Author: Karen G. Duderstadt
Publisher: Elsevier Health Sciences
ISBN: 032318720X
Category : Medical
Languages : en
Pages : 379
Book Description
"This handbook serves the needs of undergraduate medical students ,nursing students and is good refresher for Pediatric post graduates." Reviewed by: Neel Kamal, Date: Aug. 14 This portable, photo-rich guide to physical examination for Nurse Practitioners and other primary care providers will help you develop the unique range of skills required to assess children of all ages. System chapters begin with embryological development and review the key developmental stages of childhood. For infants and young children, this step-by-step guide uses the "quiet-to-active" approach favored by pediatric experts and considered more effective for this age-group than the traditional head-to-toe approach used for adults. Other key topics include pediatric mental health assessment and growth and development screening and surveillance. Uses the quiet-to-active approach to the examination of infants and young children, starting with listening and moving on to touching, the pediatric assessment approach that yields the best results in this age group. More than 300 photos and line drawings facilitate learning and familiarize you with common assessment findings. Information Gathering tables highlight questions and data needed from the patient/guardian, with questions conveniently separated by age group, to help you take an accurate history. Charting examples show you how to record physical examination findings in the health record and acquaint you with documentation language and format. Pediatric Pearls highlight effective physical examination findings and techniques gleaned from actual practice. Coverage of assessment of the preterm infant equips you with practical tools for assessing this unique pediatric population. Full-color format facilitates readability and learning. An easy-access two-column format provides quick access to concise information. Spiral binding lets you lay the book flat or fold it back for easy visualization and quick reference in the clinical setting.
Pediatric Physical Examination - E-Book
Author: Karen G. Duderstadt
Publisher: Elsevier Health Sciences
ISBN: 032318720X
Category : Medical
Languages : en
Pages : 379
Book Description
"This handbook serves the needs of undergraduate medical students ,nursing students and is good refresher for Pediatric post graduates." Reviewed by: Neel Kamal, Date: Aug. 14 This portable, photo-rich guide to physical examination for Nurse Practitioners and other primary care providers will help you develop the unique range of skills required to assess children of all ages. System chapters begin with embryological development and review the key developmental stages of childhood. For infants and young children, this step-by-step guide uses the "quiet-to-active" approach favored by pediatric experts and considered more effective for this age-group than the traditional head-to-toe approach used for adults. Other key topics include pediatric mental health assessment and growth and development screening and surveillance. Uses the quiet-to-active approach to the examination of infants and young children, starting with listening and moving on to touching, the pediatric assessment approach that yields the best results in this age group. More than 300 photos and line drawings facilitate learning and familiarize you with common assessment findings. Information Gathering tables highlight questions and data needed from the patient/guardian, with questions conveniently separated by age group, to help you take an accurate history. Charting examples show you how to record physical examination findings in the health record and acquaint you with documentation language and format. Pediatric Pearls highlight effective physical examination findings and techniques gleaned from actual practice. Coverage of assessment of the preterm infant equips you with practical tools for assessing this unique pediatric population. Full-color format facilitates readability and learning. An easy-access two-column format provides quick access to concise information. Spiral binding lets you lay the book flat or fold it back for easy visualization and quick reference in the clinical setting.
Publisher: Elsevier Health Sciences
ISBN: 032318720X
Category : Medical
Languages : en
Pages : 379
Book Description
"This handbook serves the needs of undergraduate medical students ,nursing students and is good refresher for Pediatric post graduates." Reviewed by: Neel Kamal, Date: Aug. 14 This portable, photo-rich guide to physical examination for Nurse Practitioners and other primary care providers will help you develop the unique range of skills required to assess children of all ages. System chapters begin with embryological development and review the key developmental stages of childhood. For infants and young children, this step-by-step guide uses the "quiet-to-active" approach favored by pediatric experts and considered more effective for this age-group than the traditional head-to-toe approach used for adults. Other key topics include pediatric mental health assessment and growth and development screening and surveillance. Uses the quiet-to-active approach to the examination of infants and young children, starting with listening and moving on to touching, the pediatric assessment approach that yields the best results in this age group. More than 300 photos and line drawings facilitate learning and familiarize you with common assessment findings. Information Gathering tables highlight questions and data needed from the patient/guardian, with questions conveniently separated by age group, to help you take an accurate history. Charting examples show you how to record physical examination findings in the health record and acquaint you with documentation language and format. Pediatric Pearls highlight effective physical examination findings and techniques gleaned from actual practice. Coverage of assessment of the preterm infant equips you with practical tools for assessing this unique pediatric population. Full-color format facilitates readability and learning. An easy-access two-column format provides quick access to concise information. Spiral binding lets you lay the book flat or fold it back for easy visualization and quick reference in the clinical setting.
Pediatric Physical Examination & Health Assessment
Author: Susan Sawyer
Publisher: Jones & Bartlett Publishers
ISBN: 0763774383
Category : Medical
Languages : en
Pages : 682
Book Description
Pediatric Physical Examination & Health Assessment explores physical examinations of pediatric clients from newborn through adolescence while providing key insights into how to conduct and assess them. A beginning guide for those learning to perform physical examinations on patients from birth through adolescence, this text describes the many examination techniques for infants and children throughout their development. Approaching each system from a developmental perspective, each chapter addresses a specific system divided into four major components: interviewing techniques, anatomy and physiology, examination techniques, and normal variations and common abnormal findings all detailing how to approach each age group from infant to adolescent. Since treating pediatric patients requires building ease and trust, each chapter includes seize the opportunity suggestions to help you assess that part of the body readily available without being intrusive or causing fear and discomfort. Further, following many chapters is a case study that incorporates diagnostic reasoning, critical thinking, and evidence-based practice.
Publisher: Jones & Bartlett Publishers
ISBN: 0763774383
Category : Medical
Languages : en
Pages : 682
Book Description
Pediatric Physical Examination & Health Assessment explores physical examinations of pediatric clients from newborn through adolescence while providing key insights into how to conduct and assess them. A beginning guide for those learning to perform physical examinations on patients from birth through adolescence, this text describes the many examination techniques for infants and children throughout their development. Approaching each system from a developmental perspective, each chapter addresses a specific system divided into four major components: interviewing techniques, anatomy and physiology, examination techniques, and normal variations and common abnormal findings all detailing how to approach each age group from infant to adolescent. Since treating pediatric patients requires building ease and trust, each chapter includes seize the opportunity suggestions to help you assess that part of the body readily available without being intrusive or causing fear and discomfort. Further, following many chapters is a case study that incorporates diagnostic reasoning, critical thinking, and evidence-based practice.
Nutrition Focused Physical Exam Pocket Guide
Author: Beth Modarski
Publisher: Academy of Nutrition and Dietetics
ISBN: 9780880912068
Category : Nutrition
Languages : en
Pages : 0
Book Description
The third edition of the popular NFPE Pocket Guide provides essential tools for malnutrition and micronutrient assessment, documentation and coding.
Publisher: Academy of Nutrition and Dietetics
ISBN: 9780880912068
Category : Nutrition
Languages : en
Pages : 0
Book Description
The third edition of the popular NFPE Pocket Guide provides essential tools for malnutrition and micronutrient assessment, documentation and coding.
Advanced Pediatric Assessment, Second Edition
Author: Ellen M. Chiocca, PhD, CPNP, RNC-NIC
Publisher: Springer Publishing Company
ISBN: 0826161766
Category : Medical
Languages : en
Pages : 607
Book Description
Now in its second edition, Advanced Pediatric Assessment is an in-depth, current guide to pediatric-focused assessment, addressing the unique anatomic and physiological differences among infants, children, and adults as they bear upon pediatric assessment. The second edition is updated to reflect recent advances in understanding of pediatric assessment for PNPs, FNPs, and other practitioners, as well as students enrolled in these advance practice educational programs. This includes a new chapter on the integration of pediatric health history and physical assessment, a Notable Clinical Findings section addressing abnormalities and their clinical significance at the end of each assessment chapter, updated clinical practice guidelines for common medical conditions, updated screening and health promotion guidelines, and summaries in each chapter. Based on a body-system framework, which highlights developmental and cultural considerations, the guide emphasizes the physical and psychosocial principles of growth and development, with a focus on health promotion and wellness. Useful features include a detailed chapter on appropriate communication techniques to be used when assessing children of different ages and developmental levels and chapters on assessment of child abuse and neglect and cultural considerations during assessment. The text presents nearly 300 photos and helpful tables and boxes depicting a variety of commonly encountered pediatric physical findings, and sample medical record documentation in each chapter. NEW TO THE SECOND EDITION: A chapter on the integration of pediatric health history and physical assessment Notable Clinical Findings addressing important abnormalities and their clinical significance in each assessment chapter Updated clinical practice guidelines for common medical conditions Updated screening and health promotion guidelines Accompanying student case study workbook (to be purchased separately) KEY FEATURES: Focuses exclusively on the health history and assessment of infants, children, and adolescents Provides the comprehensive and in-depth information needed by APN students and new practitioners to assess children safely and accurately Includes family, developmental, nutritional, and child mistreatment assessment Addresses cultural competency, including specific information about the assessment of immigrant and refugee children Fosters confidence in APNs new to primary care with children Ellen M. Chiocca, MSN, CPNP, APN, RNC-NIC, is a clinical assistant professor in the School of Nursing at DePaul University. She received a master of science degree in nursing and a postmaster nurse practitioner certificate from Loyola University, Chicago, and a bachelor of science degree in nursing from St. Xavier University. Prior to joining the faculty at DePaul University, she taught at Loyola University, Chicago, from 1991 to 2013. Ms. Chiocca’s clinical specialty is the nursing of children. Her research focuses on how various forms of violence affect children’s health. She is certified in neonatal intensive care nursing and as a pediatric nurse practitioner. In addition to teaching at DePaul, Ms. Chiocca also continues clinical practice as a pediatric nurse practitioner at a community clinic in Chicago. Ms. Chiocca has published more than 25 journal articles and book chapters, and is also a peer reviewer for the journal Neonatal Network. She is currently pursuing a PhD in nursing.
Publisher: Springer Publishing Company
ISBN: 0826161766
Category : Medical
Languages : en
Pages : 607
Book Description
Now in its second edition, Advanced Pediatric Assessment is an in-depth, current guide to pediatric-focused assessment, addressing the unique anatomic and physiological differences among infants, children, and adults as they bear upon pediatric assessment. The second edition is updated to reflect recent advances in understanding of pediatric assessment for PNPs, FNPs, and other practitioners, as well as students enrolled in these advance practice educational programs. This includes a new chapter on the integration of pediatric health history and physical assessment, a Notable Clinical Findings section addressing abnormalities and their clinical significance at the end of each assessment chapter, updated clinical practice guidelines for common medical conditions, updated screening and health promotion guidelines, and summaries in each chapter. Based on a body-system framework, which highlights developmental and cultural considerations, the guide emphasizes the physical and psychosocial principles of growth and development, with a focus on health promotion and wellness. Useful features include a detailed chapter on appropriate communication techniques to be used when assessing children of different ages and developmental levels and chapters on assessment of child abuse and neglect and cultural considerations during assessment. The text presents nearly 300 photos and helpful tables and boxes depicting a variety of commonly encountered pediatric physical findings, and sample medical record documentation in each chapter. NEW TO THE SECOND EDITION: A chapter on the integration of pediatric health history and physical assessment Notable Clinical Findings addressing important abnormalities and their clinical significance in each assessment chapter Updated clinical practice guidelines for common medical conditions Updated screening and health promotion guidelines Accompanying student case study workbook (to be purchased separately) KEY FEATURES: Focuses exclusively on the health history and assessment of infants, children, and adolescents Provides the comprehensive and in-depth information needed by APN students and new practitioners to assess children safely and accurately Includes family, developmental, nutritional, and child mistreatment assessment Addresses cultural competency, including specific information about the assessment of immigrant and refugee children Fosters confidence in APNs new to primary care with children Ellen M. Chiocca, MSN, CPNP, APN, RNC-NIC, is a clinical assistant professor in the School of Nursing at DePaul University. She received a master of science degree in nursing and a postmaster nurse practitioner certificate from Loyola University, Chicago, and a bachelor of science degree in nursing from St. Xavier University. Prior to joining the faculty at DePaul University, she taught at Loyola University, Chicago, from 1991 to 2013. Ms. Chiocca’s clinical specialty is the nursing of children. Her research focuses on how various forms of violence affect children’s health. She is certified in neonatal intensive care nursing and as a pediatric nurse practitioner. In addition to teaching at DePaul, Ms. Chiocca also continues clinical practice as a pediatric nurse practitioner at a community clinic in Chicago. Ms. Chiocca has published more than 25 journal articles and book chapters, and is also a peer reviewer for the journal Neonatal Network. She is currently pursuing a PhD in nursing.
Pediatric Physical Examination - E-Book
Author: Karen G. Duderstadt
Publisher: Elsevier Health Sciences
ISBN: 0323930824
Category : Medical
Languages : en
Pages : 419
Book Description
Known for its accuracy, consistency, and portability, Pediatric Physical Examination: An Illustrated Handbook, 4th Edition teaches the unique range of skills that Nurse Practitioners and primary care providers need to assess children of all ages. Spiral-bound for quick reference in clinical settings, this photo-rich, step-by-step guide to physical examination prepares you to expertly examine children from birth through adolescence. Body system chapters begin with fetal development and take you through the key developmental stages of childhood. This edition features new sections with Telehealth Tips and Considerations for Special Populations in many chapters, as well as expanded coverage of maltreatment, mental health, and social disparities of health. - Expert guidance for the pediatric physical exam employs the "quiet-to-active" approach, starting with the listening parts of the physical exam and moving on to the hands-on components, the physical assessment approach that yields the best results in the pediatric age group. - Quick-reference features include special tables/boxes, such as Information Gathering, Conditions, Pediatric Pearls, Red Flags, Interprofessional Collaboration Notes, Evidence-Based Practice, and EHR Documentation. - Easy-to-use layout provides quick access to concise guidance for the pediatric physical exam. - Richly illustrated, full-color format facilitates readability and learning with more than 300 photos and line drawings of assessment techniques and common assessment findings. - Inclusive and ethnically diverse illustrations better represent the diverse populations pediatric health care providers work with every day. - NEW! Telehealth Tips section added to chapters reflects the greatly expanded use of telehealth visits in clinical practice. - NEW! Information on maltreatment, mental and behavioral health, and social determinants of health explored throughout the chapters. - NEW! Considerations for special needs populations added to most chapters. - NEW! Guidance on use of screen time for early childhood and advice for families.
Publisher: Elsevier Health Sciences
ISBN: 0323930824
Category : Medical
Languages : en
Pages : 419
Book Description
Known for its accuracy, consistency, and portability, Pediatric Physical Examination: An Illustrated Handbook, 4th Edition teaches the unique range of skills that Nurse Practitioners and primary care providers need to assess children of all ages. Spiral-bound for quick reference in clinical settings, this photo-rich, step-by-step guide to physical examination prepares you to expertly examine children from birth through adolescence. Body system chapters begin with fetal development and take you through the key developmental stages of childhood. This edition features new sections with Telehealth Tips and Considerations for Special Populations in many chapters, as well as expanded coverage of maltreatment, mental health, and social disparities of health. - Expert guidance for the pediatric physical exam employs the "quiet-to-active" approach, starting with the listening parts of the physical exam and moving on to the hands-on components, the physical assessment approach that yields the best results in the pediatric age group. - Quick-reference features include special tables/boxes, such as Information Gathering, Conditions, Pediatric Pearls, Red Flags, Interprofessional Collaboration Notes, Evidence-Based Practice, and EHR Documentation. - Easy-to-use layout provides quick access to concise guidance for the pediatric physical exam. - Richly illustrated, full-color format facilitates readability and learning with more than 300 photos and line drawings of assessment techniques and common assessment findings. - Inclusive and ethnically diverse illustrations better represent the diverse populations pediatric health care providers work with every day. - NEW! Telehealth Tips section added to chapters reflects the greatly expanded use of telehealth visits in clinical practice. - NEW! Information on maltreatment, mental and behavioral health, and social determinants of health explored throughout the chapters. - NEW! Considerations for special needs populations added to most chapters. - NEW! Guidance on use of screen time for early childhood and advice for families.
ADA Pocket Guide to Nutrition Assessment
Author: Pamela Charney
Publisher: American Dietetic Associati
ISBN: 0880914211
Category : Medical
Languages : en
Pages : 232
Book Description
Publisher: American Dietetic Associati
ISBN: 0880914211
Category : Medical
Languages : en
Pages : 232
Book Description
Seidel's Guide to Physical Examination - E-Book
Author: Jane W. Ball
Publisher: Elsevier Health Sciences
ISBN: 0323545386
Category : Medical
Languages : en
Pages : 725
Book Description
- NEW! Emphasis on clinical reasoning provides insights and clinical expertise to help you develop clinical judgment skills. - NEW! Enhanced emphasis on patient safety and healthcare quality, particularly as it relates to sports participation. - NEW! Content on documentation has been updated with a stronger focus on electronic charting (EHR/EMR). - NEW! Enhanced social inclusiveness and patient-centeredness incorporates LGBTQ patients and providers, with special a emphasis on cultural competency, history-taking, and special considerations for examination of the breasts, female and male genitalia, reproductive health, thyroid, and anus/rectum/prostate. - NEW! Telemedicine, virtual consults, and video interpreters content added to the Growth, Measurement, and Nutrition chapter. - NEW! Improved readability with a clear, straightforward, and easy-to-understand writing style. - NEW! Updated drawing, and photographs enhance visual appeal and clarify anatomical content and exam techniques.
Publisher: Elsevier Health Sciences
ISBN: 0323545386
Category : Medical
Languages : en
Pages : 725
Book Description
- NEW! Emphasis on clinical reasoning provides insights and clinical expertise to help you develop clinical judgment skills. - NEW! Enhanced emphasis on patient safety and healthcare quality, particularly as it relates to sports participation. - NEW! Content on documentation has been updated with a stronger focus on electronic charting (EHR/EMR). - NEW! Enhanced social inclusiveness and patient-centeredness incorporates LGBTQ patients and providers, with special a emphasis on cultural competency, history-taking, and special considerations for examination of the breasts, female and male genitalia, reproductive health, thyroid, and anus/rectum/prostate. - NEW! Telemedicine, virtual consults, and video interpreters content added to the Growth, Measurement, and Nutrition chapter. - NEW! Improved readability with a clear, straightforward, and easy-to-understand writing style. - NEW! Updated drawing, and photographs enhance visual appeal and clarify anatomical content and exam techniques.
Paediatric Clinical Examination Made Easy
Author: Denis Gill
Publisher: Elsevier Health Sciences
ISBN: 0702072907
Category : Medical
Languages : en
Pages : 314
Book Description
Fully revised, this is an updated new edition of a much-loved book which has built a reputation for pithy, entertaining good sense over the course of six editions. 'Children are different. Paediatrics is much more than medicine miniaturised.' From reviews of the previous edition: 'All in all a very handy book for the student, the resident or other professionals working with children. I had a lot of fun reading it.' 'The book is full of wonderful illustrations, and funny and profound advice with quotations, like the words of Sir Dominic Corrigan (1853): "The trouble with many doctors is not that they do not know enough but that they do not see enough", or the advice to teach thy tongue to say" "I do not know" (Rabbi Moses Maimonides or Rambam, 1135-1204). I have used this book for my final medical year paediatrics exams, the DCH and the MRCP and it has been a great help. It reminds us of the most important and basic things - history and examination, and of course a friendly demeanour.' - Short, manageable chapters - Clinical examples of examination techniques - Very helpful tips and topics section - Clinical checklists - Simply illustrated - Updated throughout - New section of 'questions of fives' questions - Short glossary of Latin terms
Publisher: Elsevier Health Sciences
ISBN: 0702072907
Category : Medical
Languages : en
Pages : 314
Book Description
Fully revised, this is an updated new edition of a much-loved book which has built a reputation for pithy, entertaining good sense over the course of six editions. 'Children are different. Paediatrics is much more than medicine miniaturised.' From reviews of the previous edition: 'All in all a very handy book for the student, the resident or other professionals working with children. I had a lot of fun reading it.' 'The book is full of wonderful illustrations, and funny and profound advice with quotations, like the words of Sir Dominic Corrigan (1853): "The trouble with many doctors is not that they do not know enough but that they do not see enough", or the advice to teach thy tongue to say" "I do not know" (Rabbi Moses Maimonides or Rambam, 1135-1204). I have used this book for my final medical year paediatrics exams, the DCH and the MRCP and it has been a great help. It reminds us of the most important and basic things - history and examination, and of course a friendly demeanour.' - Short, manageable chapters - Clinical examples of examination techniques - Very helpful tips and topics section - Clinical checklists - Simply illustrated - Updated throughout - New section of 'questions of fives' questions - Short glossary of Latin terms
Advanced Pediatric Assessment, Third Edition
Author: Ellen M. Chiocca, PhD, CPNP, RNC-NIC
Publisher: Springer Publishing Company
ISBN: 0826150217
Category : Medical
Languages : en
Pages : 617
Book Description
Underscores the unique health needs of children at different ages and developmental stages This is the only text/reference book to deliver the specialized knowledge and skills needed to accurately assess children during health and illness. Comprehensive and detailed, it emphasizes the unique anatomic and physiologic differences among infants, children, and adults. The third edition features updated clinical practice guidelines, clinical decision-making, formulating differential diagnoses, and evidence-based practice. It newly addresses toxic stress and trauma-informed care and child witnesses to violent acts. Additionally, the book provides several new features facilitating quick access to key information along with new instructor and student resources. Using a body system that highlights developmental and cultural considerations, the text examines the physical and psychosocial principles of growth and development with a focus on health promotion and wellness. Especially useful features include a detailed chapter on helpful communication techniques when assessing children of various ages and developmental levels, a chapter on the assessment of child abuse and neglect, over 280 photos and charts depicting a variety of commonly encountered pediatric findings, and sample medical record documentation in each chapter. New to the Third Edition: Now in full-color! Now includes NEW instructor resources (Power Points, Test Bank, 4-color Image Bank) Updated clinical practice guidelines Clinical decision making, formulating differential diagnoses, and evidence-based practice Immigrant and refugee health Toxic stress and trauma-informed care Child witnesses to violent acts Content outline at the beginning of each chapter Call-out boxes summarizing key information Summary boxes on essential areas of physical exams Key Features: Focuses exclusively on the health history and assessment of infants, children, and adolescents Describes the unique anatomic and physiologic differences among infants, children, and adults Provides comprehensive and in-depth information for APN students and new practitioners Addresses family, developmental, nutritional, and child mistreatment assessment Includes clinical practice guidelines for common medical conditions Incorporates up-to-date screening and health promotion guidelines
Publisher: Springer Publishing Company
ISBN: 0826150217
Category : Medical
Languages : en
Pages : 617
Book Description
Underscores the unique health needs of children at different ages and developmental stages This is the only text/reference book to deliver the specialized knowledge and skills needed to accurately assess children during health and illness. Comprehensive and detailed, it emphasizes the unique anatomic and physiologic differences among infants, children, and adults. The third edition features updated clinical practice guidelines, clinical decision-making, formulating differential diagnoses, and evidence-based practice. It newly addresses toxic stress and trauma-informed care and child witnesses to violent acts. Additionally, the book provides several new features facilitating quick access to key information along with new instructor and student resources. Using a body system that highlights developmental and cultural considerations, the text examines the physical and psychosocial principles of growth and development with a focus on health promotion and wellness. Especially useful features include a detailed chapter on helpful communication techniques when assessing children of various ages and developmental levels, a chapter on the assessment of child abuse and neglect, over 280 photos and charts depicting a variety of commonly encountered pediatric findings, and sample medical record documentation in each chapter. New to the Third Edition: Now in full-color! Now includes NEW instructor resources (Power Points, Test Bank, 4-color Image Bank) Updated clinical practice guidelines Clinical decision making, formulating differential diagnoses, and evidence-based practice Immigrant and refugee health Toxic stress and trauma-informed care Child witnesses to violent acts Content outline at the beginning of each chapter Call-out boxes summarizing key information Summary boxes on essential areas of physical exams Key Features: Focuses exclusively on the health history and assessment of infants, children, and adolescents Describes the unique anatomic and physiologic differences among infants, children, and adults Provides comprehensive and in-depth information for APN students and new practitioners Addresses family, developmental, nutritional, and child mistreatment assessment Includes clinical practice guidelines for common medical conditions Incorporates up-to-date screening and health promotion guidelines
American Academy of Pediatrics Textbook of Pediatric Care
Author: Jane Meschan Foy
Publisher:
ISBN: 9781581109665
Category : Children
Languages : en
Pages : 0
Book Description
The definitive manual of pediatric medicine - completely updated with 75 new chapters and e-book access.
Publisher:
ISBN: 9781581109665
Category : Children
Languages : en
Pages : 0
Book Description
The definitive manual of pediatric medicine - completely updated with 75 new chapters and e-book access.