51.0707 - Health/Informatics (formerly 51.0000)

Cluster Foundation revisions are forthcoming. Cluster Foundation skills have been temporarily removed to avoid duplication of the MI technical skills which are the National Health Care Skill Standards (Accountability Criteria for National Health Care Cluster Foundation Standards).


Plus Technical Standards

Plus I. Academic Foundation
  Plus A. Human Structure and Function
    1. Classify the basic structural and functional organization of the human body including chemical, cellular, tissue, organ, and system
    2. Recognize body planes, directional terms, quadrants, and cavities
    3. Analyze the interdependence of the basic structures and functions of the human body as they relate to wellness, disease, disorders, therapies, and care/rehabilitation
    4. Compare the structure and function of the human body across the lifespan
  Plus B. Diseases and Disorders
    1. Compare diseases/disorders including respective classification(s), prevention, causes, pathogenesis, diagnoses, therapies, and care/rehabilitation
    2. Investigate biomedical therapies as they relate to the prevention, pathology, and treatment of disease
    3. Discuss complementary/alternative health practices as they relate to the prevention and treatment of disease
  Plus C. Medical Mathematics
    1. Apply mathematical computations related to healthcare procedures
    2. Apply mathematical principles to conversion equations used in the healthcare delivery system
    3. Apply mathematical principles involving temperature, weights, and measures used in the healthcare delivery system
    4. Apply mathematical principles to problems involving dosage calculations and other applied mathematical concepts
    5. Analyze diagrams, charts, graphs, and tables to interpret healthcare results
Plus II. Communications
  Plus A. Concepts of Effective Communication
    1. Identify styles and types of verbal and nonverbal communication
    2. Classify communication styles based on various healthcare scenarios
    3. Recognize barriers to communication
    4. Recognize resources to assist in overcoming communication barriers
    5. Report relevant information in order of occurrence
    6. Analyze communications for appropriate response and feedback
    7. Interpret verbal and non-verbal communication
    8. Report subjective and objective information
    9. Use medical terminology to communicate information including data and observations
  Plus B. Oral Communications Skills
    1. Recognize the elements of oral communication using a sender-receiver process
    2. Apply speaking and active listening skills using reflection, restatement, and clarification techniques
  Plus C. Written Communication Skills
    1. Recognize the elements of written communication
    2. Organize technical information and summaries
Plus III. Systems
  Plus A. Healthcare Delivery Systems
    1. Understand systems theory as it relates to a healthcare delivery system model
    2. Explain the cause and effect of factors influencing various healthcare delivery systems
    3. Summarize the interdependence of healthcare professions within a given healthcare delivery system
    4. Interpret the various roles of healthcare providers and clients within the healthcare system
    5. Explain the impact of 21st century emerging issues such as technology, epidemiology, bioethics, and socioeconomics on healthcare systems
Plus IV. Employability Skills
  Plus A. Personal Traits of the Healthcare Professional
    1. Classify the personal traits or attitudes desirable in a member of the healthcare team
    2. Summarize basic professional standards of the healthcare workers as they apply to hygiene, dress, language, confidentiality and behavior (i.e. courtesy and self-introductions)
  Plus B. Key Employability Skills
    1. Apply key employability skills in a healthcare setting
    2. Exemplify professional characteristics
    3. Engage in continuous self-assessment and career goal modification for personal and professional growth
  Plus C. Career Decision-making
    1. Compare potential health science career pathways using a variety of health careers within the diagnostic services, therapeutic services, health informatics services, support services, or biotechnology research and development
    2. Recognize levels of education, credentialing requirements, employment opportunities, workplace environments, and career growth potential for a service area
  Plus D. Employability Preparation
    1. Develop components of a professional portfolio
    2. Execute work assignments and formulate solutions to problems using critical thinking skills
    3. Demonstrate respectful and empathetic interactions with diverse age, cultural, economic, ethnic, and religious groups in various settings
Plus V. Legal Responsibilities
  Plus A. Legal Implications
    1. Understand legal responsibilities and limitations
    2. Analyze implications of actions
    3. Implement problem solving techniques when confronted with legal issues
    4. Explain practices that could result in malpractice, liability, and/or negligence
    5. Apply procedures for accurate documentation and record keeping
    6. Implement established procedures based on risk management criteria
    7. Understand an incident report
    8. Summarize non-discriminatory laws
    9. Interpret healthcare facility policies and procedures
  Plus B. Legal Practices
    1. Implement mandated standards for Health Insurance Portability and Accountability Act (HIPAA)
    2. Recognize common threats to confidentiality
    3. Summarize clients’ rights according to the Patients’ Bill of Rights
    4. Understand informed consent
    5. Compare licensure, certification, registration, and legislated scope of practice of a healthcare professional
    6. Explain mandated standards for harassment, labor, and employment laws
Plus VI. Ethics
  Plus A. Legal and Ethical Boundaries
    1. Differentiate between morality and ethics
    2. Differentiate between ethical and legal issues impacting healthcare including confidentiality
    3. Compare personal, professional, and organizational ethics
    4. Recognize ethical issues and their implications related to healthcare
  Plus B. Ethical Practice
    1. Apply ethical behaviors including honesty and integrity in a healthcare setting
    2. Apply procedures for reporting activities and behaviors that affect the health, safety and welfare of others
  Plus C. Cultural, Social, and Ethnic Diversity
    1. Understand religious and cultural values as they impact healthcare services
    2. Demonstrate respect for individual diversity
Plus VII. Safety Practices
  Plus A. Infection Control
    1. Apply infection control procedures including standard precautions
    2. Compare the different methods of controlling the growth of microorganisms
  Plus B. Personal Safety
    1. Apply personal safety procedures based on Occupational Safety and Health Administration (OSHA) and Center for Disease Control (CDC) regulations
    2. Apply proper use of personal protective equipment (PPE)
    3. Apply principles of body mechanics and ergonomics
  Plus C. Environmental Safety
    1. Evaluate the environment to recognize safe and unsafe working conditions
    2. Demonstrate methods of fire prevention in the healthcare setting
    3. Understand proper safety techniques to prevent accidents and to maintain a safe work environment
  Plus D. Common Safety Hazards
    1. Recognize Materials Safety Data Sheets (MSDS)
    2. Comply with safety signs, symbols, and labels
    3. Understand implications of hazardous materials
    4. Apply safety principles within given environments
  Plus E. Emergency Procedures and Protocols
    1. Explain an evacuation plan for a healthcare setting
    2. Execute an emergency plan in response to a natural disaster or other emergency
Plus VIII. Teamwork
  Plus A. Healthcare Teams
    1. Understand interdisciplinary roles of team members
    2. Recognize characteristics of effective teams
    3. Classify responsibilities of various team members
  Plus B. Team Member Participation
    1. Recognize methods for building positive team relationships
    2. Respect and value the expertise and contributions of all team members
    3. Analyze the attributes and attitudes of an effective leader
    4. Recognize underlying factors and situations that may lead to conflict
    5. Apply effective techniques for handling team conflict
Plus IX. Health Maintenance Practices
  Plus A. Healthy Behaviors
    1. Apply behaviors that promote health and wellness
    2. Describe strategies for the prevention of diseases including health screenings and examinations
    3. Apply practices that promote the prevention of disease and injury
    4. Apply appropriate safety practices as related to high-risk behaviors
    5. Discuss complementary/alternative health practices as they relate to wellness and disease prevention
Plus X. Technical Skills
  Plus A. Technical Skills
    1. Apply procedures for measuring and recording vital signs including the normal ranges
    2. Apply skills to obtain training or certification in Cardiopulmonary Resuscitation (CPR)/Automated External Defibrillator (AED)/Foreign Body Airway Obstruction (FBAO)/First Aid
Plus XI. Information Technology Applications
  Plus A. Health Information Management
    1. Identify records and files common to the healthcare setting
    2. Execute data management using electronic healthcare records
    3. Interpret information from electronic medical documents
    4. Understand the content and diverse uses of health information
  Plus B. Information Technology
    1. Implement communications using technology (i.e. Fax, E-mail, and Internet) to access and distribute data and other information
    2. Execute the use of software, hardware, and the Internet
    3. Recognize computer applications currently being used in today's healthcare setting

Plus Pathway Standards

Plus I. COMMUNICATION AND CONFIDENTIALITY
  Plus A. Health informatics professionals will communicate health/medical information accurately and within legal/regulatory guidelines established by the facility holding to the strictest standards of confidentiality.
    Plus 1. Communication.
        a. Manage the accuracy, effectiveness, and timeliness of the transfer of information.
        b. Evaluate how legal and regulatory requirements apply to the transfer of information.
        c. Distinguish who in the organization needs information and when they need it.
    Plus 2. Confidentiality.
        a. Manage recorded information and other documents within protocols that ensure confidentiality and privacy.
        b. Communicate information ensuring confidentiality of content is maintained.
        c. Communicate information on a need to know basis for optimum patient outcomes.
Plus II. ANALYSIS
  Plus A. Health informatics professionals will know the quantitative and qualitative requirements for information. They will analyze the information for designated purposes.
    Plus 1. Analysis.
        a. Synthesize information to determine the best course of action.
        b. Assess health information required by patients, staff, and the community.
        c. Assemble all necessary data components for successful completion of tasks.
        d. Appraise the accuracy and completeness of data.
        e. Assess whether information is reported and disseminated within legal, ethical and regulatory guidelines.
Plus III. ABSTRACTING AND CODING
  Plus A. Health informatics professionals will read and interpret and extract information from medical documents, applying knowledge of medical terminology and codes.
    Plus 1. Abstracting and Coding.
        a. Assemble appropriate, accurate information, including proper codes to record charges for reimbursement.
        b. Apply accurate medical terminology.
        c. Analyze and determine the need for requesting further clarification when transcribing/transferring information that may be unclear.
        d. Assess and apply information for regulatory and legal purposes.
Plus IV. INFORMATION SYSTEMS
  Plus A. Health informatics professionals will understand the resources, routes and flow of information within the health care system. They will participate in the design and implementation of effective information systems or processes.
    Plus 1. Information Systems.
        a. Integrate the information systems utilized by the organization.
        b. Assess how systems interact to facilitate the timely and accurate flow.
        c. Organize information within the parameters of the information systems.
        d. Integrate information for timely, accurate dissemination.
        e. Evaluate effectiveness of systems.
Plus V. DOCUMENTATION AND STORAGE
  Plus A. Health informatics professionals will understand the content and diverse uses of health information. They will accurately document, communicate and maintain appropriate information using legal and regulatory guidelines.
    Plus 1. Documentation.
        a. Accurately document required information.
        b. Interpret information that has been collected.
        c. Differentiate the purposes and audiences for whom the information is collected.
        d. Prepare accurate documentation for various audiences within legal and regulatory requirements, as requested.
        e. Disseminate information to various audiences using systems and guidelines within the facility.
        f. Establish and maintain a records storage system within legal requirements and protocols.
        g. Assess and recommend procedures for improvement as necessary.
Plus VI. OPERATIONS
  Plus A. Health informatics professionals will know the systems operations used to capture, retrieve, & maintain information from internal and external sources. They will utilize internal &external information & resources accurately and efficiently
    Plus 1. Operations.
        a. Analyze the internal and external sources of information and resources available.
        b. Project outcomes as interconnected components of a modified health care system.
        c. Select the systems and sources of information necessary for the successful completion of the task.
        d. Participate in the design of operational systems and processes.
        e. Evaluate operational systems and processes for areas of improvement as necessary.

Plus Career & Employability Standards

Plus I. APPLIED ACADEMIC SKILLS
  Plus A. Reading, English & Language Arts
    1. Read a technical manual and write a clear & logical report explaining the information using standard business English.
    2. Give a verbal report on reading from a technical manual.
    Plus 3. Read a case study and identify the details about the situation, define technical terms, jargon, or words with multiple meanings based on context, and summarize the conclusion.
        a. Relate the results of study to a similar situation in a verbal or writen report.
    4. Take a verbal and written position on a topic and use correct grammar to defend it.
  Plus B. Mathematics
    Plus 1. Approach practical and workplace problems using a variety of mathematical techniques.
        a. Problems include making conversions between the metric system and non-English systems of measurement, mixed units (such as hours and minutes), and can require serveral steps to finding a solution.
    2. Research how math is used in the workplace and make a presentation detailing the process.
  Plus C. Listening & Presentation Skills
    1. Use correct grammar to communicate verbally.
    2. Listen to a presentation and record important information. Report back identifying central themes and use key points to explain how the message applies to a similar situation.
  Plus D. Technology
    1. Apply technology to workplace or career situation. Include research and a written paper.
Plus II. CAREER PLANNING
  Plus A. Career Planning
    1. Organize career information and labor market trends from a variety of sources.
    2. Explain the advantages and disadvantages of working for self, others, being an employee of a large or small organization.
    3. Analyze information & preferences from work-based opportunity.
    4. Interpret information from a variety of career assessments to identify career interests and abilities.
    5. Apply a decision-making model and use career assessment information to choose a career pathway.
    6. Annually review EDP and include plan for continuing education.
Plus III. DEVELOPING AND PRESENTING INFORMATION
  Plus A. Developing and Presenting information
    1. Gather, interpret, analyze, and refine data.
    2. Analyze and synthesize information and data from multiple sources.
    3. Plan and transform ideas and requirements into a concept, service, or product.
    4. Assess the quality of the concept, service, or product using a predetermined standard.
    5. Develop a plan to market a new product, service, or concept which includes identifying of customers, a graphic presentation, product requirements, and costs.
    6. Practice and demonstrate presentation skills using a variety of media and interpretive data.
Plus IV. PROBLEM SOLVING
  Plus A. Problem Solving
    1. Apply a problem solving model to a workplace situation that involves setting goals, implementing and evaluating results.
    2. Identify typical problems that occur in a workplace and use a problem solving model to devise solutions, compare alternatives to past solutions, and predict their success.
Plus V. PERSONAL MANAGEMENT
  Plus A. Responsibility
    1. Demonstrate regular attendance, promptness, and staying with a task until satisfactory completion.
    2. Complete assignments with minimum supervision and meet deadlines.
    3. Use mistakes as learning opportunities; demonstrate persistence and adaptability to change.
    4. Initiate projects and extra activities for personal satisfaction.
  Plus B. Self-Management
    1. Monitor & evaluate accurately one's progress towards a goal or completion of a project.
    2. Demonstrate health and safety practices and drug-free behavior in school & workplace setting.
    3. Obtain a driver license and demonstrate driving skills and safety and/or use public transportation.
    4. Prioritize and accomplish tasks independently.
    5. Use appropriate personal expression and relate to school and work settings.
  Plus C. Ethical Behavior
    1. Demonstrate ethical behavior in school, work, and community situations.
    2. Describe employer-employee rights and responsibilities.
    3. Demonstrate appropriate behaviors necessary to maintaining employment.
    4. Demonstrate positive personal qualities as a group leader.
  Plus D. Respect for Self and Others
    1. View accomplishments or failures of self and others accurately and in a positive manner.
    2. Understand how to make improvements and ask for help from adults as needed.
    3. Offer encouragement and ideas to others as they work toward attaining their goals.
    4. Provide for customer needs and expectations in a helpful and courteous manner.
    5. Respect other points of view.
    6. Demonstrate customer service skills in an appropriate setting by listening, suggesting solutions, and communicating the issues at hand.
Plus VI. ORGANIZING SKILLS
  Plus A. Time
    1. Determine goals and develop an action plan to accomplish them within a given time frame.
    2. Read time charts and work schedules and perform tasks within time constraints of school or the workplace.
    3. Prioritize tasks and revise schedules as needed.
  Plus B. Money
    1. Estimate costs and prepare a detailed budget for a school-based or work-based project.
    2. Report the costs of various components of a budget and adjust budget items as needed.
    3. Understand compensation practices and financial management and explain how financial resources can be used effectively and efficiently.
  Plus C. Materials
    1. Utilize materials, tools, and processes to complete a task related to a career selection.
    2. Compile a list of materials and supplies needed in advance of an assignment.
    3. Acquire resources in a timely fashion and take responsibility for their care.
    4. Identify and prepare tools, equipment, space, and facilities appropriate for a task.
    5. Work within constraints of safety precautions and available resources.
  Plus D. Human Resources
    1. Learn cooperation and leadership in a team at school or in a workplace setting.
    2. Organize and communicate with members of a team using varied methods of communications.
    3. Recognize the individual roles of team members, delegate tasks, and give feedback on performance.
    4. Acknowledge and utilize the skills, abilities, and input of all member of a team.
Plus VII. TEAMWORK
  Plus A. Group Participation
    1. Exhibit teamwork skills including trust and loyalty to group, and demonstrate connectedness to group members, values, and culture.
    2. Take personal responsibility for influencing and accomplishing group goals.
    3. Demonstrate understanding of how effective teams operate within organization and diverse settings.
    4. Solve a career/work-related problem as a member of a team.
  Plus B. Conflict Resolution
    1. Demonstrate leadership by listening to others and asking appropriate questions to clarify a problem or issue.
    2. Summarize a problem clearly and in appropriate detail.
    3. Suggest constructive alternatives with confidence that will help resolve a conflict.
    4. Compromise and/or build consensus within a group and summarize the decision of the group while maintaining respect for minority viewpoints.
    5. Participate in the implementation of a group's decision and evaluate the results.
    6. Show sensitivity to others' thoughts and opinions and relate them to the resolution process.
  Plus C. Diversity
    1. Understand and respect the concerns of members of cultural, gender, age, and ability groups.
    2. Be respectful of a variety of differences of people in a work/school setting.
    3. Demonstrate ability to work with others with different backgrounds, cultures, and abilities.
  Plus D. Leadership
    1. Demonstrate leadership ability in a work or school setting.
    2. Recognize and take advantage of leadership opportunities that give direction to other team members, or that encourage other members to complete tasks.
Plus VIII. NEGOTIATION SKILLS
  Plus A. Negotiation Skills
    1. Using correct terminology, clarify the problem or issue to be negotiated.
    2. Identify, organize, and define ideas from various sources to logically support a position and use these ideas in debate.
    3. Demonstrate objectivity in assessing other viewpoints by considering all sides of an issue, using past experience, data and logical analysis, and showing respectful behavior towards others.
    4. Responsibly challenge existing policies and procedures and identify new solutions or policy changes.
Plus IX. UNDERSTANDING SYSTEMS AND USING TECHNOLOGY
  Plus A. Understanding Systems and Using Technology
    1. Identify trends and how they affect changes within a system.
    2. Demonstrate an understanding of business systems.
    3. Compare management systems and consider how employees function and adapt to change within them.
    4. Describe the technical systems related to a career interest area.
    5. Diagnose and make necessary corrections or improvements to a technical system in a business, industry, or simulated work place setting.
    6. Describe how changes in technology have impacted business and industry, identify current trends, and recommend how a technical system might be improved.
    7. Demonstrate the use of equipment and machines to solve practical or work-based problems.
    8. Demonstrate effective use of a variety of on-line technological resources.
    9. Determine what kind of application is needed for a given task and use effectively.
    10. Use technologies as tools for communication of technical or work-related information.
    11. Use technology effectively in solving problems in an area of career interest.
    12. Understand and demonstrate basic computer hardware and software installation and maintaining efficient machines.
    13. Demonstrate ability to adapt to different software applications, comparing and contrasting specfic functions and applying them to different projects.
Plus X. EMPLOYABILITY SKILLS
  Plus A. Employability Skills
    1. Continue the EDP process which includes an annual review with student and counselor and notification of parents.
    2. Participate in work-based opportunities such as job-shadowing, mentorships, work experiences, etc.
    3. Show ability to market oneself by preparing for and completing an interview process.
    4. Accurately complete records/documents to support job applications (inquiry letters, resume, references, evaluations, follow-up letters).
    5. Use a portfolio, resume, record of attendance, certificates, and/or transcript as self-marketing tools to demonstrate interest and competence.
    6. Apply career and labor market information to seek and obtain employment and/or pursue educational goals.
    7. Research availability of educational programs, financial requirements, and resource and complete an application process as appropriate for career goals.
    8. Understand the need for lifelong learning in a rapidly changing job market.
Plus XI. TECHNOLOGY SKILLS
  Plus A. BASIC OPERATIONS AND CONCEPTS
    1. Discuss emerging technology resources (e.g., podcasting, webcasting, compressed video delivery, online file sharing, graphing calculators, global positioning software)
    2. Identify the capabilities and limitations of emerging communication resources.
    3. Understand the importance of both the predictable and unpredictable impacts of technology.
    4. Identify changes in hardware and software systems over time and discuss how these changes might affect the individual personally in his/her role as a lifelong learner.
    5. Understand the purpose, scope, and use of assistive technology.
    6. Understand that access to online learning increases educational and workplace opportunities.
    7. Be provided with the opportunity to learn in a virtual environment as a strategy to build 21st century learning skills.
    8. Understand the relationship between electronic resources, infrastructure, and connectivity.
    9. Routinely apply touch-typing techniques with advanced accuracy, speed, and efficiency.
    10. Assess and solve hardware and software problems by using online help or other user documentation and support.
    11. Identify common graphic, audio, and video file formats (e.g., jpeg, gif, bmp, mpeg, wav)
    12. Demonstrate how to import/export text, graphics, or audio files.
    13. Proofread and edit a document using an application's spelling and grammar checking functions.
  Plus B. SOCIAL, ETHICAL, AND HUMAN ISSUES
    1. Identify legal and ethical issues related to use of information and communication technology.
    2. Analyze current trends in information and communication technology and assess the potential of emerging technologies for ethical and unethical uses.
    3. Discuss possible long-range effects of unethical uses of technology (e.g., virus spreading, file pirating, hacking) on cultures and society.
    4. Discuss the possible consequences and costs of unethical uses of information and computer technology.
    5. Identify ways that individuals can protect their technology systems from unethical or unscrupulous users.
    6. Demonstrate the ethical use of technology as a digital citizen and lifelong learner.
    7. Explain the differences between freeware, shareware, and commercial software.
    8. Adhere to fair use and copyright guidelines.
    9. Create appropriate citations for resources when presenting research findings.
    10. Adhere to the district acceptable use policy as well as state and federal laws.
    11. Explore career opportunities and identify their related technology skill requirements.
    12. Design and implement a personal learning plan that includes technology to support his/her lifelong learning goals.
  Plus C. TECHNOLOGY PRODUCTIVITY TOOLS
    1. Complete at least one online credit, or non-credit, course or online learning experience.
    2. Use technology tools for managing and communicating personal information (e.g., finances, contact information, schedules, purchases, correspondence)
    3. Have access to and utilize assistive technology tools.
    4. Apply advanced software features such as an application's built-in thesaurus, templates, and styles to improve the appearance of word processing documents, spreadsheets, and presentations.
    5. Identify technology tools (e.g., authoring tools or other hardware and software resources) that could be used to create a group project.
    6. Use an online tutorial and discuss the benefits and disadvantages of this method of learning.
    7. Develop a document or file for inclusion into a web site or web page.
    8. Use a variety of applications to plan, create, and edit a multimedia product (e.g., model, webcast, presentation, publication, or other creative work)
    9. Have the opportunity to participate in real-life experiences associated with technology-related careers.
  Plus D. TECHNOLOGY COMMUNICATIONS TOOLS
    1. Identify and describe various telecommunications or online technologies (e.g., desktop conferencing, listservs, blogs, virtual reality)
    2. Use available technologies (e.g., desktop conferencing, e-mail, groupware, instant messaging) to communicate with others on a class assignment or project.
    3. Use a variety of media and formats to design, develop, publish, and present products (e.g., presentations, newsletters, web sites) to communicate original ideas to multiple audiences.
    4. Collaborate in content-related projects that integrate a variety of media (e.g., print, audio, video, graphic, simulations, and models) with presentation, word processing. Publishing, database, graphics design, or spreadsheet applications.
    5. Plan and implement a collaborative project using telecommunications tools (e.g., groupware, interactive web sites, videoconferencing)
  Plus E. TECHNOLOGY RESEARCH TOOLS
    1. Compare, evaluate, and select appropriate internet search engines to locate information.
    2. Formulate and use evaluation criteria (authority, accuracy, relevancy, timeliness) for information located on the internet to present research findings.
    3. Determine if online sources are authoritative, valid, reliable, relevant, and comprehensive.
    4. Distinguish between fact, opinion, point of view, and inference.
    5. Evaluate resources for stereotyping, prejudice, and misrepresentation.
    6. Develop a plan to gather information using various research strategies (e.g., interviews, questionnaires, experiments, online surveys)
  Plus F. TECHNOLOGY PROBLEM-SOLVING and DECISION-MAKING TOOLS
    1. Use a variety of technology resources (e.g., educational software, simulations, models) for problem solving and independent learning.
    2. Describe the possible integration of two or more information and communication technology tools or resources to collaborate with peers, community members, and field experts.
    3. Formulate a research question or hypothesis, then use appropriate information and communication technology resources to collect relevant information, analyze the findings, and report the results to multiple audiences.