources
Department within an organisation responsible for workforce issues.
I
Incident
An event or circumstance that could have resulted, or did result, in unnecessary damage, loss or harm such as physical or mental injury to a patient, staff, visitors or members of the public
Independent Sector
Private and voluntary organisations providing health and social care services to the community.
Integrated care
See Community Hub.
Intermediate care
Short term care plan (usually up to six weeks) by a multi-disciplinary team, provided in patients’ own homes or a place of care, aimed at preventing hospital admissions or helping with early hospital discharge.
Intermediate tier
The Intermediate Tier aims to support people with health and social care needs to stay in their own home rather than being admitted to hospital or into long term care. It provides support to people when they are discharged from hospital, helps people to remain independent and helps to identify any on-going needs.
J
Joint Strategic Needs Assessment (JSNA)
An ongoing process run by Local Authorities, CCGs and other public sector partners to jointly describe the current and future health and wellbeing needs of its local population and identify priorities for action. The JSNA is not just about health and personal social care services; it is also about the wider aspects of health including poverty, employment, education, public safety, housing and the environment.
The ultimate purpose is to use the information gathered to identify local priorities and support commissioners to commission services that are based on need, to achieve better local health and wellbeing outcomes and reduce health inequalities.
K
L
Learning Disability
A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life.
Lipids and lipid-lowering drugs
Lipids is the description for types of fats, including cholesterol which are naturally produced in the human body. Lipid-lowering drugs help to lower cholesterol levels as high levels can be bad for health.
Local Authority
Local Authorities are democratically elected local bodies with responsibility for a range of functions as set out in local government legislation. They have a duty to promote the economic, social and environmental wellbeing of their geographical area. This is done individually and in partnership with other agencies, by commissioning and providing a wide range of local services.
Locality
Smaller geographical areas that make up the total area of the CCG. There are five localities – Goole, Howdenshire & West Wolds, Beverley & Driffield, Haltemprice, Holderness and Bridlington.
Locality Commissioning Forums
A forum that enables GP practices and other primary care professionals to become more involved in commissioning decisions and gives GPs greater freedoms and flexibilities to tailor services to the needs of their local community. Locality Commissioning Forums also form part of the decision making process and constitution of the CCG’s Council of Members.
Locality Hub
See Community hub.
Long term conditions
Those conditions (e.g. diabetes, asthma and arthritis) that cannot, at present, be cured but whose progress can be managed and influenced by medication and other therapies.
M
MRI (magnetic resonance imaging)
A scanning technique that uses magnetic and radio waves. An MRI scan can show images of soft tissues in the body and show up abnormalities such as lumps or swelling.
Marie Curie (palliative care) service
Marie Curie nurses support people who are coping with cancer. They also support the individual’s carers and families.
Medicines Optimisation An approach that health professionals such as GPs, pharmacists and hospital doctors adopt to make sure patients get the maximum benefit from their medication. For example, checking someone is using their asthma inhaler correctly or ensuring an elderly person taking multiple medications does not have side effects that leave them drowsy and at higher risk of experiencing a fall.
Memory assessment or clinic
A set of tests to help to understand the root cause of memory difficulties, for example, stress or the onset of a dementia condition such as Alzheimer’s Disease.
Mental Health Services
Services that provide treatment for individuals with mental health difficulties such as depression, dementia and eating disorders.
Minor ailments
Illnesses that can be treated at home or with advice from a pharmacist e.g. colds, rashes and stomach upsets.
Minor injuries
Examples are cuts, bruises, scalds and suspected closed limb fractures. The role of a minor injury unit or service would be to provide treatment for such minor injuries.
Minor injuries unit
A service to provide treatment for minor injuries.
Model of Care
See Care Model.
MDT (multi- disciplinary team)
Professionals from different disciplines, e.g. GPs, social workers, therapists and nurses caring for patients as one team.
Multi Specialty Provider
A new care model, outlined in the NHS Five Year Forward View, where GP group practices would expand bringing in nurses and community health services, hospital specialists and others to provide integrated out-of-hospital care. These practices would shift the majority of outpatient consultations and ambulatory care to out-of-hospital settings.
N
NICE
National Institute for Health and Care Excellence. Sets the standards for high quality healthcare and encourages healthy living.
Navigation / Signposting
See Single Point of Contact.
Neighbourhood Care Service (NCS)
NCS is a skilled MDT including nurses, therapists, rehabilitation and social care staff working in the East Riding to support early patient discharge from hospital and prevent unnecessary hospital admissions by providing care closer to home. The service also supports individuals with long term conditions.
Neurological
Relating to the branch of medicine which deals with the nervous system and its diseases.
Never Events
Arise from a failure of strong protective barriers which can be defined as successful, reliable and comprehensive safeguards or remedies e.g. a uniquely designed connector to prevent administration of a medicine via the incorrect route – for which the importance, rationale and good practice use should be known to, fully understood by, and robustly sustained throughout the system from suppliers, procurers, requisitions, training units and front line staff alike.
NHS 111
The NHS111 telephone service is open 24 hours a day 365 days a year. It is for people who require healthcare treatment or advice and don’t know where to go. Following an initial assessment, trained call handlers advise people on the services available to them locally at any given time, book appointments, or arrange for more urgent action, such as arranging for an ambulance to be sent out if necessary.
NHS Trust
NHS organisations that provide hospital based services, community and mental health care services and ambulance services. Also known as providers.
Nursing Homes
Residential establishments which provide the same care as in a care home but which also have registered nurses who can provide care for more complex health needs.
Nutritional Support
See dietitian.
O
Occupational Therapy
Treatment of physical and psychological conditions through specific activities to help people reach their maximum level of function and independence in all aspects of daily life. They can also provide special equipment to help people manage tasks they could not otherwise manage on their own eg. bathing chairs and walking sticks.
Orthopaedics
Branch of medical science dealing with health problems and diseases affecting the skeleton.
Out of hours Service
Medical cover provided outside the normal working hours of community health care professionals, usually from 6pm-8am Monday – Friday and 24 hours during weekends and Bank Holidays.
Outpatient
When you go to a hospital for diagnosis or treatment but do not stay any nights there.
P
Palliative Care
Supportive service for those who are living with disease that is not curable e.g. cancer or multiple sclerosis. The difference between palliative care and end of life care is that someone receiving palliative care may have an incurable condition but will live for many years whereas end of life care is only provided to someone who terminally ill and in the last few weeks of their life.
Parity of Esteem
Refers to valuing mental health on the same level as physical health.
Patient Pathway
See Care Pathways.
Personal Health Budgets
A personal health budget is an amount of money to support identified health and wellbeing needs, planned and agreed between individuals and the local NHS team. The aim is to give people with long term conditions and disabilities greater choice and control over the healthcare and support they receive.
Physiotherapy
Treatment involving the use of physical treatments such as exercise, heat and massage for rehabilitation and to aid recovery.
Place Based Approach
A place-based approach targets an entire community and aims to address issues that exist at the neighbourhood level, such as poor housing, social isolation, poor or fragmented service provision that leads to gaps or duplication of effort, and limited economic opportunities. By using a community engagement approach to address complex problems, a place-based approach seeks to make families and communities more engaged, connected and resilient.
Planned care
Care that is planned for a patient after visiting their GP, e.g. elective care such as hip replacement surgery and hospital consultant care for a long term condition such as diabetes.
Primary Care Services
Care provided by GPs and practice staff, dentists, pharmacists, opticians and other healthcare workers in the community.
Procurement
Purchasing of goods and services. In the NHS this takes into consideration things such as health needs, quality and value for money.
Providers
Organisations providing healthcare services (see NHS Trust).
Public Sector
An umbrella term which includes all government-funded organisations and functions that affect or are likely to affect the public or a section of the public, e.g. the NHS.
Q
Quality, Innovation, Productivity and Prevention (QIPP)
QIPP is a framework for looking at how the NHS can deliver efficiency savings whilst maintaining or improving quality. It sets out the need to deliver improved services under the tighter budget constraints that have been introduced in the NHS.
R
Rapid response
A response to an urgent but not emergency situation, usually within 2 to 6 hours.
Rehabilitation and reablement
A programme of patient therapy, often involving physiotherapy and occupational therapy, designed to restore independence and reduce the effects of a permanent or temporary disability caused through injury or illness.
- Practical Home Support Leaflet
- Reablement Services Leaflet
- Reablement Beds Service
- Reablement Telecare Information
Residential Homes See Care Homes.
Risk Stratification
A process used in the NHS to identify people that may particularly benefit from proactive health care or preventative treatment. For example, a GP practice may scan their patient records looking at things such as existing health conditions of all of their registered patients to identify the people that may benefit from a service targeted at supporting those with a long term condition.
S
Safeguarding
To protect people's health, wellbeing and human rights, and enabling them to live free from harm, abuse and neglect. It's fundamental to high-quality health and social care.
Screening Tests
To spot health conditions so that they can be treated at an early stage of development leading to a greater chance of full recovery. For example, a mammogram or cervical smear to spot types of cancer.
Secondary Care
Medical treatment or surgery that patients receive in an acute hospital following a referral from a GP or a serious emergency. Including elective, planned and A&E care.
Self Care or Management
Self care covers a spectrum of individual behaviour change to stay as healthy as possible. At the moderate end, self care is about healthy individuals understanding the benefits of e.g. a good diet/exercise and the health risks of smoking and choosing to make healthy choices to stay well. At the more complex end of the spectrum it is about people with one or more long term conditions who have a personalised care plan that helps them to have a clear understanding of the benefits described above as well as an understanding of how they can best manage their medical conditions to stay as well as possible. By helping people to get the right services and understand choices available to meet all of their needs, not just the medical ones, a personal care plan can also improve an individual’s independence and quality of life.
Single Point of Contact (also a Single Point of Referral)
This is a local single point of contact for patients, GPs, ambulance services, voluntary sector etc. to access a range of health/social care services. Patient care is triaged and co-ordinated from a central point by local team covering a geographical area.
Social Enterprise
Businesses involved in social enterprise have primarily social objectives. Their surpluses are reinvested principally in the business or community.
Social Care Services
If you, or someone you know, has additional needs because of a physical or mental illness, a disability or old age, they may be entitled to help from social care services.
Specialist Services
Advice, guidance and assessment provided by professionals with particular expertise, e.g. a diabetes consultant.
Speech & Language Therapist
A professional therapist who diagnoses and treats acquired or developmental communication (speech) disorders.
Stakeholder
A stakeholder can be an individual, a local group or organisation, a local politician – anyone with an interest in local community developments, e.g., the healthcare plans of the CCG. Stakeholders are involved in partnership working and are sought out for views on future developments.
Step Up Care and Step Down Care
Step up care is for people who need more care for a temporary period, for example, after a fall, until they are able to return home and live independently once more. It can avoid the need for long-term residential care and hospital admission.
Step down care is for people who need a stopover between hospital and home, for example, after surgery or after having treatment for a serious illness. This helps patients to heal and regain independence until they are ready to return to their own home.
Stroke
A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off due to a clot or a burst blood vessel. The sooner a person receives treatment for a stroke, the less damage is likely to happen. Rehabilitation is vital after a stroke for recovery or partial recovery. The risk of having a stroke can be significantly reduced through a healthy lifestyle, such as eating a healthy diet, taking regular exercise, drinking alcohol in moderation and not smoking.
Screening
Tests to spot health conditions so that they can be treated at an early stage of development leading to a greater chance of full recovery. For example, a mammogram or cervical smear to spot types of cancer.
Secondary Care
Medical treatment or surgery that patients receive in an acute hospital following a referral from a GP or a serious emergency. Including elective, planned and A&E care.
T
Telecare
Telecare supports patients who are at risk of crises and hospital admission. Patients use a hand-held electronic unit to monitor vital signs like blood pressure, weight, pulse rate and blood oxygen. These allow community nursing staff to remotely monitor on a daily basis and intervene with additional support when necessary.
Therapists (also referred to as Allied Health Professionals) Treat physical and psychological conditions through specific activities to help people reach their maximum level of function and independence in all aspects of daily life. Examples are physiotherapists, occupational therapists and speech and language therapists.
Third Sector See Voluntary and community sector.
Triage An assessment by a doctor or nurse of an individual’s health condition or injury to determine the type of treatment they need and how quickly. Triage is mostly used in unplanned, urgent and emergency care services.
U
Urgent (unplanned) care
The care needed to treat an unexpected condition that needs immediate medical treatment as an outpatient in a hospital, clinic or a health centre. An urgent condition is not life-threatening, but may cause serious medical problems if not treated quickly.
V
Virtual consultation
Use of technology such as video-conferencing for doctor-patient consultations.
Virtual ward See Hospital at home.
Voluntary sector
An umbrella term for the full range of organisations which are non-governmental and interested in furthering social, environmental or cultural benefits, rather than to make a profit. Includes registered charities and other non-profit organisations e.g. associations, self-help groups and community groups. Also known as the third sector.
W
Wellbeing
Wellbeing covers a range of factors that affect overall happiness and quality of life. Factors include where you live (housing), how much money you have to live on (economic) and how you keep yourself usefully busy through voluntary or paid work (occupation). Individual wellbeing can be affected through choice (e.g. getting ill due to smoking) and lack of choice (e.g. not being able to afford good quality housing). Social and council services help with many aspects of wellbeing. Poor health and poor wellbeing are closely related so health and social care services often work closely together.
White Paper
Documents produced by the Government setting out details of future policy on a particular subject.
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