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Continuing Education, Inc.
University at Sea
5700 4th St. N.
St Petersburg, Florida 33703
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Thanks to you, we are able to provide material to support these and other charities doing on-the-ground, humanitarian work.
Stress Free - Our Cruise Conferences provide a unique, relaxing learning environment.
Family Friendly - Our cruises are fun for the entire family. You will never run out of things to do!

2018 Update: Nursing Assessment in Clinical Medicine - Cases and Conclusions for Your Practice

6-Night Eastern Caribbean Cruise
Round-trip Ft. Lauderdale, Florida
November 04 - 10, 2018

This conference has already sailed, but that doesn't mean you have to miss the boat! Click here to see our complete schedule of upcoming programs.

<em>Carnival Conquest</em>
Carnival Conquest

COURSE CREDITS & HOURS

COURSE FEES

TARGET AUDIENCE

Nurses, Nurse Practitioners, Nurses, Nurse Practitioners,

PROGRAM PURPOSE

Topics: (all topics will include didactic lecture and case presentations)
  1. Diabetes update
  2. Hypertension update
  3. Hyperlipidemia
  4. Opiates and pain
  5. Older adult "clinical pearls" update, including immunizations
  6. Psychiatric update

IMPORTANT INFORMATION

PLEASE NOTE: To attend the conference or participate in conference events, participants, their families, and guests must book their cruise within the CEI meeting group through Continuing Education, Inc. This ensures our company can provide conference services and complimentary social amenities to all meeting participants and their guests. Thank you for your cooperation.

Register your interest and receive a full quote at 800-422-0711 (US/Can) or direct/int'l tel: +1-727-526-1571 or register online.

Conference Sessions generally take place on days at sea (as itinerary allows), giving you plenty of time to enjoy your meals, evenings and ports of call with your companion, family and friends.
BIAS FREE CME - No Commercial Support was provided for this CME activity.

Faculty

Melissa Ann Payne, BSN, MS, FNP-BC

Melissa Ann Payne, BSN, MS, FNP-BC

Niagara University School of Nursing
Department of Nursing
D'Youville College School of Nursing
Department of Nursing
University at Buffalo School of Nursing

Ms. Payne received her Master's in Nursing, Master of Family Nurse Practitioner degree from D'Youville College. 

Ms. Payne has served as a Clinical Associate professor at D'Youville College, teaching a clinical skills lab to nursing students earning their BSN.
Ms. Payne has served as a Clinical Associate Professor at University at Buffalo, school of Nursing teaching a clinical rotation in Labor and Delivery at Sisters Hospital, Buffalo New York. 

Ms. Payne practiced as a Registered Nurse for 16 years in clinical areas at Children's Hospital, Buffalo New York working in Neonatal Intensive care unit for 4years. Then choosing to work at People Inc., Buffalo New York serving the physically and developmentally disabled as a RN Field Supervisor for the next 5 years. 

Ms. Payne practiced as a Registered Nurse from 1999-2008 at Mt. St. Mary's Hospital, Lewiston New York as a staff nurse in Labor and Delivery and Newborn Nursery where she was a clinical preceptor to new RN's and a charge Nurse in the Newborn Nursery. 

Ms. Payne after graduating from D'Youville with her Masters in Family Nurse Practitioner has worked in Underserved Clinical settings, Lifetime Health Medical Group working in Primary Care and Urgent Care and has helped implement a Health and Wellness Office in Elma, New York Moog location.

Ms. Payne holds certifications from American Nurses Credentialing Center, First and Second Degree Reiki, American Heart Association holding a Basic Life Support Provider (BLS) and American Cardiovascular Advanced Life Saving (ACLS) provider and Pediatric Advanced Life Saving provider (PALS).

Ms. Payne is active and holds membership at Nurse Practitioner Association- Western New York Chapter, Sigma, Theta Tau International, and American Academy of Nurse Practitioners.

Ms Payne collaborates with many advanced health care providers within the community in order to provide the best care possible to patients.

Tammie Lee Demler, PharmD, BS Pharm, MBA, RPh, BCGP, BCPP

Tammie Lee Demler, PharmD, BS Pharm, MBA, RPh, BCGP, BCPP

Recipient of the "2019 Teacher of the Year Award" State University of New York at Buffalo - School of Pharmacy and Pharmaceutical Sciences

Winner of the "2019 Niagara Education Award of the YWCA of the Niagara Frontier".


Clinical Associate Professor
The State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences
Clinical Assistant Professor
University at Buffalo School of Medicine, Department of Psychiatry
D'Youville College School of Pharmacy
University of Florida College of Pharmacy
Clinical Pharmacist and Pharmacy Practice Residency Program Director
New York State Office of Mental Health
Buffalo, New York

 Tammie Lee Demler received her Doctor of Pharmacy, Master of Business Administration, and Bachelor of Science degrees at the State University of New York (SUNY) at Buffalo. 

Dr  Demler is a dually Board-Certified Specialist in both Psychiatric and Geriatric Pharmacy and is currently the Director of Pharmacy Services and Pharmacy residency training at the New York State Office of Mental Health (OMH) at the Buffalo Psychiatric Center. 

She holds numerous academic appointments, including Clinical Associate Professor for SUNY Buffalo School of Pharmacy and Pharmaceutical Sciences, Clinical Assistant Professor at SUNY School of Medicine Department of Psychiatry, D'Youville College School of Pharmacy, University of Florida School of Pharmacy, and Clinical Instructor for the Erie County Community College Pharmacy Technician Certification Program.

She  collaborates with both the National Association of the Boards of Pharmacy (NABP) and the Board of Pharmaceutical Specialties (BPS) to develop board examinations that establish the minimum competencies expected for new practitioners for practice in an ever changing clinical environment. Prior to embarking on her academic and institutional career, Dr. Demler's clinical practice focused on ambulatory care in community pharmacy.

Dr. Demler has authored and co-authored numerous original research articles and expert reviews for print media. She is a regular contributor to U.S. Pharmacist and reviewer for Pharmacist's Letter

Prior to launching Pharmacotherapeutics for Advanced Nursing Practice, Dr. Demler authored a chapter on insomnia in the American College of Clinical Pharmacy's (ACCP's) Ambulatory Care Self-Assessment. She also has provided expert pharmacotherapeutic consultation for other books such as the Side Effects of Drugs: Annual Volume 36 and Clinical Consult to Psychiatric Nursing for Advanced Practice . She has presented medication continuing education programs internationally and nationally, and is an Academic Educator for the New York State Medicaid Prescriber Education program sponsored by the New York Department of Health. 

Dr. Demler served as President of both the Pharmacists Society of the State of New York and the Pharmacists Association of Western New York. Dr. Demler is also a local media personality, hosting her own weekly TV talk show as well as a weekly community affairs radio segment. She has won a number of prestigious national, state, and local awards acknowledging both her professional and community-based contributions.

Accreditation

ANCC

Credit Designation for Nurses: Continuiung Education, Inc. designates this continuing nursing education activity for 12 contact hours.

Accredited status does not imply endorsement by Continuing Education, Inc./University at Sea® or ANCC of any commercial products displayed or used with an activity.

 

Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 Credits™ as needed.
Pharmacology credits are identified on individual activities.

Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 CreditsTM as needed.
Pharmacology credits are identified on individual activities.

ANCC

Credit Designation for Nurses: Continuiung Education, Inc. designates this continuing nursing education activity for 14 contact hours.

Accredited status does not imply endorsement by Continuing Education, Inc./University at Sea® or ANCC of any commercial products displayed or used with an activity.

 

Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 Credits™ as needed.
Pharmacology credits are identified on individual activities.

ITINERARY

DATE PORT OF CALL ARRIVE DEPART
Sun Nov 04 Ft. Lauderdale, Florida
- 4:00 pm
Mon Nov 05 Nassau, Bahamas
9:00 am 5:00 pm
Tue Nov 06 Half Moon Cay, Bahamas
8:00 am 4:00 pm
Wed Nov 07 Grand Turk, Turks And Caicos
11:00 am 7:00 pm
Thu Nov 08 Amber Cove, Dominican Republic
8:00 am 4:00 pm
Fri Nov 09 *At Sea - Cruising
- -
Sat Nov 10 Ft. Lauderdale, Florida
8:00 am -
*Tentative course schedule, actual class times may differ.
Carnival Cruise Lines Carnival Conquest Map

PORTS OF CALL

Ft. Lauderdale, Florida - There is an abundance of things to see and do in the Ft. Lauderdale area: visit the newly redesigned Ft. Lauderdale Beach and cafes, stroll the historic Riverwalk, shop the luxurious stores on Las Olas Boulevard or adventure to the Everglades for an intriguing air boat excursion.

Nassau, Bahamas - Caribbean charm shines in the Bahamian capital, where you’re never more than a few steps away from rhythmic percussions, appetizing flavors, white-sand beaches, and some of the clearest waters in the world. This picture-perfect paradise was once a pirate’s haven— and you can explore its colorful past of buccaneers, blockade-runners and bootleggers along historical streets and at the three colonial fortresses that line the shores. If you’re looking for a more hands-on maritime adventure, look no further. Cruise to Swim with stingrays, dive with dolphins, or spot colorful coral on a glass-bottom boat.

Half Moon Cay, Bahamas - All Bahama Islands are full of tropical wonders and sun-kissed beaches. But Half Moon Cay, Holland America Line’s private island in the Bahamas is an absolute stunner. When you feel the sugar-white sand on your toes or see its brilliant blue lagoon, you’ll understand why cruise travelers love Half Moon Cay. True bucket-list excursions, secluded cabanas, and stunning beaches make it ideal for any type of vacation.

Grand Turk, Turks And Caicos - Grand Turk is a picturesque island with a relaxed pace and a warm, friendly atmosphere. There are no fast food chains and no sprawling resorts.In addition to the amazing year around diving, with Oasis Divers you have seasonal attractions such as the North Atlantic humpback whales during the winter and manta rays in the summer, you're sure to be amazed.

Amber Cove, Dominican Republic - Amber Cove, the Caribbean's newest cruise port is located on the Bay of Maimon near Puerto Plata on the Dominican Republic's North Coast. Amber Cove is designed in three architectural styles - Victorian, Colonial, and Fortaleza. The complex boasts a fort-like structure at its entrance, cobblestoned plazas, retail and food and beverage buildings, and surrounding ocean and mountain views. For your shopping pleasure, expect a combination of big-name retailers like Diamonds International, Effy, and Harley Davidson; local specialties such as rum, coffee, chocolate, amber, and Larimar; as well as a marketplace for local artisans and producers.

At Sea - Cruising - Cruising

Carnival Conquest

PLEASE NOTE: To attend the conference or participate in conference events, participants, their families, and guests must book their cruise within the CEI meeting group through Continuing Education, Inc. This ensures our company can provide conference services and complimentary social amenities to all meeting participants and their guests. Thank you for your cooperation.

Register your interest and receive a full quote at 800-422-0711 (US/Can) or direct/int'l tel: +1-727-526-1571 or by registering online.
STATEROOM DETAILS
PRICING PER PERSON

Prices below are for the full cruise including meals and evening entertainment

Suite/Deluxe

Grand Suite, GS Grand Suite (GS)
Two twin beds (convert to king) and double sofa bed. Sofa, armchairs and coffee table. Desk and seat. Full bathroom with shower/whirlpool tub/bidet/ double sinks. Walk-in dressing area with vanity table (and small sink), seat and ample closet space. Private large balcony with patio chairs and table. Stateroom: 345 sq. ft. Balcony: 85 sq. ft. 
Call: 800-422-0711
and we'll find the best value for you.
Ocean Suite, OS Ocean Suite (OS)
Two twin beds (convert to king). Sofa, armchair and coffee table. Desk and seat. Full bathroom with shower/whirlpool tub/double sinks. Walk-in dressing area with vanity table, seat and ample closet space. Private large balcony with patio chairs and table. Ocean Suite sizes vary based on location. Stateroom: 275-450 sq. ft. Balcony: 65-110 sq. ft. 
Call: 800-422-0711
and we'll find the best value for you.
Captain's Suite, CS Suite/Deluxe Captain's Suite (CS)
Separate Bedroom: Two twin beds (convert to king). Full bathroom with shower/whirlpool tub. Walk-in closet. Living Room: Double sofa bed and one lower pullman. Sofa, armchairs and coffee table. Desk and seat. Full bathroom with shower. Large balcony with patio chairs and table. Stateroom: 548 sq. ft. Balcony: 258 sq. ft.
Call
800-422-0711
for Pricing
Junior Suite, JS Suite/Deluxe Junior Suite (JS)
Two twin beds (convert to king). Sofa, armchair and coffee table. Desk and seat. Full bathroom with shower/whirlpool tub/double sinks. Walk-in dressing area with vanity table, seat and ample closet space. Private balcony with patio chairs and table. Stateroom: 275 sq. ft. Balcony: 50 sq. ft.
Call
800-422-0711
for Pricing

Balcony

Balcony Stateroom, 8B Balcony Stateroom (8B)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 35 sq. ft. 
Call: 800-422-0711
and we'll find the best value for you.
Balcony Stateroom, 8A Balcony Balcony Stateroom (8A)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 35 sq. ft.
Call
800-422-0711
for Pricing
Balcony Stateroom, 8C Balcony Balcony Stateroom (8C)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 35 sq. ft.
Call
800-422-0711
for Pricing
Balcony Stateroom, 8D Balcony Balcony Stateroom (8D)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table.
Stateroom: 185 sq. ft. Balcony: 35 sq. ft.
Call
800-422-0711
for Pricing
Balcony Stateroom, 8E Balcony Balcony Stateroom (8E)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 35 sq. ft.
Call
800-422-0711
for Pricing
Balcony Stateroom, 8F Balcony Balcony Stateroom (8F)
Two twin beds (convert to king). Sofa and coffee table. Full bathroom with shower. 3 closets. Private balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 35 sq. ft.
Call
800-422-0711
for Pricing
Aft-View Extended Balcony, 8M Balcony Aft-View Extended Balcony (8M)
Two twin beds (convert to king) and single sofa bed. Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Private aft-facing extended balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 60 sq. ft.
Call
800-422-0711
for Pricing
Aft-View Extended Balcony, 8N Balcony Aft-View Extended Balcony (8N)
Two twin beds (convert to king) and single sofa bed. Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Private aft-facing extended balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 60 sq. ft.
Call
800-422-0711
for Pricing
Premium Balcony, 9B Balcony Premium Balcony (9B)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 2 closets. Private large balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 75 sq. ft.
Call
800-422-0711
for Pricing
Premium Vista Balcony, 9C Balcony Premium Vista Balcony (9C)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Private wrap-around balcony with patio chairs and table. Stateroom: 185 sq. ft. Balcony: 75 sq. ft.
Call
800-422-0711
for Pricing

Outside

Oceanview Stateroom, 6B Oceanview Stateroom (6B)
Two twin beds (convert to king). Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Picture window. Stateroom: 220 sq. ft. 
Call: 800-422-0711
and we'll find the best value for you.
Porthole Upper/Lower Stateroom, 1A PT Outside Porthole Upper/Lower Stateroom (1A PT)
Twin bed and one upper pullman or twin bed and single sofa bed. Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Two porthole window. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Oceanview Stateroom, 6A Outside Oceanview Stateroom (6A)
Two twin beds (convert to king). Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Picture window. Stateroom: 220 sq. ft.
Call
800-422-0711
for Pricing
Oceanview Stateroom, 6C Outside Oceanview Stateroom (6C)
Two twin beds (convert to king). Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Picture window. Stateroom: 220 sq. ft.
Call
800-422-0711
for Pricing
Scenic Oceanview, 6J Outside Scenic Oceanview (6J)
Two twin beds (convert to king) and double sofa bed. Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Floor-to-ceiling windows. Stateroom: 230 sq. ft.
Call
800-422-0711
for Pricing
Scenic Grand Oceanview, 6K Outside Scenic Grand Oceanview (6K)
Two twin beds (convert to king). Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Floor-to-ceiling windows. Stateroom: 320 sq. ft.
Call
800-422-0711
for Pricing
Porthole Stateroom, PT Outside Porthole Stateroom (PT)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Two porthole windows. Stateroom: 220 sq. ft.
Call
800-422-0711
for Pricing

Inside

Interior Stateroom, 4B Interior Stateroom (4B)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft. 
Call: 800-422-0711
and we'll find the best value for you.
Interior Upper/Lower Stateroom, 1A Inside Interior Upper/Lower Stateroom (1A)
Twin bed and one upper pullman or twin bed and single sofa bed. Sofa and coffee table. Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4A Inside Interior Stateroom (4A)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4C Inside Interior Stateroom (4C)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4D Inside Interior Stateroom (4D)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4E Inside Interior Stateroom (4E)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4F Inside Interior Stateroom (4F)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4G Inside Interior Stateroom (4G)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior Stateroom, 4H Inside Interior Stateroom (4H)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing
Interior with Picture Window (obstructed views), 4J Inside Interior with Picture Window (obstructed views) (4J)
Two twin beds (convert to king). Desk and seat. Full bathroom with shower. 3 closets. Picture window facing public observation deck. Stateroom: 185 sq. ft.
Call
800-422-0711
for Pricing

Port Charges, Taxes & Fees $284.25 per person.
Deposit $250.00 per person

Cruise pricing is presented per person, based double occupancy of the stateroom, per standard industry practice. Pricing presented above is listed accordingly to allow easy comparison for the stateroom categories displayed. Our agents always provide 'total cost' pricing disclosing all particulars before you make any commitment.

3rd/4th in Stateroom - Please call to secure the best possible pricing

COMPETITIVE PRICING PROMISE: We will match any price currently offered by the cruise line; this promise includes their short-term, promotional rates. As a value-added organizer of meetings at sea, however, we do not seek to compete with 'cruise discounters,' 'travel clubs,' or 'distressed inventory' sales operations.
PRICING SUBJECT TO CHANGE: Market Rates offered directly by the cruise line and quoted by our agents are also subject to change at any time prior to depositing on your stateroom. Those rates are capacity and revenue controlled and can be withdrawn without notice.
CANCELLATION PENALTY POLICY WILL APPLY: We recommend Travel Insurance to protect your investment from unexpected, late cancellations.
Cruise Cancellation Policy:Late Cancellation policies vary by cruise line, itinerary and length of cruise. When reserving your stateroom, please congirm the policy applicable to this cruise with one of our agents.
Course Fee Cancellation Policy: 30+ days before sailing date - 75% Refund ; 7-29 days before sailing date - 50% Refund; Less than 7 days before sailing date - No Refund
FUEL SUPPLEMENT: During periods of unusual oil price volatility, cruiselines may implement a fuel surcharge at any time prior to sailing.

Chubb Travel Protection Overview

Please note, this insurance protection is available to the residents of the United States only,
that coverage limits are per person and that limits can vary by State.

Standard Plan Benefits Travel Basics Travel Essentials Travel Choice
Trip Cancellation 100% of Trip Costs
($100,000 maximum)
100% of Trip Costs
($100,000 maximum)
100% of Trip Costs
($100,000 maximum)
Trip Interruption 100% of Trip Costs
($100,000 maximum)
150% of Trip Costs
($150,000 maximum)
150% of Trip Costs
($150,000 maximum)
Trip Interruption - Return Air Only $500 $750 $1,000
Trip Delay $500 ($100 per day) $750 ($150 per day) $1,000 ($200 per day)
Missed Connection NA $250 $500
Baggage & Personal Effects $750 ($50 deductible) $1,000 $2,500
Baggage Delay $200 $300 $500
Accident & Sickness Medical Expense* $15,000 ($50 deductible) $25,000 $50,000
Emergency Evacuation & Repatriation of Remains $150,000 $500,000 $1,000,000
Accidental Death & Dismemberment NA $10,000 $50,000
Assistance Services Included Included Included
Additional Benefits (if purchased within 15 days of Initial Trip Payment; Day 1 is the date the Intial Trip Payment is made)
Pre-Existing Medical Condition Exclusion Waiver Included Included Included
Trip Cancellation/ Interruption due to Financial Default Included Included Included
Accident Sickness Medical Expense Excess Coverage Primary Coverage Primary Coverage
Baggage & Personal Effects Excess Coverage Excess Coverage Primary Coverage
Flight Accident $25,000 $50,000 NA
Missed Connection NA Additional $250 Included in base plan
Optional Benefits (if selected byt the Applicant and required premium is paid)
Medical Coverage Upgrade Included in base plan Included in base plan Additional $50,000
including Emergency Evacuation* Additional $150,000 Additional $500,000 Included in base plan
Car Rental Collision Coverage $35,000 ($250 Deductible) $35,000 ($250 Deductible) $35,000 ($250 Deductible)
Flight Accident Amount selected up to $500,000 Amount selected up to $500,000 NA
*Coverage, pricing and availability may vary by state
*Additional Benefits change not available for CA, CO, KS, MN, MO, MT, NH, NY, PA, TX or WA residents at this time.


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Questions?
Call us at 800.422.0711 (US & Canada)
Or +1-727-526-1571
We can assist you with all your travel arrangements. We'd be happy to help you plan your flights, hotels or tours before and/or after your cruise conference.