Aging and Musculoskeletal Disorders

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Publisher :
ISBN 13 :
Total Pages : 400 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Aging and Musculoskeletal Disorders by : Horace Mitchell Perry

Download or read book Aging and Musculoskeletal Disorders written by Horace Mitchell Perry and published by . This book was released on 1993 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Aging Musculoskeletal System

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Publisher :
ISBN 13 :
Total Pages : 208 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Aging Musculoskeletal System by : Carl L. Nelson

Download or read book The Aging Musculoskeletal System written by Carl L. Nelson and published by . This book was released on 1984 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Selected Health Conditions and Likelihood of Improvement with Treatment

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Publisher : National Academies Press
ISBN 13 : 0309670950
Total Pages : 319 pages
Book Rating : 4.3/5 (96 download)

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Book Synopsis Selected Health Conditions and Likelihood of Improvement with Treatment by : National Academies of Sciences, Engineering, and Medicine

Download or read book Selected Health Conditions and Likelihood of Improvement with Treatment written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-07-12 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers' compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don't result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.

Rheumatic Disease in Geriatrics

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Publisher : Springer Nature
ISBN 13 : 3030442349
Total Pages : 391 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Rheumatic Disease in Geriatrics by : Gleb Slobodin

Download or read book Rheumatic Disease in Geriatrics written by Gleb Slobodin and published by Springer Nature. This book was released on 2020-05-25 with total page 391 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a practical guide to the diagnosis and management of rheumatic disease in geriatric patients. It details information on the effect of ageing on musculoskeletal and immune systems and specifies impact of a variety of inflammatory and degenerative rheumatic disorders on the elderly. The clinical diagnostic approach to an older individual with musculoskeletal complaints is a cornerstone of this book, which includes also insights into the most important comorbidities for this age and discusses in depth available treatments and rehabilitation tools. The symptoms, imaging features and recommendations on the interpretation of specific laboratory tests for rheumatic diseases in geriatrics are also covered. This book encompasses traditionally associated with older age conditions including temporal arteritis, polymyalgia rheumatica, osteoarthritis, as well as common systemic autoimmune diseases that can produce atypical manifestations in the elderly. It will enable the readers to develop a thorough understanding of how to deal with these patients in their clinical practice. Rheumatic Disease in Geriatrics: Diagnosis and Management systematically describes how to diagnose and treat geriatric patients with a variety of rheumatic conditions and is a valuable resource for all medical professionals involved.

Physiology and Pathophysiology of Musculoskeletal Aging

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Publisher : Frontiers E-books
ISBN 13 : 288919390X
Total Pages : 88 pages
Book Rating : 4.8/5 (891 download)

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Book Synopsis Physiology and Pathophysiology of Musculoskeletal Aging by : Ali Mobasheri

Download or read book Physiology and Pathophysiology of Musculoskeletal Aging written by Ali Mobasheri and published by Frontiers E-books. This book was released on 2015-04-15 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: We live in a world with an ever-increasing aging population. This aging population is predicted to place a huge financial burden on healthcare systems around the world. Understanding healthy ageing is a key research priority, along with a better understanding of the pathophysiology of ageing that occurs in a number of age related diseases, such as arthritis. By gaining a better understanding of healthy musculoskeletal ageing we can provide better care and new therapies for common musculoskeletal problems. This Research Topic is intended to bring together basic researchers and clinicians working in the broad area of musculoskeletal ageing. The topic includes mechanisms of healthy ageing in the musculoskeletal system, which we define as skeletal muscle and the synovial joint, particularly constituent structures including articular cartilage, subchondral bone tendon and ligament. A particular focus of this Research Topic is dietary modulation of musculoskeletal ageing.

World Report on Ageing and Health

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Publisher : World Health Organization
ISBN 13 : 9241565047
Total Pages : 260 pages
Book Rating : 4.2/5 (415 download)

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Book Synopsis World Report on Ageing and Health by : World Health Organization

Download or read book World Report on Ageing and Health written by World Health Organization and published by World Health Organization. This book was released on 2015-10-22 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt: The WHO World report on ageing and health is not for the book shelf it is a living breathing testament to all older people who have fought for their voice to be heard at all levels of government across disciplines and sectors. - Mr Bjarne Hastrup President International Federation on Ageing and CEO DaneAge This report outlines a framework for action to foster Healthy Ageing built around the new concept of functional ability. This will require a transformation of health systems away from disease based curative models and towards the provision of older-person-centred and integrated care. It will require the development sometimes from nothing of comprehensive systems of long term care. It will require a coordinated response from many other sectors and multiple levels of government. And it will need to draw on better ways of measuring and monitoring the health and functioning of older populations. These actions are likely to be a sound investment in society's future. A future that gives older people the freedom to live lives that previous generations might never have imagined. The World report on ageing and health responds to these challenges by recommending equally profound changes in the way health policies for ageing populations are formulated and services are provided. As the foundation for its recommendations the report looks at what the latest evidence has to say about the ageing process noting that many common perceptions and assumptions about older people are based on outdated stereotypes. The report's recommendations are anchored in the evidence comprehensive and forward-looking yet eminently practical. Throughout examples of experiences from different countries are used to illustrate how specific problems can be addressed through innovation solutions. Topics explored range from strategies to deliver comprehensive and person-centred services to older populations to policies that enable older people to live in comfort and safety to ways to correct the problems and injustices inherent in current systems for long-term care.

The Aging Musculoskeletal System

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Publisher : Collamore Press
ISBN 13 : 9780023865800
Total Pages : pages
Book Rating : 4.8/5 (658 download)

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Book Synopsis The Aging Musculoskeletal System by : Carl L. Nelson

Download or read book The Aging Musculoskeletal System written by Carl L. Nelson and published by Collamore Press. This book was released on 1984-08-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Brocklehurst's Textbook of Geriatric Medicine and Gerontology E-Book

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Publisher : Elsevier Health Sciences
ISBN 13 : 0702063444
Total Pages : 1100 pages
Book Rating : 4.7/5 (2 download)

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Book Synopsis Brocklehurst's Textbook of Geriatric Medicine and Gerontology E-Book by : Howard M. Fillit

Download or read book Brocklehurst's Textbook of Geriatric Medicine and Gerontology E-Book written by Howard M. Fillit and published by Elsevier Health Sciences. This book was released on 2016-05-06 with total page 1100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The leading reference in the field of geriatric care, Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 8th Edition, provides a contemporary, global perspective on topics of importance to today’s gerontologists, internal medicine physicians, and family doctors. An increased focus on frailty, along with coverage of key issues in gerontology, disease-specific geriatrics, and complex syndromes specific to the elderly, makes this 8th Edition the reference you’ll turn to in order to meet the unique challenges posed by this growing patient population. Consistent discussions of clinical manifestations, diagnosis, prevention, treatment, and more make reference quick and easy. More than 250 figures, including algorithms, photographs, and tables, complement the text and help you find what you need on a given condition. Clinical relevance of the latest scientific findings helps you easily apply the material to everyday practice. A new chapter on frailty, plus an emphasis on frailty throughout the book, addresses the complex medical and social issues that affect care, and the specific knowledge and skills essential for meeting your patients’ complex needs. New content brings you up to date with information on gerontechnology, emergency and pre-hospital care, HIV and aging, intensive treatment of older adults, telemedicine, the built environment, and transcultural geriatrics. New editor Professor John Young brings a fresh perspective and unique expertise to this edition.

Gerontology Nursing Case Studies

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Publisher : Springer Publishing Company
ISBN 13 : 0826194052
Total Pages : 292 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Gerontology Nursing Case Studies by : Donna J. Bowles, MSN, EdD, RN, CNE

Download or read book Gerontology Nursing Case Studies written by Donna J. Bowles, MSN, EdD, RN, CNE and published by Springer Publishing Company. This book was released on 2015-04-08 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Praise for the first edition: “This is an excellent teaching guide and resource manual for instructors, gerontological nursing students, and practicing nurses and social workers who wish to learn more about geriatric concerns and care. It will be kept by nursing students long after they graduate as a guide to resources that will be valuable throughout their nursing careers. As a home care nurse working mainly with the geriatric community, I found the resources helpful in my practice. As an instructor, I found the book to be a very useful guide for teaching geriatrics.” Score: 90, 4 Stars —Doody’s Medical Reviews “[This] is a unique volume that effectively addresses the lack of gerontology case studies for use with undergraduate nursing students. Case studies are a pedagogically powerful approach to active learning that offer opportunities to apply content to clinical practice.” —The Gerontologist “The case narrative approach of this book promotes active learning that is more meaningful to students (and practicing nurses) and more likely to increase the transfer of evidence into practice. An excellent resource for faculty (staff educators) to facilitate critical learning skills.” —Liz Capezuti, PhD, RN, FAAN Dr. John W. Rowe Professor in Successful Aging Co-Director, Hartford Institute for Geriatric Nursing New York University College of Nursing Vivid case examples help guide nurses in developing appropriate interventions that include complementary and alternative health therapies and provide a basis for evaluating outcomes. Exercises interspersed throughout each case study include numerous open-ended and multiple-choice questions to facilitate learning and critical thinking. The text is unique in that some of the presented cases focus on psychosocial issues such as gambling addiction, hoarding behavior, emergency preparedness, and long-distance caregiving. Cases also depict geriatric clients who are living healthy, productive lives to counter myths and negative attitudes about older adults. Scenarios demonstrating ethical dilemmas prepare students to appropriately respond to “gray area” situations. The text is geared for AACN and NLN accreditation and is organized according to the needs of actual clinical settings. With cases that take place in the home and community or within primary, acute, and long-term care facilities, this book will be useful for courses specific to gerontology nursing or across any nursing curriculum. New to the Second Edition: A completely new section of Aging Issues Affecting the Family New cases addressing health care disparities, aging in place, and prevention of catheter-associated urinary tract infection Additional contemporary case studies The addition of Quality for Safety in Nursing Education (QSEN) initiatives A greater focus on prioritization and delegation of client’s needs infused throughout exercises

Respiratory Muscle Training

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Publisher : Elsevier Health Sciences
ISBN 13 : 0702054550
Total Pages : 403 pages
Book Rating : 4.7/5 (2 download)

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Book Synopsis Respiratory Muscle Training by : Alison McConnell

Download or read book Respiratory Muscle Training written by Alison McConnell and published by Elsevier Health Sciences. This book was released on 2013-04-18 with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt: Respiratory Muscle Training: theory and practice is the world’s first book to provide an "everything-you-need-to-know" guide to respiratory muscle training (RMT). Authored by an internationally-acclaimed expert, it is an evidence-based resource, built upon current scientific knowledge, as well as experience at the cutting-edge of respiratory training in a wide range of settings. The aim of the book is to give readers: 1) an introduction to respiratory physiology and exercise physiology, as well as training theory; 2) an understanding of how disease affects the respiratory muscles and the mechanics of breathing; 3) an insight into the disease-specific, evidence-based benefits of RMT; 4) advice on the application of RMT as a standalone treatment, and as part of a rehabilitation programme; and finally, 5) guidance on the application of functional training techniques to RMT. The book is divided into two parts – theory and practice. Part I provides readers with access to the theoretical building blocks that support practice. It explores the evidence base for RMT as well as the different methods of training respiratory muscles and their respective efficacy. Part II guides the reader through the practical implementation of the most widely validated form of RMT, namely inspiratory muscle resistance training. Finally, over 150 "Functional" RMT exercises are described, which incorporate a stability and/or postural challenge – and address specific movements that provoke dyspnoea. Respiratory Muscle Training: theory and practice is supported by a dedicated website (www.physiobreathe.com), which provides access to the latest information on RMT, as well as video clips of all exercises described in the book. Purchasers will also receive a three-month free trial of the Physiotec software platform (via www.physiotec.ca), which allows clinicians to create bespoke training programmes (including video clips) that can be printed or emailed to patients. Introductory overviews of respiratory and exercise physiology, as well as training theory Comprehensive, up-to-date review of respiratory muscle function, breathing mechanics and RMT Analysis of the interaction between disease and respiratory mechanics, as well as their independent and combined influence upon exercise tolerance Analysis of the rationale and application of RMT to over 20 clinical conditions, e.g., COPD, heart failure, obesity, mechanical ventilation Evidence-based guidance on the implementation of inspiratory muscle resistance training Over 150 functional exercises that incorporate a breathing challenge www.physiobreathe.com - access up-to-date information, video clips of exercises and a three-month free trial of Physiotec’s RMT exercise module (via www.physiotec.ca)

Anatomy and Physiology

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Publisher :
ISBN 13 : 9781947172807
Total Pages : 0 pages
Book Rating : 4.1/5 (728 download)

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Book Synopsis Anatomy and Physiology by : J. Gordon Betts

Download or read book Anatomy and Physiology written by J. Gordon Betts and published by . This book was released on 2013-04-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Musculoskeletal Disorders and the Workplace

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Publisher : National Academies Press
ISBN 13 : 0309132991
Total Pages : 510 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Musculoskeletal Disorders and the Workplace by : Institute of Medicine

Download or read book Musculoskeletal Disorders and the Workplace written by Institute of Medicine and published by National Academies Press. This book was released on 2001-05-24 with total page 510 pages. Available in PDF, EPUB and Kindle. Book excerpt: Every year workers' low-back, hand, and arm problems lead to time away from jobs and reduce the nation's economic productivity. The connection of these problems to workplace activities-from carrying boxes to lifting patients to pounding computer keyboards-is the subject of major disagreements among workers, employers, advocacy groups, and researchers. Musculoskeletal Disorders and the Workplace examines the scientific basis for connecting musculoskeletal disorders with the workplace, considering people, job tasks, and work environments. A multidisciplinary panel draws conclusions about the likelihood of causal links and the effectiveness of various intervention strategies. The panel also offers recommendations for what actions can be considered on the basis of current information and for closing information gaps. This book presents the latest information on the prevalence, incidence, and costs of musculoskeletal disorders and identifies factors that influence injury reporting. It reviews the broad scope of evidence: epidemiological studies of physical and psychosocial variables, basic biology, biomechanics, and physical and behavioral responses to stress. Given the magnitude of the problem-approximately 1 million people miss some work each year-and the current trends in workplace practices, this volume will be a must for advocates for workplace health, policy makers, employers, employees, medical professionals, engineers, lawyers, and labor officials.

Fragility Fracture Nursing

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Publisher : Springer
ISBN 13 : 3319766813
Total Pages : 169 pages
Book Rating : 4.3/5 (197 download)

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Book Synopsis Fragility Fracture Nursing by : Karen Hertz

Download or read book Fragility Fracture Nursing written by Karen Hertz and published by Springer. This book was released on 2018-06-15 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

Osteosarcopenia: Bone, Muscle and Fat Interactions

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Publisher : Springer Nature
ISBN 13 : 3030258904
Total Pages : 383 pages
Book Rating : 4.0/5 (32 download)

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Book Synopsis Osteosarcopenia: Bone, Muscle and Fat Interactions by : Gustavo Duque

Download or read book Osteosarcopenia: Bone, Muscle and Fat Interactions written by Gustavo Duque and published by Springer Nature. This book was released on 2019-11-06 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This edited work presents the most current evidence on osteosarcopenia from bench to bedside, which is expected to facilitate the understanding of this syndrome and to develop preventive and therapeutic strategies. With our aging population, chronic diseases such as osteoporosis and sarcopenia are becoming highly prevalent. Fortunately, our understanding of the bone and muscle interactions has increased in recent years. This has allowed to the coining of the term osteosarcopenia to describe a syndrome in which these two diseases overlap. This overlap between osteoporosis and sarcopenia has major negative effects not only on our older adults but also on health systems worldwide. Readers will find a highly translational approach that starts with a summary of recent discoveries on stem cells biology, muscle and bone interactions – including the role of local bone and muscle fat – followed by comprehensive reviews on myokines (i.e. myostatin), osteokines (i.e. osteocalcin) and adipokines (i.e. interleukins) as major players and determinants of bone and muscle loss with aging. In addition, the role of sex steroids (i.e. estrogens, androgens), and calciotropic hormones (i.e. parathyroid hormone, vitamin D) in the pathogenesis of this syndrome is also reviewed. Moreover, using practical diagnostic and therapeutic tips, this book summarizes the clinical characteristics of osteosarcopenic patients thus facilitating the diagnosis and treatment of this syndrome in clinical practice. Finally, the book presents the case for the Falls and Fractures Clinic as the optimal model of care for this syndrome, aimed to avoid fragmentation and optimize osteosarcopenia care, and simultaneously prevent falls and fractures in older persons. This book offers relevant information on the mechanisms of osteosarcopenia, and a practical guide on how to identify and treat this geriatric syndrome and its adverse outcomes, which are dramatically affecting our aging population. The work is written by leaders in the field and is especially suited not only to any researcher in the musculoskeletal arena but also to medical specialists and allied health professionals involved in the care of older persons.

A Life Course Approach to Healthy Ageing

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Publisher : Oxford University Press, USA
ISBN 13 : 0199656517
Total Pages : 299 pages
Book Rating : 4.1/5 (996 download)

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Book Synopsis A Life Course Approach to Healthy Ageing by : Diana Kuh

Download or read book A Life Course Approach to Healthy Ageing written by Diana Kuh and published by Oxford University Press, USA. This book was released on 2014 with total page 299 pages. Available in PDF, EPUB and Kindle. Book excerpt: This title investigates the lifetime determinants of healthy ageing and their implications for policy and practice, bringing together authorities in ageing research and knowledge transfer from across the world.

Geriatric Gastroenterology

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Publisher : Springer Science & Business Media
ISBN 13 : 1441916237
Total Pages : 660 pages
Book Rating : 4.4/5 (419 download)

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Book Synopsis Geriatric Gastroenterology by : C. S. Pitchumoni

Download or read book Geriatric Gastroenterology written by C. S. Pitchumoni and published by Springer Science & Business Media. This book was released on 2012-07-26 with total page 660 pages. Available in PDF, EPUB and Kindle. Book excerpt: As aging trends in the United States and Europe in particular are strongly suggestive of increasingly older society, it would be prudent for health care providers to better prepare for such changes. By including physiology, disease, nutrition, pharmacology, pathology, radiology and other relevant associated topics, Geriatric Gastroenterology fills the void in the literature for a volume devoted specifically to gastrointestinal illness in the elderly. This unique volume includes provision of training for current and future generations of physicians to deal with the health problems of older adults. It will also serve as a comprehensive guide to practicing physicians for ease of reference. Relevant to the geriatric age group, the volume covers epidemiology, physiology of aging, gastrointestinal physiology, pharmacology, radiology, pathology, motility disorders, luminal disorders, hepato-biliary disease, systemic manifestations, neoplastic disorders, gastrointestinal bleeding, cancer and medication related interactions and adverse events, all extremely common in older adults; these are often hard to evaluate and judge, especially considering the complex aging physiology. All have become important components of modern medicine. Special emphasis is be given to nutrition and related disorders. Capsule endoscopy and its utility in the geriatric population is also covered. Presented in simple, easy to read style, the volume includes numerous tables, figures and key points enabling ease of understanding. Chapters on imaging and pathology are profusely illustrated. All chapters are written by specialists and include up to date scientific information. Geriatric Gastroenterology is of great utility to residents in internal medicine, fellows in gastroenterology and geriatric medicine as well as gastroenterologists, geriatricians and practicing physicians including primary care physicians caring for older adults.

Bone Health and Osteoporosis

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Publisher :
ISBN 13 : 9781410219275
Total Pages : 0 pages
Book Rating : 4.2/5 (192 download)

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Book Synopsis Bone Health and Osteoporosis by : United States Public Health Service

Download or read book Bone Health and Osteoporosis written by United States Public Health Service and published by . This book was released on 2004-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This first-ever Surgeon General's Report on bone health and osteoporosis illustrates the large burden that bone disease places on our Nation and its citizens. Like other chronic diseases that disproportionately affect the elderly, the prevalence of bone disease and fractures is projected to increase markedly as the population ages. If these predictions come true, bone disease and fractures will have a tremendous negative impact on the future well-being of Americans. But as this report makes clear, they need not come true: by working together we can change the picture of aging in America. Osteoporosis, fractures, and other chronic diseases no longer should be thought of as an inevitable part of growing old. By focusing on prevention and lifestyle changes, including physical activity and nutrition, as well as early diagnosis and appropriate treatment, Americans can avoid much of the damaging impact of bone disease and other chronic diseases. This Surgeon General's Report brings together for the first time the scientific evidence related to the prevention, assessment, diagnosis, and treatment of bone disease. More importantly, it provides a framework for moving forward. The report will be another effective tool in educating Americans about how they can promote bone health throughout their lives. This first-ever Surgeon General's Report on bone health and osteoporosis provides much needed information on bone health, an often overlooked aspect of physical health. This report follows in the tradition of previous Surgeon Generals' reports by identifying the relevant scientific data, rigorously evaluating and summarizing the evidence, and determining conclusions.