RCare News & Blog
If this year has taught us anything, it’s that anything can happen – wildfires, hurricanes, and even global pandemics. And the year is only half over. “Be prepared” is not just a motto for scouting. Knock on wood, your community or healthcare facility won’t need to evacuate suddenly, or to expand quickly to handle a surge in patients. But it never hurts to be prepared, to be ready to protect your residents and to make sure operations and care can return to normal as quickly as possible. In fact, Federal law requires that Medicare and Medicaid-certified facilities have written plans and procedures to meet all potential emergencies.
If you haven’t been thinking about your community’s emergency preparation plan, let the events of this year be the nudge you needed to get started. And as you’re creating your plan, here are five helpful tips to make your plan more effective.
Disaster Planning Tips
- Data Backup: Start by assuming that every technology system in use in your facility is built on a database that stores important data, such as patient information and incident information. If you were to lose your system to a disaster, would you lose all your data history? Your answer should be no. All data for all your systems should be backed up regularly and stored safely offsite, to be ready for you should you need it.
- Data Restore: Just as important as backing up the data is restoring it. If faced with a hardware or system failure for any reason, can you restore and make use of your data again? It’s important to schedule periodic tests to be sure that backups have been done successfully, with no data corruption, that restored data is accessible, usable, and that you are able to restore the data and resume operations quickly.
- Hardware Backup: With your data safely secured, it’s important to have a plan for replacing your hardware quickly. whether it’s due to a normal hardware failure, or a flood or fire or other disaster. Be sure to have a source for the equipment that can ship quickly. In the midst of an emergency, you can’t be waiting weeks for back-ordered equipment. Be sure your plan includes a complete list of critical hardware to replace. And be sure that your systems, and your backed up system data, are compatible with your new replacement equipment.
- Peripherals: In addition to the system server, many systems have peripheral devices used by caregivers such as printers, phones, and monitor screens, as well as resident or patient devices, such as pendants and pull cords. When you’re recovering from an equipment failure, the biggest time investment will likely be inputting the settings for the peripherals, to reconnect them to the system. Strategize now about the best way to input or restore device settings as efficiently as possible, to get the system back to work. At the minimum, keep a hard copy of your plans and settings, and store it safely to be sure it’s available should it be necessary to rebuild your systems. Better yet, can the settings be backed up and restored like other data? Whatever you decide, don’t overlook this critical piece of your recovery plan.
- Temporary Solutions: Another consideration is having a stop-gap solution that you can swap into place in the short-term, while you wait for your systems to be restored to their normal functioning. Even in a crisis, your residents need to be equipped with an emergency call device. If you need to relocate your operations to another facility, or to expand temporarily into another location, a portable or stripped down system may be necessary to help you continue to provide care.
If this year has taught us anything, it’s that anything can happen.
How RCare can Help
RCare is a global provider of wireless nurse call and personal emergency response systems for the entire spectrum of eldercare and senior living. We’ve given a lot of thought to disaster preparation and recovery, because we know your call light system is critically important for the health and safety of your residents.
Rapid Deployment Kit – Portable Nurse Call System
Our Rapid Deployment Kit is a portable nurse call systems in a box, designed to be installed quickly, even outside of normal healthcare environments. It’s a temporary nurse call solution that has been employed nationwide by health systems to create temporary field hospitals to care for the surge of COVID patients. It’s quick to deploy, quick to take down, and easy to store. And it can help you be prepared in the event of an emergency. Learn more about RCare’s Rapid Deployment Kit.
Data Backup and Disaster Recovery Service for RCare’s Nurse Call Systems
RCare’s Data Backup and Disaster Recovery service minimizes disruption of service and recovery costs for our clients. It provides regular software backups, with data securely stored offsite. It also provides hardware protection, with a quick replacement of your RCare nurse call system hardware, no matter what the reason, with the replacement guaranteed to be compatible. System and device settings are also backed up, so that peripherals can be put back into use quickly and reliably. Learn more about RCare’s Data Backup and Disaster Recovery Program.
You can count on RCare every day to provide excellent, reliable nurse call capabilities for your community. And when the chips are down, you can count on RCare to help you provide the best possible care.
The Rochester Business Journal (RBJ) announced that RCare’s CEO, Myron Kowal, has been selected as a 2020 recipient of the Health Care Hero award. This annual award celebrates and recognizes excellence, promotes innovation, and honors the efforts of organizations and individuals making a significant impact on the quality of healthcare in the Rochester area.
RCare’s Kowal is being recognized as a COVID-19 Hero, a special category created this year to honor individuals and organizations making exceptional efforts to help fight the COVID-19 health crisis and address the unique health care needs caused by the pandemic.
Headquartered in Webster, NY, RCare manufactures wireless nurse call and emergency monitoring systems for long-term care and senior housing communities. During the early days of COVID infections, RCare saw an unmet challenge. As cases were surging and hospitals were reaching capacity, providers were forced to create makeshift triage areas, tents in parking lots as well as full-scale temporary hospitals. These temporary solutions were missing the high-quality, reliable nurse call systems that play an integral role in safe patient care.
RCare’s response was to create a portable, durable, wireless nurse call system, a simple solution that could be set up quickly and easily, particularly in non-traditional patient settings. This special nurse call system, called the RCare Rapid Deployment Kit (RDK), is a nurse call system in a box. It’s completely plug and play, so it can be installed in minutes, even in non-standard settings that may lack traditional infrastructure, while providing the reliability of a hospital-grade nurse call solution. The kit provides effective, reliable nurse call communications between patients and caregivers, or between equipment (such as ventilators) and caregivers, even in non-healthcare, field operation environments.
Through the initial wave of infections, the RDK was installed in field hospitals throughout the country. One example is UMass Memorial Hospital, which created a 216-bed “pop-up” hospital in the 50,000 square foot Exhibit Hall of the DCU Center in Worcester, MA, to handle their patient overflow.
The DCU Center is an indoor arena and convention center in downtown Worcester. In April, its Exhibition Hall was converted to a field hospital to help nearby UMass Memorial Hospital handle the overflow of COVID-19 patients, those sick enough to require hospitalization, but not ICU care or a ventilator. The center was repurposed to act as both a field hospital led by UMass, and a shelter for homeless people who were positive for COVID-19. The installation was quick, smooth, and successful.
The hospital was created in a 50,000 square foot exhibition hall with cube-type barriers separating patient spaces. Nothing about the setting was traditional. Nothing could be permanently mounted. The server was placed behind folding tables that nurses used for charting, on a box, with the paging encoder on top of it. Locators were hung on centrally-located poles with tie wraps. The server and paging encoder were plugged into a network switch with a patch cable. Pendants were given to the staff for distribution to patients as they were admitted.
Sean Grady, Unit Director for UMass Memorial said this about the installation: “The RCare rollout was probably the best of any vendor rollout involved with the DCU project. From project management to technical install, it could not have gone any more smoothly. I can tell you that the nurse call system has worked great for us at the field hospital we have set up in Worcester.”
The installation happened very quickly, despite the tight schedule and chaotic environment. The goal was to complete the entire hospital in just ten days. In fact, UMass smashed the goal and completed the project in only 8 days. Even as the nurse call system was being installed, the IT department was setting up computers and networking infrastructure, Pharmacy was loading Picsys machines, Biomed was setting up their equipment, contractors were running the O2 infrastructure, and news crews were there documenting the whole thing.
The RDK nurse call system includes a touchscreen server, one pendant for each patient, and four pagers. No internet connection is needed for the system, and no phone lines. The system is preprogrammed by the integrator, to be ready to use right out of the box. This capability is mission critical for overworked clinical staff who have neither the time nor the technical expertise to spend on installation. Each kit is designed for 40 patients, although expansion kits allow it to be used for many more. As easily as it is installed, the RDK can be uninstalled when the hospitals are no longer needed, and redeployed if needed again.
RCare’s founder and CEO Myron Kowal will be accepting the award at an exclusive virtual awards ceremony at noon on August 24.
Juneteenth, celebrated on June 19th, is an American holiday that commemorates the day in 1865 when the last enslaved people in the United States were finally freed. Although the Emancipation Proclamation signed by President Lincoln on January 1, 1863 abolished slavery in the United States, many slaveholders didn’t comply with the order until Union troops arrived to enforce it, according to the Smithsonian National Museum of African American History and Culture. June 19, nicknamed Juneteenth, was chosen as a day to celebrate freedom for all.
New York’s Governor Cuomo issued an Executive Order this year, recognizing Juneteenth as a holiday for state employees. He said in an accompanying statement, “Friday is Juneteenth – a day to commemorate the end of slavery in the United States – and it’s a day that is especially relevant in this moment in history. Although slavery ended over 150 years ago, there has still been rampant, systemic discrimination and injustice in this state and this nation, and we have been working to enact real reforms to address these inequalities.”
RCare is closing early to allow our team to join in the celebration, to honor our nation’s rich and diverse history, and to take time to reflect on America’s achievements and its flaws, and its efforts to address the ongoing social injustice that continues today against our brothers and sisters. It is our hope that by honoring Juneteenth, RCare is making a small contribution to making this country a better place.
It is the middle of the night. Joyce from Room 118 gets up to answer the call of nature, and falls in the bathroom. She presses her pendant button. What happens next?
The answer is, it depends. Usually, the call is received, and an aide arrives at Joyce’s room to help her. The speed at which this occurs can depend on how reliable and robust the call light system is.
But sometimes there are added complications:
- Perhaps Joyce lives in an Assisted Living community that is lightly staffed late at night, as a cost-saving measure. Unfortunately, at the same time that Joyce needs help, the staff are busy answering other residents, which means Joyce will wait where she’s fallen until the staff is done.
- Perhaps Joyce lives in a low-income senior housing unit, and there’s nobody staffed to even answer the call. She’ll just have to wait on the floor until tomorrow morning at 8am when she receives the automated check-in phone call. When she doesn’t answer the phone, she’ll be added to a list for someone to check on later in the day.
- Maybe Joyce lives in Independent Living. Normally there’s someone at the night desk to receive calls, but tonight the WiFi went out, and push button calls weren’t received by the system during the 30-minute outage. Unfortunately, Joyce’s call will go unanswered.
- Or maybe there’s an extraordinarily high volume of calls that come in right before Joyce’s call. Unfortunately, she will simply have to wait, hoping that someone received her call.
Not only is Joyce fearful and agitated, she is now at risk for dehydration, pressure sores, increased blood pressure and heightened anxiety. All of these factors can lead to a potential bad outcome for Joyce.
What can be done? How can we ensure that all residents get the help and support when they need it?
Introducing: RCare’s Central Station Monitoring Service
No matter how great your staff and your nurse call system, sometimes you need backup to make sure that none of your residents slip through the cracks. RCare has partnered with Security Central, a nationally licensed service provider with a track record for excellence and reliability. Security Central has been in business for 57 years. Their staff is available 24/7 to answer the phones, and based on the pre-set protocols for your community, to take appropriate action.
With the integration of central station monitoring into your RCare nurse call system, you can be sure that every call is answered. Depending on your pre-set protocols, the operator may first contact the resident to confirm that it isn’t a false alarm and that help is really needed. Once this has been determined, the operator will gather additional essential information before contacting emergency responders.
No matter how great your staff and your nurse call system, sometimes you need backup to make sure that none of your residents slip through the cracks.
Or, your protocol may call for a series of escalating calls to be made, e.g. first to the on-call staff, then to the facility director, then to family members, and finally to 911 (when needed). It’s entirely flexible and customizable to fit your community, your caregivers and your administrators.
You might decide that any call that has not been answered by staff after a predefined period of time can be escalated to the central monitoring system.
Not to mention, if your community experiences a tech emergency, RCare’s cellular failover backup means calls are received even during power and WiFi outages.
Who benefits from Central Station Monitoring?
From Independent Living, to Assisted Living, to Skilled Nursing, to Affordable Housing communities, Central Station Monitoring can provide endless benefits. The integration with RCare’s nurse call system ensures that room-level information is routed immediately to someone who can help.
RCare’s Central Station Monitoring works over a standard phone line, IP, or cellular. Cellular is also available as a backup option for phone lines or IP setups.
Emergencies happen and response time is critical. RCare’s integration with Security Central provides a proven, cost-effective model to provide critical, life-saving services for your residents when it matters the most.
Want to learn more? Contact RCare.
UMass Memorial Hospital had a problem. At the peak of the COVID-19 outbreak, it was being flooded with patients, and needed to expand capacity, fast.
To convert the 50,000 square foot Exhibit Hall of the DCU Center, a convention center and arena, into a “pop-up” temporary field hospital, to handle the overflow of patients.
They had just ten days. They finished in eight.
The DCU Center is an indoor arena and convention center in downtown Worcester, MA. In April, its Exhibition Hall was converted to a field hospital to help nearby UMass Memorial Hospital handle the overflow of COVID-19 patients, those sick enough to require hospitalization, but not sick enough to require ICU care or a ventilator. It was repurposed to act as both a field hospital led by UMass, and a shelter for homeless people who tested positive for the disease.
Despite the unconventional setting, with its many challenges, the quality of care needed to be top-notch, and that included the nurse call system. It had to be quick to install, and completely reliable, because lives would depend on it.
Signet Electronic Systems, a trusted RCare integrator, used RCare’s Rapid Development Kit (RDK) nurse call solution to help UMass create the temporary hospital. The installation was quick, smooth and successful.
Signet has a long-standing relationship with UMass Memorial Health Care. It installs the majority of the beds in both of their Worcester campuses as well as satellite locations, with high-end wired nurse call solutions, in addition to managing other systems such as public address and master clocks. They knew they could count on RCare for a solution that works.
A Rapid Deployment Kit nurse call system includes a touchscreen server, one pendant for each patient, and four pagers. No internet connection is needed for the system, and no phone lines. The system is designed to be plug and play, and is pre-programmed to be ready to use right out of the box. One RCare RDK is fully programmed for up to 40 patients and 4 caregivers, however it can be expanded with RCare’s Expansion Kits. Patient beds are outfitted with clip-on placards that correspond to patient call buttons, so caregivers can see which patients are calling. RCare’s G4 platform provides best-in-class range to cover large campuses and deepen building penetration, which allows it to be reliable in any setting.
The UMass temporary hospital was created in a 50,000 sq ft exhibition hall with cube-type barriers separating patient spaces. Nothing could be permanently mounted. The server was placed behind folding tables that nurses use for charting, on a box, with the paging encoder on top of it. Locators were hung on centrally-located poles with tie wraps. The server and paging encoder were plugged into a network switch with a patch cable. Pendants were given to the staff for distribution to patients as they were admitted. The openness of the space proved to be a benefit for signal transmission, allowing calls to be initiated from a pendant and received the full length of the space.
The system was installed overnight, and was completed and tested the following morning. Mark Roy, Senior Client Executive at Signet, described the scene.
“Everyone was in there doing everything at the same time. Hospital folks were setting up computers, networking and other technical infrastructure, pharmacy was loading Picsys machines, Biomed was setting up all their equipment, contractors were running O2 infrastructure, and news crews were there at the same time, documenting the whole thing.
Despite the tight schedule, Mark praised the UMass staff, who were very helpful, and provided everything needed in record time.
UMass returned the compliment. Sean Grady, Unit Coordinator for UMass Memorial said this about the installation:
“The RCare rollout was probably the best of any vendor rollout involved with the DCU project. From project management to technical install, it could not have gone any more smoothly. I can tell you that the nurse call system has worked great for us at the field hospital we have set up in Worcester.”
RCare is proud to be part of the solution for this ambitious project. Our Rapid Deployment Nurse Call Kit (RDK) is a plug-and-play, portable, pre-programmed nurse call system in a box that can be set up in hours instead of days, in a situation lacking standard infrastructure, while providing the critical, reliable communications required in a hospital setting, even a non-traditional one.
The numbers of infected patients continues to rise, and hospitals in hard-hit areas are being forced to expand rapidly and efficiently. RCare can help. Our staff have been working hard, assembling Rapid Deployment Nurse Call Systems Kits. These kits provide effective, reliable nurse call communications between patients and caregivers, and between equipment and caregivers, even in non-healthcare, field operations environments.
These plug-and-play systems are preprogrammed by RCare’s expert technicians and ready for use immediately out of the box. They include one small touchscreen server, one pendant for each resident or patient, and four pagers. Expansion kits are available. Only one internet connection is required, and no landlines are necessary.
“Our mission here is to help win this war.” – Myron Kowal, RCare founder and CEO
Designed for speed of implementation, and ease-of-use in emergency situations, RCare’s Rapid Deployment Kit installs in only five minutes and offers a reliable, secure nurse call system in a box. RCare’s G4 platform provides best-in-class range to cover even the largest of campuses and deepen building penetration. UL 1069 version available. Contact RCare to find out more.
When there’s a national health crisis, RCare can help you be ready.
Designed for speed and ease-of-use in emergency situations, RCare’s Rapid Deployment Kit installs in only five minutes and offers a reliable, secure, 40-patient nurse call system in a box. RCare’s G4 platform provides best-in-class range to cover even the largest of campuses and deepen building penetration.
“The overall risk from this virus is still unknown, but what we do know is that many hospitals and providers are being overwhelmed with patients,” said Myron Kowal, CEO of RCare. “We decided to quickly extend our technology capabilities to places where they are in dire need.”
The plug-and-play system is preprogrammed by RCare’s expert technicians and ready for use immediately out of the box. It includes one small touchscreen server, one pendant for each resident or patient, and four pagers. Expansion kits are available. Only one internet connection is required, and no landlines are necessary.
RCare Rapid Deployment Kit Includes:
- NurseCall Master with Integrated Touchscreen Console
- 40 Pushbutton Pendants (waterproof; reusable if disinfected or disposable)
- 40 Clip-On Bed Signs
- 4 Alpha-Numeric Apollo Pagers
- G4 Master Receiver
- 2 G4 Locators
- Single-Input Serial Page Encoder 5W
- Compact, Heavy Duty Pelican Case
- Easy step-by-step instructions and link to instructive video
The touchscreen console displays incoming patient calls with an audible tone. Patient beds are outfitted with clip-on placards that correspond to patient call buttons, so caregivers know which patients are calling. UL 1069 version available. If interested please contact us.
RCare is hitting the road for a multi-city roadshow tour this spring. Each stop is a content-rich seminar, exclusive for RCare distributors.
These two-day seminars are a chance to take a deep dive into the ever-changing senior living industry and into RCare’s innovative and expanding product line. Understanding senior living communities and their needs is key to customizing a perfect solution, providing the latest features to help caregiving staff provide the highest level of care, while increasing efficiencies and the bottom line. RCare’s latest innovations also include solutions to help a broader cross-section of the market.
“We’ve been adding important functionality rapidly in the last few years, and that’s not going to stop anytime soon,” said RCare Founder and CEO Myron Kowal. “The roadshow is diving deep into our new technologies, best practices and latest integrations.”
What are some of RCare’s latest innovations?
RCare’s HCube for Affordable Housing is a system built and designed exclusively for affordable and subsidized senior housing. The HCube combines all of the critical capabilities of RCare’s flagship wireless nurse call technologies at a fraction of the cost. It features low cost of entry, minimal hardware to maintain, and nominal ongoing fees. It requires only one internet connection for the entire facility, and no landlines.
RCare has integrated with Inovonics, and is an authorized Inovonics reseller, providing clients with a new line of products. Communities that are already equipped with Inovonics sensors can incorporate their existing devices into a new RCare nurse call solution. It’s a great opportunity to upgrade to a feature-rich RCare solution, while leveraging their existing hardware investment for cost savings.
iCall is RCare’s new full-IP wired nurse call system. It brings all of RCare’s powerful features to a full-IP wired solution, which makes RCare’s nurse call solutions available for the first time to communities that require a wired system. Communities also have the option to integrate iCall with RCare’s wireless solutions, providing the flexibility to customize the best solution across the entire community.
RCare’s interoperability with other market leading systems, including electronic medical records, wander management, and even Alexa, has helped make life simpler for administrators and caregivers by reducing redundant data entry and reducing the number of systems to monitor.
“We had a record year last year, and there’s a reason. We make a good product that helps a lot of people. And we keep making it better. And educating our distributors is critical because we always expect them to offer the best possible solution to our clients,” said Kowal.
RCare CEO and founder Myron Kowal was the feature of a recent Bridge the Gap podcast. He spoke with hosts Joshua Crips and Lucas McCurdy about the origins of RCare, the history, challenges, triumphs, and the future of nurse call systems as it relates to the aging population, and the critical importance of response times in senior living.
Kowal observed that 20 years ago, when everyone had home telephones, the early PERS devices “would call somebody on the telephone and say, hey, this person needed help. The cool thing about that was it had a voice to voice connection so when that person did call for help, they knew someone was coming. It was like, okay, someone’s on the way. I’m gonna be okay.”
As technology improved, the voice-to-voice interaction went away. “When that person pressed the button, they weren’t sure that someone was coming. They would hope that someone was coming and most of the time they did.”
If residents wait too long for help, or even if it just feels like they’ve waited too long, they try to do things on their own, and risk getting seriously hurt.
RCare did a pilot project with Fellowship Square in Arizona using Amazon Alexa. (See “Alexa, please call my nurse.“) “They’re able to say, ‘Alexa, I need help.’ And that would call a caregiver. And we have a voice-to-voice connection that says, ‘A caregiver is on the way.’ It makes people feel like I’m okay. That panic that ensues when you’re in trouble can cause a lot of things to happen.”
According to Kowal, he’s on an “answer the call kick.” If residents wait too long for help, or even if it just feels like they’ve waited too long, they try to do things on their own, and risk getting seriously hurt.
In addition to offering voice-to-voice options, RCare wants to help communities reduce their response times. “You can’t manage what you don’t measure. You need to look at the data, draw your own conclusions, make your improvements, and then measure your effectiveness.”
RCare provides detailed metrics to communities, to help them understand what their response times are, what factors affect the length of those response times, and how they can be improved. “What are the mean and average response times to calls? How many calls are we getting? How many caregivers are actually logged into the system in a facility where this is the number of calls that we have as opposed that are logged into the system? We can see those things right now by taking a look at that data, and we’re trying to give it back to the industry so that they can make those improvements.”
Check out the full Bridge the Gap podcast here.
One year ago, the American Hotel & Lodging Association (AHLA) made a groundbreaking pledge to improve the safety and security of hotel workers in the United States. Member hotels were invited to commit to the 5-Star Promise, a voluntary pledge to improve the safety of their workers by improving their sexual harassment policies, training and resources. The most significant point of the 5-Star Promise was the promise to provide electronic safety devices (ESDs) to their staff, to keep them safe on the job.
When the 5-Star Promise began, there were 17 participating hotels and hotel chains nationwide. Now, just one year later, participation has grown to 56, a dramatic 230% increase. This represents an estimated 20,000 hotel properties, with an estimated 1.2 million employees who will be safer on the job.
“As an industry of people taking care of people, we have always been deeply committed to safety and security for our employees and guests. We have a responsibility to ensure they feel safe and secure,” said Chip Rogers, president and CEO of AHLA. “I’m proud of the progress we have made as an industry over the past year, and we will continue our efforts to ensure America’s hotels are safe places for all those who work in and visit them.”
“Just the possibility of danger has been enough of a morale depletant over the decades to give certain organizational roles a toxic aura.” – Larry Mogelonsky, Hotel Security Consultant
Housekeepers typically work alone. When confronted with risky situations, they have little protection. Stories abound of guests exposing themselves to workers, or worse. With an electronic safety device, the endangered worker presses a button to summon assistance from hotel security. The alert is sent automatically, and includes the location of the employee, so security can respond immediately to where help is needed.
The impact of the 5-Star Promise is even greater than just the safety and security of current employees. It also changes the perception of the job and its risks, which is critical to staffing, an important challenge for the industry.
“Just the possibility of danger has been enough of a morale depletant over the decades to give certain organizational roles a toxic aura. For instance, I don’t doubt for a second that the horror stories of housekeepers past have deterred many potential hires, thereby contributing to the current staffing problems we presently face,” according to hotel security consultant Larry Mogelonsky. “Given this likelihood for not only widely augmented safety but also improved morale and employee retention, I’m all over ESD adoption at any hotel worldwide.”
Choosing the right ESD system is important. In case of an emergency, you want to ensure that your system works as needed in your facility. RCare’s wireless ALP Hospitality Suite can help. RCare has been an innovator and leader in the crisis alert and nurse call industry for over a decade. RCare’s systems have a proven track record for reliability and accuracy, even in the toughest conditions. RCare’s hotel crisis system uses military-grade RF, a signal protocol proven to be far more reliable than WiFi or Bluetooth, to ensure every alert is received. It has a wide listening range, even in the oldest buildings with challenging infrastructure. It uses Advanced Locating Protocol (ALP) to send location information with every call, so valuable time isn’t wasted determining where help is needed. Regardless of your hotel’s size or budget, RCare can help.
Want to know more about hotel duress systems? Contact RCare to find out how they can enhance safety and security for your hospitality staff.