Lyme Disease Essays (1202 words) - Rheumatology, RTT,

Lyme Disease Lyme disease is a tick-transmitted inflammatory disorder characterized by an early focal skin lesion, and subsequently a growing red area on the skin (erythema chronicum migrans or ECM). The disorder may be followed weeks later by neurological, heart or joint abnormalities. Symptomatology The first symptom of Lyme disease is a skin lesion. Known as erythema chronicum migrans, or ECM, this usually begins as a red discoloration (macule) or as an elevated round spot (papule). The skin lesion usually appears on an extremity or on the trunk, especially the thigh, buttock or the under arm. This spot expands, often with central clearing, to a diameter as large as 50 cm (c. 12 in.). Approximately 25% of patients with Lyme disease report having been bitten at that site by a tiny tick 3 to 32 days before onset of ECM. The lesion may be warm to touch. Soon after onset nearly half the patients develop multiple smaller lesions without hardened centers. ECM generally lasts for a few weeks. Other types of lesions may subsequently appear during resolution. Former skin lesions may reappear faintly, sometimes before recurrent attacks of arthritis. Lesions of the mucous membranes do not occur in Lyme disease. The most common symptoms accompanying ECM, or preceding it by a few days, may include malaise, fatigue, chills, fever, headache and stiff neck. Less commonly, backache, muscle aches (myalgias), nausea, vomiting, sore throat, swollen lymph glands, and an enlarged spleen may also be present. Most symptoms are characteristically intermittent and changing, but malaise and fatigue may linger for weeks. Arthritis is present in about half of the patients with ECM, occurring within weeks to months following onset and lasting as long as 2 years. Early in the illness, migratory inflammation of many joints (polyarthritis) without joint swelling may occur. Later, longer attacks of swelling and pain in several large joints, especially the knees, typically recur for several years. The knees commonly are much more swollen than painful; they are often hot, but rarely red. Baker's cysts (a cyst in the knee) may form and rupture. Those symptoms accompanying ECM, especially malaise, fatigue and low-grade fever, may also precede or accompany recurrent attacks of arthritis. About 10% of patients develop chronic knee involvement (i.e. unremittent for 6 months or longer). Neurological abnormalities may develop in about 15% of patients with Lyme disease within weeks to months following onset of ECM, often before arthritis occurs. These abnormalities commonly last for months, and usually resolve completely. They include: 1. lymphocytic meningitis or meningoencephalitis 2. jerky involuntary movements (chorea) 3. failure of muscle coordination due to dysfunction of the cerebellum (cerebellar ataxia) 4. cranial neuritis including Bell's palsy (a form of facial paralysis) 5. motor and sensory radiculo-neuritis (symmetric weakness, pain, strange sensations in the extremities, usually occurring first in the legs) 6. injury to single nerves causing diminished nerve response (mononeuritis multiplex) 7. inflammation of the spinal cord (myelitis). Abnormalities in the heart muscle (myocardium) occur in approximately 8% of patients with Lyme disease within weeks of ECM. They may include fluctuating degrees of atrioventricular block and, less commonly, inflammation of the heart sack and heart muscle (myopericarditis) with reduced blood volume ejected from the left ventricle and an enlarged heart (cardiomegaly). When Lyme Disease is contracted during pregnancy, the fetus may or may not be adversely affected, or may contract congenital Lyme Disease. In a study of nineteen pregnant women with Lyme Disease, fourteen had normal pregnancies and normal babies. If Lyme Disease is contracted during pregnancy, possible fetal abnormalities and premature birth can occur. Etiology Lyme disease is caused by a spirochete bacterium (Borrelia Burgdorferi) transmitted by a small tick called Ixodes dammini. The spirochete is probably injected into the victim's skin or bloodstream at the time of the insect bite. After an incubation period of 3 to 32 days, the organism migrates outward in the skin, is spread through the lymphatic system or is disseminated by the blood to different body organs or other skin sites. Lyme Disease was first described in 1909 in European medical journals. The first outbreak in the United States occurred in the early 1970's in Old lyme, Connecticut. An unusually high incidence of juvenile arthritis in the area led scientists to investigate and identify the disorder. In 1981, Dr. Willy Burgdorfer identified the bacterial spirochete organism (Borrelia Burgdorferi) which causes this disorder. Affected Population Lyme Disease occurs in wooded areas with populations of mice and deer which carry ticks, and can be contracted during any season of the year. Related Disorders Rheumatoid Arthritis is a disorder similar in appearance to

Performance Management Analysis

Performance Management Analysis Introduction In the recent past, there has been a shifting paradigm from Taylor’s model of organizational management to more productive methods of production. The new methods aim at increasing production through efficient management of human and capital resources. A number of scholars have conducted extensive research to establish the effects of various managerial techniques on the performance of employees.Advertising We will write a custom report sample on Performance Management Analysis specifically for you for only $16.05 $11/page Learn More Some researchers note that task formulation is the most notable aspect of management, whereas others observe that the availability of human resources is the crucial factor that influences the performance of the management team. However, scholars concur that three factors are essential as far as the best managerial practices are concerned. One of the factors is production management while the other is the organi zation of work. In addition, the relationship between various groups in the organization influences the performance of employees. Scholars agree that a new model of management should be applied in case the organization is to achieve high results. The new model must incorporate the tenets of neo-liberalism into its productivity structures. Currently, scholars focus on exploring the new management dynamics that relate to post-Ford model of production. Scholars in the UK and the US perceive that the model should be adopted in order to enhance productivity in organizations. However, changing the work structure has micro and macro implications. Scholars of political economy and ethnographic sociology have posted their findings on the topic given its importance in the performance of organizations. This paper reviews a number of articles in order to shed some light on the topic. Views of Various Scholars on Post-Ford Production Model As earlier noted, scholars have posted various views reg arding the management models in the current managerial systems. Their views can be categorized into a number of models. Under high performance work systems model, scholars such as Danford and Thompson have contributed enormously in enriching the topic. Handel and Gittleman are some of the scholars who have contributed to the development of high-performance work practices model. Ashton and Sung have conducted extensive research to establish the influence of high-performance work on organizations.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More A number of scholars have also discussed the issue of high involvement in detail. Some have talked about high involvement work systems while others stick to high involvement work practices. Harmon is one such scholar who talks about high involvement work systems while Fuertes and Sanchez capitalize their study on high involvement practices. The issue of high involvement management is also of importance to scholars. Forth and Millward are some of the scholars who analyze the relationship between high involvement practices and the management strategies. Scholars such as Brown and Reich have postulated their findings regarding the relationship between high performance and employment systems. High commitment management is another model employed in analyzing the performance of employees. Baird, Whitefield, and Poole are some of the scholars who have posted their findings on commitment management model. Danford (2004) notes that the idea of high performance work systems is a mechanistic model that does not take into account the demands of human beings. He conducted a study on JetCo manufacturing company and came up with a number of suggestions. The company had a number of efficient practices at the start, but ended up with practices that were unpleasant to the workforce. The company had prolific initiatives aimed at improvin g the quality of production. The introduction of team leaders created tension among employees, which lowered the firm’s productivity. Employees perceived that their views were not given serious attention. On his part, Thompson (2003) notes that a significant factor regarding high performance work systems is reciprocity. In this regard, employers have a responsibility of ensuring that they develop trust and commitment towards employees. Therefore, the employer is charged with the responsibility of ensuring that the employee is provided with adequate training and efficient reward system. However, Thomson admits that employers in the neo-liberal economy are unable to fulfill the wishes of employees due to the challenges posed by the economy. On high performance work practices, Handel and Gittleman (2004) criticize the model by observing that it does not create a working relationship between workers and employers. The model is only known to increase wages. Therefore, the new mode l of high performance management is simply aimed at benefitting an individual, but does not increase productivity in the organization.Advertising We will write a custom report sample on Performance Management Analysis specifically for you for only $16.05 $11/page Learn More Ashton and Sung (2002) assert that it is proven scientifically that a strong relationship between human resource practices and improved performance exist. In particular, the relationship is strong in matters related to profitability and productivity. Therefore, the two scholars suggest that performance practices are closely related to the skills acquired by the employee. The relationship serves to strengthen the effectiveness and efficiency of the organization. However, the scholars caution that the model is only applicable to certain industries. This means that the model does not solve managerial problems in all scenarios. Harmon (2003) conducted a research to explore the efficiency of the American health care sector. In the study, a conclusion was drawn suggesting that a relationship between high performance management and employee efficiency existed. The study can be interpreted to mean that high involvement work systems are related to financial aspects. Fuertes and Sanchez (2003) extend the works of Harmon by observing that some factors motivate employers to adopt certain models. Employers calculate the benefits of the model before adopting it. Employers might prefer using less costly strategies, as opposed to using strategies that would drain their resources. Employers do not prefer some of the practices, such as rewarding employees with financial benefits because they eat up their profits. Employers prefer using non-financial rewards to appreciate their employees, such as awarding a promotion. Forth and Millward (2004) assert that high performance management is a concept that cannot be neglected given its effectiveness and influence on the performance of the organization. They further observe that all management practices are related to the high performance management model in one way or the other. Forth and Millward note that the high performance management model might be interrupted by deregulation of financial markets. Organizations in the modern financial markets go through a number of challenges that make it hard for employers to implement high performance management models.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Competition in the market is stiff implying that employers are concerned with sustaining market competition, not enhancing structural organization of firms. Brown and Reich (1999) conducted a study on one of the Australian manufacturing companies. The company formulated a number of strategies aimed at improving the performance of the organization. The firm emphasized on team building, development of staff, and training. The firm adjusted its policies that focused on Taylor’s model to reflect modern managerial practices. Efficient planning and role allocation were some of the new strategies employed by the firm. The new tactics improved the performance of the organization in a number of ways. Whitefield and Poole (1997) observe that high commitment management is a highly sensitive issue. Therefore, it must be handled carefully. The main concern of employers is to increase production and organize work. The scholars note that before talking about performance management, the caus es of perennial problems in the organization must be handled. The above scholars suggest that organizations utilize their competitive advantages in the market to formulate innovative practices. The researchers conclude that implementation of high performance managerial practices generate new techniques that improve the performance of the organization. High performance management strategies are extremely costly, but their outcomes are productive. In this regard, they observe that high performance management models must produce high results for them to be maintained. In a study conducted in Europe, it was established that organizations with comprehensive new work practices tended to have high training needs. Regarding high commitment management, Baird (2002) notes that all stakeholders in the organization must be consulted before formulating any policy. Through consultative forum, the organization utilizes its resources in the most cost effective way. Moreover, embracing dialogue help s the firm in achieving its competitive advantage in the market. The role of professionals in the organization is to ensure social bonding and commitment to the new techniques of production. Conclusions Model managerial theories suggest that the work place is the main learning institution that enhances the capacity of employees. Older models suggest that employees are expected to join organizations when they are already equipped with adequate knowledge from colleges and universities. Things have since changed in the modern society. For instance, the works of modern scholars suggest that teamwork is one of the most crucial aspects of management. Employees are expected to be given chances to explore their potentials in the organization. This implies that employers are expected to allow some flexibility that permits sovereignty. References Ashton, D., Sung, J. (2002). Supporting Workplace Learning for High Performance Working. Geneva: International Labor Office. Baird, M. (2002). Chan ges, Dangers, Choice and Voice: Understanding What High Commitment Management Means for Employees and Unions. The Journal of Industrial Relations, 44(3), 359-375. Brown, C., Reich, M. (1997). Micro-Macro Linkages in High Performance Employment Systems. Organizational Studies, 18(5), 765-781. Danford, A. (2004). High Performance Work Systems and Workplace Partnership: A Case Study of Aerospace Workers. New Technology, Work and Employment, 19(1), 14-29. Forth, J., Millward, N. (2004). High-Involvement Management and Pay in Britain’, Industrial Relations, 43(1), 98-119. Fuertes, M., Sanchez, F. (2003). High-Involvement Practices in Human Resource Management: Concept and Factors that Motivate their Adoption. International Journal of Human Resource Management, 14(4), 511-529. Handel, J., Gittleman, M. (2004). Is There a Wage Pay-off to Innovative Work Practices? Industrial Relations, 43(1), 67-97. Harmon, J., (2003). Effects of High-Involvement Work Systems on Employee Satisfa ction and Service Costs in Veteran Healthcare. Journal of Health Management, 48(16), 393-418. Thompson, P. (2003). Disconnected Capitalism: Or Why Employers Cannot Keep Their Side of the Bargain. Work Employment and Society, 17(2), 359-378. Whitefield, K., Poole, M. (1997). Organizing Employment for High Performance: Theories, Evidence, and Policy. Organization Studies, 18(5), 745-764.