Development of Joints

Project for the European Commission Directorate General on Health and Consumer Protection Development of indicators on consumer satisfaction and Pilot survey Contract n° B5-1000/03/000382 FINAL REPORT 1 February, 2005 © Communautés européennes, 2005 This report was produced by a joint team INRA and Deloitte & Touche for DG Health & Consumer Protection and represents the views of the contractor or author. These views have not been adopted or in any way approved by the Commission and should not be re-lied upon as a statement of the Commission's or DG Health & Consumer Protection's views. The European Commission does not guarantee the accuracy of the data included in this report, nor does it accept responsibility for any use made thereof. Table of Contents 1. Introduction 1 1.1 Background to this assignment _________________________ 1 1.1.1 The EU consumer policy _____________________________________________ 1 1.1.2 Policy-makers need information _______________________________________ 1 1.2 Scope of the assignment ______________________________ 2 1.2.1 Main objectives and expected outcomes_________________________________ 2 1.2.2 Policy-making needs ________________________________________________ 2 1.2.3 Geographical coverage_______________________________________________ 3 1.2.4 Sector coverage ____________________________________________________ 3 1.2.5 Additional requirements______________________________________________ 4 1.3 Methodology adopted_________________________________ 4 1.3.1 Overview _________________________________________________________ 4 1.3.2 Clarification of objectives and requirements ______________________________ 5 1.3.3 Desk research______________________________________________________ 5 1.3.4 Organisation of focus group discussions _________________________________ 6 1.3.5 Model development _________________________________________________ 6 1.3.6 Questionnaire design ________________________________________________ 7 1.3.7 Conducting a Pilot survey ____________________________________________ 7 1.3.8 Statistical analysis of the Pilot survey data _______________________________ 8 1.3.9 Development of final guidelines________________________________________ 8 2. The measurement of consumer satisfaction 9 2.1 Introduction ________________________________________ 9 2.2 Concepts and definitions ______________________________ 9 2.2.1 Consumers ________________________________________________________ 9 2.2.2 Consumer satisfaction ______________________________________________ 10 2.2.3 Manifest and latent variables_________________________________________ 11 2.2.4 Indicators and indexes______________________________________________ 14 2.3 The development of national customer satisfaction indexes __ 15 2.3.1 General concept and origin __________________________________________ 15 2.3.2 The American Customer Satisfaction Index and related approaches __________ 15 2.3.3 The European Consumer Satisfaction Index _____________________________ 17 2.4 Development of a provisional model ____________________ 18 2.4.1 Conceptual model _________________________________________________ 18 2.4.2 Overview of the variables for the provisional model_______________________ 20 2.4.3 Main differences from other models ___________________________________ 22 2.5 Discussion of the variables included in the Development of Joints Development of Joints Bởi: OpenStaxCollege Joints form during embryonic development in conjunction with the formation and growth of the associated bones The embryonic tissue that gives rise to all bones, cartilages, and connective tissues of the body is called mesenchyme In the head, mesenchyme will accumulate at those areas that will become the bones that form the top and sides of the skull The mesenchyme in these areas will develop directly into bone through the process of intramembranous ossification, in which mesenchymal cells differentiate into bone-producing cells that then generate bone tissue The mesenchyme between the areas of bone production will become the fibrous connective tissue that fills the spaces between the developing bones Initially, the connective tissue-filled gaps between the bones are wide, and are called fontanelles After birth, as the skull bones grow and enlarge, the gaps between them decrease in width and the fontanelles are reduced to suture joints in which the bones are united by a narrow layer of fibrous connective tissue The bones that form the base and facial regions of the skull develop through the process of endochondral ossification In this process, mesenchyme accumulates and differentiates into hyaline cartilage, which forms a model of the future bone The hyaline cartilage model is then gradually, over a period of many years, displaced by bone The mesenchyme between these developing bones becomes the fibrous connective tissue of the suture joints between the bones in these regions of the skull A similar process of endochondral ossification gives rises to the bones and joints of the limbs The limbs initially develop as small limb buds that appear on the sides of the embryo around the end of the fourth week of development Starting during the sixth week, as each limb bud continues to grow and elongate, areas of mesenchyme within the bud begin to differentiate into the hyaline cartilage that will form models for of each of the future bones The synovial joints will form between the adjacent cartilage models, in an area called the joint interzone Cells at the center of this interzone region undergo cell death to form the joint cavity, while surrounding mesenchyme cells will form the articular capsule and supporting ligaments The process of endochondral ossification, which converts the cartilage models into bone, begins by the twelfth week of embryonic development At birth, ossification of much of the bone has occurred, but the hyaline cartilage of the epiphyseal plate will remain throughout childhood and adolescence to 1/3 Development of Joints allow for bone lengthening Hyaline cartilage is also retained as the articular cartilage that covers the surfaces of the bones at synovial joints Chapter Review During embryonic growth, bones and joints develop from mesenchyme, an embryonic tissue that gives rise to bone, cartilage, and fibrous connective tissues In the skull, the bones develop either directly from mesenchyme through the process of intramembranous ossification, or indirectly through endochondral ossification, which initially forms a hyaline cartilage model of the future bone, which is later converted into bone In both cases, the mesenchyme between the developing bones differentiates into fibrous connective tissue that will unite the skull bones at suture joints In the limbs, mesenchyme accumulations within the growing limb bud will become a hyaline cartilage model for each of the limb bones A joint interzone will develop between these areas of cartilage Mesenchyme cells at the margins of the interzone will give rise to the articular capsule, while cell death at the center forms the space that will become the joint cavity of the future synovial joint The hyaline cartilage model of each limb bone will eventually be converted into bone via the process of endochondral ossification However, hyaline cartilage will remain, covering the ends of the adult bone as the articular cartilage Review Questions Intramembranous ossification gives rise to the bones of the limbs produces the bones of the top and sides of the skull produces the bones of the face and base of the skull involves the conversion of a hyaline cartilage model into bone B Synovial joints are derived from fontanelles are produced by intramembranous ossification develop at an interzone site are produced by endochondral ossification C Endochondral ossification is 2/3 Development of Joints the process that replaces hyaline cartilage with bone tissue the process by which mesenchyme differentiates directly into bone tissue completed before birth the process that gives rise to the joint interzone and future joint cavity A Critical Thinking Questions Describe how synovial joints develop within the embryonic limb Mesenchyme gives rise to cartilage models of the future limb bones An area called the joint interzone located between adjacent cartilage models will become a synovial joint The ...Gornik et al. Critical Care 2010, 14:R130http://ccforum.com/content/14/4/R130Open AccessRESEARCH© 2010 Gornik et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.ResearchA prospective observational study of the relationship of critical illness associated hyperglycaemia in medical ICU patients and subsequent development of type 2 diabetesIvan Gornik*1, Ana Vujaklija-Brajković1, Ivana PavlićRenar2 and Vladimir Gašparović1AbstractIntroduction: Critical illness is commonly complicated by hyperglycaemia caused by mediators of stress and inflammation. Severity of disease is the main risk factor for development of hyperglycaemia, but not all severely ill develop hyperglycemia and some do even in mild disease. We hypothesised that acute disease only exposes a latent disturbance of glucose metabolism which puts those patients at higher risk for developing diabetes.Methods: Medical patients with no history of impaired glucose metabolism or other endocrine disorder admitted to an intensive care unit between July 1998 and June 2004 were considered for inclusion. Glucose was measured at least two times a day, and patients were divided into the hyperglycaemia group (glucose ≥7.8 mmol/l) and normoglycaemia group. An oral glucose tolerance test was performed within six weeks after discharge to disclose patients with unknown diabetes or pre-diabetes who were excluded. Patients treated with corticosteroids and those terminally ill were also excluded from the follow-up which lasted for a minimum of five years with annual oral glucose tolerance tests.Results: A five-year follow-up was completed for 398 patients in the normoglycaemia group, of which 14 (3.5%) developed type 2 diabetes. In the hyperglycaemia group 193 patients finished follow-up and 33 (17.1%) developed type 2 diabetes. The relative risk for type 2 diabetes during five years after the acute illness was 5.6 (95% confidence interval (CI) 3.1 to 10.2).Conclusions: Patients with hyperglycaemia during acute illness who are not diagnosed with diabetes before or during the hospitalization should be considered a population at increased risk for developing diabetes. They should, therefore, be followed-up, in order to be timely diagnosed and treated.IntroductionHyperglycaemia commonly occurs in the course of anycritical illness. This now generally known fact, firstdescribed by Claude Bernard in 1878 [1], became widelyaccepted after studies had shown its association withworse outcomes [2,3] and the positive effects of tight glu-cose control in the critically ill [4,5]. The issue is stillfocussed on after later studies [6] opened up a debate onhow tight the control of glycaemia should be [7,8]. Theusual idioms used for this phenomenon are stress hyperg-lycaemia and critical illness hyperglycaemia whichinclude hyperglycaemia that occurs in patients with andwithout diabetes. The term hospital acquired hypergly-caemia [9] is proposed for hyperglycaemia in patients towhom no disorder of glucose metabolism can be diag-nosed after 1 PREAMBLEI would like to start the topic with a question: What is the essence value of an organization? There are many different answers, such as capital, equipment, technology, human resource, etc. However, in a society of integration, capital which can be mobilized and borrowed from banks or other credit agencies; machinery, equipment and technology that are equality between firms around the world (technology handover at home and abroad), the remaining factor which makes a powerful difference of a firm is human resource. Therefore, in order for an organization stably develops, there’s a need to attach special importance to developing human resources in an organization.During the period of probation at MISA Joint Stock Company, I found that company has a great potential for strong development: large capital, modern technology, high-qualified human resource, management board always has innovative and modern ideas. Thus, developing orientation of the company in recent years focused on human resource development. According to developing orientation of the company and study in-depth on how to create a strong development, I research on the topic “Strategies of human resource development of MISA JSC”The topic goes into the details of activities, plans to manage and develop human resources of the company, for example, recruitment, training, strategies of developing human resources and attracting talents. The topic also researches on employee-encouraging policies in their job to make motivation and dedication of them with the company. The topic is studied in the following chapters:Chapter 1. Introduction about MISA Joint Stock Company (MISA JSC)Chapter 2. Activities of human resource management and development of MISA JSCChapter 3. Recommendation for promoting human resource development of MISA JSC 1CHAPTER 1. An introduction into MISA JSCI.An overview about MISA JSCInformation technology (IT) plays an important role in development of national economy, MISA Joint Stock Company (MISA JSC) was formed 25th December, 1994 – one of the leading software units in Vietnam that has large contribution in the computerization for administrative units and enterprises in over 16 years. MISA has now 01 head office, 01 software development center where launch software products with high quality, 05 representative offices in Hanoi, Da Nang, Buon Ma Thuot, Can Tho and HCM city. With over 45,000 customers, MISA has become the indispensable companion of the business community as well as the state agency. MISA has 05 representative offices performing the promotion and implementation of MISA's products, after-sales services, consultancy, support, organization of training courses about instructions for use software for customers. The MISA software is introduced popularly to 63 provinces in the whole country.MISA is proud of one of the leading companies in the construction and deployment of application software solutions, contributing to the development of information technology –media of country. MISA is also the familiar product with universities, colleges, training centers of information technology, business administration, and finance accounting in the whole country. More than 250 universities, colleges and vocational schools have introduced MISA software into teaching job. MISA is also the partner of Departments; Ministry, Development of a method to measure consumer emotions associated with foods Silvia C. King a, * , Herbert L. Meiselman b a McCormick and Company, Inc., 204 Wight Avenue, Hunt Valley, MD 21030, USA b Herb Meiselman Training and Consulting Services, P.O. Box 28, Rockport, MA 01966, USA article info Article history: Received 30 October 2008 Received in revised form 9 February 2009 Accepted 13 February 2009 Available online 23 February 2009 Keywords: Emotion Mood Consumer Food abstract Emotion attributes have been generally associated with product brands but little work has been pub- lished to understand consumer emotions associated with the product itself. The purpose of this series of studies was to develop an emotion-specific questionnaire to test foods with consumers in person or on the internet. A list of emotion terms was screened and validated with consumers. The emotion terms selected for foods were generally positive, as compared with emotion testing originating within a clinical framework. The list of emotions was useful in differentiating between and within categories of foods. Higher overall acceptability scores correlated with higher emotions, but differences in emotion profiles did not always correlate to differences in acceptability. A description of the approach used to develop the questionnaire, questionnaire format, effect of test context, and specific applications of the method to foods are presented. This test represents a major methodological advance in consumer testing of food products in a commercial environment. Ó 2009 Elsevier Ltd. All rights reserved. 1. Introduction Food affects the way we feel, and researchers have included mood as a key variable determining food choices. One of the clear- est demonstrations of this is the Food Choice Questionnaire devel- oped by Steptoe, Pollard, and Wardle (1995) to identify determinants of food choice. Nine factors were identified including mood, which has also been identified in a number of follow-up cross-cultural studies (Eertmans, Victoir, Notelaers, Vansant, & Van den Bergh, 2006). Mood has also been identified as a key behavioral outcome of foods along with cognitive and physical performance (Lieberman, 2005). In fact, mood is often the easiest outcome to measure, more easily measured than physical outcomes or subtle cognitive out- comes. Much of the published food and mood research has come about as part of this tradition of looking for effects of food on hu- man performance (Gibson, 2006; Lieberman, 2005). Despite the evidence that food affects mood, there has been rel- atively little published on mood research within food product development. This can be attributed to a number of factors includ- ing the practice that food companies keep this material secret in order to gain a competitive advantage. However, another reason is the lack of a standard method or methods for measuring emo- tions associated with food within the product development con- text. This context is important because techniques which are appropriate for the academic laboratory research might not be appropriate for commercial settings of consumer laboratories. Aca- demic laboratory research typically uses student volunteers who sometimes participate as part of course requirements. Such studies have minimal time constraints. They also have fewer constraints on the content of the questionnaire materials presented to stu- dents or the RESEA R C H ART I C L E Open Access Development of proteoglycan-induced arthritis depends on T cell-supported autoantibody production, but does not involve significant influx of T cells into the joints Adrienn Angyal 1† , Colt Egelston 2† , Tamás Kobezda 1 , Katalin Olasz 1 , Anna László 1 , Tibor T Glant 1 , Katalin Mikecz 1* Abstract Introduction: Inflammatory joint destruction in rheumatoid arthritis (RA) may be triggered by autoantibodies, the production of which is supported by autoreactive T cells. Studies on RA and animal models of the disease suggest that T cells recruited in the joints can locally initiate or propagate arthritis. Herein, we investigated the role of joint- homing versus lymphoid organ-homing T cells in the development of proteoglycan-induced arthritis (PGIA), an autoimmune model of RA. Methods: To identify T cells migrating to the joints before and during development of autoimmune arthritis, we transferred fluorescence-labeled T cells, along with antigen-presenting cells, from BALB/c mice with PGIA to naïve syngeneic severe combined immunodeficient (SCID) mice. We then monitored the recruitment of donor T cells in the ankle joints and joint-draining lymph nodes of the recipients using in vivo two-photon microscopy and ex vivo detection methods. To limit T-cell access to the joints, we selectively depleted T cells in the blood circulation by treatment with FTY720, an inhibitor of lymphocyte egress from lymphoid organs. Reduction of T cell presence in both lymphoid organs and blood was achieved by injection of donor cells from which T cells were removed prior to transfer. T and B cells were quantitated by flow cytometry, and antigen (PG)-specific responses were assessed by cell proliferation and serum antibody assays. Results: Despite development of adoptively transferred arthritis in the recipient SCID mice, we found very few donor T cells in their joints after cell transfer. Treatment of recipient mice with FTY720 left the T-cell pool in the lymphoid organs intact, but reduced T cells in both peripheral blood and joints. However, FTY720 treatment failed to inhibit PGIA development. In contrast, arthritis was not seen in recipient mice after transfer of T cell-depleted cells from arthritic donors, and serum autoantibodies to PG were not detected in this group of mice. Conclusions: Our results suggest that antigen-specific T cells, which home to lymphoid organs and provide help to B cells for systemic autoantibody production, play a greater role in the development and progression of autoimmune arthritis than the small population of T cells that migrate to the joints. Introduction Rheumatoid arthritis (RA) is a systemic autoimmune disease involving mainly the peripheral synovial joints and causing chronic inflammation and profound tissue destruction in affected patients [1]. The autoimmune character of RA is best supported by the presence of cir- culating autoantibodies (autoAbs) against immunoglobu- lins (rheumatoid factor), citrullinated proteins, and other endogenous proteins [2,3], which may become detect- able in serum years before the development of joint symptoms [4]. The systemic production of autoAbs indi- cates that autoreactive T cells that provide help to B cells for Ab secretion are located in the secondary lym- phoid organs and therefore are indirectly involved in * Correspondence: Katalin_Mikecz@rsh.net † Contributed equally 1 Section of Molecular Medicine, Department of Orthopedic Surgery, Rush University Medical Center, 1735 West Harrison Street, Chicago, IL 60612, USA Angyal et al. Arthritis Research & Therapy 2010, 12:R44 http://arthritis-research.com/content/12/2/R44 © 2010 Angyal et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution L icense (http://creativecommons.o rg/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly ... gives rise to the bones of the limbs produces the bones of the top and sides of the skull produces the bones of the face and base of the skull involves the conversion of a hyaline cartilage model.. .Development of Joints allow for bone lengthening Hyaline cartilage is also retained as the articular cartilage that covers the surfaces of the bones at synovial joints Chapter... cartilage model of each limb bone will eventually be converted into bone via the process of endochondral ossification However, hyaline cartilage will remain, covering the ends of the adult bone