Septic Arthritis and Reactive Arthritis Comparison

Septic Arthritis and Reactive Arthritis Comparison Septic infectious arthritis and reactive arthritis are two arthritic disorders that result from an infection. Though they both are related in their etiology and in their characteristic of causing arthritic joints, each of them are actually different in the way the infection triggers the condition. The main difference between the two conditions may be further clarified with the examination of the terminology used for each. Origin of Terminology Septic arthritis derives its name from the term sepsis which pertains to the systemic compromise due to the spread of infection  [1]  ; this is the reason why the term is at times used interchangeably with infectious arthritis. Reactive arthritis was previously known as Reiters Syndrome named after the late German physician Hans Conrad Julius Reiter who was instrumental in the identification and description of the condition.  [2]  The term Reiters syndrome has lost popularity due to the exposure of Reiters history as a Nazi party member during his prosecution in the Nuremberg trials as a war criminal because of his alleged participation in the forced human experimentations in the Buchenwald concentration camp; this urged a group of doctors to campaign for the renaming of term Reiters syndrome into reactive arthritis back in 1977.  [3]  The condition may also be known as arthritis urethritica, polyarteritis enterica, or venereal arthritis. (1) The term arthritis urethritic a was coined due to its tendency to occur after a genitourinary infection, (2) the term polyarteritis enterica was coined due to its tendency to affect multiple joints and its tendency to occur after a gastrointestinal infection, and (3) the term venereal arthritis was coined due to the tendency of the condition to occur after a known venereal disease infection. The main difference between reactive arthritis from septic arthritis is that septic arthritis caused by the infection of the joint. However, reactive arthritis is not caused by an infection to the joint itself, but is rather an autoimmune response in reaction to an infection on another part of the body. Each disorder will be discussed further in depth in this chapter. Overviews, Microbiology, and Prevalence Septic Arthritis Septic arthritis is an infection resulting in an arthritis characterized by purulent invasion and intense pain at the infected joint.  [4]  Aside from being interchangeable with the term infectious arthritis, this condition may also be known as suppurative arthritis due to its characteristic of producing purulent substances or pus, and may also be known as bacterial arthritis, even though the condition may at times be of fungal or viral origin instead of the commonly bacterial origin. The causative infectious agent in septic arthritis can spread to the joint from other previously infected areas of the body. The infection may sometimes only affect a single joint without affecting other parts of the body, but the infection may still spread to other body parts. Septic arthritis commonly affects the knee or wrist, and may also affect other joints such as the ankle, hip, elbow, shoulder, and shoulder. The infection infiltrates and damages the joint causing severe pain, suppuration, he at, and swelling. This severe form of arthritis also develops along with the sudden onset of fever, chills, and joint pain.  [5]  On the occasion that the sufferer of some forms of septic arthritis do not seek rapid medical attention for diagnosis and treatment, the joint may incur irreversible and permanent damage and in a period of days. Therefore, the situation should be regarded as a medical emergency. Gonococcal arthritis is the most prevalent form of septic arthritis in the United States  [6]  . This class of septic arthritis is less prevalent in other areas of the world such as Western Europe where it is presently uncommon. The causative organism behind this form of the condition is the gram-negative diplococcus bacteria called Neisseria gonorrhoeae which was most likely spread to the joint systematically due to disseminated gonococcal infection (DGI). This specific condition can be manifested as either arthritis-dermatitis syndrome which is a bacteremic infection accounting for sixty percent of gonococcal arthritis cases, or it can be manifested as an arthritic infection localized to a single joint which accounts for the remaining forty percent of cases.  [7]   Reactive Arthritis Reactive arthritis is an autoimmune condition caused by the bodys immune response to an infection. The causative infection is not located at the affected joint itself (cross-reactivity).  [8]  The triggering infection is usually or often already in remission by the time the patient presents with arthritic symptoms, thus making it difficult to ascertain the initial cause. Cultures taken from the synovial fluid of the joints affected by reactive arthritis will characteristically yield negative results indicating the cause is not a direct infection to the joint, but instead may be plausibly due to the over-stimulation of the autoimmune response or by the depositing of bacterial antigens in the joints by an unknown manner. Though the mechanism of reaction from the infection is still unknown, it is said that reactive arthritis often manifests within one to three weeks after a known infection. Microbiology of Arthritis The etiology of septic arthritis is commonly bacterial in naturemycobacterial, viral, and fungal arthritis occur in rare cases.  [9]  The pathogen responsible for septic arthritis must reach the synovial membrane of the joint. The micro-organisms are usually carried to the joint by the bloodstream from an infectious source such as wound infections and abscesses located elsewhere on the body, introduced by skin lesions or trauma that penetrates into the joint, or by extension of the infection from adjacent body tissue such adjacent soft tissue infections or bones suffering from an osteomyelitic condition. Being the most common cause of septic arthritis, there are various strains of bacteria that may be the culprit behind this condition. Staphylococcus aureus is the common causative pathogen in adults, while streptococci is the second-most likely causative pathogen in adults.  [10]  Neisseria gonorrhoea is the most prevalent causative microorganism in young adults, although thi s is now thought to be rare in Western Europe.  [11]  Moreover, Haemophilus influenzae was the most prevalent causative pathogen in children but is now declining in areas where haemophilus vaccinations have been introduced.  [12]  Escherichia coli (E. coli) are the most likely causative micro-organism among the elderly, the seriously ill, and users of intravenous drugs. Salmonella, brucella, and tuberculosis are the causative pathogens behind septic spinal arthritis.  [13]  Pseudomonas aeruginosa, which is the bacterium responsible for endocarditis, has also been identified as a causative pathogen for septic arthritis in children who have suffered a penetrating wound directly to the joints.  [14]   Reactive arthritis may also be caused by bacterial infection. It is triggered by a recent preceding infection; the most common culprit in the United States would be the genital infection Chlamydia trachomatis. The bacterium known as Ureaplasma urealytium, which is a pathogen of the urinary tract, is also known to trigger the condition. The condition may also be triggered by bouts of gastrointestinal infection or food poisoning from Salmonella, Shigella, Yersinia, and Campylobacter, which are all enteric bacteria genera.  [15]  The infection is not located in the ailing joint, and may no longer present elsewhere on the body by the time the reactive arthritis develops. Other microorganisms may still be behind a case reactive arthritis but the evidence indicating them to be the actual cause is still circumstantial.  [16]   Prevalence of Septic Arthritis and Reactive Arthritis Young children, older adults, and individuals with artificial joints are at greater risk than the general population to develop septic arthritis. Those with artificial joints may be infected with different organisms in comparison with the general population, and may present with slightly different symptoms.  [17]  In general, if an individual affected by septic arthritis seeks medical attention and treatment within a week after the first symptoms appear, they will most likely make a full recovery. On the other hand, individuals aged twenty to forty years of age are more likely to be affected by reactive arthritis. Men are more likely to be affected by the condition than women. Caucasian people are more likely to be affected than individuals of African-American descent; this is due to the frequent occurrence of the HLA-B27 gene within the white population.  [18]  Patients infected with the Human Immunodeficiency Virus (HIV) also have an increased risk of developing this condit ion. Arthritis makes it extremely difficult for affected individuals to remain physically active as many individuals become bound to their homes. These individuals will increase their risk for obesity, depression, and heart disease due to their inactivity and anxiety from worsening disability.  [19]   The Immune Systems Role in Arthritis Septic arthritis and reactive arthritis are both conditions that involve the immune systems autoimmune response. However, septic arthritis is the result of the bodys normal immune response to an actual infection present at the ailing joint. On the other hand, reactive arthritis is the result of the immune systems abnormal immune response to what it believes is a present infection at the joint but is, however, absent or is an infection on a part of the body aside from the joint; this mistaken response which may be due to misinterpretation or oversensitivity is considered abnormal and is classified as an autoimmune disease. An overview of the human bodys immune system can better explain the mechanism by which these two conditions come into fruition. Overview of the Human Immune System The human immune system is an intricate defense system designed to specifically defend against the many different types of pathogens. Pathogens are any organism, usually a live organism, which can cause disease. Pathogens include bacteria which are single celled organisms capable of living outside the body, protozoa which are single celled organisms that live and are spread through water, pathogenic proteins which are multi-celled organisms that can only reproduce in another more complex living organism, fungi which are plant-like multi-celled organisms that take nutrition from other living organism such as plants and animals, viruses which are actually multi-celled organisms that invade and reproduce inside another microbial organism, and parasites which are full complex organisms which feed off the nutrients of another complex organisms and which tend to live in the intestinal tract or bloodstream of the human body. In theory any one of these organisms can cause septic arthritis or reactive arthritis, but parasites are very unlikely to cause these conditions and bacteria are the most prevalent culprit. In the event that a pathogen passes through the bodys outer physical barriers, such as mucus and the skin, and penetrates into the internal structures of the human body, the immune system kicks in.  [20]   The human bodys immune system response is composed of the non-specific response and the specific response. Non-specific response consists of the complement response, the interferon response, fever response, and the inflammatory response. The complement response is conducted by the activation of complement proteins which bind with pathogens with lipid layers, such as bacteria, to destroy their lipid layers allowing water to shift into the pathogen to drown them, or by the activation of macrophages which engulf the invading pathogen. Interferon response is conducted by a cell that has been infected with a virus. The infected cell produces a chemical protein known as interferon which will bind to uninfected cells preventing the virus from readily infecting them. The fever is conducted in response to toxin present in the body which may or may not be produced by bacteria; pyrogen, which is a chemical also known as Interleukin 1, is responsible for resetting and increasing the bodys temper ature and may cause gradual joint degeneration. Inflammatory response is the result of the release of histamines in response to tissue damage or infection; histamine is capable of causing capillary dilation which allows for greater capillary permeability, which in turn allows for white blood cells to gather at an infected site, for fluid to create inflammation and swelling at the site to create cushioning, and for an increase in temperature at the affected site. The inflammatory response and fever response are the main responses responsible for the signs and symptoms present during both septic arthritis and reactive arthritis. The human bodys specific immune response is mostly managed by the different types of leukocytes which are better known as white blood cells (WBCs). White blood cells can be classified as eosinophils, macrophages, and lymphocytes. Eosinophils serve to produce interleukins which are chemicals that serve a vital role as immune system neurotransmitters that relay messages between the many different white blood cells to ensure that they work together and cooperate as an effective system against pathogens and to ensure that the immune system does not attack the bodys own cells. Macrophages are also known as phagocytes, meaning they are capable of conducting phagocytosis which is the process of engulfing, killing, and digesting of pathogens and cellular debris; after digestion, the degraded pathogen is turned in peptides which can act as antigens. The antigens produced by the macrophages are then carried by the macrophages into the lymph nodes where the helper T-cells utilize them to signal the B-cells to create antibodies. The last type of white blood cell is collectively called lymphocytes. The lymphocytes can be further subdivided into B-cells, NK cells, and T-cells. B-cells are responsible for creating immunoglobulin, or antibodies, that are specific to a certain pathogen as identified by their antigen. Antigens are protein peptides that exist on the outer surface of pathogens; these antigens are used to differentiate and identify cells and pathogens that are foreign to the host body. The helper T-cells who receive the antigen produced by the macrophage produce lymphokines which instruct the B-cells on the production of the specific antibody. When the B-cells produce the specific antibody, B plasma cells begin to create more copies of its own self to create more antibodies. These antibodies, when released into the bloodstream, will then proceed to bind with the antigens on the actual pathogens to signal the killer T-cells to attack these foreign organisms. The B-cells will also produce B memory cells, which are inactive B plasma cells. These inactive B memory cells last longer than their active B plasma cell counterparts, which last for about five to seven days; the presence of the B memory cells in the bloodstream allows them to respond faster to secondary exposures to the same pathogens in the future. Natural killer (NK) cells are cells that are activated by interferons, which interfere with virus replication, and chemicals produced by macrophages which have ingested a virus. Natural killer cells engulf virus pathogens to prevent them from reproducing until a killer T-cell is developed to kill the contained virus. T-cells are responsible for identifying and destroying specific pathogens and consist of helper T-cells, killer T-cells, memory T-cells, and suppressor T-cells. Helper T-cells receive antigens from macrophages which have ingested a pathogen and instruct the B-cells to produce antibodies which will in turn signal the killer T-cells. Killer T-cells are responsible for finding and destroying pathogens by injecting them with cytotoxins. Memory T-cells are derivatives of helper T-cells which circulate around the body and perform the same functions as their parent cells. Suppressor T-cells are responsible for slowing down and deactivating the immune response once the foreign o rganisms and pathogens have been eliminated. What Goes Wrong with the Immune Response Septic arthritis is really the result of the damage caused by the invading organisms and the normal immune response of the body to the infection in that specific joint or set of joints. In septic arthritis, the macrophages ingest a pathogen that has infected a joint. The macrophages then degrade the pathogen into antigens and relay them to the helper T-cells in the lymph nodes. The T-cells then create antibodies specific to the antigens on the pathogens. The inflammatory response also releases histamine which increases the blood flowing into the affected joint to cause swelling, redness, and pain, which in turn causes stiffness and difficulty moving in the joint to cause arthritic symptoms. Meanwhile, the invading organisms cause damage to the joints. Such damage incurred by the joints may be irreparable if medical attention is not immediately sought after. Suppuration which is the result of the white blood cells fight against the invading microorganisms may also contribute to the ar thritic condition. The fever response that triggers the release of pyrogen may also contribute to the degeneration of the joint. Although the exact etiology of the condition is still uncertain, unlike septic arthritis, reactive arthritis is caused by a faulty immune system response. The condition occurs in the absence and aftermath of an actual infection that is located in a part of the body aside from the affected joints. Two theories exist for the purpose of explanation. The first theory speculates that there are antigens deposited in the affected joint; the second theory speculates that the immune system has become faulty in detecting the actual presence or absence pathogens and creates an exaggerated immune response in the joints even though there is no infection or the infection is located elsewhere on the body. These theories causes the immune system to believe in a current infection and will release histamine and pyrogen to produce inflammation and fever. The inflammation will again cause the joint(s) to be stiff, painful, and immobileall of which are arthritic symptoms. The absence of an actual pathogen may mean that the inflammation and fever will last for an uncertain length of time but the absence of an actual pathogen will also mean that there is little to no actual damage to the affected joint. Distinguishing Characteristics There are over a hundred forms of arthritis, all of which involve some degree of inflammation, pain, and immobility of an affected joint.  [21]  The many different types are the result of several different causes and these causes may point towards what distinguishes each form of arthritis from the other. Osteoarthritis is a degenerative joint disease and is the most common presentation of arthritis; it can result from trauma to the joint, direct infection to the joint, daily wear and tear, muscle strain, fatigue, or simply from old age. Other forms of arthritis such as rheumatoid arthritis and psoriatic arthritis are attributed to autoimmune diseases. The main thing that differentiates septic arthritis and reactive arthritis from other types of arthritis is that they are mainly results of infection. This means that they will most likely present with fever. The main difference between reactive arthritis from septic arthritis is that the latter is when infection of the joint itself is the cause of the suppuration leading to the arthritis. However, reactive arthritis is not caused by an infection to the joint itself, but rather the inflammation is caused by an autoimmune response to an infection located on another part of the body; this is known as cross reactivity.  [22]  Septic arthritis will most likely affect an individual joint (monoarthritic) if only one joint is infected. Nonetheless, the possible systemic nature of reactive arthritis allows it to most likely affect several joints (polyarthritis). Septic arthritis will also most likely yield positive culture results and present with suppuration, unlike reactive arthritis which may not yield the same results due to the absence of an infection at the actual site of arthritic symptoms. Techniques and Research Diagnostic Techniques The diagnosis of arthritis in general is made through a clinical examination that is conducted by a duly licensed and qualified health professional, who may require other examinations such as blood tests and radiology to create a differential diagnosis for the suspected arthritis. However, radiographs (x-ray) and sonographs (ultrasound) are mostly used only to assess and monitor the severity and progression of the condition. Magnetic resonance imaging (MRI) is also an effective diagnostic tool. The history of the current disorder may guide diagnosis; some significant markers include: speed and time of onset, pattern and symmetry of joint involvement, aggravating and relieving factors, quality and severity of pain, and other systemic symptoms. An example of this is the use of pain patterns; for example, rheumatoid arthritis is generally worse in pain and stiffness during mornings, but in comparison, osteoarthritis is usually aggravated after strenuous activities such as exercise. There is no diagnostic test to completely rule out septic arthritis; however, it should be considered whenever a patient presents with rapid onset of joint pain. Usually it only affects one joint (monoarthritis); however, several joints can be affected simultaneously in cases involving staphylococcus or gonococcus infections. The affected joints may present with pain, swelling, redness, and warmth, often affecting joints in the limbs instead of deep joints such as the hips or shoulders. A fever of a bove 38.5 degrees Celsius and history of septic arthritis may also be indicative of the condition. The Gram stain can rule towards a septic arthritis diagnosis but cannot rule it out.  [23]  Gram stain and culture of fluid from the joint and blood test serums can also rule towards a positive diagnosis when yielding elevated neutrophils, erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and WBCs. Being a sort of systemic autoimmune disorder, reactive arthritis can be expected to cause polyarthritis which is a multiple joint arthritic condition. The affected joints may also present with pain, swelling, redness, and warmth. Swabs taken from the urethra, cervix, stool, urine, or the throat can be cultured in an attempt to identify the causative organisms. Blood tests and synovial fluid cultures may also be done to reveal elevated erythrocyte sedimentation rate (ESR), and CRP to support the diagnosis. A blood screening may be done to identify the presence of the gene HLA-B27, which is present in an estimated eighty percent of all patients suffering from reactive arthr itis.  [24]   Treatment Techniques Treatment for arthritis in general includes lifestyle changes such as exercise and weight control, physical therapy, orthopedic braces, and medications. The main goal of treatment for both septic and reactive arthritis is to identify and eradicate the causative pathogen with the appropriate antibiotics. In the meantime, the treatment is symptomatic. Medications such as antibiotics, NSAIDS, steroids, and analgesia can help decrease inflammation in the joint resulting in decreased pain and hampered joint damage.  [25]  Reactive arthritis may require immunosuppressant medications in addition to the above medications to reduce oversensitivity of the immune system. Extreme pain, redness, and swelling may require drainage by needle puncture to alleviate these signs of inflammation. Surgical replacement of the joints may also be needed in eroding types of arthritis such as certain strains of septic arthritis. Surgical debridement or arthrotomy is usually indicated for infections involvi ng prosthetic joints. Individuals for whom surgery is contraindicated will have to undergo long-term trial antibiotic therapy.  [26]   Analysis Septic arthritis and reactive arthritis are two arthritic conditions that result from the human immune systems response to infection. Septic arthritis is the result of an infection on the arthritic joint; if one joint is infected, only one joint shall be suffer arthritic symptoms. Reactive arthritis is the result of an exaggerated immune response to an infection that does not involve the arthritic joint; this condition may be systemic and may affect multiple joints. Septic arthritis and reactive arthritis may both be caused by any pathogen including bacteria, mycobacterium, virus, and fungi; however, bacterial infections are the most prevalent culprit. Since both septic arthritis and reactive arthritis are the result of an infection, what distinguishes them from most other forms of arthritis is that both of them may present with fever and some degree of suppuration in addition to the usual symptoms of inflammation which include pain, swelling, redness, and warmth at the joint. Septic arthritis will however prove to be the more destructive of the two conditions because it directly infects the joint and may cause permanent and irreversible damage. Since both of the conditions are the result of an infection, both of their treatments include antibiotics, which may usually be given intravenously, and medications that may deal with the symptoms of pain and inflammation may be given. Orthopedic bracing for support and surgical intervention for damaged joints may also be needed in certain cases.

Mongols †How Barbaric Were the “Barbarians? Essay

The Mongols began to lift to power under the great Genghis Khan. and during the thirteenth century they created the largest imperium in history. The Mongols during the 1300s were really known. and feared by many. it was about rare to happen countries that hadn’t heard of the Mongols. These â€Å"barbarians† ruled over many countries. expanded across about all of Asia ; and killed 1000000s of people wherever they went. Mongols ruthlessly slaughtered many people. and used many tactics to guarantee their triumph. The Mongols had built such a repute that some countries would give up without seting up a battle. while others formed ground forcess of 1000s with their best arms and work forces ; but all were crushed one time the Mongols arrived. The Mongols were pitiless slayers and reduced the populations of countries greatly. caused people’s lives to be ruined ; and were non even mentioned in the history of certain countries. because of the atrocious things they caused . But despite all these things the â€Å"barbarians† caused. they besides helped many countries to develop ; and better trade and many other factors. Mongolians are pitiless slayings who didn’t head in killing others. and were known for butchering 1000000s people in history. They even severed the caputs of work forces. adult females. and kids where they conquered. and even made separate hemorrhoids for them. As described by Ata-Malik Juvaini. Mongols would kill everything in towns including animate beings so there was no 1 left ( Doc. Tocopherol ) . Peoples would enter the sum of people the Mongols killed. and some weren’t even able to do out a specific figure because of how much the Mongols killed! Even Iranian manuscripts that were found illustrated work forces being buried alive. and Mongols hiting work forces invariably with their pointers ( Doc. F ) . This illustrates how pitiless the Mongols were. and the atrocious things and ways they killed people were done. In add-on. John of Piano Carpini stated the different tactics used by Mongol. which allowed them to take over fortresses with their ghastly tactics ( Doc. D ) . One of many things the Mongols did. was take the fat of people they killed. run it. and catapult it onto houses and fortresses. â€Å"And wherever the fire falls on this fat it is about inextinguishable. † The Mongols would even flim-flam people into give uping and take the people they want. and so kill the remainder with an axe. As a consequence. the Mongols gained the repute they did. as pitiless work forces who plundered through metropoliss killing everyone along the manner. But there is ever another side to every narrative including this 1. and these savages were non every bit â€Å"barbaric† as they were described. but besides helped societies develop and make a foundation for their hereafter. The Mongols are non credited plenty for the good things that they did. every bit much as the bad things that they did. And if you were to weigh the good and bad workss they committed. the bad workss would non outweigh the good. and the graduated table wouldn’t topple over. but alternatively ; it would about equilibrate out. It is true the Mongols killed 1000s of people and destroyed countries. but as clip went on. the Mongols increased the economic systems of countries. became more tolerant. and even blended in with other societies. The Mongols would non hold been able to accomplish this if they didn’t conquer all the countries they did. and although they made many forfeits along the manner ; the Mongols managed to prevail over the largest country conquered in history. and at the same clip better and raise the population in these countries ( Doc. A ) . Furthermore. one illustration of something good the Mongols did. was aid better the economic systems of countries ; par ticularly Persia and China. Described by Charles J. Halperin. Mongols in Yuan China continued the Grand Canal which improved transit and communicating with other countries. ( Doc. J ) . This helped increase trade which allowed many people to derive new merchandises and go wealthier. lending to their economic system. In add-on. this was really of import to people in China and to other countries. because the Mongols had united China ; which had many merchandises it would so portion with the universe. Particularly the silk from China became popular. and the Iranian silk industry greatly benefitted China opening up to the remainder of the â€Å"world. † The Mongols non merely increased trade in countries. but besides stopped offenses and larceny in many states as stated by Paul Ratchnevsky ( Doc. K ) . It was said that people who lived under Mongol regulation did non even have locks or bolt on their carts or houses because of how safe the environment was. The Mongols made certain it was safe everyplace. and one time the people abided by the regulations ; they would non be punished. More so. a papers compiled by Marco Polo. described the system of couriers and how organized it was ( Doc. L ) . There were stations set up. and the Mongols built roads so couriers and travellers could travel from topographic point to put easy. Each station had Equus caballuss specially for the couriers. and there were even ferry’s to traverse over H2O. This displays how the Mongols non merely killed and conquered people. that they were besides capable of puting up organized systems and build roads. Furthermore. Mongols besides had tolerance for different faiths. and even took involvement in them. For illustration. William of Rubruck composed a papers of Mongke Khan who was a Mongol swayer. funny of other faiths ( Doc. M ) . Mongke sent his Scribe who told the people which included Christians. Buddhists and Muslims. to come together and organize a conference ; and compose down what they say so Mongke can â€Å"know the truth. † The work forces did as they were told. and Mongke did non state they were incorrect. but alternatively he stated that the Mongols believe in one God. â€Å"But merely as God gave different fingers to the manus so has he given different ways to work forces. † This illustrates how the Mongols did non knock others for following their faith. but accepted their beliefs and still stuck to their ain. allowing them live their lives. The Mongols were viewed as ruthless slayers who slaughtered 1000000s of people with no clemency. and caused many metropoliss to die. Although Mongols committed many horrific Acts of the Apostless which will ne'er be forgotten. it is besides of import to take in history the good things these â€Å"barbarians† did. The Mongols helped better the economic systems in countries. promote trade which allowed societies to farther develop and modernize. Mongols besides created many systems and roads which increased communications with other countries. and caused cultural diverseness. Many missionaries set out to change over others since it was easier to go. and they succeeded ; particularly in China. Therefore. the Mongols were barbarous liquidators and were feared by many because of the atrocious things they did. But it would non be valid to state they merely did bad things. because they impacted history in a positive manner excessively ; and these â€Å"barbarians† helped socie ties further develop. overhaul. turn in wealth. size. and make a political system for the hereafter which is still used today.

Studies on Employee Satisfaction

With the increased competition, fast-paced environment and globalization efforts, companies are finding that they need the support of their employees more than ever. However, the new breed of personnel wants more than pay as a benefit. They are increasingly being motivated by other factors such as greater involvement with business decisions. Recent studies are researching ways that successful organizations are encouraging positive employee morale despite ongoing business changes. Full employee participation is required for any organizational change to succeed. Joint development of programs gives people ownership and the motivation to ensure the support of the change process. At SmithKline Beecham and Levi Strauss, for example, the strategy is view employees as business partners (Reid, 2004, p. 40). Some of the ways that Beecham and Strauss are instituting change include: 1) An emphasis on values as well as goals, since employees want to know how the organization expects to meet the desired results; 2) Along with #1, encourage joint goal setting that leads to greater involvement and dialogue. Joint goal setting can be a powerful motivator (Reid, 2004, p. 40). 3) Support anonymous real-time feedback through the Internet or the traditional suggestion boxes. 4) In tandem with #3, respond to feedback to let employees know their ideas have been heard. 5) Test and reward new ideas and response to challenges; 6) See employee involvement as an ongoing process that builds over time, rather than a one-shot deal; and 7) Continually review the goals established to see what headway is being made and changes needed. Survey employees regularly to measure whether needs are being met and the degree of interest in the company's success. Employee specialist Joel Schettler also notes the importance of updating training that in many cases still treats personnel as â€Å"grist for the mill† (2003, p. 56). Training programs should be cast as enhancing a right rather than negating a wrong. Employee motivation and incentives and training programs must go hand-in-hand to become an effective tool in today's environment. Training should also develop teamwork and foster pride in one's work. Pay-for-performance approaches bring only short-term, skin-deep results. When an employees' emotional involved, unexpected positive results occur. Arnett (2002, p. 87) stresses that companies are always putting an emphasis on external marketing programs when they should be marketing their internal customers, â€Å"the employees,† as well. He argues that a successful internal-marketing strategy can enhance both job satisfaction, organizational pride and positive employee behavior that is characterized by a commitment to customer service, cooperation with other employees, and to the company. Looking at the research that has thus far been conducted on employee motivation, Arnett (2002, p. 88) says that the effects of employee satisfaction have been researched extensively, but not the effect of pride. In a study, he hypothesized that both job satisfaction and pride are important variables that managers can use to encourage employees to engage in desired behavior. Further, developing a good relationship with employees is a precursor to building a good relationship with customers. Specifically, the study looked at job satisfaction, or an employee's general affective evaluation of his or her job; pride, an emotion that is crucial to understanding human behavior that is derived from both self-appraisals and others' opinions and represents a belief that one is competent and viewed positively by others; role clarity, where employees are clear about the scope and responsibilities of their job; a reward system where employees know they will be measure on how well they perform their duties and that positive performance brings rewards; work environment that is pleasing and offers rewarding experiences; managers that provide the proper training, listen to employees and are fair; an organization that promotes its performance to employees so they know they are a part of that performance; and activities that foster positive employee behavior and the well-being of the organization. Arnett (2004) developed a questionnaire that was responded to by 860. The majority of the respondents had been with the organization for between 1 and 5 years, 26 percent had been with the corporation less than one year, and the remaining 3 percent had been with the company for over five years. Most respondents were hourly employees, 9 percent were supervisors, 4 percent were salaried non-management employees, and 4 percent were managers. The results showed that job satisfaction and pride have the desired goal of promoting positive employee behavior. Three factors seem especially critical to building job satisfaction among employees–role clarity, the work environment, and employees' evaluations of managers' performance. Employees who believed they had a clear understanding of what it took to do their job were more likely to be satisfied. Therefore, employers should try to ensure that employees have a clear understanding of their responsibilities and expectations. Interestingly, the employees' evaluation of the reward system did not influence their job satisfaction. However, the researchers feel this is not an indication that employees do not care about the reward systems in their organizations. Instead, it may be an indication that other factors are more important for changing employee behavior. The results do support the proposition that the work environment affects job satisfaction. Therefore, organizations should not focus solely on the guests' environment, but should also examine that used by their employees as well. Employee evaluations of managers is related positively to job satisfaction, so managers should monitor the perceptions that employees have of the management team and make changes as necessary. In fact, the workers' evaluation of managers is most important to job satisfaction; role clarity is the next most important, followed by work environment. The study also showed that job satisfaction effected pride positively. Employees who were the most satisfied with their jobs exhibited the most pride in their organizations. Therefore, we suggest that job satisfaction influences employee behavior. Second, it affects positive employee behavior indirectly by encouraging, pride in the organization, which then leads to positive employee behavior. The results support the fact that employees' evaluation of managers has a positive effect on pride in the organization, as well. The Arnett research concluded that both job satisfaction and pride in the organization are important factors that influence employee behavior. Therefore, organizations that wish to promote positive behavior in their employees should focus on both of these factors. Although many organizations have specific programs and procedures designed to improve employee satisfaction, fewer organizations make a concerted effort to increase employee pride. Our results suggest that more organizations should focus on improving employee pride. What these above studies demonstrate is that if a company wants to encourage positive change and employee behavior, they need to look at other factors than pay and other material incentives. Although these will always continue to part of an employee incentive package, it is also necessary to reward personnel with the knowledge that their feedback and involvement are important to the company's success.

Walt Whitman Once Wrote - Free Essay Example

Sample details Pages: 3 Words: 884 Downloads: 10 Date added: 2019/08/08 Category People Essay Level High school Tags: Walt Whitman Essay Did you like this example? Walt Whitman once wrote,I exist as I am, that is enough(Whitman, Song of Myself) .Walt lived his life by this quote, many people questioned the themes of his writings and found them obscure and obscene but he continued his themes and didnt let anyone change his style. Walt was born into a non religious family that resided in the suburbs of New York City, New York. At a young age he was taken out of school and thrown into the workforce. Don’t waste time! Our writers will create an original "Walt Whitman Once Wrote" essay for you Create order He worked for many journalism organizations until starting his own writing. He has been referenced in many movies, books, and literary works. Walt Whitman was an American poet, author, journalist, nurse, novelist, and philosopher. Walt Whitman was born on May 31, 1819 in West Hills, New York as the second son of Walter Whitman and Louisa Van Velsor. His family was relatively poor, as his dad was a house builder and his mother was a stay at home. His family jumped between multiple houses in the Brooklyn, New York and Long Island, New York. He was the 2nd of 9 children. He grew up next to his brothers, George Washington Whitman, Andrew Jackson Whitman, Jesse Whitman, Edward Whitman, and Thomas Jefferson Whitman. His sisters were Mary Elizabeth Whitman, and Hannah Louisa Whitman. He had one other sibling, that died as an infant. Due to his familys low income, his father forced him out of school and into the workforce at the age of 11. His first job was as an office boy for a Brooklyn based attorney team and eventually found employment in the printing business. At the age of 12, he began to learn the printers trade. Largely self-taught, he read voraciously, becoming acquainted with the works of Homer, Dante, Shakespeare, and the Bible. At 17, he became a teacher in Long Island, New York until he turned to journalism as his career. In 1838, he started a weekly called the Long Islander, that quickly folded. He then went back to teaching but found it boring while he loved journalism and writing. As an adult Walt bounced around many jobs but never settled down at one specific job. He worked for the Tattler, Daily Plebeian, the Statesman, the Mirror, the Democrat, and the Sun and the Star. In 1845 Walt moved to New Orleans and was offered a job at the New Orleans Crescent but he soon resigned and moved back to Brooklyn. He then worked for the Brooklyn Weekly Freeman which advocated for the new states to join the Union and go against slavery. In 1850-54, Walt ran a printing office, stationery store, and does freelance writing and house building. In 1862, Walt read a list of injured soldiers and found his brother on the list. As a result of this Walt traveled south in search of his brother and found him in Fredericksburg, Virginia, hardly scaved. He then found a desire to help wounded soldiers and moved to Washington D.C.. He then found a job at Department of the Interior but soon got fired after his boss read Leaves of Grass. Through the end of his life Walt suffered many strok es debilitating most of his body. It is obvious that Walt Whitman had great literary impact on todays generation of writers and readers and even the readers and writers of his generation. Although he did not get the recognition that he deserved until after his death. One of Whitmans best poems was Song of Myself. In the poem there are a lot of things happening. In the poem he invites his soul to hang out and stare at a blade of grass. He then explains how much he loves the world and especially nature stating everything fits together as it should and that nature has patterns that fit together like a well built house which Walt knows about well built houses as he built many houses along with his father. His most well renowned poem O Captain! My Captain!, was written about a sailor singing a song that praises his captain for leading the ship and the crew to the harbor after a dangerous voyage. It is then that the poem speaks of people celebrating on land and the sailor finding the captain dead. This scene is what characterizes Walts writing. Many people found scenes like this obscene and that is why they did not appreciate his work. Finally, there was Leaves of Grass which was a poetry collection written throughout Walts life. Walt Whitman has been described as the great poet of America by Andrew Carnegie and America by Ezra Pound. I found Walt Whitman to be a very interesting man. From what I read about him many people thought that he might be bisexual or homosexual. I also read that many people found his work very obscene. Walt did not care what other people thought and this was apparent in his writing as he wrote many strange poems. His childhood wasnt the best as he bounced from house to house and was taken out of school at the age of 11. Even through all of this he still managed to become one of the best poets of all time. Walt passed away at the age of 72, in Camden New Jersey. His cause of death were the many strokes that he had that paralyzed his body.