An Information Technology Framework for Predictive, Preventive and Personalised Medicine

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Author :
Publisher : Springer
ISBN 13 : 3319121669
Total Pages : 143 pages
Book Rating : 4.3/5 (191 download)

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Book Synopsis An Information Technology Framework for Predictive, Preventive and Personalised Medicine by : Leonard Berliner

Download or read book An Information Technology Framework for Predictive, Preventive and Personalised Medicine written by Leonard Berliner and published by Springer. This book was released on 2015-03-04 with total page 143 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explores how PPPM, clinical practice, and basic research could be best served by information technology (IT). A use-case was developed for hepatocellular carcinoma (HCC). The subject was approached with four interrelated tasks: (1) review of clinical practices relating to HCC; (2) propose an IT system relating to HCC, including clinical decision support and research needs; (3) determine how a clinical liver cancer center can contribute; and, (4) examine the enhancements and impact that the first three tasks will have on the management of HCC. An IT System for Personalized Medicine (ITS-PM) for HCC will provide the means to identify and determine the relative value of the wide number of variables, including clinical assessment of the patient -- functional status, liver function, degree of cirrhosis, and comorbidities; tumor biology, at a molecular, genetic and anatomic level; tumor burden and individual patient response; medical and operative treatments and their outcomes.

Digital Health in Focus of Predictive, Preventive and Personalised Medicine

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Author :
Publisher : Springer Nature
ISBN 13 : 3030498158
Total Pages : 164 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Digital Health in Focus of Predictive, Preventive and Personalised Medicine by : Lotfi Chaari

Download or read book Digital Health in Focus of Predictive, Preventive and Personalised Medicine written by Lotfi Chaari and published by Springer Nature. This book was released on 2020-09-30 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: The edition will cover proceedings of the second International conference on digital health Technologies (ICDHT 2019). The conference will address the topic of P4 medicine from the information technology point of view, and will be focused on the following topics: - Artificial Intelligence for health • Knowledge extraction • Decision-aid systems • Data analysis and risk prediction • Machine learning, deep learning - Health data processing • Data preprocessing, cleaning, management and mining • Computer-aided detection • Big data analysis, prediction and prevention • Cognitive algorithms for healthcare handling dynamic context management • Augmented reality, Motion detection and activity recognition - Devices, infrastructure and communication • Wearable & connected devices • Communication infrastructures, architectures and standards Blockchain for e-Health • Computing/storage infrastructures for e-Health • IoT devices & architectures for Smart Healthcare - Health information systems • Telemedicine, Teleservices • Computing/storage infrastructures for e-Health • Clinical Data Visualisation Standards - Security and privacy for e-health • Health data Analytics for Security and Privacy • E-health Software and Hardware Security • Embedded Security for e-health - Applications in P4 medicine

Anticipation and Medicine

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Author :
Publisher : Springer
ISBN 13 : 3319451421
Total Pages : 363 pages
Book Rating : 4.3/5 (194 download)

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Book Synopsis Anticipation and Medicine by : Mihai Nadin

Download or read book Anticipation and Medicine written by Mihai Nadin and published by Springer. This book was released on 2016-10-22 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, practicing physicians and experts in anticipation present arguments for a new understanding of medicine. Their contributions make it clear that medicine is the decisive test for anticipation. The reader is presented with a provocative hypothesis: If medicine will align itself with the anticipatory condition of life, it can prompt the most important revolution in our time. To this end, all stakeholders—medical practitioners, patients, scientists, and technology developers—will have to engage in the conversation. The book makes the case for the transition from expensive, and only marginally effective, reactive treatment through “spare parts” (joint replacements, organ transplants) and reliance on pharmaceuticals (antibiotics, opiates) to anticipation-informed healthcare. Readers will understand why the current premise of treating various behavioral conditions (attention deficit disorder, hyperactivity, schizophrenia) through drugs has to be re-evaluated from the perspective of anticipation. In the manner practiced today, medicine generates dependence and long-lasting damage to those it is paid to help. As we better understand the nature of the living, the proactive view of healthcare, within which the science and art of healing fuse, becomes a social and political mandate.

Predictive, Preventive, and Personalised Medicine: From Bench to Bedside

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Author :
Publisher : Springer Nature
ISBN 13 : 3031348842
Total Pages : 352 pages
Book Rating : 4.0/5 (313 download)

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Book Synopsis Predictive, Preventive, and Personalised Medicine: From Bench to Bedside by : Halina Podbielska

Download or read book Predictive, Preventive, and Personalised Medicine: From Bench to Bedside written by Halina Podbielska and published by Springer Nature. This book was released on 2023-12-01 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume presents advanced bio/medical sciences with a particular value for translating research achievements into daily medical practice in the framework of Predictive, Preventive and Personalised Medicine (3PM/PPPM). First two decades of the 21st century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The paradigm change from reactive to predictive preventive and personalised medicine is essential to promote population health by application of individualised patient profiling, multi-parametric analysis leading to cost-effective targeted prevention. To this end, inadequate data for risk assessment on speed and urgency of COVID-19, combined with increased globalization of human society, led to the rapid spread of COVID-19. Despite an abundance of digital methods that could be used in slowing or stopping this virus and future pandemics, the world remains unprepared, and lessons have not been learned from previous cases of pandemics. The book presents PPPM strategies which might be of great clinical utility for future pandemics. In a long-term way, a significantly improved healthcare economy is one of the clear benefits of the proposed paradigm shift; a tight collaboration between all stakeholders including scientific community, healthcare providers, patient organisations, policy-makers and educators is analysed for the smooth implementation of the 3PM concepts. Further issues linked to big data management and medical ethics have to be carefully treated in the context of application of artificial intelligence in medicine.

Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine

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Author :
Publisher : Springer
ISBN 13 : 3030118002
Total Pages : 88 pages
Book Rating : 4.0/5 (31 download)

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Book Synopsis Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine by : Lotfi Chaari

Download or read book Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine written by Lotfi Chaari and published by Springer. This book was released on 2019-07-10 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collection, entitled Digital Health for Predictive, Preventive, Personalized and Participatory Medicine contains the proceedings of the first International conference on digital healthtechnologies (ICDHT 2018). Ten recent contributions in the fields of Artificial Intelligence (AI) and machine learning, Internet of Things (IoT) and data analysis, all applied to digital health. This collection enables researchers to learn about recent advances in the above mentioned fields. It brings a technological viewpoint of P4 medicine. Readers will discover how advanced Information Technology (IT) tools can be used for healthcare. For instance, the use of connected objects to monitor physiological parameters is discussed. Moreover, even if compressed sensing is nowadays a common acquisition technique, its use for IoT is presented in this collection through one of the pioneer works in the field. In addition, the use of AI for epileptic seizure detection is also discussed as being one of the major concerns of predictive medicine both in industrialized and low-income countries. This work is edited by Prof. Lotfi Chaari, professor at the University of Sfax, and previously at the University of Toulouse. This work comes after more than ten years of expertise in the biomedical signal and image processing field.

Preventive and Predictive Genetics: Towards Personalised Medicine

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Author :
Publisher : Springer
ISBN 13 : 3319153447
Total Pages : 378 pages
Book Rating : 4.3/5 (191 download)

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Book Synopsis Preventive and Predictive Genetics: Towards Personalised Medicine by : Godfrey Grech

Download or read book Preventive and Predictive Genetics: Towards Personalised Medicine written by Godfrey Grech and published by Springer. This book was released on 2015-06-24 with total page 378 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pharmacogenomics supports personalized medicine by translating genome-based knowledge into clinical practice, offering enhanced benefit for patients and health-care systems at large. Current routine practice for diagnosing and treating patients is conducted by correlating parameters such as age, gender and weight with risks and expected treatment outcomes. In the new era of personalized medicine the healthcare provider is equipped with improved ability to prevent, diagnose, treat and predict outcomes on the basis of complex information sources, including genetic and genomic data. Targeted therapy and reliable prediction of expected outcomes offer patients access to better healthcare management, by way of identifying the therapies effective for the relevant patient group, avoiding prescription of unnecessary treatment and reducing the likelihood of developing adverse drug reactions.

Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine

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Author :
Publisher :
ISBN 13 : 9783030118013
Total Pages : 99 pages
Book Rating : 4.1/5 (18 download)

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Book Synopsis Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine by :

Download or read book Digital Health Approach for Predictive, Preventive, Personalised and Participatory Medicine written by and published by . This book was released on 2019 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collection, entitled #x1B;(S0#x1B;(B Digital Health for Predictive, Preventive, Personalized and Participatory Medicine#x1B;(S1#x1B;(B contains the proceedings of the first International conference on digital health technologies (ICDHT 2018). Ten recent contributions in the fields of Artificial Intelligence (AI) and machine learning, Internet of Things (IoT) and data analysis, all applied to digital health. This collection enables researchers to learn about recent advances in the above mentioned fields. It brings a technological viewpoint of P4 medicine. Readers will discover how advanced Information Technology (IT) tools can be used for healthcare. For instance, the use of connected objects to monitor physiological parameters is discussed. Moreover, even if compressed sensing is nowadays a common acquisition technique, its use for IoT is presented in this collection through one of the pioneer works in the field. In addition, the use of AI for epileptic seizure detection is also discussed as being one of the major concerns of predictive medicine both in industrialized and low-income countries. This work is edited by Prof. Lotfi Chaari, professor at the University of Sfax, and previously at the University of Toulouse. This work comes after more than ten years of expertise in the biomedical signal and image processing field.

Predictive, Preventive, and Personalised Medicine: From Bench to Bedside

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Author :
Publisher : Springer
ISBN 13 : 9783031348839
Total Pages : 0 pages
Book Rating : 4.3/5 (488 download)

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Book Synopsis Predictive, Preventive, and Personalised Medicine: From Bench to Bedside by : Halina Podbielska

Download or read book Predictive, Preventive, and Personalised Medicine: From Bench to Bedside written by Halina Podbielska and published by Springer. This book was released on 2023-11-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume presents advanced bio/medical sciences with a particular value for translating research achievements into daily medical practice in the framework of Predictive, Preventive and Personalised Medicine (3PM/PPPM). First two decades of the 21st century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The paradigm change from reactive to predictive preventive and personalised medicine is essential to promote population health by application of individualised patient profiling, multi-parametric analysis leading to cost-effective targeted prevention. To this end, inadequate data for risk assessment on speed and urgency of COVID-19, combined with increased globalization of human society, led to the rapid spread of COVID-19. Despite an abundance of digital methods that could be used in slowing or stopping this virus and future pandemics, the world remains unprepared, and lessons have not been learned from previous cases of pandemics. The book presents PPPM strategies which might be of great clinical utility for future pandemics. In a long-term way, a significantly improved healthcare economy is one of the clear benefits of the proposed paradigm shift; a tight collaboration between all stakeholders including scientific community, healthcare providers, patient organisations, policy-makers and educators is analysed for the smooth implementation of the 3PM concepts. Further issues linked to big data management and medical ethics have to be carefully treated in the context of application of artificial intelligence in medicine.

Personalised Health Care

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Author :
Publisher : Springer Nature
ISBN 13 : 3030523993
Total Pages : 135 pages
Book Rating : 4.0/5 (35 download)

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Book Synopsis Personalised Health Care by : Stefania Boccia

Download or read book Personalised Health Care written by Stefania Boccia and published by Springer Nature. This book was released on 2020-11-23 with total page 135 pages. Available in PDF, EPUB and Kindle. Book excerpt: Practitioners are increasingly adopting a personalised medicine approach to individually tailored patient care, especially disease diagnosis and treatment with the use of biomarkers. However, development and implementation of such approaches to chronic disease prevention need further investigation and concerted efforts for proper use in healthcare systems. This book provides high-quality, multidisciplinary knowledge from research in personalised medicine, specifically personalised prevention of chronic disease. It addresses different perspectives of prevention in the field, and is the outcome of a four-year work of the Personalized prevention of Chronic Disease (PRECeDI) Consortium, a multi-disciplinary and multi-professional team of experts. The Consortium jointly agreed to document and address the five aspects or domains of personalised medicine and prevention as individual chapters: Identification of biomarkers for the prevention of chronic disease Evaluation of predictive genomic applications Ethico-legal and policy issues surrounding personalised medicine Roles and responsibilities of stakeholders in informing healthy individuals on their genome: a sociotechnical analysis Identification of organisational models for the provision of predictive genomic applications The book focuses on the Consortium's recommendations that are derived from each of these domains based on up-to-date evidence and research that the authors write, follow, and systematically organise and report. Personalisation of health care is, eventually, a driver of innovation in research and healthcare systems. With this SpringerBrief on Personalised Health Care: Fostering Precision Medicine Advancements for Gaining Population Health Impact, the Consortium provides further evidence of the clinical validity and utility of personalised medicine with special emphasis on the prevention of chronic diseases. The book is a useful resource for policy makers, industry and healthcare professionals, scientists, technology-sector professionals, investors, citizens, and private companies that need proper advice to realise the potential of personalised medicine.

PHealth 2018

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Author :
Publisher : IOS Press
ISBN 13 : 161499868X
Total Pages : 234 pages
Book Rating : 4.6/5 (149 download)

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Book Synopsis PHealth 2018 by : B. Blobel

Download or read book PHealth 2018 written by B. Blobel and published by IOS Press. This book was released on 2018-06-05 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: Smart mobile systems, such as microsystems, smart textiles, smart implants, and sensor-controlled medical devices, together with innovative sensor and actuator techniques and related networks, have become important enablers for telemedicine and a new generation of health services. Social media and gamification have added even more knowledge to pHealth as an ecosystem. This book presents the proceedings of pHealth 2018. Held in Gjøvik, Norway, in June 2018, this is the 15th in a series of scientific conferences which have brought together expertise from medical, technological, political, administrative, and social domains, and even from philosophy or linguistics. Initiated in 2003 as part of a European project, the scope of these conferences now encompasses technological and biomedical facilities, legal, ethical, social, and organizational requirements and impacts, as well as necessary basic research for enabling future-proof care paradigms. The conferences thereby combine medical services with public health, preventive medicine, social and elderly care, wellness and personal fitness to establish participatory, predictive, personalized, preventive, and effective care settings. The book includes 1 of the 2 keynotes presented at the conference, 4 invited talks, 16 oral presentations, and 7 short poster presentations. All submissions were carefully and critically reviewed by at least two independent experts, and this selective review process resulted in a full papers rejection rate of 50%.

P5 eHealth: An Agenda for the Health Technologies of the Future

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Author :
Publisher : Springer Nature
ISBN 13 : 3030279944
Total Pages : 191 pages
Book Rating : 4.0/5 (32 download)

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Book Synopsis P5 eHealth: An Agenda for the Health Technologies of the Future by : Gabriella Pravettoni

Download or read book P5 eHealth: An Agenda for the Health Technologies of the Future written by Gabriella Pravettoni and published by Springer Nature. This book was released on 2019-11-29 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access volume focuses on the development of a P5 eHealth, or better, a methodological resource for developing the health technologies of the future, based on patients’ personal characteristics and needs as the fundamental guidelines for design. It provides practical guidelines and evidence based examples on how to design, implement, use and elevate new technologies for healthcare to support the management of incurable, chronic conditions. The volume further discusses the criticalities of eHealth, why it is difficult to employ eHealth from an organizational point of view or why patients do not always accept the technology, and how eHealth interventions can be improved in the future. By dealing with the state-of-the-art in eHealth technologies, this volume is of great interest to researchers in the field of physical and mental healthcare, psychologists, stakeholders and policymakers as well as technology developers working in the healthcare sector.

Healthcare Overview

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Publisher : Springer Science & Business Media
ISBN 13 : 9400746024
Total Pages : 522 pages
Book Rating : 4.4/5 (7 download)

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Book Synopsis Healthcare Overview by : Vincenzo Costigliola

Download or read book Healthcare Overview written by Vincenzo Costigliola and published by Springer Science & Business Media. This book was released on 2012-11-06 with total page 522 pages. Available in PDF, EPUB and Kindle. Book excerpt: In healthcare, the realisation of an optimistic prognosis against pessimistic ones depends on current innovations in diagnostic and cost-effective treatment approaches being widely adopted in clinical practice. Utilisation of advanced early and predictive diagnostics, targeted prevention and personalised medical approaches could enable the elderly subpopulation to reach the 100-year age limit in good physical and mental health, as actively contributing members of society. This task requires intelligent political regulations and creation of new guidelines to advance current healthcare systems. In this book, we will collect contributions from several geopolitical regions of Europe, Asia and USA that provide expert opinion on healthcare organisation and outlook as well as economical aspects of personalised medicine.

Emerging Health Technology

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Publisher : Springer Science & Business Media
ISBN 13 : 364232570X
Total Pages : 137 pages
Book Rating : 4.6/5 (423 download)

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Book Synopsis Emerging Health Technology by : Kristian Wasen

Download or read book Emerging Health Technology written by Kristian Wasen and published by Springer Science & Business Media. This book was released on 2012-11-02 with total page 137 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book reports cutting-edge cases of emerging health technologies. Some health care fields are experiencing paradigmatic shifts because of robotic technologies and the new relationships that they create in r-Health (r-Curing and r-Caring) activities. The book explores emerging health care technologies such as image-guided surgical robotics, pharmacy robots, new visualisation methods (3D, 4D & ′′5D′′) and home telehealth management systems and their acceptance in the workplace but also, more generally, their special role in business and society. These technologies allow health care professionals to effectively reach far beyond the current service offerings, providing new methods for communication, diagnosis, and treatment. The relocation of certain knowledge areas from physicians to patients in self-care management or the reconfiguration of health care expertise from one health profession to another are examples of topics developed in this book. The book describes the emerging relocation of innovative visual knowledge and expertise within health care organisations and beyond, such as in the patient’s home environment.

Healthtech Innovation

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Publisher : CRC Press
ISBN 13 : 1000737225
Total Pages : 337 pages
Book Rating : 4.0/5 (7 download)

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Book Synopsis Healthtech Innovation by : Silvia Micalo

Download or read book Healthtech Innovation written by Silvia Micalo and published by CRC Press. This book was released on 2022-10-03 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: Today, over 500,000 medical technologies are available in hospitals, homes, and community care settings. They range from simple bandages to complex, multi-part body scanners that cost millions of dollars to develop. Yet a typical technology has a lifecycle of just 21 months before an improved product usurps it—the healthcare ecosystem is rapidly advancing and driven by a constant flow of innovation. And those innovations need innovators. With $21 billion made available for investment in the digital healthcare industry in 2020 (a 20x increase on 2010), entrepreneurs, investors, and related actors are entering the healthcare ecosystem in greater numbers than ever before. Last year alone, over 17,000 medical technology patents were filed, the third highest of all patent types. Each of those has a dedicated team of entrepreneurs behind it. Yet with increasingly strict regulations and pharmaceutical giants growing more aggressive, many thousands of entrepreneurs fail before even the patent stage: just 2% secure revenue or adoption. Healthtech Innovation: How Entrepreneurs Can Define and Build the Value of Their New Products is a down-to-earth survival guide for entrepreneurs struggling to secure a strategic position within the healthtech ecosystem. Which is expected that by 2026, the global digital health market size will be around $657 billion. This book is designed to help innovators navigate this complex and newly volatile landscape. It covers business strategy, marketing, funding acquisition, and operation in a global regulatory context. It is written in simple language, evidenced by the latest academic and industry research, and explained using real-world examples and case studies.

Personalized Digital Health and Patient-centric Services

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Author :
Publisher : Frontiers Media SA
ISBN 13 : 2889748278
Total Pages : 233 pages
Book Rating : 4.8/5 (897 download)

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Book Synopsis Personalized Digital Health and Patient-centric Services by : Maria Hägglund

Download or read book Personalized Digital Health and Patient-centric Services written by Maria Hägglund and published by Frontiers Media SA. This book was released on 2022-03-28 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Managing Healthcare Transformation Towards P5 Medicine

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Author :
Publisher : Frontiers Media SA
ISBN 13 : 2832534848
Total Pages : 141 pages
Book Rating : 4.8/5 (325 download)

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Book Synopsis Managing Healthcare Transformation Towards P5 Medicine by : Bernd G.M.E Blobel

Download or read book Managing Healthcare Transformation Towards P5 Medicine written by Bernd G.M.E Blobel and published by Frontiers Media SA. This book was released on 2023-09-29 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health and social care systems around the world are facing radical organizational, methodological and technological paradigm changes to meet the requirements for improving quality and safety of care as well as efficiency and efficacy of care processes. In this they’re trying to manage the challenges of ongoing demographic changes towards aging, multi-diseased societies, development of human resources, a health and social services consumerism, medical and biomedical progress, and exploding costs for health-related R&D as well as health services delivery. Furthermore, they intend to achieve sustainability of global health systems by transforming them towards intelligent, adaptive and proactive systems focusing on health and wellness with optimized quality and safety outcomes.

Digital Identity in the New Era of Personalized Medicine

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Author :
Publisher : IGI Global
ISBN 13 : 179988967X
Total Pages : 290 pages
Book Rating : 4.7/5 (998 download)

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Book Synopsis Digital Identity in the New Era of Personalized Medicine by : Vasiliu-Feltes, Ingrid

Download or read book Digital Identity in the New Era of Personalized Medicine written by Vasiliu-Feltes, Ingrid and published by IGI Global. This book was released on 2022-11-18 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: Within the past decade, we have witnessed an increased adoption of emerging technologies as well as the exponential pace of scientific discoveries within all industries. The level of digital innovation and digital transformation experienced in healthcare and life sciences has been markedly accelerated by the COVID-19 pandemic. There is a new sense of urgency to design and develop a new global health ecosystem that is more suitable for the digital era and future generations. Deploying precision medicine solutions that can redefine the way we diagnose and treat disease, as well as shift the focus towards a customized human-centered approach, such as those offered by personalized medicine, can be a viable sustainable model. Digital Identity in the New Era of Personalized Medicine highlights the latest trends in precision medicine and the important role digital identity plays in upholding ethical values, safeguarding human rights, and practicing responsible personalized medicine. It provides an overview of the current healthcare legal and regulatory landscapes as well as some of the major challenges and opportunities we face in this digital, virtual, and precision medicine-powered era. Covering topics such as data-centric compliance, global health, and identity management, this book is an essential resource for doctors, healthcare administration, academicians, clinicians, health and bio-tech executives, researchers, medical professionals, medical engineers, medical students, and government officials looking for a resource that addresses challenges in healthcare including trust, privacy, data integrity, and ownership.