Where will healthcare be in the next five years Term Paper

Where will healthcare be in the next five years - Term Paper Example What is the future of health care in America? This piece seeks to address some of those questions in detail. I believe that health care reform in the United States is still going to be a hotly-contested issue, especially when it comes to the complaints that will be heard by: doctors; insurance companies; and small business owners, especially when it comes to issues like long-term care, walk-in clinics, hospitals, and health care reform bill issues. Doctors are not going to like the new health insurance plan. Since doctors are going to have to treat everyone from now on, regardless of whether they can pay or not, obviously this is going to have a huge effect on how doctors do business. Doctors cannot now turn away patients. They must be willing to see anyone who comes to them with a problem because now everyone will have insurance in order to pay for their doctors’ visits. Doctors are going to most likely be upset with health care reform because of several reasons. Doctors are going to be more in demand now more than ever because they will have to treat so many new patients. They can’t charge whatever they want—they are going to have to receive whatever payment the government gives them. This may upset many doctors because, before now doctors could control much of what their salary was when they regulated the prices for their visits. Since health care is going to be mandated, many doctors will have to receive subsidies from the government for seeing people on the public health care plan, and they are not going to like this establishment for long-term care. Walk-in clinics are most likely going to be overwhelmed. Doctors in hospitals will have to treat whomever walks through their doors, for the most part. They must now treat everyone, regardless of people having had pre-existing conditions. Now doctors must treat whoever comes to them for help; they cannot pick and choose. â€Å"Like insurance companies, physicians and hospitals will

What is Serial Killer behavior and profiling

What is Serial Killer behavior and profiling What is a serial killer? Many have their own ideas as to what a serial killer is, what they look like, and what kind of job they have or how they were raised or even where they live. In order for the reader to really understand the definition of a serial killer the research must pinpoint what makes a serial. Statistical data as well as demographic data will also be discussed so that it can show accuracy between profiles and stereotypes. Past studies and the articles under consideration mostly point out two major factors that result into causing the homicidal behavior. These factors are psychological aspects and disturbed family background. The studies that we are going to review have analyzed the serial killing attitudes using different approaches. Geographical Profiling, Decision Support System, Motives, Comparison of single and serial killers, Distinction between antisocial personality disorder and psychopaths, Demographics of victims, the White trash phenomenon and a criticism ove r generalities profiling are our studied approaches and findings. The psychological aspects include abnormal kinds of satisfaction that a homicide derives from abusive attitude. This satisfaction may be either of sexual nature or revenge or both. Other abusive activities such as indulging into drugs, alcoholism and minor crimes are also considered in the psychological aspects. A disturbed background at home includes split family, abusive parent or guardian, the circumstances that lead to staying at care. A child when goes through disturbed phases within family it is a big stimulus for that child to turn into a homicide. The children who live in foster care have a potency to engage into abusive activities in future when they leave care. The reviewed studies follow logarithmic and quadratic distribution, normalization parameter, literature review, integration approach, comparative approach, cinematic approach and profiling approach. Truth behind Serial Murder Serial homicide, in its youngest form was known by the FBI as a lust murder (Egger, 1998). Still the question arises as to what is the actual definition of a serial killer. Another describes a serial killer as one that explodes in homicidal rampage (Egger, 1998). Then you look at law enforcement and what they say is serial murder is sexual attacks, the death of men, women and children committed by a male killer (Egger, 1998). Though there are many definitions to what a serial killer may be, one may have to look further in depth to really understand what the definition is. Here are some ideas to think about when defining this aspect. First, serial murder occurs when one or more individuals commit murder of three or more people over a period of time. Second, there is a cooling off period between each murder. This could be weeks, months or even years before they go after another victim. Third, there is usually no connection between the victim and assailant. Forth, Serial killings are us ually different in geographic area and can move from one location to another. Last, but not least motives are not for material reasons, but for power and control (Holmes, 1998). As one may notice researchers have been studying and trying to create an iron clad definition to go by when establishing what a serial killer is. Although as difficult as one may think this is, the above mentioned characteristics of a serial killer help Law enforcement further in their serial killer cases. In another attempt at defining a serial killer it was stated as any offenders, male or female, who kill over time with a minimum of three to four victims who have a pattern with their killing that can be associated with the types of victims selected or the method or motives (Hickey, 2002). Ideologies of Serial murder There have been numerous researches done in order to create many categories, types, and labels of murders. Some of these categories include biological, psychological, and sociological traits (Siegel, 1998). Other researchers have gone further in categorizing murders as brain disorders, passive aggressive, alcoholics, mentally retarded, and hysterical (Hickey, 2002). Other researchers in yet more categories such as the visionary type who hears voices, which tell them to act in horrible acts. Then there is the mission type who believes it is their duty to get rid of evil people in the world and example of this is Hitler. Some examples of what may be considered as evil are certain religions, ethnic groups and homosexuals. Next, is the hedonistic type which commits violent acts for fun. They kill for only the pleasure of it, there is no personal gain with this type. Last, but not least there is the power type who desires to be in control (hickey, 1997). An example of this is actually a m ovie called Saw where they get pure pleasure by setting someone up in a contraption that will kill them if they do not do something for the killer. The victim does what is expected, but in most cases they still die thinking that they were going to live. This is also where the background of bedwetting and animal cruelty begins (Douglas, 1999). Males Serial Killers The earliest documentation after the 1800s of an adult male serial killer was Edward Rulloff, also known as the educated murderer, in 1846. It wasnt until the 1900s that we saw a dramatic increase (Hickey, 2002). A study done by D.K Rossmo in 1995 stated that males were involved in over 90% of serial murders. He found that the average age for a serial killer was around the mid-20. In his study he went on to show that 73% were white males, 22% were African American, 3% were Hispanic, and 1 % Asian (Hickey, 2002). The mobility classifying gets a little difficult for it differs for each serial killer. About one-third of male killers have killed people in multiple states. Over 50% of male serial killers stayed locally when committing their murders. Over 10% of serial killers use their own home (Hickey, 2002). Most victims however, are killed by a local serial killer. The victims of these serial killers can be categorized into three different targets. First, is the stranger. Next, which i s the most targeted is the acquaintances, and last but not least is the family members. The occupation of a male serial killer is very diverse. Jobs such as a plumber to a physician are common. Many known serial killers were in jobs you would never think of them being in given their nasty habits. A good example of this is Ted Bundy who was thought to have been a law student. Another was Bianchi who was a security officer and an ambulance driver as well. He over a seven year period held over 10 jobs (Egger, 1998). It is examples like these that show the assortment of backgrounds that these men share. It does not seem to be a factor as far as education goes. Some of these men never made it through high school whereas some did, yet they did not further their education past high school and a few did. In addition to this many also had a prior criminal history. Results were astonishing as the combination of offenses such as prison, mental hospital, property offenses, sex crimes, crimes on children, drugs, fire starting, homicide, and assault was 68% (Hickey, 2002). Next, what we will talk about is the importance of the motives and methods of a serial killer, which a lot of researches see as the most important. Eric Hickeys study illustrated that 41% of serial killers uses some fire arms. 42% of serial killers in his study used a combination of methods. Such methods that were used include 37% strangulation and 34 % stabbing. 26% used some bludgeoning, and 19% used firearms only. It went on to say that 13 % stabbed only. The last 2% used other means as their way of killing (Hickey, 2002). Serial Killer Most Frequent Method à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã‚ ¾ Albert DeSalvo Strangulation à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã‚ ¾ Ed Kemper Shooting à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã‚ ¾ Carlton Gary Strangulation à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã‚ ¾ Robert Long Combination à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã‚ ¾ Kenneth Bianchi Strangulation (Hickey, 2002; Egger, 1998). Female Serial Killers Many do not think of a female as being a serial killer, but contrary to that belief they do exist. Females are more often than not dismissed as being serial killers, because of the stereotype under which they fall. Researchers provide evidence to prove that they indeed are capable of committing serial murder. When fitting women to this profile it is hard because you think of your mom who is loving and nurturing. The last think anyone wants is to think that their mother could be such a thing as a serial killer. The public just doesnt think of their mothers and sisters as having the capability of murder (Holmes, 1998). Unfortunately statistics show that 10 to 15 percent of American serial killers have been women (Jenkins, 1994). The FBI called Aileen Wuornos the first female serial killer after killing seven men by shooting them in the torso in 1989 (Egger, 1998). Females can be as cruel and uncompassionate as male serial killers (Abbot et al. 2001). Like the male serial killer there i s documentation of female serial killers going as far back as the 1800s. From 1826 to 1995 there have been a total of 59 cases of female serial killings. The number of victims killed within this time frame is over 834 (Hickey, 2002). Most of female serial killers seem to lead a normal average life. According to a study by Hickey, 32% of female serial killers have been homemakers, 18% were nurse or had been a nurse, and 15 % had a prior criminal record. Also like men the average were whit and around there early 30s. As far as female serial Killers victims it seems that according to research they fall into the same three categories as men. In most of the other aspects women are pretty close to the same in their serial killings. However motives seem to be somewhat different of that of male serial killers. These are usually based on emotions, such as being physically abused, sexually abused. The many aspect of a serial killer that were discussed in this paper show both the sides of a male and a female serial killer and the many profiling behaviors of each. Our reviewed studies have analyzed the relationship of all these factors using various techniques. It is possible that many serial murderers are apprehended before they kill three or more victims required to qualify as such. Similarly, there are some who are detained for mental institutions and not directly answer for their crimes. Others continue to kill many more people to over the years without being arrested.

The Harlem Renaissance Essay -- essays research papers fc

HARLEM RENAISSANCE Throughout the history of African Americans, there have been important historical figures as well as times. Revered and inspirational leaders and eras like, Martin Luther King and the Civil Rights Movement, Nat Turner and the slave revolt, or Huey Newton and the Black Panther Party. One such period that will always remain a significant part of black art and culture is the Harlem Renaissance. It changed the meaning of art and poetry, as it was known then. Furthermore, the Harlem Renaissance forever left a mark on the evolution of the black culture. The Harlem Renaissance found its birth in the early 1920’s, in Harlem, New York. The period has been thought of as one of African Americans greatest times in writing. After War World I in 1918, African Americans were faced with one of the lowest points in history since the end of slavery. Poverty increased greatly in the South, as did the number of lynchings. The fear of race riots in the South caused large number of African Americans to move North between 1919 and 1926, to cities such as Chicago and Washington D.C. The idea that an educated black person should lead blacks to liberation was first founded from the works of W.E.B. DuBois. He also believed that blacks could not gain social equality by imitating the ideas of white people. Equality would have to be achieved by teaching black racial pride with an emphasis on black cultural heritage. The Cultural Revolution began as a series of literacy discussions in bars and coffee shops of lower Manhattan (Greenwich Village) and (Upper Manhattan) Harlem. Jean Toomer did one of the first and highly praised works. This would be Toomer’s only contribution to a time that he would later reject. Toomer is also known for his exquisite poetry like; Cotton Song, Evening Song, Georgia Dusk and Reapers. Jane Weldon Johnson had written the controversial â€Å"Autobiography of an Ex-colored Man† in 1924 and he had also edited â€Å" The Book of American Negro Poetry.† This collection included many of the Renaissance’s most talented poets. Included was Claude McKay, a Jamaican born writer. Weldon’s collection also included a young talented poet named Langston Hughes. Hughes had a love for music, mainly the blues, which became a bridge between African American Literature and Folk music. Zora Neale Hurston, an anthropologist originally... ... Furthermore, with that knowledge going on to have racial esteem, to do great things and influence others, thus making a mark on the world. The Harlem Renaissance taught future artist to look at art from an all-encompassing view. It knocked down barriers between literary and musical expression. The Renaissance added a new chapter in American History. A chapter that would highlight the African American thoughts and feelings as well as display their many talents. Bibliography Huggins, Nathan Irvin. Harlem Renaissance. New York: Oxford University Press.1971. Lewis, David Levering. When Harlem was in vogue. New York: Oxford University Press.1979. Reuben, Paul P. "Chapter 9: Harlem Renaissance - An Introduction." PAL: perspectives in American Literature- A Research and Reference Guide. URL: http://www.csustan.edu/english/reuben/pal/chap9/9intro.html, 1999. Roses, Lorraine E. Harlem Renaissance and Beyond: Literary Biographies of 100 Black women Writers, 1900-1945. Boston: Gik. Hall, 1990. Tate, Claudia. Domestic allegories of political desire: The black heroine's text at the turn of the century. New York: Oxford University Press, 1992.

Forgetting About Something Essay

Have you ever experienced forgetting about something? Like where did you put your pair of socks, where did you leave your car keys, or where did you put your pen? Did you ever wonder why or how this happens? For a period of three (3) days, I tried to observe myself. I used to forget where I put my door key. I realized that I have forgotten where my key in three different situations: – When I need to get out of the room – When something reminded me about keys like doors and door knobs, and – When I saw the usual spot for my room key and the key is not there. As I have researched, forgetting, also called as cue-dependent forgetting, is the failure to recall a memory due to missing stimuli or cues that were present at the time the memory is encoded. There are factors why retrieval of the memory fails. Usually, the information no longer exist in the mind that why a material cannot be found or cannot be recalled. Emotions also play a crucial role. The reason why I forget where I leave my key is that I am always in a hurry. And as I have observed, there are also reasons why I manage to remember where my key is. First, whenever I forgot where my key is, I am in a hurry to get out of the room and I cannot think properly where I last put my key. Then, I remember to recall where I put my key because I saw an object that reminds me of my key such as doors and knobs. Lastly, when I manage to relax for a while and see if I have got everything in order, I tend to look at the spot where I place my key. Being an important object or simply because it is a personal belonging, I have a list on my mind where my important things are. Concluding the activity, when someone is in hurry or feeling excited, the tendency to forget is very possible because there is so much going on with our minds. But once we take time to relax, recall, or back track our activities earlier, we can avoid retrieval failure on our memories. Reference Baddeley, A. D. (1997). Human Memory: Theory and Practice. Taylor and Francis Group.

Critical Discourse Analysis, Organizational Discourse, and Organizational Change Essay

Discourses is an element of all concrete social events (actions, processes) as well as of more durable social practices, though neither are simply discourse: they are articulations of discourse with non-discoursal elements. ‘Discourse’ subsumes language as well as other forms of semiosis such as visual images and ‘body language’, and the discoursal element of a social event often combines different semiotic forms (eg a television programme). But the use of the ‘term ‘discourse’ rather than ‘language’ is not purely or even primarily motivated by the diversity of forms of semiosis, it is primarily registers a relational way of seeing semiosis[i], as one element of social events and practices dialectically interconnected with other elements. The overriding objective of discourse analysis, on this view, is not simply analysis of discourse per se, but analysis of the dialectical relations between discourse and non-discoursal elements of the social, in order to reach a better understanding of these complex relations (including how changes in discourse can cause changes in other elements). But if we are to analyse relations between discourse and non-discoursal elements, we must obviously see them as ontologically (and not just epistemologically, analytically) different elements of the social. They are different, but they are not discrete – that is, they are dialectically related, in the sense that elements ‘internalize’ other elements, without being reducible to them (Harvey 1996, Chouliaraki & Fairclough 1999, Fairclough 2003, Fairclough, Jessop & Sayer 2004). A realist view of social life sees it as including social structures as well as social events – in critical realist terms, the ‘real’ (which defines and delimits what is possible) as well as the ‘actual’ (what actually happens). There is a general recognition that the relationship between structures and events must be a mediated relation, and I follow for instance Bhaskar (1986) and Bourdieu (Bourdieu & Wacquant 1992) in regarding social practices as the mediating entities – more or less durable and stable articulations of diverse social elements including discourse which constitute social selections and orderings of the allowances of social structures as actualisable allowances in particular areas of social life in a certain time and place. Social fields, institutions and organizations can be regarded as networks of social practices. Networks of social practices include specifically discoursal selections and orderings (from languages and other semiotic systems, which are counted amongst social structures) which I call ‘orders of discourse’, appropriating but redefining Foucault’s term (Foucault 1984, Fairclough 1992). Orders of discourse are social structurings of linguistic/semiotic variation or difference. Realist discourse analysis on this view is based in a dialectical-relational social ontology which gives ontological priority to processes and relations over objects, entities, persons, organizations etc, yet sees the latter as socially produced ‘permanences’ (Harvey 1996) which constitute a pre-structured reality with which we are confronted, and sets of affordances and limitations on processes. Epistemological priority is given to neither pre-constructed social structures, practices, institutions, identities or organizations, nor to processes, actions, and events: the concern is with the relationship and tension between them. People with their capacities for agency are seen as socially produced, contingent and subject to change, yet real, and possessing real causal powers which, in their tension with the causal powers of social structures, are a focus for analysis. Social research proceeds through abstraction from the concrete events of social life aimed at understanding the pre-structured nature of social life, and returns to analysis of concrete events, actions and processes in the light of this abstract knowledge. Discourse and non-discoursal elements of social events and social practices are related in many ways. I distinguish three main ways: representing, acting (and interacting), and being. At the level of social practices, orders of discourse can be seen as articulations of specific ways of representing, acting, and being – ie specific discourses, genres and styles. A discourse is a particular way of representing certain parts or aspects of the (physical, social, psychological) world; a genre is a particular way of (inter)acting (which comprises the discoursal element of a way of inter)acting which will also necessarily comprise non-discoursal elements); a style is a way of being (the discoursal element of a way of being, an ‘identity’, which will also include non-discoursal elements). I shall use the term ‘text’[ii], in a generalized sense (not just written text but also spoken interaction, multi-semiotic televisual text etc) for the discoursal element of social events. Texts are doubly contextualized, first in their relation to other elements of social events, second in their relation to social practices, which is ‘internal’ to texts in the sense that they necessarily draw upon orders of discourse, ie social practices in their discoursal aspect, and the discourses, genres and styles associated with them. However, events (and therefore texts) are points of articulation and tension between two causal forces: social practices and, through their mediation, social structures; and the agency of the social actors who speak, write, compose, read, listen to, interpret them. The social ‘resource’ of discourses, genres and styles is subject to the transformative potential of social agency, so that texts do not simply instantiate discourses, genres and styles, they actively rework them, articulate them together in distinctive and potentially novel ways, hybridize them, transform them. My focus in this paper is on organizational change, and this version of CDA has indeed been developed in association with research on discourse in social change. Social change comprises change in social structures, social practices, the networking of social practices, and (the character of) social events; and change in languages and other semiotic systems, in orders of discourse and relations between orders of discourse, and in texts. With respect to orders of discourse, social change includes change in the social structuring of linguistic/semiotic variation, therefore change in discourses, genres and styles, and change in their articulation in orders of discourse, and change in relations between orders of discourse (eg political and media orders of discourse). With respect to texts, social change includes tendential change in how discourses, genres and styles are drawn upon and articulated/hybridized together in various types of text. The process of social change raises questions about causal relations between different elements. Causal relations are not simple or one-way. For instance, it would seem to make more sense to see new communication technologies (ICTs) as causing the emergence of new genres than vice-versa – changes in discourse caused by changes in non-discoursal elements. In other cases, change appears to be discourse-led. A pervasive contemporary process (for instance in processes of ‘transition’ in central and eastern Europe) is change initiated through the recontextualization[iii] in an organization, a social field, or a country of ‘external’ discourses, which may then be enacted in new ways of (inter)acting including new genres, inculcated as new ways of being including styles, and materialized in for example new ways of organizing space. These enactments, inculcations and materializations are dialectical processes. There is an important proviso however: these processes are contingent, they depend upon certain conditions of possibility. For instance, when a discourse is recontextualized, it enters a new field of social relations, and its trajectory within those social relations is decisive in determining whether or not it has (re)constructive effects on the organization, social field etc overall. In contexts of social change, different groups of social actors may develop different and conflicting strategies for change, which have a partially discursive character (narratives of the past, representations of the present, imaginaries for the future), and inclusion within a successful strategy is a condition for a discourse being dialectically enacted, inculcated and materialized in other social elements (Jessop 2002, Fairclough, Jessop & Sayer 2004). Discourses construe aspects of the world in inherently selective and reductive ways, ‘translating’ and ‘condensing’ complex realities (Harvey 1996), and one always needs to ask, why this particular selection and reduction, why here, why now? (For a discussion of ‘globalisation’ discourse in these terms, see Fairclough & Thomas forthcoming. Locating discourses in relation to strategies in contexts of social change enables us to connect particular representations of the world with particular interests and relations of power, as well assess their ideological import. Discourses do not emerge or become recontextualized in particular organizations or fields at random, and they do not stand in an arbitrary relation to social structures and practices, forms of institutionalization and organization. If we can construct explanations of change in non-discoursal elements of social reality which attribute causal effects to discourses, we can also construct explanations of change in discourses which attribute causal effects to (non-discoursal elements of) structures and practices, as well as social and strategic relations. The social construction of the social world may sometimes be a matter of changes in non-discoursal elements caused by discourses (through the concrete forms of texts), but discourses (and texts) are also causal effects, the dialectics of social change is not a one-way street. We can distinguish four elements, or moments, in the social trajectories of discourses: their emergence and constitution (through a re-articulation of existing elements); their entry into hegemonic struggles from which they may emerge as hegemonic discourses; their dissemination and recontextualization across structural and scalar boundaries (ie between one field or institution or organization and others, and between one scale (‘global’, macro-regional (eg the EU), national, local) and others; and their operationalization (enactment, inculcation, materialization). These are distinct moments with respect to the causal effects of discourses on non-discoursal (as well as discoursal, ie generic and stylistic) elements of social life, and they are all subject to non-discoursal as well as discoursal conditions. CDA claims that social research can be enriched by extending analysis of social processes and social change into detailed analysis of texts. More detailed (including linguistic) analysis of texts is connected to broader social analysis by way of (a) analysing texts as part of analysing social events, (b) interdiscursive analysis of shifting articulations of genres, discourses, styles in texts (Fairclough 2003). The latter locates the text as an element of a concrete event in its relationship to orders of discourse as the discoursal aspect of networks of social practices, and so allows the analyst to (a) assess the relationship and tension between the causal effects of agencies in the concrete event and the causal effects of (networks of) social practices, and through them of social structures (b) detect shifts in the relationship between orders of discourse and networks f social practices as these are registered in the interdiscursivity (mixing of genres, discourses, styles) of texts. Text can be seen as product and as process. Texts as products can be stored, retrieved, bought and sold, cited and summarized and so forth. Texts as processes can be grasped through seeing ‘texturing’, making texts, as a specific modality of social action, of social production or ‘making’ (of meanings, understandings, knowledge, beliefs, attitudes, feelings, social relations, social a nd personal identities, institutions, organizations). The focus is on ‘logogenesis’ (Iedema 2003:115-17), including the texturing of entities (objects, persons, spaces, organizations) which can, given certain preconditions, be dialectically internalized (enacted, inculcated and materialized) in non-discoursal elements of social life. See for instance the discussion of the significance of nominalization as a logogenetic process in texts in processes of organizing, producing organization objects, in Iedema (2003). Organizational Discourse  I shall construct my very selective comments on organizational discourse analysis around the following four themes: organization and organizing; variation, selection and retention; understandings of ‘discourse’; and intertextuality. Organization and organizing Mumby & Stohl (1991) argue that researchers in organizational communication most centrally differ from those in other areas of organization studies in that the former problematize ‘organization’ whereas the latter do not. ‘For us, organization – or organizing, to use Weick’s (1979) term – is a precarious, ambiguous, uncertain process that is continually being made and remade. In Weick’s sense, organizations are only seen as stable, rational structures when viewed retrospectively. Communication, then, is the substance of organizing in the sense that through discursive practices organization members engage in the construction of a complex and diverse system of meanings’. Another formulation of this shift in emphasis from organizations as structures to ‘organizing’ (or ‘organizational becoming’, Tsoukas & Chia 2002) as a process is that of Mumby & Clair (1997: 181): ‘we suggest that organizations exist only in so far as their members create them through discourse. This is not to claim that organizations are â€Å"nothing but† discourse, but rather that discourse is the principal means by which organization members create a coherent social reality that frames their sense of who they are’. Despite the disclaimer at the beginning of the second sentence, this formulation can as argued by Reed (forthcoming) be seen as collapsing ontology into epistemology, and undermining the ontological reality of organizational structures as constraints on organizational action and communication. From the perspective of the realist view of discourse I have outlined, it makes little sense to see organizing and organization, or more generally agency and structure, as alternatives one has to choose between. With respect to organizational change, both organizational structures and the agency of members of organizations in organizational action and communication have causal effects on how organizations change. Organizational communication does indeed organize, produce organizational effects and transform organizations, but organizing is subject to conditions of possibility which include organizational structures. The paper by Iedema, Degeling, Braithwaite and White (2004) in the special issue of Organizational Studies is an analysis of how a ‘doctor-manager’ in a teaching hospital in Australia manages ‘the incommensurable dimensions’ of his ‘boundary position between profession and organization’ by positioning himself across different discourses, sometimes in a single utterance. The authors identify a heteroglossia ‘that is too context-regarding to be reducible to personal idiosyncracy, and too complex and dynamic to be the calculated outcome of conscious manipulation’. They see the doctor-manager’s talk as a ‘feat’ of ‘bricolage’, not as a display of ‘behaviours that are pre-programmed’. Nor is it an instantiation of a ‘strategy’, for ‘strategies are they assume ‘conscious’. Although the authors recognize that organizations can ‘set limits’ on what workers can say and do, impose ‘closure’, they see the doctor-manager as successfully ‘deferring closure on his own identity and on the discourses that realize it’. One can take this as an interesting and nuanced study of organization as the ‘organizing’ that is achieved in interaction (nuanced in the sense that it does not exclude organizational structures, though it does suggest that they are more ‘fluid’ and less ‘categorical’ than they have been taken to be, and it does recognize their capacity to impose ‘closure’). I would like to make a number of connected observations on this paper. First, one might see the doctor-manager’s ‘feat’ in this case as a particular form of a more general organizational process, the management of contradictions. Second, discourse figures differently in different types of organization (Borzeix 2003, referring to Girin 2001). The type of organization in this case seems to be in Girin’s terms a ‘cognitive’ (or ‘learning’, or ‘intelligent’) organization, in which the normative force of (written) texts (rules, procedures) is limited, and there is an emphasis on learning in spoken interaction. There seems to be, in other terms, a relatively ‘network’ type of structure rather than a simple hierarchy, where management involves a strong element participatory and consultative interaction with stakeholders. Third, connecting the first two points, spoken interaction in this type of organization accomplishes an ongoing management of contradictions which contrasts with the management of contradictions through suppressing them by imposing rules and procedures. Fourth, the doctor-manager’s ‘feat’ can be seen as a performance of a strategy as long as we abandon the (somewhat implausible) claim that all aspects and levels of strategic action are conscious – the doctor-manager would one imagines be conscious of the need to sustain a balancing act between professional and managerial perspectives and priorities, and of certain specific means to do so, but that does not entail him being conscious of all the complex interactive means he uses to do it. Fifth, while particular performances of this strategy (or, indeed, any strategy) are not ‘pre-programmed’, the strategy is institutionalized, disseminated, learnt, and constitutes a facet of the type of organization as a network of social practices, ie a facet of organizational structure. Sixth, it strikes me that bringing off a sense of creative bricolage is perhaps itself a part of the managerial style of this type of organization, ie part of the strategy, the network of social practices, the order of discourse. My conclusion is that even in a case of this sort, rather more emphasis is needed on the relationship between organizing and organization, performance and practice, ‘feat’ and strategy[iv]. Organizational discourse studies have been associated with postmodernist positions (Chia 1995, Grant, Harvey, Oswick & Putnam forthcoming, Grant, Keenoy, Oswick 2001), though the field as a whole is too diverse to be seen as simply postmodernist. Chia identifies a postmodern ‘style of thinking’ in organizational studies which ‘accentuates the significance, ontological priority and analysis of the micro-logics of social organizing practices over and above their stabilized ‘effects’ such as ‘individuals’. As this indicates, the focus on organizing rather than organisation is strongly associated with this ‘style of thinking’. Like the dialectical-relational ontology I advocated earlier, this ‘style of thinking’ sees objects and entities as produced within ontologically prior processes. The key difference is that this ‘style of thinking’ tends towards a one-sided emphasis on process, whereas the realist view of discourse analysis I have been advocating centres upon the tension between (discoursal) process and pre-structured (discoursal and linguistic, as well as non-discoursal) objects. This form of realism is not subject to the tendency within modernist social research which is criticized by Woolgar (1988) to take the objects it arrives at through abstraction (which would include in the case of CDA orders of discourse, as well as language and other semiotic systems) to be exhaustive of the social reality it researches. The key difference in this case is whereas this form of modernist research moves from the concrete to the abstract and then ‘forgets’ the concrete, the dialectic-relational form of realism I have advocated crucially makes the move back to analysis of the concrete. CDA is not merely concerned with languages and orders of discourse, it is equally concerned with text and texturing, and with the relations of tension between the two.