Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

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Author :
Publisher : OECD Publishing
ISBN 13 : 9264805907
Total Pages : 447 pages
Book Rating : 4.2/5 (648 download)

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Book Synopsis Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies by : OECD

Download or read book Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Clinical Pathways in Emergency Medicine

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Author :
Publisher : Springer
ISBN 13 : 8132227107
Total Pages : 823 pages
Book Rating : 4.1/5 (322 download)

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Book Synopsis Clinical Pathways in Emergency Medicine by : Suresh S David

Download or read book Clinical Pathways in Emergency Medicine written by Suresh S David and published by Springer. This book was released on 2016-05-23 with total page 823 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book aims to provide condensed and crystallised knowledge, providing the rationale for investigations and interventions. Emergency medicine is a specialty where time and knowledge are critical factors in deciding appropriate management which could otherwise result in loss of life or limb. The challenge often is to have lucid management plans, whilst standing at the bedside of the patient. In order to address this challenge, a manuscript is needed which aims to enhance the clinical skills of the emergency physician. The objective of this book is to compile a road map for practitioners of emergency medicine, which would guide them through algorithm-based pathways. This format is distinctive by nature for its concise presentation, which facilitates easy reading and early application. Written by global experts, this book aims to be a truly international representation of emergency physicians who have come together to deliver contemporary concepts in emergency patient care.

High Quality Care for All

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Publisher : The Stationery Office
ISBN 13 : 9780101743228
Total Pages : 92 pages
Book Rating : 4.7/5 (432 download)

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Book Synopsis High Quality Care for All by : Secretary of State for Health

Download or read book High Quality Care for All written by Secretary of State for Health and published by The Stationery Office. This book was released on 2008 with total page 92 pages. Available in PDF, EPUB and Kindle. Book excerpt: This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.

Perioperative Care of the Orthopedic Patient

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Author :
Publisher : Springer
ISBN 13 : 1461401003
Total Pages : 403 pages
Book Rating : 4.4/5 (614 download)

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Book Synopsis Perioperative Care of the Orthopedic Patient by : C. Ronald MacKenzie

Download or read book Perioperative Care of the Orthopedic Patient written by C. Ronald MacKenzie and published by Springer. This book was released on 2014-08-01 with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by experts at the top-ranked Hospital for Special Surgery in New York, Perioperative Care of the Orthopedic Patient is a comprehensive, multidisciplinary manual providing preoperative considerations, postoperative complications, and guidelines for the anesthetic and medical management of patients undergoing orthopedic surgery. Beginning with chapters covering preoperative evaluations and general principles and practices of perioperative medicine, the book then considers anesthesiologic management in orthopedic surgery and the role of postoperative pain management. This is followed by a section on medical management in specific clinical settings, discussing patients with connective tissue disease, cardiac disease, chronic pulmonary and renal diseases, diabetes and psychiatric and neurological diseases. A fourth section covers specific perioperative problems in orthopedic surgery, such as care of the elderly patient, venous thromboembolism, infection, nutrition, compartment syndrome, and bone health. Finally, the role of allied services, quality improvement and ethics are highlighted, and selected case studies are included to illustrate real-world perioperative issues and management strategies in orthopedic surgery. A comprehensive yet concise reference, Perioperative Care of the Orthopedic Patient will be an invaluable resource for orthopedic surgeons, sports medicine specialists and any professional involved in orthopedic surgery.

Joint Arthroplasty

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Publisher : Springer Science & Business Media
ISBN 13 : 4431685294
Total Pages : 428 pages
Book Rating : 4.4/5 (316 download)

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Book Synopsis Joint Arthroplasty by : Shinichi Imura

Download or read book Joint Arthroplasty written by Shinichi Imura and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt: The introduction of total joint arthroplasty throughout the world has contributed manifold benefits to patients who suffer from joint diseases. Concurrently, however, there has been an increase in revision surgery. Many orthopedic surgeons agree that durability of prostheses is an eternal problem. In particular, periprosthetic osteolysis recently has been identified as one of the serious problems affecting prosthetic dura bility. To improve durability, osteolysis and many other problems must be investi gated and solved both experimentally and clinically with respect to such aspects as prosthetic material, design, and biological and biomechanical behavior. This book comprises 37 papers that were presented by orthopedic surgeons and biomedical engineers at the 28th Annual Meeting of the Japanese Society for Replace ment Arthroplasty, held in March 1998 in Kanazawa, Japan. The volume is thus a compilation of the latest knowledge about the pathogenesis and reduction of osteolysis and wear, newly developed total hip prostheses, and other current topics of total knee arthroplasty. We earnestly hope that this book will be of benefit to clinicians and researchers, and that it will contribute to the creation of more durable total joint prostheses in the future. SHINICHI IMURA v Contents Preface .................... '" .. .. .. ... . .. .. .. . ... .. . . .. . ... . . .. . V List of Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI . . . . . . . . . . . . Part 1 Wear and Pathogenesis of Osteolysis Friction and Wear of Artificial Joints: A Historical Review N. AKAMATSU ................................................ , 3 Matrix Degradation in Osteoclastic Bone Resorption Under Pathological Conditions .

Data Analysis and Applications 4

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Author :
Publisher : John Wiley & Sons
ISBN 13 : 111972158X
Total Pages : 247 pages
Book Rating : 4.1/5 (197 download)

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Book Synopsis Data Analysis and Applications 4 by : Andreas Makrides

Download or read book Data Analysis and Applications 4 written by Andreas Makrides and published by John Wiley & Sons. This book was released on 2020-04-09 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: Data analysis as an area of importance has grown exponentially, especially during the past couple of decades. This can be attributed to a rapidly growing computer industry and the wide applicability of computational techniques, in conjunction with new advances of analytic tools. This being the case, the need for literature that addresses this is self-evident. New publications are appearing, covering the need for information from all fields of science and engineering, thanks to the universal relevance of data analysis and statistics packages. This book is a collective work by a number of leading scientists, analysts, engineers, mathematicians and statisticians who have been working at the forefront of data analysis. The chapters included in this volume represent a cross-section of current concerns and research interests in these scientific areas. The material is divided into three parts: Financial Data Analysis and Methods, Statistics and Stochastic Data Analysis and Methods, and Demographic Methods and Data Analysis- providing the reader with both theoretical and applied information on data analysis methods, models and techniques and appropriate applications.

Colorectal Surgery

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Publisher : John Wiley & Sons
ISBN 13 : 1118674782
Total Pages : 356 pages
Book Rating : 4.1/5 (186 download)

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Book Synopsis Colorectal Surgery by : Bruce George

Download or read book Colorectal Surgery written by Bruce George and published by John Wiley & Sons. This book was released on 2016-05-02 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: Using a case-based approach, Colorectal Surgery: Clinical Care and Management provides practical, clinical and expert guidance to illustrate the best care and clinical management of patients requiring colorectal surgery for colorectal disease. Real-life cases illustrate the entire syllabus of GI/colorectal surgery, being specially selected to highlight topical or controversial aspects of colorectal care. Cases have a consistent approach throughout and as well as outlining the actual management of each individual case, also offer an honest appraisal of the chosen management route, its successes and areas that could have been managed differently. Pedagogic features such as learning and decision points boxes aid rapid understanding/learning, enabling the reader to improve their patient management. In full colour and containing over 100 outstanding clinical photos and slides to support the cases, each section also covers recent developments/ landmark papers/ scoring systems and a thorough discussion of clinical management based on the major society guidelines from NICE, ASCRS and ECCO. Reliable, well-written and perfect for consultation in the clinical setting, Colorectal Surgery: Modern Clinical Care and Management is the perfect tool for all members of the multi-disciplinary team managing patients suffering from colorectal disease, specifically GI surgeons, gastroenterologists, oncologists and general surgeons.

Managing care pathways for patients with complex care needs

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Author :
Publisher : Linköping University Electronic Press
ISBN 13 : 9176850692
Total Pages : 66 pages
Book Rating : 4.1/5 (768 download)

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Book Synopsis Managing care pathways for patients with complex care needs by : Magdalena Smeds

Download or read book Managing care pathways for patients with complex care needs written by Magdalena Smeds and published by Linköping University Electronic Press. This book was released on 2019-05-15 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: One of the central challenges for the healthcare system today is how to manage care for patients with complex needs. This patient group is not well-defined but covers patients with serious diseases and comorbidities, or with a limited ability to perform basic daily functions due to physical, mental or psychosocial challenges. This group has a high service and resource utilisation resulting in high costs for the healthcare system and, typically, poor health outcomes. To improve care for these patients, it is necessary to implement strategies to manage the differentiated care needs, the additional support needs, the uncertainty in care delivery, and the coordination needs of the involved providers and the patient. Care pathways are increasingly used internationally to make care more patient-centred and to structure and design care processes for individual patient groups. Important elements in care pathways include structuring care activities, by defining their content and sequence; coordinating between providers and professionals; and involving patients in their care process. In this thesis, care pathways are proposed as the overall strategy for managing care for patients with complex care needs. The purpose of this thesis is thus to contribute with knowledge on how care pathways can be managed for patients with complex care needs. This is achieved by analysing how the practices coordination, standardisation, customisation and personalisation can support management of care pathways and by discussing how these practices influence quality of care. The quality of care dimensions discussed are accessible, timely, equitable, and patient-centred care. The empirical context in this thesis is the Standardised Cancer Care Pathways (CCPs) which were implemented in Sweden from 2015 to 2018. CCPs is the umbrella term for the national initiative to shorten waiting times, decrease regional differences and reduce fragmentation in care processes. CCPs include elements such as diagnosis-specific pathways and guidelines, introduction of CPP coordinators, and mandatory reporting of waiting times. Focus has been on implementing care pathways for 31 cancer diagnoses in all Swedish healthcare regions. Both qualitative and quantitative research methods have been used. A case study was conducted to examine standardised and customised care pathways, and coordination and multidisciplinary work in care pathways. A document study of regional reports on CCPs was analysed to study effects of care pathways on accessibility, timeliness and equitability. Finally, a national survey was conducted to deepen the understanding of the role of coordination, as performed by coordinators, in care pathways. This thesis argues that standardised and customised care pathways should be combined to manage care for patients with complex care needs. The customised pathway in particular benefits patients with serious unspecific symptoms, unknown primary tumour or more complex care needs, while patients with care needs that can be treated independently of the main diagnosis benefit from following a standardised care pathway. Coordinators are an important means to manage coordination, customisation and personalisation in the care pathway. The coordinators’ role is twofold: the first role is to manage care pathways by customising the care pathway and coordinating involved providers; the second role is to support and guide patients through the care pathway. This can be achieved by adapting interpersonal communication with patients through personalisation. This thesis further argues that care pathways have most potential to positively influence accessibility, timeliness, equitability, and patient-centredness. Accessibility has been positively influenced, especially for patients with ambiguous symptoms where symptoms indicating cancer have improved their chances of accessing cancer diagnostics. A negative aspect of prioritising patients who follow CCPs has been the potentially longer waiting times for other patient groups in equal need of urgent care. Notwithstanding, prioritised access to care is perceived to positively influence timeliness for patients following CCPs. Care pathways are perceived to have positively influenced patient-centredness by shifting the focus from what to deliver to how to deliver it.

An Introduction to Quality Assurance in Health Care

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Author :
Publisher : Oxford University Press
ISBN 13 : 0199748020
Total Pages : 233 pages
Book Rating : 4.1/5 (997 download)

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Book Synopsis An Introduction to Quality Assurance in Health Care by : Avedis Donabedian

Download or read book An Introduction to Quality Assurance in Health Care written by Avedis Donabedian and published by Oxford University Press. This book was released on 2002-12-26 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: Avedis Donabedian's name is synonymous with quality of medical care. He unraveled the mystery behind the concept by defining it in clear operational terms and provided detailed blueprints for both its measurement(known as quality assessment) and its improvement(known as quality assurance). Many before him claimed that quality couldn't be defined in concrete objective terms. He demonstrated that quality is an attribte of a system which he called structure, a set of organized activities whihc he called process, and an outcome which results from both. In this book Donabedian tells the full story of quality assessment and assurance in simple, clear terms. He defines the meaning of quality, explicates its components, and provides clear and systematic guides to its assessment and enhancement. His style is lucid, succinct, systematic and yet personal, almost conversational.

Surgical Site Infection

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Publisher :
ISBN 13 : 9781904752691
Total Pages : 142 pages
Book Rating : 4.7/5 (526 download)

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Book Synopsis Surgical Site Infection by : Andrew Welsh

Download or read book Surgical Site Infection written by Andrew Welsh and published by . This book was released on 2008 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.

Clinical Pathways in Stroke Rehabilitation

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Publisher : Springer Nature
ISBN 13 : 3030585050
Total Pages : 284 pages
Book Rating : 4.0/5 (35 download)

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Book Synopsis Clinical Pathways in Stroke Rehabilitation by : Thomas Platz

Download or read book Clinical Pathways in Stroke Rehabilitation written by Thomas Platz and published by Springer Nature. This book was released on 2021-01-14 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.

Developing Care Pathways

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Publisher : Radcliffe Publishing
ISBN 13 : 9781857754995
Total Pages : 100 pages
Book Rating : 4.7/5 (549 download)

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Book Synopsis Developing Care Pathways by : Kathryn De Luc

Download or read book Developing Care Pathways written by Kathryn De Luc and published by Radcliffe Publishing. This book was released on 2001 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The relationship between poverty and child health has always been assumed but this book demonstrates how the evidence of history and of other societies establishes a causal link. The practical implications in health and social policy are presented in the context of child care services, together with some innovative approaches to future development. This is a book for professionals in medicine, nursing and the social services who are involved in research and the practical issues of delivering a modern health care service to disadvantaged children.

Measuring Capacity to Care Using Nursing Data

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Publisher : Academic Press
ISBN 13 : 0128169788
Total Pages : 500 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Measuring Capacity to Care Using Nursing Data by : Evelyn Hovenga

Download or read book Measuring Capacity to Care Using Nursing Data written by Evelyn Hovenga and published by Academic Press. This book was released on 2020-03-13 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: Measuring Capacity to Care Using Nursing Data presents evidence-based solutions regarding the adoption of safe staffing principles and the optimum use of operational data to enable health service delivery strategies that result in improved patient and organizational outcomes. Readers will learn how to make better use of informatics to collect, share, link and process data collected operationally for the purpose of providing real-time information to decision- makers. The book discusses topics such as dynamic health care environments, health care operational inefficiencies and costly events, how to measure nursing care demand, nursing models of care, data quality and governance, and big data. The content of the book is a valuable source for graduate students in informatics, nurses, nursing managers and several members involved in health care who are interested in learning more about the beneficial use of informatics for improving their services. Presents and discusses evidences from real-world case studies from multiple countries Provides detailed insights of health system complexity in order to improve decision- making Demonstrates the link between nursing data and its use for efficient and effective healthcare service management Discusses several limitations currently experienced and their impact on health service delivery

Blumgart's Surgery of the Liver, Pancreas and Biliary Tract E-Book

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Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0323340873
Total Pages : 2520 pages
Book Rating : 4.3/5 (233 download)

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Book Synopsis Blumgart's Surgery of the Liver, Pancreas and Biliary Tract E-Book by : William R. Jarnagin

Download or read book Blumgart's Surgery of the Liver, Pancreas and Biliary Tract E-Book written by William R. Jarnagin and published by Elsevier Health Sciences. This book was released on 2016-10-10 with total page 2520 pages. Available in PDF, EPUB and Kindle. Book excerpt: Extensively revised with new illustrations, new clinical photos, this classic text remains the most comprehensive and up-to-date resource on surgery of the hepatobiliary and pancreatic region. Dr. William Jarnagin and his team of internationally recognized surgeons continue the Blumgart’s tradition of excellence, bringing you the latest advances in diagnostic and surgical techniques. You’ll find updates on the newest minimally invasive surgeries, new interventional diagnostic techniques, and complete coverage of all relevant diseases, including those seen in the tropics. Considers all worldwide opinions and approaches to management, and includes key data on surgical outcomes to better inform your clinical decision-making. Covers exactly what you need to know, balancing basic science with information on clinical practice. Presents cutting edge guidance on pathology, diagnostics, surgery and non-operative intervention of the liver, biliary tract, and pancreas in a single, comprehensive reference. Covers the most recent non-surgical therapies for pancreatic cancer, microwave ablation, and other emerging technologies. Brings you up to date with recent developments in transplantation, minimally invasive surgery, percutaneous devices, pre- and post-care, blood transfusion, and surgical techniques for the spleen. Features an extensively revised art and illustration program, with new anatomical line drawings (including hundreds now in color), more than 750 new clinical photos, more schematic diagrams that summarize information, and new graphs and algorithms throughout.

Perioperative Pain Management

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Author :
Publisher : Oxford University Press
ISBN 13 : 0199937214
Total Pages : 141 pages
Book Rating : 4.1/5 (999 download)

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Book Synopsis Perioperative Pain Management by : Richard D. Urman

Download or read book Perioperative Pain Management written by Richard D. Urman and published by Oxford University Press. This book was released on 2013-05-23 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Perioperative Pain Management is an up-to-date, evidence-based guide for clinicians who diagnose and treat post-surgical patients.

Rapid Recovery in Total Joint Arthroplasty

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Author :
Publisher : Springer Nature
ISBN 13 : 3030412237
Total Pages : 355 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Rapid Recovery in Total Joint Arthroplasty by : Giles R. Scuderi

Download or read book Rapid Recovery in Total Joint Arthroplasty written by Giles R. Scuderi and published by Springer Nature. This book was released on 2020-04-02 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: The approach to total hip and total knee arthroplasty is changing around the world. There is now a strong emphasis on a more rapid recovery and on more outpatient surgery. Each step of the process is now being modified with more thorough pre-operative evaluations, streamlined surgical approaches, rapid mobilization and faster return to normal activities. These changes place new pressures on all of the health care providers in the system. This unique text - the first of its kind - is a practical guide for each member of the clinical team with updates by the leading authorities from around the country. Each chapter addresses a specific issue and will outline the important new items that need to be addressed, very similar to a handbook. Topics covered include the implementation of new payment models and outcome measurements, recommendations to streamline the pre-, peri- and post-operative protocols, the utility and application of outpatient joint replacement programs, multimodal pain management and post-acute rehabilitation strategies. There is no publication at present that addresses all of these items together in one convenient place. Rapid Recovery in Total Joint Arthroplasty is written and edited by experienced clinicians and surgeons, sharing their years of experience to create a practical, up-to-date text useful for everyday work.

Clinical Pathways in Neuro-ophthalmology

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Author :
Publisher : Thieme
ISBN 13 : 9783131086426
Total Pages : 500 pages
Book Rating : 4.0/5 (864 download)

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Book Synopsis Clinical Pathways in Neuro-ophthalmology by : Andrew G. Lee

Download or read book Clinical Pathways in Neuro-ophthalmology written by Andrew G. Lee and published by Thieme. This book was released on 2003 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: This updated and expanded second edition uses an evidence-based approach to link symptoms to specific findings.