Cancer Registry Annual Report Coursework Example | Topics and Well Written Essays - 2000 words

Cancer Registry Annual Report - Coursework Example ology program will move, it evaluates the protocols and the quality of care available using both external and internal sources of data and puts forward recommendations that could help to bring about improvements to meet the required regulatory standards. The total number of patients treated for cancer this year was 590, of which 268 were male and 249 were female. Lung and breast cancer reported the highest incidence of cancer; among the males the highest incidences were of lung and colon cancer, while among the females, the highest incidences were of breast and cervical cancer. The largest number of all cancer types occurs between the ages of 41 to 60, followed by the ages 61 to 75. During the diagnosis stage, 262 cancer cases were localized, while 230 were regional. In most instances, i.e., 49 cases, diagnosis was made by bronchoscopy, while 22 were made by percutaneous biopsy. There has been a steady rise in the number of lung cancer cases from 2001 to 2005, with the steepest rise occurring between 2003-4. The most common age when a lung cancer diagnosis has been made is between the ages of 65 to 74. The Oncology standards at this hospital are quite high, because the primary purpose of the Oncology Committee is to direct and evaluate the Oncology program and to suggest recommendations for improvement. The organization has received commendation by the Commission on Cancer, which is also the reason why it has received funding. The hospital specializes in lung cancer, but various other forms of cancer are also treated. Mr. Johannson, the CEO has set achievement of quality as one of the most important organizational goals, which has led to the achievement of awards and accreditation for the hospital. The head of the Oncology program is Nancy Turlick and she has been the prime mover behind implementing these quality of care standards and based upon the results the hospital has achieved, the standards of care at the hospital have been revised. Hospital data is

External Environment Analysis of Rio International Company in Dubai Essay

External Environment Analysis of Rio International Company in Dubai - Essay Example The company currently provides its services to the Middle East and other Asian countries at large. It is believed that it is through its lengthy relations that the company has stronger networks and connections. Locally, the company extends its services to airports, resorts, catering suppliers, restaurants, coffee shops, supermarkets, and Multi Star Hotels (Atninfo, 2013). In as much as the company can rejoice and celebrate so many years of existence, there is much that it should do about its environmental factors that directly affect its performance and its future success. To be able to do this, the company needs to carry out an environmental analysis that would involve analyzing all the factors in its external environment that directly affect its performance. In analyzing Rio International’s external environment, we use the following tools: Most of the equipment that are provided by the companies in the food processing industry in Dubai are manufactured and imported from Switzerland and Germany. This has inhibited adequate growth in the industry as most of the revenues earned taken back to the countries where the products come to purchase more. When the industry depends so much on other countries for the supply of the equipment, it loses the independence to keep itself in business without overreliance on other countries. The industry can, therefore, face easy extinction in case the countries supplying it with the equipment decides to put unfriendly policies that would make it hard for bilateral or multilateral trade between the countries. The government of Dubai is involved largely in the key sectors of the economy. Manufacturing and processing being one such sector, the government can use its political influences to protect such sectors from external exploitation. Therefore, the industry is protected politically through formulation of appropriate legal conditions to make it grow and survive without much

Interpersonal Communications Essay Example | Topics and Well Written Essays - 1500 words

Interpersonal Communications - Essay Example (Guffey, 2006; Bonnet, 2000) The incident that I am going to cite here is actually observed by one of my friends in his internship at a software house last summer. My friend was there at the business analysis department and the incident took place in the same department. The incident shows that how the poor listening can lead to negative consequences. It was Friday morning, the weekend was about to start in few hours and was a signal of relaxation after the week long tiresome efforts of business analysis. The last task for the week that Ms. Jenifer Mitchells, the supervisor of my friend, had to make the last visit of the day to New Star and Company for the purpose of requirement analysis for the decision support system the Soft Tech, the company to which Ms. Jenifer belonged, was developing. This project meant a lot to the Soft Tech because New Start Company was a very big client for them. This was the first time Soft Tech was given any information system development project by New Star and Company, an organization dealing in logistics. On that day my friend also accompanied her. My friend told that he got a feeling that on one hand Ms. Jenifer is a bit in hurry for one of his personal commitments few hours later (she herself told this to my friend) that's why she wanted to end the meeting soon. Moreover, Ms. Jenifer was a fresh graduate of a renowned technical university with the gold medal. This, according to my friend, made Ms. Jenifer a bit arrogant. After reaching there, the formal introduction and greeting was done. Then the discussion moved to the main point that was business requirements. Since the new system that was supposed to be designed was the decision support system that would help the strategic managers and decision makers in resource optimization and the supervisor of my friend Ms. Jenifer had done her final year project on decision support system that is why she was not at all interested in listening what the customers want, rather time and again she used to start telling about her project and pra ising about it, trying to let the clients know that she is a gold medalist. According to my friend, when the customers were telling to her about their requirements, she was repeatedly looking at her wrist watch, probably that was giving a gesture that she is running out of time. Moreover she was not noting down their requirements on paper as much. When the reason for it was asked by friend, she said that she had done such project earlier too, so now doing such project again is not an issue for her, thus she did not need to note each and everything down on paper. It was suggested by the person briefing to us that we should conduct interviews from people involved in decision making who would be using the system that they develop so as to have the better understanding of what they exactly want. Ms. Jenifer was not interested in even that too. Finally the meeting ended with all 'hearing' but no 'listening'. On Monday when Ms. Jenifer came to work again, she presented the meeting report to her manager. Her

Writing problems for high school students Research Paper

Writing problems for high school students - Research Paper Example On top of the list is the anxiety that many students have when the adjustment to college writing is a necessity. According to â€Å"Writing Anxiety†, since many are not accustomed to it, there is the feeling of mild confusion. As expected, when this issue goes unnoticed and unresolved, it leaves the student in an awkward position. This is because many fear asking questions lest they seem daft but it is not the way it ought to be. In order to resolve this, the teachers should explain in details what college-writing entails. Secondly, letting the students understand that it is normal for anxiety to exist where one has never been before is a great help to them. Additionally, anxiety can also be overcome by showing the students their strengths as opposed to highlighting weaknesses. In other words, whenever a student feels inferior because of not understanding the style of college writing, it is vital to show them that there are other strong areas to focus on. Unlike in high school where students would write using any words, college-level writing prohibits usage of some words. Normally, this puts a block in the inexperienced student’s way because formal language has to be used. For instance, in college writing, the use of pronouns is hardly allowed; colloquialism and abbreviation of names are strictly to be avoided.

Trying to Understand Catch 22 by Joseph Heller Essay Example for Free

Trying to Understand Catch 22 by Joseph Heller Essay Catch 22 is a satirical war novel that was written in the 1950’s, but was published in 1961. Joseph Heller, the American author, was known for his novels to represent a comic vision of modern society with serious moral connections. His major theme throughout his writing is the conflict that occurs when individuals interact with such powerful institutions, such as: corporations, the military, and the government. Catch 22 was written in the post modernism era of the literature timeline. In the 1950’s, the Korean War was beginning, World War II ended, and Castro became the dictator of Cuba. All of these events had an influence on Heller as he was writing this novel about the WWII bombardier, Yossarian, and his struggle to stay sane with bombs bursting all around him. Chapter 1: The Texan * Summary: Yossarian is hiding from the war in a hospital ward with a â€Å"liver disease† when he meets Dunbar, the bigoted Texan, and the soldier in white. * The Texan: an obnoxious patient that annoys all the patients in the ward and talks to the soldier in white all the time. * â€Å"You fellas are crazy† (Heller 11) Chapter 2: Clevinger * Summary: Yossarian is paranoid about the crazy people in the camp: Havermeyer, McWatt, Orr, and Nately; but, Clevinger insists Yossarian is the crazy one and Doc Daneeka cannot and will not release him because Cathcart raised the missions yet again. * Clevinger: An ingenious Harvard graduate who is the first to call Yossarian crazy. He is picked on in cadet training by lieutenant Scheisskopf, who brings him up on contrived charges before the action board. He is presumed dead when his plane crashes. * â€Å"Who’s they?.. Who, specifically, do you think is trying to murder you?† (Heller 17) Chapter 3: Havermeyer * Summary: Yossarian is accompanied by a dead soldier in his tent (Mudd), Orr, and Hungry Joe who are driving him crazy, but Doc Daneeka still refuses to diagnose Yossarian as crazy in order to send him home; telling him he needs be more like Havermeyer. * Havermeyer: The best bombardier in the whole squadron. He loves peanut brittle, never misses a target, and never takes evasive action. Doc Daneeka told Yossarian to become more like Havermeyer. * â€Å" Chapter 4: Doc Daneeka * Summary: Yossarian argues with Hungry Joe, trying to explain that he is the crazy one, when Doc Daneeka begins to ponder why he of all the doctors was forced to deal with these babbling buffoons. * Doc Daneeka: A flight surgeon who resents his position and is bitter about the war taking away his practice in the states. Doc Daneeka is the one who explains catch 22. He is afraid to fly, so has McWatt sign his name. McWatt’s plane crashed, and people believed he was dead. * â€Å"I’m not on the plane.† (Heller 339) Chapter 5: Chief White Halfoat * Summary: Doc Daneeka was yearning for his practice back home and explains to Yossarian that catch 22 prevents him from grounding him when Chief White Halfoat enters the tent to begin telling stories of before the war; expressing his hate for the white men that kicked him and his family from home to home because of the unearthing of oil. * Chief White Halfoat: A Native American chief is the intelligence officer. He despises white men for kicking him off his home settlements and claims he will die of pneumonia, and he jokingly says he will slit his throat. Chapter 6: Hungry Joe * Summary: Hungry Joe had his way with the prostitutes in Rome, had flown the most missions in the in the whole squadron, and had horrible nightmares resulting with bone chilling screams, but Doc Daneeka, despite Yossarian’s despondent pleas, could not even declare Hungry Joe as crazy thanks to catch 22. * Hungry Joe: Hungry Joe is the soldier with the most missions flown in the entire squadron, but his orders to return home never come. He has horrible nightmares that cause him to scream in horror, however, he is very good with the whores in Rome. He dies one night in his sleep because Huple’s cat suffocated him. Chapter 7: McWatt * Summary: McWatt is Yossarian’s pilot whose bed sheet was stolen by Milo Minderbender, the new mess officer that is involved in black market deals and Yossarian becomes his new friend that he confides in about these actions. * McWatt: McWatt is a cheerful pilot who often flies Yossarian’s planes, but he likes to joke around a lot, such as buzzing the beaches. One day sliced Kid Sampson in half, and flew into a mountain immediately afterwards. Chapter 8: Lieutenant Scheisskopf * Summary: Yossarian has an affair with Lieutenant Scheisskopf’s wife, but he is too obsessed with trying to beat Clevinger in the weekly parades and finally wins two years in a row; ending Scheisskopf’s precious parades. * Lieutenant Scheisskopf: Lieutenant Scheisskopf was the colonel that trained Yossarian’s squadron in America and is fascinated with the military parades, and later on, he is promoted to general due to a misunderstanding of memos by General Peckem. Chapter 9: Major Major Major Major * Summary: Major is a man who was promoted to squadron commander, but rather than helping his reputation, it made him resort to being a recluse; until Yossarian tackled him in the woods. * Major Major: Major Major is very shy, awkward, and submissive. He resembles Henry Fonda and was promoted to squadron commander, which made the soldiers loathe him, causing him to become reclusive and distancing himself from the others. Chapter 10: Wintergreen * Summary: Yossarian tells ex-P.F.C. Wintergreen, a loser forced to dig punishment holes for going AWOL, about Clevenger’s disappearance, and Dr. Stubbs snickers at the fact everyone sees Yossarian as crazy because he may be the last one in the camp that is sane. * Wintergreen: Ex- P.F.C. Wintergreen was a mail clerk at the Air Force Headquarters, but Wintergreen refuses to go to work; resulting in his rank being stripped and digging punishment hole. Chapter 11: Captain Black * Summary: Major Major was chosen as the new squadron commander over Captain Black, and Captain Black created the Glorious Loyalty Oath Crusade to make all the men miserable until Major de Coverley returns and puts an end to the crusade. * Captain Black: Captain Black is the squadron’s intelligence officer, but he longs to become the squadron commander. He adores watching his men suffer and taunts them just to be a jerk. Chapter 12: Bologna * Summary: Yossarian moves the bomb line on the map over night to avoid the mission to Bologna and results with General Peckem receiving a medal, the men getting drunk, stealing a car, and Clevenger returning back to the camp; fussing at the men when the stolen car flips. Chapter 13: Major de Coverley * Summary: Major de Coverley rents apartments for all the enlisted men and officers to retreat to when on leave and has a transparent eye patch, but Yossarian’s team that went to bomb the bridge in Bologna all missed their target; resulting in a second trip that has to be covered up. * Major de Coverley: Everyone idolizes and fears Major de Coverly. He also rents apartments for men on their rest leaves. Chapter 14: Kid Sampson * Summary: Yossarian ordered Kid Sampson to turn the plane around in Bologna because of a â€Å"defective intercom,† and when they return safely back to base, Yossarian sneaks away to the beach for a nap when he realizes that the planes that were his companions left once more. * Kid Sampson: Kid Sampson was a pilot in Yossarian’s squadron. He was sliced in half on the beach as a result of McWatt’s reckless flying. Chapter 15: Piltchard and Wren * Summary: Following Captains Piltchard and Wren request that no one decides to leave the mission for no reason, Yossarian begins to panic over Bologna because of the flack and tells McWatt to drop the bomb and leave as fast as he could when he noticed his fellow planes were missing, but when he returned home, he finds missing his comrades, begins to feel relieved, and leaves to Rome to find Luciana. * Piltchard and Wren: Captain Piltchard and Captain Wren are the joint squadron operation officers. They love to fly missions. Chapter 16: Luciana * Summary: Luciana was a whore in Rome that mooched off of Yossarian, a man jealous of the women magnet, Aarfy, and Coronel Cathcart raised the missions again to 40. * Luciana: A beautiful young girl that lives in Rome. She and Yossarian have an affair, and he impulsively asks her to marry him. Instead of saying yes, she gives him her address, and Yossarian rips it up and regrets it later. * â€Å"You don’t want to sleep with me?† (Heller 154) Chapter 17: The Soldier in White * Summary: Yossarian returns to the hospital once again to seek a safe haven from the brutality of the war when he encounters the soldier in white, a helpless body encased in white gauze, but Dunbar, maddened by malaria, creates a ruckus about the sheathed soldier. * The Soldier in White: The soldier in white is a broken soldier who is encased in a full body cast. The nurses must do everything for him, and Dunbar makes a huge commotion over him. Chapter 18: The Soldier Who Saw Everything * Summary: The hospital staff are irritated because there is nothing wrong with Yossarian because he is faking his liver condition, but one day another soldier claims he is seeing doubles; giving Yossarian the idea to copy his illness. Chapter 19: Coronel Cathcart * Summary: Colonel Cathcart will do anything to become general and wants to be famous (mentioned in newspaper), so he calls in the chaplain to â€Å"pray† without bringing religion into the act to make him famous. The chaplain tells Coronel Cathcart the missions are beginning to reach a ridiculous height. * Colonel Cathcart: Coronal Cathcart is the commanding colonel who yearns to be general. Colonel Cathcart is the main antagonist of the novel because he volunteers his men for dangerous missions and constantly raises the number of missions needed to be dismissed. * â€Å"He’s the best damned bombardier we’ve got.† (Heller 29) Chapter 20: Corporal Whitcomb * Summary: Corporal Whitcomb talked to a CID man, who was investigating the big â€Å"Washington Irving† scandal, and blames the chaplain of signing â€Å"Washington Irving† on some of the censored letters and documents and stealing Coronel Cathcart’s plum tomato. * Corporal Whitcomb: Corporal Whitcomb it the chaplain’s assistant, and he is later promoted to sergeant. He blames the chaplain for being a roadblock in his career, and tells the CID men that the chaplain was the one signing â€Å"Washington Irving† and who stole Colonel Cathcart’s plume tomato. * â€Å"I threw it away as soon as I tore it open and read it.† (Heller 275) Chapter 21: General Dreedle * Summary: General Dreedle has no tolerance for Yossarian or his son-in-law; however, he does have his own nurse that the men always stare at; irritating General Dreedle. * General Dreedle: General Dreedle is in charge of the wing containing Yossarian’s squadron. General Peckem is always trying to over throw General Dreedle; annoying him tremendously. Chapter 22: Milo the Mayor * Summary: Milo became the mayor of Palermo because he managed to manipulate the economy of Palermo to put them on the map along with Malta, Oran, and Cairo; and, Milo puts Yossarian to work hauling bananas, another of his black market crops. Chapter 23: Nately’s Old Man * Summary: The nasty old man in Rome is the same man who threw the puncturing rose Major de Coverley’s eye, and he believes Italy will triumph over America and Nately argues about his political values. Nately realizes his whore is missing. * Old Man: This old man is a very disgusting old man in Rome. He is the man responsible for throwing the rose that abolished Major de Coverley’s eye. He does not side with the Americans at all, and believes the Italians will be triumphant. This old man is an important character because he is the one who argues with Nately about political beliefs. Chapter 24: Milo * Summary: Milo is so blinded by his want for profit that he will do anything for a profit, such as selling his surplus of Egyptian cotton to the U. S. like Yossarian had suggested. * Milo Minderbinder: Milo is the mess hall officer who creates a colossal black market scandal to bring in vast amounts of profits. He is so successful in dealing with other countries even, that he was elected to several public offices within the countries he dealt with. Milo desires his profit so much that he even makes a deal with the Germans to bomb his own unit for profit. * â€Å"In a democracy, the government is the people.† (Heller 259) Chapter 25: The Chaplain * Summary: The chaplain is a massive pushover that will not stand up for himself and is â€Å"unimportant† to the new Sergeant Whitcomb. * Chaplain A. T. Tappman: Anabaptist minister who is shy and pushed arpund by almost all the officials and even Whitcomb, his assistant. He changes from the beginning on the novel when he is super shy never say anything to the end of the novel when he tells Coronel Cathcart the number of missions are too high and the burst of confidence he received from Yossarian leaving to Sweden. Chapter 26: Aarfy * Summary: Aarfy was on the plane with Yossarian and simply watched Yossarian bleed due to the shot in his thigh rather than helping, but McWatt rushed to help the bleeding captain. * Aarfy: Captain Aardvark is Captain Yossarian’s navigator, however, he has no sense of direction. Aarfy is completely oblivious to the calls of his flight crew for help when Yossarian wounded his leg. He is an ex-fraternity boy who brags about not having to pay for the sex given from the whores in Rome. * â€Å"I don’t think we’re at the target yet. Are we?† (Heller 30) Chapter 27: Nurse Duckett * Summary: Yossarian and Dunbar harass Nurse Duckett and are fussed at, resulting in them being forced to talk to the psychiatrist, Major Sanderson; Yossarian making up diseases as they talk. * Nurse Duckett: Nurse Duckett is a nurse at the hospital Yossarian is staying. She is the â€Å"love of Yossarian’s life† after they have an affair, but she quickly tells Yossarian that she is going to marry a doctor. Chapter 28: Dobbs * Summary: Dobbs created a big scheme to assassinate Coronel Cathcart due to the ridiculous mission requirements rising, but he changes his mind. Orr’s plane went down over the sea on the way to Bologna, faking his death, but his crew and he actually swam safely to shore and escaped to Sweden. * Dobbs: Dobbs was Yossarian’s co-pilot. He is the one who took control of the plane for Huple on the way to Avignon. Chapter 29: Peckem * Summary: General Peckem and Scheisskopf do not get along, but all the men, McWatt, Dunbar, Major Danby, and others, agree that bombing the small mountain town is very vindictive act to do, but Coronel Korn disagrees. * General Peckem: General Peckem is the special operations general who is constantly trying to figure out how to over throw General Dreedle. He finally over throws him, but Lieutenant Scheisskopf is promoted rather than Peckem. Chapter 30: Dunbar * Summary: Dunbar has become crazy from staying in the hospital for so long; falling on his face every morning. Yossarian did not mind McWatt as his pilot, but his foolish act of buzzing the beach sliced Kid Sampson in half. McWatt immediately flew his plane into a nearby mountain; killing himself. * Dunbar: Dunbar is one of Yossarian’s good friends who always manages to cause a scene. He is taken by officials and mysteriously â€Å"disappeared.† Chapter 31: Mrs. Daneeka * Summary: Doc Daneeka was pronounced dead when the plane he was supposed to be on crashed, but despite the fact the squadron knew he was still alive, they sent a letter of condolence to Mrs. Daneeka. Doc Daneeka fought this and sent letters to his wife telling her he was fine, but she loved the money she was receiving for his death more than him; leaving Doc Daneeka unloved and invisible to the men in the squadron. Chapter 32: Yo- Yo’s Roomies * Summary: All of Yossarian’s comrades are either dead or missing, so they are being replaced with new people that are obnoxious and unbearable. Chapter 33: Nately’s Whore * Summary: Yossarian and Nately finally found Nately’s missing whore and convinced the American coronel she was with to give her back, but when Nately brought her home and took care of her, she told him she did not want to stop hustling. * Nately’s Whore: Nately’s whore is a whore that lives in Rome with her little sister in the apartments, but Nately has fallen madly in love with her. She does not like the fact that he tries to control her life; however, when she was heard about Nately’s death from Yossarian, she became vindictive, chasing him around trying to kill him. Chapter 34: Thanksgiving * Summary: The new men in the squadron act recklessly, shooting guns and stabbing each other, but when they wake Yossarian, he goes crazy, badly injured and hospitalized Nately, who was trying to hold him back. Chapter 35: Milo the Militant * Summary: Nately wants to fly more missions so he can be closer to his beloved whore (Yossarian advises him not to volunteer), but Yossarian and Nately were both forced to go on that last mission. There was so much flak, ground fire, that Havermeyer took evasive action, but it was too late; Nately was dead. Chapter 36: The Cellar * Summary: The chaplain was accused of false crimes and took a writing test to prove he was innocent, but they said the test was wrong and he faked his handwriting; leaving the chaplain out of work. Chapter 37: General Scheisskopf * Summary: Peckem believed he was going to fill in as general for Dreedle, but it was discovered that General Scheisskopf was now the heading officer. Chapter 38: Kid Sister * Summary: Yossarian was sent to Rome to relax when he saw Nately’s whore and told her about his death. The whore and her little sister tried killing him and even stalked Yossarian back to Pianosa. * Michela: â€Å"Kid Sister† was Nately’s whore’s twelve year old sister. She constantly imitates her big sister, and follows her everywhere. Chapter 39: The Eternal City * Summary: Yossarian returns to Rome with Milo when they realize the city is in total ruins. Yossarian saw police brutality and drunks all throughout the city, when he saw the 12 year old Michela’s limp body in the street. Yossarian went into the apartment, where Aarfy has raped the young girl and threw her through a window, to tell him he will be arrested for murder, but Yossarian was the one who was arrested, brought back to Coronel Korn, and is told â€Å"go home.† Chapter 40: Catch 22 * Summary: General Scheisskopf and Peckem agreed to send Yossarian home as long as he talked gallantly of them or he would be court marshaled and arrested. Nately’s whore wanted to throw all of her anger at Yossarian, so she took out her wrath by stabbing him when he left the conference. Chapter 41: Snowden * Summary: Yossarian is in surgery, but afterwards he speaks with the chaplain to learn that Hungry Joe had died in his sleep and this begins to trigger the memories of Snowden’s fatal death and his attempt to try and mend his wounded leg, but he gets a lap full of his guts. * Snowden: Snowden was a gunner on the Avignon mission. His death haunts Yossarian throughout the entire novel because it was much worse than he thought it was; spilling guts everywhere. His death killed Yossarian’s courage and gave him a taste of what war really is. Chapter 42: Yossarian * Summary: Major Danby explains the deal is coming along nicely, but Yossarian is going to run away because he had realized that Orr had faked his death to escape the war, as Yossarian does by fleeing to Sweden with Orr. * Yossarian: Yossarian is the novel’s protagonist and hero. He is a captain in the Air Force and a lead bombardier in his squadron, but he hates the war. He believes that everyone is out to kill him, including his own squadron. He is haunted by Snowden’s death. The settings play a major role in all the madness within this novel as well. The two main settings are Pianosa, an island off the coast of Italy, and Rome, Italy in 1944. Joseph Heller could have created any size island he wanted, but he chose to put all of this action on a tiny island. Pianosa is a fictional island that is very small because the size of the island contradicts the large amount of action going on in the novel. Located on the island of Pianosa is the squadron’s base camp, where a lot of the trouble is started. Another major setting in this novel is the air. The planes were always in the air for a mission, and the air is where all the bombs were. Also, the soldiers would often take leave and go to Rome and stay in apartments with the whores. Rome was normal looking until one day Yossarian and Milo go to Rome and it is all in ruins. This time period was 1944, during World War II. The time sequences between all these settings are very disjointed. In the beginning of the novel Yossarian is faking a liver disease when he begins to have flashbacks to Snowden’s death, and the novel jumps before Snowden’s death to after Snowden’s death throughout the whole novel. The time frame of the events going on are at the end of WWII and in the summer of 1944- the winter of 1944 and a flash back to 1942. The main conflict that is tossed throughout the entire book is Catch 22 itself. Within several of the chapters, a catch 22 will appear. The main catch is that of Catch 22. It seemed as though it was Yossarian against the military. Every time Yossarian finds a loop hole, his commanding officers would just tell him to go back to his missions. Yossarian just could not win. When Yossarian was in the hospital with his â€Å"liver disease†, he was forced to go back out to the missions again. He cannot win. Many people cannot stand Yossarian and want him dead. His other main conflict is that it is everyone else against him. These two conflicts intertwine because Yossarian is still fighting for something. Without his life, the military would not have anything to control, so Yossarian’s conflicts go together because without one, the other would not happened. The two climaxes in the novel happen simultaneously. The first occurs when Yossarian is offered a choice: he can either face a court martial or be sent home and talk good about his commanding officers. The second climax, however, occurs as Yossarian has his final flashback about Snowden’s death in which all details are revealed. Yossarian has had a rough life in the military and absolutely hated it with everything he had. The worst experience he has had was the gruesome death of his comrade, Snowden.

Freuds Concept of the Unconscious Hitchcocks Psycho

Freuds Concept of the Unconscious Hitchcocks Psycho In this essay I have analysed the famous Hitchcock film psycho using Freuds concept of the unconscious. The bleak, monochrome film is made more effective by Bernard Herrmanns sparse, but driving, recognisable score, first played under the frantic credits. The criss-crossing patterns, like mirror-images, are correlated to the split, schizophrenic personality of a major protagonist. The initial usage of staccato chords immediately provides us with a hint of detachment of a character to be involved, this along with the titles created by Saul Bass, (who was known for his style reminiscent of 1920s Soviet poster art) immediately provide the audience with apprehension. The screech of the violins is representative of birds, which we later see depicted throughout the film. Many of Hitchcocks recurring images are important in Freudian dream interpretation. It is apparent right from the beginning what lies ahead is no ordinary story, and a strange feeling of anxiety swells with the visual and musical intro. Screenwriter Joseph Stefano adapted Robert Blochs novel Psycho into what would become one of Alfred Hitchcocks influential works and one of the classic films of all time. We are led to believe Psycho is a film about cloak-and-dagger affairs, misappropriation, murder, secrets, and mental struggle; although in the darkness, there lies an examination of the temptations of wealth, sexual identity, gender roles, sexual expression, it depicts the appalling events which can occur with the departure of normal advancement. Psycho reiterates to its viewers that people sometimes provide a visual falsity of who they are and stories we have read as children of a bad person visually representative of their character traits in life are not often the case, and when the personal development has not reached an expected level that immoral crimes may occur. Sigmund Freud wrote about the human psyche in the 1920 essay Beyond the Pleasure Principle, and fully elaborated upon it in The Ego and the Id (1923). Freuds theory of the subconscious consists of three parts, the Id, the Ego, and the Super Ego and the interaction between them all. The Id is considered to be chaotic, the center for animalistic impulses, and is governed by the pleasure principle, otherwise known as instant gratification. It is also the location of the libido, which is our life force or our sexual drive. The Ids driving instinct is for self-preservation. The Ego is quite different from the Id, it is the broker between the Id and the Super Ego. The Ego is also the personality we show others, founded upon the reality formula. The Super Ego represents our conscience or moral standards, ideas of right and wrong which are permanently instilled in our minds by our parents or other authority figures. Freud regarded the mind to be like an Iceberg (see Figure 1) where the uncon scious lies below the surface, and the conscious above. To conclude: the Id demands gratification, the Ego responds to reality (civilization), and the Superego which is our moral code and also is dictated by the demands of society. The storyline of this film involves a young woman who through the pleasure principle of the id steals $40,000 from her employer. Marion is motivated by her desire to settle down and have a family with her lover Sam and to have financial freedom. Her super ego and the moral side have been outbalanced by her personal desires to live the perfect life with her lover. She ends up on a personal odyssey towards terror when she encounters a disturbed young hotel proprietor who is dominated by his mother. Throughout the film is a parallel to psychoanalysis as it attempts to piece together limited parts to understand as a coherent whole. Even the films cinematographic techniques reinforce individual images as being composed of fragmentary pieces. Part of Psychos visual appeal comes from Hitchcocks use of montage. James Naremore quotes Hitchcock describing montage as puttinglittle bits and pieces of film together Marion drives to her lover and a curtain of rain leads her to check into the Bates Motel. Paths and steps and roads are prevelant in Pyscho , the path between the motel and house which symbolises a path between the normal and the insane, in Psycho stairs lead to madness. In his documentary The PervertHYPERLINK http://en.wikipedia.org/wiki/The_Perverts_Guide_to_CinemaHYPERLINK http://en.wikipedia.org/wiki/The_Perverts_Guide_to_Cinemas Guide to Cinema, Slavoj Ã…Â ½iÃ…Â ¾ek remarks that Norman Bates mansion has three floors, paralleling the three levels that psychoanalysis attributes to the human mind: the first floor would be the superego (Figure 2a), where Bates mother lives on; the ground floor is then Bates ego (Figure 2b), where he functions as an apparently normal human being; and finally, the basement would be Bates id (Figure 2c). For Freud, most repressed memories relate to sexuality. One type, for example, derives from the primal scene, where the child witnesses his parents having sex, then represses the memory of the scene. In Psycho, Norman Bates is said to have murdered his mother and her lover after finding them in bed together. Freud identified the tendency of a person who has experienced a traumatic event to re-live the negative event over and over, in action, in memory, or in dreams. A key aspect of the theory is the urge to put oneself into situations where the traumatic experience is likely to recur. Some forms of sexual dysfunction are interpreted as examples of repetition compulsion for example, an individual spanked as a child may seek out masochistic sexual experiences The best known of Freuds theories about childhood sexuality is named from the mythological king Oedipus, who killed his father and married his mother. As Freud described the complex, a young boy is sexually attracted to his mother, and as a result desires to kill his father in order to possess the mother. This forbidden desire is then repressed, only to return later in neurotic form. In popular Freudianism, mothers are often seen as encouraging the Oedipal complex through possessive or flirtatious behavior toward sons. As Norman Bates tells Marion Crane, a boys best friend is his mother. (But also: A son is a poor substitute for a lover.). Freud believed the purpose of psychoanalysis is to recover these repressed memories so that the patient can deal with them in the conscious mind. In Freudianism, a successfully integrated personality is under control of the Ego. We see Norman engage in a discussion with Marion in the parlour where he reveals a desire to escape from mothers tyrannical grip, but cannot gain the will to do so. Norman fails to achieve the self-mastery which Freud claimed psychoanalysis may provide. At this stage Marion retires to her room and decides to return to her old life. In the parlour adjacent to Marions room we see Norman remove a painting to reveal a spy-hole. The audience is forced into Normans secret world as he watches her undress. Normal develops masculine and sexual feelings towards Marion. Bates alter ego of his mother is not happy about the prospect of an attractive young woman disrupting the love affair between mother and son. He even holds conversations with himself thinking hes speaking to his mother. While dressed as his mother, Bates with knife in hand murders Crane while she is taking a shower in one of the Bates motel rooms. During the shower scene the piercing violin strings play a large part in creating sheer terror during the horrific scene, screaming begins before Marions own shrieks. The murder during the shower scene destabilises the audience as the blade is pointed at her abdominal womb area, attacking the site of motherhood is perhaps a gesture to prevent her giving birth to men like himself see Figure 3a and 3b. From Freud we learn Normans id becomes the core of the psyche and determining force causing the mother half of Norman Bates to commit murder. Normans psyche represses this information causing the fear of reappearance. The compulsion to repeat is a manifestation of the power of the repressed (Freud, 1920), illustrating the strength of the influence of the repressed and the unconscious.ÂÂ   After the murder of Marion and Norman disposing of her in the swamp next to the house, the spectators turn to Norman to replace Marion as its main focus in its subjective role. Later on, when Sam and Lila search for evidence regarding Marions disapparance, Sam Loomis distracts Norman as Lila quietly walks up to the house to talk to Normans mother. She finds in the lower floor Normans mothers dead body which has been removed from its grave and preserved. At this point we realise Norman is two people. Norman is metamorphosised and revealed as his Mother when as he attempts to kill again his disguise is stripped away and ripped off. The Norman self completely dies, while his macabre Mother self is brought to life, shown by his mothers hysterically-laughing face, animated and resurrected by the light. Normans restricted personal growth this can be linked with the Oedipus complex. During the development of the Oedipus Complex the child develops a strong sense and powerful urges for sexual possession of the opposite sex parent. This urge gives rise to serious problems. The boy identifies with his father, and in doing so, internalises the fathers moral standards consequently the boy takes on the morals from his father, forming the superego. In Normans case, the absense of his father has resulted in an unresolved oedipus complex which results in a weak superego. Perhaps its this reason why he struggles with identity disorder as he houses his mothers superego in attempt to compensate for the one which he never developed as a result of his fathers absence. At the end of the film the psychiatrist explains: When reality came too close, when danger or desire threatened that illusion, he dressed up, even to a cheap wig he bought. Hed walk about the house, sit in her chair, speak in her voice. He was never all Norman, but he was often only Mother. Freud believed that traumatic events, usually from childhood, are repressed by the conscious mind. However, these destructive memories remain in the subconscious, where they are the source of neuroses and psychoses. The purpose of psychoanalysis is to recover these repressed memories so that the patient can deal with them in the conscious mind. The audience, although they had received an explanation for Normans actions, is left terrified and confused by the last scene of Norman and the manifestation of his split personality. Faced with this spectacle, Hitchcock forces the audience to examine their conscious self in relation to the events that they had just played a role in. Psycho creates a fear not necessarily from the brutality of the murders but from the subconscious identification with the films characters. To conclude, Hitchcock enforces the idea that all the basic emotions and sentiments derived from the film can be felt by anyone as the unending battle between good and evil exists in all aspects of life. The effective use of character parallels and the creation of the audiences subjective role in the plot enables Hitchcock to entice terror and convey a lingering sense of anxiety within the audience through a progressively intensifying theme. Freuds concept of the unconscious is so explicitly mirrored throughout the film. We have a seemingly normal woman whose balance is offset by a desire and which drives her to commit a financial crime. At the other end of the spectre we have again a man who most would think was harmless enough but due to his childhood and developmental restrictions has for other reasons allowed his unconscious to take full control of his conscious. According to Freud the essence of repression lies simply in the turning something away, and keeping it at a distance f or the conscious; Freud believed traumatic memories usually of childhood events are repressed as a defence mechanism which keeps the ego free of conflict and tension, however something can induce the momentary retrieval of a repressed memory and in the case of Norman Bates this triggered a psychotic in his mother psyche episode.

Ethical And Effective Practice With Service Users Social Work Essay

Ethical And Effective Practice With Service Users Social Work Essay Selecting an appropriate method of intervention is central to ethical and effective practice with service users. The aim of this essay is to define what is meant my method of intervention, explore the main factors which influence the worker when selecting a method and critically consider the role of partnership working and empowerment. Intervention is rarely defined. It originates from the Latin inter (between) and venire (to come) and means coming between (Trevithick, 2005: 66). Interventions are at the heart of everyday social interactions and make inevitably make up a substantial majority of human behaviour and are made by those who desire and intend to influence some part of the world and the beings within it (Kennard et al. 1993:3). Social work interventions are purposeful actions we undertake as workers which are based on knowledge and understanding acquired, skills learnt and values adopted. Therefore, interventions are knowledge, skills, understanding and values in action. Intervention may focus on individuals, families, communities, or groups and be in different forms depending on their purpose and whether directive or non-directive. Generally, interventions that are directive aim to purposefully change the course of events and can be highly influenced by agency policy and practice or by the practitioners perspective on how to move events forward. This may involve offering advice, providing information and suggestions about what to do, or how to behave and can be important and a professional requirement where immediate danger or risk is involved. In non-directive interventions the worker does not attempt to decide for people, or to lead, guide or persuade them to accept his/her specific conclusions (Coulshed and Orme, 1998: 216). Work is done in a way to enable individuals to decide for themselves and involves helping people to problem solve or talk about their thoughts, feelings and the different courses of action they may take (Lishman, 1994). Counselling skills can be beneficial or important in this regard (Thompson 2000b). Work with service users can therefore involve both directive and non-directive elements and both types have advantages and disadvantages (Mayo, 1994). Behaviourist, cognitive and psychosocial approaches tend to be directive but this depends on perspective adopted and the practitioners character. In contrast, community work is generally non-directive and person-centred. Interventions have different time periods and levels of intensity which are dependent on several factors such as setting where the work is located, problem presented, individuals involved and agency policy and practice. Several practice approaches have a time limited factor such as task-centred work, crisis intervention and some behavioural approaches and are often preferred by agencies for this reason. In addition, practice approaches that are designed to be used for a considerable time such as psychosocial are often geared towards more planned short-term, time limited and focused work (Fanger 1995). Although negotiation should take place with service users to ensure their needs and expectations are taken into account, it is not common practice for practitioners to offer choice on whether they would prefer a directive or non-directive approach or the practice approach adopted (Lishman, 1994). However, this lack of choice is now being recognised and addressed with the involvement of service users and others in the decision-making process in relation to agency policy, practice and service delivery (Barton, 2002; Croft and Beresford, 2000). The purpose and use of different interventions is contentious. Payne (1996: 43) argues that the term intervention is oppressive as it indicates the moral and political authority of the social worker. This concern is also shared by others with Langan and Lee (1989:83) describing the potentially invasive nature of interventions and how they can be used to control others. Jones suggests that in relation to power differences and the attitude of social workers especially with regards to people living in poverty: the working class poor have been generally antagonistic toward social work intervention and have rejected social works downward gaze and highly interventionist and moralistic approach to their poverty and associated difficulties (Jones, 2002a: 12). It is recognised that intervention can be oppressive, delivered with no clear purpose or in-depth experience however, some seek and find interventions that are empathic, caring and non-judgemental due to practitioners demonstrating rele vant experience and show appropriate knowledge (Lishman, 1994:14). For many practitioners, these attributes are essential in any intervention and are demonstrated through commitment, concern and respect for others which are qualities that are valued by service users (Cheetham et al. 1992; Wilson, 2000). Dependent on the nature of help sought there are different opinions on whether interventions should be targeted on personal change or wider societal, environmental or political change. Some may want assistance in accessing a particular service or other forms of help and not embrace interventions that may take them in a particular direction i.e. social action (Payne et al. 2002). In contrast, problems may recur or become worse if no collective action is taken. Importance has reduced in relation to methods of intervention over recent years as social work agencies have given more focus to assessment and immediate or short-term solutions (Howe, 1996; Lymbery 2001). This is strengthened by the reactive nature of service provision which is more concerned with practical results than with theories and principles. This has a reduced effect on workers knowledge of a range of methods resulting in workers using a preferred method which is not evidenced in their practice (Thompson, 2000). Methods of intervention should be the basis of ongoing intervention with service users, but often lacks structured planning and is reactive to crisis. This reactive response with emphasis on assessment frameworks is concerning, as workers are still managing high caseloads and if not supervised and supported appropriately, workers are at risk of stress and eventual burn-out (Jones, 2001; Charles and Butler, 2004). Effective use of methods of intervention allows work to be planned, structured and prioritised depending on service users needs. Methods can be complicated as they are underpinned by a wide range of skills and influenced by the approach of the worker. Most methods tend to follow similar processes of application: assessment, planning of goals, implementation, termination, evaluation and review. Although the process of some methods is completed in three/four interactions others take longer. This difference shows how some methods place more or less importance on factors such as personality or society, which then informs the type of intervention required to resolve issues in the service users situation (Watson and West, 2006). More than one method can be used in conjunction with another, depending on how comprehensive work with service users needs to be (Milner and OByrne, 1998). However, each method has different assessment and an implementation process which looks for different types of information about the service users situation for example, task centred looks for causes and solutions in the present situation and psychosocial explores past experiences. Additionally, the method of assessment may require that at least two assessments be undertaken: the first to explore the necessity of involvement and secondly, to negotiate the method of intervention with the service user. An effective assessment framework that is flexible and has various options is beneficial but should not awkward or time consuming to either the worker or the service user. As Dalrymple and Burke (1995) suggest, a biography framework is an ideal way as it enables service users to locate present issues in the context of their life both past and present. Workers should aim to practice in a way which is empowering and the process of information gathering should attempt to fit into the exchange model of assessment, irrespective of the method of intervention and should be the basis of a working relationship which moves towards partnership (Watson and West, 2006). As part of the engagement and assessment process, the worker needs to negotiate with the service user to understand the issue(s) that need to be addressed and method(s) employed and take into account not only the nature of the problem but also the urgency and potential consequences of not intervening (Doel and Marsh, 1992). Importance should be placed on presenting and underlying issues early in the assessment process as it enables the worker to look at an assessment framework and approach that assists short or long-term methods of intervention. An inclusive and holistic assessment enables the service user to have a direct influence on the method of intervention selected and be at the heart of the process. The process of assessment must be shared with and understood by the service user for any method of intervention to be successful (Watson and West, 2006). The workers approach also has an influence on method selection as this will affect how they perceive and adapt to specific situations. The implementation of methods is affected by both the values of the method and value base of the individual worker. The worker will also influence how the method is applied in practice through implementation, evaluation, perceived expertise and attitude to empowerment and partnership. Methods such as task centred are seen to be empowering with ethnic minority and other oppressed groups as service users are seen to be able to define their own problems (Ahmad, 1990). However, when an approach is used which is worker or agency focused the service user may not be fully enabled to define the problem and results in informing but not engaging them in determining priorities. Empowerment and partnership involves sharing and involving service users in method selection, application of the method, allocation of tasks, responsibilities, evaluation and review and is crucial in enabling facing challenges in their situations and lives. However, service users can have difficulty with this level of information-sharing and may prefer that the worker take the lead role rather than negotiating something different and not wish to acquire new skills to have full advantage of the partnership offered. Selecting a method of intervention should not be a technical process of information gathering and a tick box process to achieve a desired outcome. Milner and OByrne (2002) suggest it requires combining various components such as analysis and understanding of the service user, worker and the mandate of the agency providing the service otherwise intervention could be is restrictive and limit available options. However, negotiation and the competing demands of all involved parties must be considered and the basis of anti-oppresive practice established. Methods of intervention can be a complex and demanding activity especially in terms of time and energy and therefore, short-term term methods are seen as less intensive and demanding of the worker as well as more successful in practice. However, Watson and West (2006: 62) see this as a misconception, as the popular more short-term methods often make extensive demands on the workers time and energy. Workers are often dealing with uncertainty as each service user have different capabilities, levels of confidence and support networks. Therefore, there is no one ideal method for any given situation but a range of methods that have both advantages and disadvantages and as Trethivick (2005: 1) suggests workers need to have a toolkit to begin to understand people and need to widen the range of options available in order for them to respond flexibly and appropriately to each new situation (Parker and Bradley, 2003). When using methods of intervention, workers have to be organised to ensure that the task is proactively carried out and often attempt to prioritise involvement with service users against both local and national contexts and provide an appropriate level of service within managerial constraints. This prioritisation means in practice that, given the extensive demands, work using methods can only be with four or five service users at any one time and with the additional pressure of monitoring and supervising service users and reports, risk response is often responsive and crisis driven (Watson and West, 2006). To work in an empowering and anti-oppressive perspective is to ensure that intervention focuses clearly on the needs of the service user, is appropriate to the situation than the needs of the service. An understanding of these competing demands and the workers ability to influence decision-making processes does impact on method selection however, this should not mean that the service is diluted and methods be partially implemented as this is not conducive to managerial or professional agendas on good practice. Thompson (2000:43) sees this as the set of common patterns, assumptions, values and norms that become established within an organisation over time and a concern of workers is competitive workplace cultures where ability is based on the number of cases managed rather than the quality that is provided to service users which may result in use of less time-consuming methods. For work to be effective, an ethical and a professional not just a bureaucratic response to pressures faced is required and is not about the service user fitting into the worker or agencys preferred way of working but looking at what is best for the service user and finding creative ways to make this happen. Workers need to be careful not to seen as the expert who will resolve the situation as even the most established and experienced practitioners have skills gaps and often develop skills when working with the service users. This process of learning in practice requires good support and supervision, enabling the worker to reflect on assumptions about service users and their capabilities especially in relation to gender, race, age or disability to prevent internalised bias to impact on what the service user requires to work on to change the situation (Watson and West, 2006). It is crucial to appreciate the situation from the service users perspective and see them as unique individuals as Taylor and Devine (1993: 4) state the clients perception of the situation has to be the basis of effective social work. This concern is also shared by Howe (1987:3) describing the clients perception is an integral part of the practice of social work. Service users often have their own assumptions about what social work is and what workers are able to provide which is generally based on past relationships and experiences for example, black service users experience may reflect a service which in the past was not appropriate to their needs (Milner and Byrne, 1998: 23) but to alleviate this practitioners need to work in an open, honest and empowering manner and recognise that although service users may be in negative situations they also have strengths and skills that need to be utilised in the social work relationship. Workers should ensure that written agreements are developed that acknowledge all participants roles and responsibilities and avoid assumptions or issues (Lishman, 1994), this avoids breakdown in trust and encourages honesty and open shared responsibility between service user and worker. This involves negotiation on what should be achieved, by whom, including agency input. Agreements can provide the potential for empowering practice that involves partnership. However, cognisance has to be taken to ensure that the agreement does not become a set of non-negotiated tasks that service users have no possibility of achieving, combined with no reciprocal commitment or obligations by the worker as this does not address the issue of empowerment or oppression and can reinforce the power difference (Rojek and Collins, 1988). The final stage of the process is termination which should be planned and allow both parties time and opportunity to prepare for the future however, it has to be carefully and sensitively constructed and is much easier to achieve if the work has been methodical with clear goals as it demonstrates what has been achieved. Evaluation is beneficial as it enables the service user and worker to be reminded of timescales and can acknowledge the service users increasing skills, empowerment, confidence and self-esteem which can be utilised after the intervention has ended. Endings can however, be difficult for both the worker and service user resulting from various factors such as complexity of service users situation, issues of dependency and lack of clarity about purpose and intervention. This lack of clarity can result in a situation of uncertainty for both worker and service user (Watson and West, 2006). Finally, termination as part of the change process creates opportunities but also fea r, anxiety and loss (Coulshed and Orme, 1998). It is important for workers to take a step back and reflect on their practice and review their experiences to ensure that they are providing the best possible service in the most ethical and effective manner. Reflective practice provides support and enables workers to not just meet the needs of the organisation but also develop their own knowledge and skills and increased understanding of their own approach and the situation experienced by service users. A good tool to facilitate this is the use of reflective diaries. Reflecting in action and on action both influences and enhances current and future practice. The use of effective supervision is another process where workload management, forum for learning and problem-solving should take place which should be supportive and enabling to the worker (Kadushin and Harkness, 2002). However, the workers role in supervision is often viewed as passive as the supervisor sets the agenda. This can lead to disempowerment of the worker in relation to the agency and is potentially oppressive and discriminatory and provides a poor role model for work with service users and therefore consideration must be given on how they can create a positive and empowering relationship (Thompson, 2002). In conclusion, good practice requires workers to have knowledge to understand the person in situation, (Hollis, 1972) understanding both sociological (society and community) and psychological (personality and life span) and the interrelation and impact on the service user (Howe, 1987). A critical skill for effective and ethical practice is empowerment which is based on knowledge and values and is the difference between informing and genuine partnership and the importance of active participation of service users throughout the process. Social work is a value based activity and workers through reflection and supervision can all learn from experiences, adapt and enhance these to develop practice and gain self-awareness to understand how they themselves and their approach impacts on service users.