Development of appropriateness criteria for the surgical treatment of symptomatic lumbar degenerative spondylolisthesis (LDS).

PURPOSE: Spine surgery rates are increasing worldwide. Treatment failures are often attributed to poor patient selection and inappropriate treatment, but for many spinal disorders there is little consensus on the precise indications for surgery. With an aging population, more patients with lumbar degenerative spondylolisthesis (LDS) will present for surgery. The aim of this study was to develop criteria for the appropriateness of surgery in symptomatic LDS. METHODS: A systematic review was carried out to summarize the current level of evidence for the treatment of LDS. Clinical scenarios were generated comprising combinations of signs and symptoms in LDS and other relevant variables. Based on the systematic review and their own clinical experience, twelve multidisciplinary international experts rated each scenario on a 9-point scale (1 highly inappropriate, 9 highly appropriate) with respect to performing decompression only, fusion, and instrumented fusion. Surgery for each theoretical scenario was classified as appropriate, inappropriate, or uncertain based on the median ratings and disagreement in the ratings. RESULTS: 744 hypothetical scenarios were generated; overall, surgery (of some type) was rated appropriate in 27 %, uncertain in 41 % and inappropriate in 31 %. Frank panel disagreement was low (7 % scenarios). Face validity was shown by the logical relationship between each variable's subcategories and the appropriateness ratings, e.g., no/mild disability had a mean appropriateness rating of 2.3 ± 1.5, whereas the rating for moderate disability was 5.0 ± 1.6 and for severe disability, 6.6 ± 1.6. Similarly, the average rating for no/minimal neurological abnormality was 2.3 ± 1.5, increasing to 4.3 ± 2.4 for moderate and 5.9 ± 1.7 for severe abnormality. The three variables most likely (p < 0.0001) to be components of scenarios rated "appropriate" were: severe disability, no yellow flags, and severe neurological deficit. CONCLUSION: This is the first study to report criteria for determining candidacy for surgery in LDS developed by a multidisciplinary international panel using a validated method (RAM). The panel ratings followed logical clinical rationale, indicating good face validity. The work refines clinical classification and the phenotype of degenerative spondylolisthesis. The predictive validity of the criteria should be evaluated prospectively to examine whether patients treated "appropriately" have better clinical outcomes.

An Integral Abutment Bridge with Precast Concrete Piles, May 2007

The use of precast, prestressed concrete piles in the foundation of bridge piers has long been recognized as a valuable option for bridge owners and designers. However, the use of these precast, prestressed concrete piles in integral abutment bridges has not been widespread because of concerns over pile flexibility and the potential for concrete cracking and deterioration of the prestressing strands due to long-term exposure to moisture. This report presents the details of the first integral abutment bridge in the state of Iowa that utilized precast, prestressed concrete piles in the abutment. The bridge, which was constructed in Tama County in 2000, consists of a 110 ft. long, 30 ft. wide, single-span PC girder superstructure with a left-side-ahead 20º skew angle. The bridge was instrumented with a variety of strain gages, displacement sensors, and thermocouples to monitor and help in the assessment of structural behavior. The results of this monitoring are presented, and recommendations are made for future application of precast, prestressed concrete piles in integral abutment bridges. In addition to the structural monitoring data, this report presents the results of a survey questionnaire that had been mailed to each of the 50 state DOT chief bridge engineers to ascertain their current practices for precast, prestressed concrete piles and especially the application of these piles in integral abutment bridges.

Improving How Listening Skills are Taught in the Efl Classroom: Guidelines to Producing Better Speakers of the English Language

This research paper is concerned with the need to improve how listening skills are taught in the Capeverdian EFL classroom. Teaching English through listening is not an easy task, especially when there are many factors that impede the learning process such as: lack of adequate materials and conditions; lack of qualified teachers with good pronunciation, and lack of innovative approaches to teaching listening skills. If our goal as teachers is to produce good English speakers we must invest in training good listeners. In this work I will focus on the following aspects: an evaluation of how effectively listening skills are taught in the Capeverdian EFL classroom; a look at how we can turn teaching problems into positive solutions; how to improve teaching listening skills and materials and recommendations for best practices in teaching listening skills in the EFL classroom. In conclusion I will include listening activities which reflect these best practices and offer recommendations for further research.

A avaliação de desempenho como factor de motivação

Este estudo, realizado sobre a temática “A Avaliação de Desempenho como Factor de Motivação”, através da revisão bibliográfica e de um estudo de caso na Sociedade Cabo-verdiana de Tabacos, SA, teve como objectivo mostrar os impactos da avaliação de desempenho na motivação dos colaboradores. O trabalho encontra-se estruturado em quatro capítulos, sendo que no primeiro e segundo fez-se uma revisão bibliográfica, para uma melhor fundamentação teórica do trabalho. O terceiro capítulo, refere-se ao estudo de caso feito na referida empresa, onde foi aplicado um questionário para apurar, acerca da percepção que os colaboradores têm do sistema de avaliação de desempenho que são submetidos e da adequabilidade do mesmo à estrutura da organização, e ainda a aplicação da teoria de Victor Vroom para medir a motivação dos colaboradores. E por último, no quarto capítulo, referimos às conclusões e subsequentes recomendações. Da análise dos dados recolhidos na empresa, verificamos que o nível motivacional com que a maioria dos colaboradores da SCT, SA desenvolvem as suas tarefas está abaixo da média, o que conduziu-nos a conclusão de que eles estão desmotivados, pelo que a empresa deverá criar medidas que possam estimular os colaboradores de forma a reverter essa situação. This study about the topic "Performance Evaluation as Motivation Factor", through literature review and a case study in Sociedade Cabo-verdiana de Tabacos, SA, aimed to show the impact of performance evaluation on employee motivation. The work is structured in four chapters and in the first and second we did a literature review for better theoretical foundation of the work. The third chapter refers to the case study in the company mentioned above, which was administered a questionary to know what the employees think about the performance evaluation system in the company, and so the application of Victor Vroom´s theory to measure the employees motivation. And finally in the fourth chapter we refer some conclusions and recommendations for the company. After the analysis of the data given in the company, we realized that the motivation level witch the majority of the employees in SCT, SA work is under the average, what made us come to the conclusion that they are not motivated. So we suggest the company to develop strategies to stimulate the employees in order to reverse this situation

Status of Females in the Juvenile Justice System, 2007

On October 12th 2007, the inaugural Girls’ Summit on females in the juvenile justice system was held. This Summit brought together key decision makers in an exploration of research and data. Those who attended were also asked to make recommendations regarding a course of action. This report represents an effort to improve our response to these young women in Iowa. It highlights pertinent information covered at the Summit as well as resulting conclusions and recommendations. On behalf of the Iowa Gender Specific Services Task Force and the participants of the Girls’ Summit, it is my hope that this report will serve as a road map for necessary improvements as well as a means to reinforce the effective tools that are already in place. There are differences that exist between young women and young men in the juvenile justice system and the efficacy of professionals rests heavily on a better understanding of these differences and how they impact the justice system response.

Ethical abuses in the authorship of scientific papers

Problems regarding the order of authorship of scientific papers have become more frequent and more abusive. These problems may have heightened due to the ever increasing pressure to "publish or perish" in the academic world, given that the publication of scientific articles has become the benchmark of success in a field with few job opportunities. This article reviews the abuses in the authorship of scientific papers. Different examples are given of the most common problems and recommendations are provided for authors and journal editors.

Actividades e Tarefas Desenvolvidas na Embaixada de Cabo Verde em Portugal

O presente relatório inclui os resultados do estudo dos Sectores de Actividades da Embaixada de Cabo Verde em Portugal. Este trabalho decorreu em três etapas essências. A primeira foi leitura de um Manual de Procedimentos sobre a “Concepção e Implementação de um Sistema Administrativo e de Controlo Orçamental. A segunda centrou-se no Sector Administrativo, onde foram aplicados conhecimentos estatísticos nas diversas actividades realizadas. A última centrou-se no sector da Tesouraria e Contabilidade, onde adquiri conhecimentos básicos sobre o sector financeiro. O relatório encontra–se estruturado em 5 capítulos: O capítulo I fornece, de um modo sintético, uma panorâmica histórica da Embaixada de Cabo Verde em Portugal. O capítulo II, tem um carácter descritivo, ou seja descreve sumáriamente, os diversos sectores de actividades. As mais variadas actividades que giram em torno do Serviço Administrativo e Financeiro, justificaram um tratamento detalhado no capítulo III. A questão da comunidade cabo-verdiana, residente em Portugal, os softwares de Contabilidade Primavera, e Gestão de Requisição são abordadas no capítulo IV, sendo analisado o posicionamento da população de origem cabo-verdiana que reside em Portugal, aplicando certos casos e exemplos nos próprios softwares. O capítulo V sintetiza e conjuga as principais conclusões parcelares que foram apresentadas nos diversos capítulos, incluindo também limitações e trabalho futuro. Por fim está organizado um conjunto de anexos compostos por: documentos da Embaixada, glossário financeiro, e scrip do software “R”, que serviram de suporte ao estudo.

Final Report, Secondary Road Fund Distribution Advisory Committee, 2002-2005

This report presents the findings and recommendations of the Secondary Road Fund Distribution Advisory Committee (SRFDAC) established by SF 2192 of the 2002 Iowa Acts.

Electronic Payments for Driver's Licensing Transactions,December 31, 2008

House File 2196 required the Department of Transportation (DOT) to study the acceptance of electronic payments at its customer service sites and sites operated by county treasurers. Specifically the legislation requires the following: “The department of transportation shall review the current methods the department employs for the collection of fees and other revenues at sites operated by county treasurers under chapter 321M and at customer service sites operated by the department. In conducting its review, the department, in cooperation with the treasurer of state, shall consider providing an electronic payment option for all of its customers. The department shall report its findings and recommendations by December 31, 2008, to the senate and house standing committees on transportation regarding the advantages and disadvantages of implementing one or more electronic payment systems.” This review focused on estimating the costs of providing an electronic payment option for customers of the DOT driver’s license stations and those of the 81 county treasurers. Customers at these sites engage in three primary financial transactions for which acceptance of electronic payments was studied: paying for a driver’s license (DL), paying for a non-operator identification card (ID), and paying certain civil penalties. Both consumer credit cards and PIN-based debit cards were reviewed as electronic payment options. It was assumed that most transactions would be made using a consumer credit card. Credit card companies charge a fee for each transaction for which they are used. The amount of these fees varies among credit card companies. The estimates for credit card fees used in this study were based on the State Treasurer of Iowa’s current credit card contract, which is due to expire in September 2009. Since credit card companies adjust their fees each year, estimates were based on the 2008 fee schedule. There is also a fee for the use of PIN-based debit cards. The estimates for PIN-based debit card transactions were based on information provided by Wells Fargo Merchant Services for current fees charged by debit card networks. Credit and debit card transactions would be processed through vendor-provided hardware and software. The costs would be determined through the competitive bidding process since several vendors provide this function; therefore, these costs are not reflected in this document.

Sports-related chronic repetitive head trauma as a cause of pituitary dysfunction.

Traumatic brain injury (TBI) is recognized as a cause of hypopituitarism even after mild TBI. Although over the past decade, a growing body of research has detailed neuroendocrine changes induced by TBI, the mechanisms and risk factors responsible for this pituitary dysfunction are still unclear. Around the world, sports-especially combative sports-are very popular. However, sports are not generally considered as a cause of TBI in most epidemiological studies, and the link between sports-related head trauma and hypopituitarism has not been investigated until recently. Thus, there is a paucity of data regarding this important concern. Because of the large number of young sports participants with near-normal life expectancy, the implications of undiagnosed or untreated postconcussion pituitary dysfunction can be dramatic. Understanding the pathophysiological mechanisms and risk factors of hypopituitarism caused by sports injuries is thus an important issue that concerns both medical staff and sponsors of sports. The aim of this paper was to summarize the best evidence for understanding the pathophysiological mechanisms and to discuss the current data and recommendations on sports-related head trauma as a cause of hypopituitarism.

Escala de madurez gonadal de bonito Sarda chiliensis chiliensis (Cuvier, 1832)

El objetivo fue elaborar la escala de madurez gonadal macroscópica de Sarda chiliensis chiliensis con una validación basada en análisis histológicos. Se analizaron 591 muestras de gónadas provenientes del plan de seguimiento de la pesquería pelágica en el año 2014. A cada gónada se asignó un estadio de madurez macroscópico luego de la observación del desarrollo ovocitario y espermatogénico en los cortes histológicos. Se describieron seis estadios de maduración que van desde 0 (virginal) hasta el estadio 5 (recuperación en hembras, post expulsante en machos). Se compara la descripción de esta escala con trabajos anteriormente realizados, se discuten los criterios de catalogación y se dan recomendaciones para el seguimiento de la pesquería.

Iowa’s Historic Automobile Roads A National Register Study of Pre-1948 Arterial Highways, 2009

This study of Iowa’s Historic Automobile Roads has been prepared by the Highway Archaeology Program under the terms of an annual cultural resource surveys contract between the Iowa DOT and The University of Iowa. Under this agreement, state transportation funds are appropriated by the Iowa DOT for The University of Iowa Highway Archaeology Program to locate and determine the significance of cultural resources in the area of proposed highway and transportation improvement work. Cultural resources include archaeological, historical, and architectural sites. The study of Iowa’s Historic Automobile Roads reported herein, including archival research and survey, was conducted between June 2002 and June 2007, by Marlin R. Ingalls and Maria F. Schroeder. The University of Iowa Highway Archaeology Program is solely responsible for the content and accuracy of these reports with respect to site location description, interpretation, and recommendations. Duplicate project reports are filed at the State Historic Preservation Office (SHPO), Community Programs Bureau in Des Moines. Illustrations in this report may have been altered for clarity and sized to fit the page.

Housing Task Force Report, August 2008

Few disaster recovery initiatives are more important than those that house the people and assist them to repair or replace their homes. The widespread damage to housing from the tornadoes, storms, and floods in 2008 creates greater challenges in housing than the state has faced from previous disasters. The Housing Task Force gratefully submits its Report to the Rebuild Iowa Advisory Commission as an opportunity to place data, issues, priorities and recommendations before residents, communities, state officials, and policymakers at all levels for consideration of how best to guide, support, and resource these efforts. Quantifying the impact of the disasters on communities is daunting. The many personal accounts and sets of community statistics paint pictures of Iowans who have emerged from the rubble or muck of their homes with a determination and commitment to rebuild not just like they were previous to the disasters, but better and stronger. Damage statistics are telling.

Supplemental Information to the August 2008 Housing Task Force Report, August 2008

Few disaster recovery initiatives are more important than those that house the people and assist them to repair or replace their homes. The widespread damage to housing from the tornadoes, storms, and floods in 2008 creates greater challenges in housing than the state has faced from previous disasters. The Housing Task Force gratefully submits its Report to the Rebuild Iowa Advisory Commission as an opportunity to place data, issues, priorities and recommendations before residents, communities, state officials, and policymakers at all levels for consideration of how best to guide, support, and resource these efforts. Quantifying the impact of the disasters on communities is daunting. The many personal accounts and sets of community statistics paint pictures of Iowans who have emerged from the rubble or muck of their homes with a determination and commitment to rebuild not just like they were previous to the disasters, but better and stronger. Damage statistics are telling. Supplemental Information to the August 2008

Serum androgen levels in elite female athletes.

OBJECTIVE: Prior to the implementation of the blood steroidal module of the Athlete Biological Passport, we measured the serum androgen levels among a large population of high-level female athletes as well as the prevalence of biochemical hyperandrogenism and some disorders of sex development (DSD). METHODS AND RESULTS: In 849 elite female athletes, serum T, dehydroepiandrosterone sulphate, androstenedione, SHBG, and gonadotrophins were measured by liquid chromatography-mass spectrometry high resolution or immunoassay. Free T was calculated. The sampling hour, age, and type of athletic event only had a small influence on T concentration, whereas ethnicity had not. Among the 85.5% that did not use oral contraceptives, 168 of 717 athletes were oligo- or amenorrhoic. The oral contraceptive users showed the lowest serum androgen and gonadotrophin and the highest SHBG concentrations. After having removed five doped athletes and five DSD women from our population, median T and free T values were close to those reported in sedentary young women. The 99th percentile for T concentration was calculated at 3.08 nmol/L, which is below the 10 nmol/L threshold used for competition eligibility of hyperandrogenic women with normal androgen sensitivity. Prevalence of hyperandrogenic 46 XY DSD in our athletic population is approximately 7 per 1000, which is 140 times higher than expected in the general population. CONCLUSION: This is the first study to establish normative serum androgens values in elite female athletes, while taking into account the possible influence of menstrual status, oral contraceptive use, type of athletic event, and ethnicity. These findings should help to develop the blood steroidal module of the Athlete Biological Passport and to refine more evidence-based fair policies and recommendations concerning hyperandrogenism in female athletes.