Inner Corner Of Eye Itchy

If it causes symptoms it can be surgically removed. Pain toward the corner of eyes can be the consequence of various diverse reasons.

Home Remedies For Bloodshot Eyes American Academy Of Ophthalmology

It may be a result of a chronic eye irritation but exact cause is not known.

Inner corner of eye itchy. You should see your optician if you think you have conjunctivitis. Localized area of itching redness and swelling may be an allergic reaction. I clean and scrub my eye lids to keep them clean but obviously cant clean the inside corner.

Commonly any itchy eye is also associated with redness and watering of eyes. Itching of the eyes due to allergies ie. If it is seasonal in natureit is most commonly allergic in natureU need to consult your eye care practioner.

Most conditions that result in the itchy eyes in the corner are not serious enough to affect our vision or have any long-term effect on eye health. Some Common Pointers to be Kept in Mind While Evaluating your Problem of Itchy Eye are. Treatment includes an eye ointment containing a cortisone and possibly a.

Eye allergies are reactions to pet dander pollens dust and chemicals. In some cases the itchiness can be felt in the inner. It can be triggered by a variety of conditions including allergic reactions and infection.

If i itch it it gets much much worse and lasts longer to. Itchy eyes are acommpanied by a red or pink-coloured eye a sore or burning feeling and sometimes a discharge from the eye. According to WebMD itching in the corners of the eyes is a common symptom of eye allergies also referred to as allergic conjunctivitis.

Itching at corner of eyes can result from allergies or due to blepharitis. My problem is the inside corners of them where that little bump is not the white of the eye itches like mad. Diagnosis of the Cause of Itchy Eyes.

The fact is that itching eyes particularly in the inner corners is usually due to the eyes being dry. Eyes itchy in corners as a whole eyes itchiness also referred to as ocular pruritis affect many individuals and are a routine reason for checking out the eye doctor. Dacryocystitis is often caused by bacteria typically Staphylococcus staph and Streptococcus strep species.

They may recommend antibiotic eye. A remote body aggravation because of an outside reason or even a headache that is confined to that piece of the district near the side of the eyes. Pterygium 4 is a small fleshy outgrowth from the cornea usually appearing in the inner corner of the eye.

Itching of the eye in the corner is not a disease but a symptom could indicate a disease that has affected your eye. Viruses and bacteria can infect the lining of the eye or tear duct causing itching in the corner of the eye. So then I have to use my first fingers tip to press against the small lump of flash in the inner merging corner of the eye.

But some causes of itchy eyes such as an inflammation of the eye called blepharitis can be problematic because flareups tend to recur often. It usually starts with a casual touch or rub and then you just can not seem to stand the itchiness. Hello there since 1995 I am 31 now I have had the inner corner of my both eyes very itchy.

Its most itchy at night and in the morning during the day it isnt as bad. It gets worse when rubbing on them. Allergic conjunctivitis is usually associated with a white stringy discharge andor seasonal nasal allergies.

Irresistible eye infections can be ordered in two ways. In certain cases there might be itchiness in the inner corners of the eyes or the outer corners of the eyes. Additional symptoms include redness and irritation of the eyes swollen eyelids burning and sensitivity to light.

Some symptoms of dacryocystitis include. The inner corners of my eyes are very very itchy and it has been like this for three weeks. Less common causes of a bump inside the corner of your eye include cysts which are pockets of fluid that build up and disrupt your vision and papillomas which usually are benign growths that may be pink or skin-colored.

Allergies and how often the body produces. Itchy eyes can be a symptom of this common eye condition. However certain causes of itchy eyes like Blepharitis or inflammation of the eye can be problematic as flare-ups tend to recur quite often.

Florida Health Department Broward

The Florida Department of Health in Broward County provides routine immunizations for children and adults in order to decrease vaccine-preventable diseases. Volunteers needed to help keep Hollywood Beach butt freeMarch 02 2015.

About Us Florida Department Of Health In Broward

DOH-Broward sites for COVID-19 test available wo appointment.

Florida health department broward. Coral Springs WIC Center. Call 954-412-7300 for general info. Serious outcomes of flu infection are hospitalization or death.

And homebound testing appts. Influenza can cause mild to severe illness. Florida Department of Health in Broward CountyMain Office 780 SW.

Coronavirus Covid-19 Health Details. 10077 NW 29th Street Coral Springs FL 33065 954-767-5111. The Florida Department of Health is issuing 2019 Novel Coronavirus COVID-19 updates every day to keep residents and visitors safe and aware.

Fort Lauderdale Health Center Temporarily all immunization services are offered at our Fort Lauderdale Health Center location to find where your. 24th Street Fort Lauderdale FL 33315 954-467-4700. Call 954-412-7300 for general info.

Florida Department of Health in Broward Addresses County Health RankingsMarch 25 2015. Updates are made as new information is received from the Florida Department of Health in Broward County and from local federal and state partnersFor more information please call 866-779-6121 or email email protected or visit the Florida Department of Health vaccine website here. Florida Department Health Broward County.

Broward County Community Reports. DOH-Broward does not discriminate on the basis of differing ability in admission to or operation of its programs services activities or facilities. Although DOH-Broward is a state agency it maintains a very strong partnership with Broward County Government which is formalized in a core contract.

Broward County officials continue to work closely with the Florida Department of Health the Centers for Disease Control and Prevention CDC the Governors office and the Florida Division of Emergency Management to help residents visitors and employees weather this health crisis. The Florida Department of Health and the COVID-19 Call Center cannot provide results tell you exactly when or how youll get your results or expedite results. Influenza or flu is a viral respiratory illness mainly spread by droplets made when people with flu cough sneeze or talk.

See our list of DOH-Broward Location. Armstrong Will Read to Students in BrowardJanuary 23 2015. Updates are made as new information is received from the Florida Department of Health in Broward County and from local federal and state partners.

The Licensing and Regulation section provides information relating to professional facility and. The latest tweets from FLHealthBroward. Confirmed Cases of Pertussis Whooping Cough in Broward CountyMarch 11 2015.

If you are looking to establish a successful career in Public Health you have come to the right place. DOH-Broward sites for COVID-19 test available wo appointment. The Accommodation Request Form may be used by individuals and their companions with a differing ability seeking access to a Florida Department of Health in Broward County program service.

As the local supply of vaccines increases the Department of Health in Broward County along with their partners will vaccinate individuals ages 65 and older as well as additional priority groups as they are identified. The Florida Department of Health in Broward County has launched a website where those 65 and older may register for an appointment to be vaccinated against COVID-19. Please take a look at the recent vacancies that we have available within the Department.

The Florida Department of Health in Broward County DOH-Broward is one of 67 Public Health Departments under the governance of the integrated Florida Department of Health DOH. If you test positive for COVID-19 see guidance for what to do while youre sick. Florida is currently experiencing a moderately severe influenza season.

Exposed or tested positive. And homebound testing appts. Serious outcomes of flu infection are hospitalization or death.

Influenza can cause mild to severe illness. Thank you for your interest in career opportunities with the Florida Department of Health. The Florida Department of Health is responsible for the regulation of health practitioners for the preservation of the health safety and welfare of the public.

For more information please call 866-779-6121 or email COVID-19flhealthgov or visit the Florida Department of Health vaccine website here. Florida State Surgeon General Dr. Influenza or flu is a viral respiratory illness mainly spread by droplets made when people with flu cough sneeze or talk.

Stepwise Approach To Asthma Treatment

A stepwise approach aims to stop symptoms quickly and to improve peak flow. The report is updated each year.

Stepwise Approach For Managing Asthma In Children 0 4 Yr Of Download Scientific Diagram

If your doctor follows other guidelines your treatment may be different.

Stepwise approach to asthma treatment. After starting initial controller treatment Review response after 2-3 months or according to clinical urgency Adjust treatment including non-pharmacological treatments Consider stepping down when asthma has been well-controlled for 3 months 34. Where you begin on the steps depends on how intense your asthma is at first. At the onset give therapy at a higher level to achieve rapid control and then step down to the minimum therapy needed to maintain control.

The stepwise approach to asthma treatment and management is a six-step approach according to which the number and the dose of medications and frequency of management are increased as necessary when symptoms persist and then decreased when goals are achieved and maintained Arcangelo Peterson 2013. Be sure to address the. And iii if higherintensity treatment is used it does not need to be maintained indefinitely.

Step down if well controlled and re-assess in 3 months. The recommended approach to gaining control of asthma. The stepwise approach to the treatment and management of asthma can involve a step-down therapy or step-up therapy Bernstein Mansfield 2019.

A higher level of therapy can be accomplished by either adding a course of oral steroids to inhaled steroids or using a higher dose of inhaled steroids. This approach to asthma treatment is called stepwise. Asthma is best treated by adopting the stepwise approach management.

Advanced practice nurses often provide treatment to patients with these disorders. Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Stages of Stepwise Management Step one of the approach applies to persons of all ages.

STEPWISE APPROACH FOR MANAGING ASTHMA IN YOUTHS 12 YEARS AND ADULTS Step up if needed check adherence environmental control and comorbidities Step down if possible asthma well controlled for 3 months EPR-3 p333-343. A stepwise approach to pharmacotherapy appears to be ideal for asthma given that i most patients benefit substantially from low doses of one medication ICS. Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment.

Ii if response is inadequate it is more effective to increase the dose or to add a second medication LABA than to switch to a different medication. Your allergist will gradually increase or decrease step up or step down your medication doses until the best balance is found. The medication offered in this step is the short acting beta agonist for example the albuterol prn Holt 2009.

Re-assess in 2 to 6 weeks. Since symptoms and attacks are often induced by a. Asthma and Stepwise Management Asthma is a respiratory disorder that affects children and adults.

The stepwise approach is meant to assist not replace the clinical decision-making required to meet individual patient needs. Clinicians who administer immunotherapy or omalizumab should be prepared and equipped to identify and treat anaphylaxis that may occur. It is extremely important to take your medications as directed.

Stepwise approach to treating asthma The National Asthma Education and Prevention Program recommends a stepped approach to asthma treatment based on age and asthma severity. Daily Medication Step up as indicated although address possible poor adherence to medication. It focuses not only on the existing strong evidence base but also on clarity of language and on providing tools for feasible implementation in clinical practice.

Step-up therapy involves beginning with low-dose treatment that is increased gradually until optimal control is achieved. Treatment should be started at the level most appropriate to initial severity of asthma. STEPWISE APPROACH TO MANAGING ASTHMA Intermittent Asthma STEP 1 all ages STEP 2 STEP 3 STEP 4 STEP 5 STEP 6 Persistent Asthma.

Initiating Therapy See Stepwise Approach for Managing Asthma Long Term page 7 The stepwise approach is meant to help not replace the clinical decisionmaking needed to meet individual patient needs. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious life-threatening ones. The aim is to achieve early control and to maintain it by stepping up treatment as necessary and decreasing treatment when control is good.

Step 1 Step 2 Step 3 Step 3 medium-dose ICS option Step 3 Step 3 Step 3 medium-dose ICS option or Step 4 Step 4 or 5 2 Asthma Care Quick. If very stables then assess control every 3 to 6 months. Provides a comprehensive and integrated approach to asthma management that can be adapted for local conditions and for individual patients.

Technical Specification Document

Business users verify that the solution addresses their concerns and technical reviewers verify that the described solution can be implemented. A technical specification is an important document of every business project which contains detailed information for the technical requirements.

Sap Technical Specification Template

Attribution Non-Commercial BY-NC Available Formats.

Technical specification document. It typically includes functional requirements performance requirements interface requirements design requirements development standards maintenance standards or. What is technical specification documentation. Technical specifications A contract or tender document often references technical specifications about the specific requirements and construction standards for various elements of a project.

The original assumption for the TSD was that the final solution would be custom developed software which. New land management system based on the requirements identified in the Business Requirements Document BRD which was the first major deliverable. Functional specification documents are mainly for developers as they are going to be the ones who code your product to provide the ultimate solution for the user.

A technical specification might contain detailed flow diagram indicating flow of data from source to target from. Functional specifications documents follow an approval process. Means as used herein a specification that documents the requirements of a system or system component.

Technical specifications is a broad term. It has a set of requirements for the product in order for it to work as it was meant to be. Download as PDF TXT or read online from Scribd.

Functional specifications describe the expected behavior of a software system. 24 Systems Flow Diagram In case of an interface development a system flow diagram can also be given here to represent the data flow between the systems. Simply put technical specification or documentation is a document that every project or product manager must write before starting the actual web or mobile development.

Save Save SAP Technical Specification Template For Later. It describes any characteristic of an engineered system that must conform to a specific metric within some degree of error. A technical specification document refers to a documentation that voice outs the prerequisites of a product procedure or project that is to be executed.

In the technical specifications you describe your future app in detail like a step-by-step recipe for a dish. List all documents to be referred for this technical spec. That said however your functional specification document should be readable by everyone and accessible to everyone on your team including the client.

On the basis of functional specification technical consultant ABAP consultant prepares document which answers the how part of solution in details. Flag for inappropriate content. This includes how the work will be done the quality of workmanship and.

The spec is the data that map out the fundamental aspects needed for the project regarding its strategy technical outline and growth. Since this document specifies technical details about how the solution is to be designed and hence is called technical specification document. 100 7 100 found this document useful 7 votes 5K views 4 pages.

Overview of Land Division and Current SLIMS Page 8. We can define technical specifications as being like a cooking book where you write down what ingredients youre going to use the quantity and in. Program specifications describe what the software is supposed to achieve.

A project manager needs to get ready the business specifications before the project is even started. Often key reviewers include testers end users technical writers and product or. Technical Specifications Document.

Should Boys Get Hpv Vaccine

It can also be. Who Gets 2 Doses.

Hpv Vaccine Recommended For Boys Girls Men And Women Ssm Health Matters Blog Ssm Health

HPV Vaccine for Boys As demonstrated by the statistics a lack of correct information continues to make people think that HPV only causes cancer in girls leading to the lower rates of vaccinated boys.

Should boys get hpv vaccine. Plus when boys are vaccinated they are less likely to spread HPV to their current and future partners. HPV is very common. HPV types 16 and 18 the 2 types that cause 80 of cervical cancer cases.

The Centers for Disease Control and Prevention CDC and many other expert groups recommend that boys and girls age 11 or 12 get the HPV vaccine. In England all boys and girls aged 12 to 13 years are routinely offered the 1st HPV vaccination when theyre in Year 8 at school. HPV vaccine is cancer prevention.

Girls and boys aged 12 to 13 years are offered the human papillomavirus HPV vaccine as part of the NHS vaccination programme. The human papillomavirus HPV vaccine protects boys against the HPV infections that can cause cancers of the anus penis and mouththroat in men. Yes Its Recommended.

About 14 million Americans including teens become infected with HPV each year. Recommending HPV vaccination for all 1112 year-olds can protect them long before they are ever exposed. Be it resolved that all adolescent girls and boys should be vaccinated against HPV before they are sexually active since more than half of all sexually active men and women will get HPV at.

Almost every person who is sexually active will get HPV at some time in their life. Boys aged between 12 and 13 in England will be given a vaccine to protect them against HPV-related cancers Public Health Minister Steve Brine has. Its ideal for girls and boys to receive the vaccine before they have sexual contact and are exposed to HPV.

By getting HPV vaccine at the recommended agebetween 9 and 12 years oldboys. HPV vaccination is recommended for all preteens including girls and boys at age 1112 years. It also broadened the recommendation to include men and women up to age 45.

25 2011 -- Boys and men aged 11 to 21 should routinely be offered the Gardasil vaccine for HPV the human papillomavirus the Advisory. In June 2019 the Advisory Committee on Immunization Practice at CDC in the United States recommended the HPV vaccine to be given to all boys and young men up to age 26. HPV vaccination is recommended for all children at age 1112-years to protect against cancers caused by HPV infections.

The HPV vaccine is applicable to both males and females. Research has shown that receiving the vaccine at a young age isnt linked to an earlier start of sexual activity. Some 20 countries have now introduced the vaccination for boys including Australia where the uptake rate is up to 90 per cent.

A 2-dose schedule is recommended for people. If youre eligible and miss the HPV vaccine offered in Year 8 at school you can get it for free on the NHS up until your 25th birthday. Teens and young adults through age 26 years who didnt start or finish the HPV vaccine series also need HPV vaccination.

The HPV vaccine helps protect against cancers caused by HPV including. Vaccinate your son or daughter when they are 11 or 12 to protect them against HPV cancers later in life. Nearly one in four Americans are infected.

The HPV vaccine protects against. The vaccine is available from ages 9 to 21 for men. 85 of people will get an HPV infection in their lifetime.

The 2nd dose is offered 6 to 24 months after the 1st dose. Yes boysmen can also get the HPV vaccine which goes by the brand name Gardasil 9. The HPV vaccine is routinely recommended for girls and boys ages 11 or 12 although it can be given as early as age 9.

Six Reasons to Vaccinate Your Child Learn why all 11-12 year old boys and girls should get the HPV vaccine. HPV types 6 and 11 which cause 90 of genital warts cases. All preteens need HPV vaccination so they are protected from HPV infections that can cause cancer later in life.

CDC recommends two doses of HPV vaccine for all adolescents at age 11 or 12 years. Its also recommended for those 13 to 26 years old who didnt get the vaccine when they were younger. It can be given starting at age 9.

Men should be vaccinated.

Newborn Screening Tests By State

Public health departments as part of their newborn health programs offer some newborn screening to all infants born within their jurisdiction. Missouri Newborn Screening Sample Storage and Release Policy Newborn Blood Spot Screening Program The MSPHL performs laboratory screening for mandated genetic metabolic conditions on all infants born in Missouri so that early detection and intervention promotes healthy outcomes for those infants with these conditions.

Delays In Adding New Newborn Screening Tests Harm Babies Families

The sample is tested for conditions that may cause mental retardation or death if untreated.

Newborn screening tests by state. Are routinely screened using a few drops of blood from the newborns heel for certain genetic endocrine and metabolic disorders and are also tested for hearing loss and critical congenital heart defects CCHDs prior. It remains on the Recommended Uniform Screening Panel RUSP a list of disorders that the HHS recommends for states to screen as part of their state universal newborn screening programs. It also contains cutoff tables for the disorders results classifications and corresponding follow-up actions.

Newborn screening is a public health service done in each US. Each state has its own newborn screening panel which is a list of the conditions that the state checks during NBS. If after hearing all the benefits of newborn screening and the risks involved in refusing testing a parent may refuse.

The Newborn Screening Group provides laboratory testing services in support of the Texas Newborn Screening Program. Screening tests recommended for all newborns The Secretarys Advisory Committee on Heritable Disorders in Newborns and Children SACHDNC part of the US. While all states require newborn screening for every infant the number of conditions on state screening panels vary.

Infants with these disorders usually appear healthy at birth and without screening the disorders are not likely to be detected and treated in time to prevent death or severe disability. Results from blood spot screening are usually ready in about five to seven days. Each year millions of babies in the US.

Washington State Newborn Screening Screening Tests Result Classifications and Corresponding Follow-Up Actions briefly explains the tests for the disorders This document screened for by the Washington State Newborn Screening Program. The Washington State Department of Health Office of Newborn Screening NBS tests all infants born in Washington for a number of rare but treatable disorders using a dried blood spot specimen. Most of these illnesses are very rare but can be treated if caught early.

Arizona law requires providers to order newborn screening for all newborns born in the state for these potentially fatal conditions. Phenylketonuria PKU galactosemia congenital hypothyroidism sickle cell disease and congenital adrenal hyperplasia CAH. This allows steps to be taken before symptoms develop.

Department of Health and Human Services recommends that all newborns be screened for 34 core disorders and 26 secondary disorders. Every infant born in Texas is required by law to be tested for five disorders. If you choose to refuse your provider may ask you to sign a waiver in which you accept responsibility for adverse consequences.

The types of newborn screening tests that are done vary from state to state. Each state public health department decides which conditions are coded on its panel. Two tests those for phenylketonuria PKU and congenital hypothyroidism are universally mandated 5151 juristictions.

A filter paper blood spot sample is required by state law GS 130A-125 to be submitted to the North Carolina State Laboratory of Public Health for each infant born in North Carolina. For information about your state. This is why blood tests are used to screen newborns for these problems.

Newborn screening tests look for developmental genetic and metabolic disorders in the newborn baby. Whereas previously these specimens were viewed as primarily useful for program quality assurance and perhaps as final testing material that could be rean-. To see the newborn screening panel for your state visit the State pages.

Maryland created an expert advisory group to recommend best practices for screening for congenital heart disease. New York State Newborn Screening Panel When Elisa Seeger discovered there was a newborn screening test available for ALD and not one state. Each state has its own newborn screening program so the number of tests performed varies by state.

With a simple blood test doctors can check for rare genetic hormone-related and metabolic. The goal is to identify infants at risk for these conditions early enough to confirm the diagnosis and provide intervention that will alter the clinical course of the disease and prevent or ameliorate the clinical manifestations. Are testing their babies for ALD.

They also develop and manage each states newborn screening program which is designed to ensure that babies with out-of-range screening results are notified and receive diagnostic testing and follow-up care. Currently only 21 states and Washington DC. Newborn screening programs are also faced with is-sues regarding storage and management of residual specimens that remain after newborn screening tests are complete.

In January 2017 Nebraska introduced a bill that specifically adds the three new conditions to the states newborn screening panel enabling the state to be current with the RUSP recommendations. Newborn screening is a public health program of screening in infants shortly after birth for conditions that are treatable but not clinically evident in the newborn period. Every newborn is tested for a group of health disorders that arent otherwise found at birth.

NBS started with the.

Birth Control Implant Name

It releases the hormone progestin to stop you from getting pregnant. 279 rows Contraceptives are the name given to medicines and other devices that are used to.

Implantable Contraception For Teens Nemours Kidshealth

The birth control implant brand name Nexplanon is considered one of the most effective reversible contraceptive methods available.

Birth control implant name. The Nexplanon rod can remain in place and provide continuous contraception for up to 3 years. Its so small in fact most people cant see it once its insertedwhich means it can be your little secret if youre so inclined. Etonogestrel stops you from becoming pregnant in two ways similar to the progestin-only birth control pill.

Nexplanon Birth Control Implant What is a Nexplanon Birth Control Implant Nexplanon is a form of birth control that is administered via a radiopaque rod that is inserted into the skin of your upper arm. Ad Search Faster Better Smarter Here. The tube releases hormones that can help protect against pregnancy for up to 3 years.

NRFA connects adoptee families with embryo donors. A health care provider inserts the implant into your arm during a simple procedure. Redirected from Implanon Etonogestrel is a medication which is used as a means of birth control for women.

Implantable contraception often called the birth control implant is a small flexible plastic tube that doctors put under the skin of a girls upper arm. Previously Implanon is a teeny-tiny rod thats inserted under the skin of your upper arm. The contraceptive implant Nexplanon is a small flexible plastic rod thats placed under the skin in your upper arm by a doctor or nurse.

The implant The implant is more than 99 effective. The implant also known as the rods are a type of long-acting reversible contraception LARC. In the US the birth control implant is sold under the brand name Nexplanon.

More than 99 effective Works for up to five years Fit and forget. The implanted tube slowly releases low levels of the. It provides protection from pregnancy for up to three years with a 001 chance of pregnancy.

This small plastic rod contains of the hormone etonogestrel that is time-released over the course of. The birth control implant is a small flexible plastic rod that is placed just under the skin of the upper arm. Internationally its available under a variety of different brand names.

A doctor inserts the implant under the skin of your upper arm. In the United States its sold under the brand name Nexplanon. It was previously available under the name Implanon.

Etonogestrel is contained in a small plastic rod that is implanted into the skin of your upper arm. It is available as an implant placed under the skin of the upper arm under the brand names Nexplanon and Implanon and in combination with ethinylestradiol an estrogen as a vaginal ring under the brand names NuvaRing and Circlet. Ad Search Faster Better Smarter Here.

The implant Nexplanon is the brand name. The implant is one of the most effective birth control methods available its 99 effective in preventing pregnancy 1 and it works for up to 3 to 5 years. Nexplanon is radiopaque implant used as contraception to prevent pregnancy.

Its also called Nexplanon and theres a slightly older version called Implanon. The birth control implant is a tiny thin rod about the size of a matchstick. The medicine is released slowly into the body.

It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years. A contraceptive implant is a type of hormonal birth control. Ad Get more information about an alternative to expensive IVF treatments.

NRFA connects adoptee families with embryo donors. Ad Get more information about an alternative to expensive IVF treatments. Nexplanon is a type of birth control known as a long-acting reversible contraceptive LARCs.