Thesis on the Respondent’s Perception on Cost Overrun Mitigation Measures in the Construction industry Projects: Galliford Try, UK Case Study

Industries specializing in construction projects significantly contribute to development of economic growth in any country. Recent studies have shown that construction industry is becoming among the leading industries across the world. Construction projects are increasingly becoming more complex which indicates that there is rising demand for construction managers who are able to deliver projects within estimated budget, with expected quality and on time. Among the major challenges facing construction industry in both developing and developed countries is the problem of cost overruns which is chronic. Cost overrun can also be referred to as budget overrun or cost increase and entails costs incurred which exceed projected amount as a result of underestimation of actual cost in the process of budgeting. Flyvberg et al., (2002) did comprehensive study and found out that 9 out of 10 construction projects registered cost overrun. It means the cost overrun problem is a key factor that deserves serious attention and studies in order to mitigate its effects on future construction projects. There are two main categories of incidences causing cost overruns – those attributed to forces beyond the control of management, and those attributed to poor planning and management of resources. There’s little management can do over incidences that are beyond its control but for everything else, it is important for project management to do everything within its scope of power to exercise control over cost performance of construction projects to make sure that the construction cost is not beyond projected budget. Hence project cost management is necessary for keeping construction projects within their defined budget.

Types of Construction Costs

For a project to be said to be completed successfully, it must have been done within budget. Niazi and Painting (2017) note that a construction company’s productivity is known through its cost management of projects. To know the cost overrun of a project, find the difference between the estimated planned cost and actual cost on project completion. Since costs have a direct correlation with cost overrun, the project work unit’s cost consists of various cost elements which include plant and machinery costs, material costs, labour costs, and administration costs among other expenses.

1.1       Sources of Cost Overrun

As Aljohani et al. (2017) observed that 90% of projects end up being cost overrun. Their study found at least 173 causes of cost overrun with the main culprits being finances, design changes, payment delays, contractor inexperience, poor cost estimation, poor material purchasing, and management. Olawale and Sun (2010) highlighted that cost overrun as a rule in the construction industry applies to construction projects in UK. For example, Kunda, Barley, and Evans (2002) listed major important projects undertaken in UK which suffered cost overruns. Construction of new office of parliament situated proximally to the House of Parliament and which was considered as among the most expensive buildings constructed in the UK encountered cost overruns. The cost overruns encountered were attributed to delay in approval of costs and designs, inflation changes and problems of underground stations located under the construction site. Another construction project whose final cost was thrice of the base budget is the British Library which was constructed in 1998.

Cleopatra and Phaedra

analyzing two characters based on two different books, Antony and Cleopatra by William Shakespeare and Phaedra by Jean Racine. There are evidently many differences and similarities between these two characters that manifest as one explores the way each author has presented or expressed the characters given the circumstances their circumstances. However, Shakespeare’s clarity in portrayal of a more sensible character inspires the reader to identify with the emotions of his plot more closely. On the other hand, Racine’s portrayal of character makes the readers wonder continuously. These are the attributes that bring similarities and differences in related plots that develop and cannot be overlooked. Therefore, it is necessary to look into the characters of Cleopatra in Antony and Cleopatra by Shakespeare and Phaedra in Phaedra by Racine when examining their similarities and differences

In Antony and Cleopatra, Shakespeare explores the character of Cleopatra through her actions in the play. Cleopatra has a very strong character in some sense; she is an attractive woman, loves drama and most of all she is in love with Marc Antony (Shakespeare 1998, pp.23 – 24). However, she may have done things that Antony disapproved, but it is clear throughout the plot that she is deeply and truly in love with him considering that she committed suicide after learning about Antony’s death (Shakespeare 1998, p.144). Cleopatra’s charm and competence in comparison with other women of her time gave her more opportunities and authority in life (Shakespeare 1998, pp.67 – 70,). On the other hand, Phaedra by Racine has totally different characters to Cleopatra. Phaedra is a woman to feel sorry for and the plans she makes in life make her look evil and not smart. She falls in love with her husband’s son Hippolytus which as a consequence, shocks everyone else and causes her a lot of pain and misery (Racine 2004, pp.190 – 191, Racine). In contrast to Cleopatra, Phaedra is not a strong character. She is a very confused woman and it seems that all she seeks is the love of Hippolytus without considering the consequences (Racine 2004, pp.175 -177).  Phaedra was in a bad situation and could not think clearly, but even in this circumstance she could at least have avoided sorrow and mystery of those around her through her actions. Even though, Phaedra is not in control of her feelings, she is in a completely different situation from Cleopatra, and her forbidden love makes it hard for one to sympathize with her pain and mystery. As a result, one cannot adequately compare Cleopatra and Phaedra’s behavior as they both are in different and unique circumstances.

Cleopatra and Phaedra have some similarities especially with regards to their positions in the society with both being queens. In addition, Mark Anthony loves his wife Cleopatra dearly as does Theseus, Phaedra’s husband. However unlike Cleopatra, Phaedra does not know what to do at awkward moments or to cherish the love of her husband. Phaedra is confused most of the time; she is very weak and cannot control her feelings for Hippolytus (Racine 2004, pp.158 -152). Furthermore, she is unable to find a solution to stop her suffering and distress; she is extremely confused and cannot make decisions on her own which makes her seek help from Oenone, her nurse (Racine 2004, p.186). Even though, Phaedra’s character does not make her rule the entire story, but it was due to her inappropriate love that the story is a tragedy. Phaedra’s love for her husband’s son is out of her control since it’s her destiny or fate and by the power of gods, though ultimately, the audience is made to believe that it is the absence of morals that make her fall in love passionately (Racine 2004, p. 201- 202). Despite the fact that she fell in love with Hippolytus her husband’s son, she could have at least tried not to make her feelings so obvious and hence cause trouble, but instead she chose to show her feelings and caused suffering to everyone.  On the other hand, Cleopatra is a captivating character that is rare among women of her time and in comparison to Phaedra she has a charming personality (Shakespeare 1998, pp.67 – 70). In addition, she often tries to find solutions that bring happiness and makes extraordinary plans to make her reach her desired goals (Shakespeare 1998, pp.14- 19). Cleopatra is one of the strongest and most inspiring female characters of Shakespeare’s story even though the entire story is not based on her, but her presence is nevertheless vital for the plot. She is the reason why Shakespeare’s story seems so extreme and interesting. Evidently, Cleopatra is a woman who expresses her feelings very accurately, has a strong personality gives her authority over large number of people even though sometimes she can be unyieldingly harsh (Shakespeare 1998, pp.133 – 134).

 

Shakespeare has a good understanding of the character he created Cleopatra. Indeed, he made her act clear enough to be understood and makes his audience admire his creation. In addition, the book Antony and Cleopatra is written clearly with the intent of having an excellent understanding of Cleopatra’s character and personality. Shakespeare’s writing on Cleopatra leave s one wondering what she would do in tough situations (Shakespeare 1998, p. 77 – 79). Certainly, Shakespeare has a superior understanding of Cleopatra as her actions and words leave a great impression on the readers of the play. Phaedra is one of Racine’s most admirable creations; he has made her neither innocent nor guilty but because of the guilt she feels towards her feelings for Hippolytus makes her mostly a victim than a sinner (Racine 2004, p.213 – 214). Evidently, Racine expressed Phaedra in a satisfactory way but not in a way to make the audience have a full understanding of her actions; due to conflicting views he created in her personality that made her appear neither guilty nor innocent. However, this difference is only visible when the two characters, Cleopatra and Phaedra are put under consideration. Racine’s lack of cautiousness and curiosity in comparison to Shakespeare restricts his characters to be free and independent and made them be more concealed just like the way he represents Phaedra in his book. Also, Racine created two conflicting characters in Phaedra in his story; one is that she was an innocent woman worthy of pity from readers as she could her feelings of forbidden love and also made her a sinner due to the plans she made that makes her to be guilty. Therefore, this makes it very difficult to distinguish which set of characteristics suits her the most out of all. Racine named his book Phaedra because the entire story is based on her and all the drama comes from this character.

In essence, both Phaedra and Cleopatra have their differences and similarities as the plots of the plays develop. The depiction of Phaedra is that of a character confused and unable to deal with her circumstances, but had Racine shown one side of characterization then readers would clearly have an idea about her character as she is neither good nor evil. On one hand, one feels pity for Phaedra as she cannot deal with forbidden love, making the story tragic. On the other hand, it seems that destiny is cruel to her and her bad experiences are similar to those of Cleopatra.  On the contrary, Shakespeare shows one side of Cleopatra as one who is strong willed, to the extent that readers clearly understand how she deals with her circumstances. Cleopatra’s character and personality is so alluring that readers can identify with her. Furthermore, her actions make one to empathize with her situation after the death of Anthony, while her strong personality gives her influence over other people. Thus, both authors are successful in showing the lives of both Queens and how their personalities affect choices.  Cleopatra is a likeable character who facilitates the plot of the story making the story so fascinating, Phaedra may bring out both positive and negative feelings from reader, but being a tragic story the play also has along lasting impact on readers

 

Canada’s multiculturalism and the integration of immigrants in the Canadian society

Multiculturalism connotes that there is equality among diverse people in a society regardless of their religion, origin, race or culture. In Canada, multiculturalism and integration of immigrants matters because they contribute to the economy’s growth, while social inclusion ensures that there is social harmony among diverse cultures. The official recognition of multiculturalism through policy formulations ensures that there is no discrimination on basis of ethnicity. According to Reitz (528) multiculturalism in Canada is an approach toward integration of immigrants and not isolationist. Cultural freedom and political participation of people in Canadian institutions is proof that there is belief in the concept of unity in diversity.Canada is a country of immigrants, and the demographic makeup of the nation has changed significantly over time along with the immigration patterns. Prior to colonization, the nation was mainly composed of aboriginal groups, but colonization brought new demographic trends. During colonization the population of Europeans especially the English and French grew substantially with the nation now populated by three major ethnic groups namely the English, French and aboriginal people.

The emphasis on high education attainment for immigrants recognizes their role in enriching the culture and facilitating growth of Canada’s economy; the government is keener to attract immigrants who can best use their talents, skills and abilities in the country. Multiculturalism makes Canada unique because of the plurality of the nation. Equally, most Canadians have a positive view on immigration and multiculturalism unlike most Western nations where opinion is divided.  Ultimately, Multiculturalism is good for immigrants as they practice their culture in an environment that respects them allows international cooperation, trade and peaceful coexistence.

Bombing effects on the environment and consequently on human health

Even though, there is increased awareness on environmental health matters over the last decades, environmental pollution still poses health challenges for the nursing profession.  Nursing professionals have the burden of dealing with environmental related illnesses with regards guidance, treatment and provision of information to patients. However, few health care practitioners receive training on environmental health. But, there has been a shift towards integrating environmental related issues in the nursing profession by taking into account the effect of the environment on the health status of patients. Nursing professionals are taking steps to bridge the gap on environmental health through education and sensitization on environmental health hazards. These measures also include communicating to the communities, since the members expect nurses to offer guidance on how to reduce the risk of environmental hazards.

Florence Nightingale’s contribution to the field of nursing and particularly on the impact of the environment provides insights on the relation between the environment and health.  Though, there is no specific theory that guides nurses, the writings of Nightingale led to the call for the development of professional practices that could be adhered to by all nursing professionals.  In her writing, Nightingale focused on the role of an appropriate environment in facilitating the recovery of patients.  Thus, the interaction of self care, the environment and nursing profession were all relevant to the recovery process. Essentially, there is a need to minimize environmental health hazards and provide hygienic conditions for patients.

International treaties mostly focus on the physical impact of war on the environment and people, but fail to address the issue of environmental degradation occasioned by war. Thus, there is a need to institute stiff penalties in these agreements with regards to the consequences of chemical warfare and bombing. On the other hand, the nursing profession needs to sensitize the communities more often on the need to minimize environmental pollution because this affects the health status.  Nursing professional bodies can also liaise with government institutions in there quest to ensure that there is environmental protection particularly on air pollution and water quality.

 

Obesity in Children in the United States

The increasing rates of childhood obesity are a worrying trend, and the issue has been in the public domain over the last decades since it is a public health problem. Besides calls for action by health practitioners, the entry of politicians in the debate on childhood obesity has necessitated actions with regards to programs, policies and research on the link between childhood obesity and the overall health situation of the American population. Similar to adulthood obesity, there is increased health risks associated with childhood obesity. In addition, childhood obesity increases the likelihood of adult obesity.  In any case the cost implications of obese related diseases are enormous and prevention of childhood obesity ought to be a top priority among health professionals. For there to be effective intervention strategies, there is a need to measure obesity using consistent definition and criteria. Even though obesity levels decreased between the years 2003 to 2010, approximately 2.5 million American children and adolescents were obese (Center for Disease Control and Prevention, 2013)

complications brought about by childhood obesity are the alteration of the development, this mainly are the changes in the onset of menarche and thelarche, the development of boys during puberty and undesirable development of the bone structure for both boys and girls. The association between skeletal development and adipose tissue is also associated with child obesity, whereby androgens may be altered to mimic estrogen. Another mechanism through which obesity affects the timing of puberty is through signaling brought about by leptin and insulin which then affects the reproductive mechanism.  The occurrence of orthopedic discomforts including impaired mobility, fractures and other complications affecting the musculo skeletal system affect obese children more than others (Han et al., 2010).

There are also other viable methods that are used to distinguish between obesity and normal weight, but all methods measure the percentage of body fat.  These other approaches include magnetic resonance imaging (MRI), underwater weighing (densitometry) and multi frequency bioelectrical impedance analysis (Dehghan et al ., 2005).  On the other hand, clinical approaches mostly use BMI or other techniques including, skin thickness and waist circumference.  Even though, research methods may be more accurate than these techniques the approaches are nonetheless effective in recognizing risk. BMI may be widely used among adults, but for children the approach may be ineffective, as it does not identify fat free mass or fat.  In addition, BMI may also overestimate the obesity levels of more muscular children (Dehghan et al,. 2005).

Comparison of Health Care Policies between United States and France

The healthcare of the United States remains a contemporary issue of argument in the continent. Many people claim that it forms the healthcare system arguments in the continent following the consistent emerging issues. Ironically, the federal government has invested huge capital in healthcare services whose end results do not much the money spent; the services are extremely poor. On the contrary, France offers universal healthcare services yet on moderate capital investment. In fact, according to World Health Organization’s statistics, France offers exemplary healthcare services in the whole world. In comparison, France and United States health care systems operate distinctly.

In both countries, the healthcare systems rely majorly on private and government insurance. It should be noted that both countries have national insurance. However, the national insurance level varies in the two countries. Unlike the United States, France healthcare system majorly depends on national insurance policies. Cooper and Gardner institute that the United States does not only rely on national insurance policies but also on public and private organizations. Similarly, in both countries, the healthcare insurance services are provided by the employers. However, the level of government financing health care services differs in both countries. In particular, the United States government depends largely on private institutions for finance whereas the government of France depends much on itself to finance health services. As of 2014, the healthcare expenditure was seventeen point two percent whereas that of France was at eleven point three which implies that the government of the United States spends much of health yet low-quality services. France has reduced expenditure on healthcare yet the services are of high quality.

In summary, the health care systems of France and the United States constitute differences and similarities. In terms of the quality, France has the best healthcare services to its citizens. Likewise, the government of the United States spends a lot of money to fund the delivery of healthcare service yet they are of low quality. Although France records higher risk factors compared to that of the United States, it still holds quality healthcare services delivery. The governments of United States have many citizens who have no access to healthcare insurance cover, unlike France where healthcare insurance is compulsory. In fact, the United States can derive many lessons from the healthcare system of France to advance their services. For instance, the US government can adopt the principle of compulsory healthcare insurance to enhance all of her citizens have access to healthcare insurance.

 

Physician and Nurse Shortages in United States

Physician and nurse shortage is a major challenge in the United States which leaves millions of Americans at health risk. There is no positive impact on the Physician and Nurse shortage because the result is poor patient’s health and increased rate of mortality. Registered nurses in United States are few and they do not meet the demand in the market and aspect that has left vacancy rate of 7.2% according to the NSI Nursing Solutions.  Nevertheless, the demand for Physician and Nurse continue to increase and according to the Bureau of Labor Statistics the  projected rate of demand is 16%.The insufficient number of nurses has led to various challenges in the out organization. For instance, this has resulted to under staffing and thus there is more pressure to the few nurses in the organization. They often work for long hours and job dissatisfaction which results to fatigue. Due to this, they are prone to making medical errors and mistakes which leads to deterioration in their profession and working environment While there have been challenges in the organization due to the insufficient number of nurses, the information management systems have been crucial in  providing short term goals. For instance, the technology has provided decision support on patient care and this have had great impacts in improving quality as well as patient safety. While there have been less physicians and less nurse to consult, information systems have streamlined and integrated documentation support

Nursing Theories and Role Development;Interpersonal Relations Theory

Nurse scholars have for the longest time recognized that nurses utilize some form of nursing theory and conceptual theories in their day to day activities and they insist that nursing theory is a critical part to the field of medicine. Today, the need for a working partnership between a patient and a nurse is very crucial in nursing practice as it enables healthcare providers and physicians to come up with effective therapeutic interventions that are beneficial to the clients. As such, through theory analysis, nurses can gain the necessary skills and power by understanding knowledge that characterizes the nursing activity. It’s from such interventions that Hildegard E. Peplau conceptualized her prominent –Interpersonal Relations Theory- in 1952 which is still used even today. Dr. Peplau’s contribution to nursing is remarkable and quite significant in the evolution of nursing. In her attempts to bridge the gap between theory and practice, she was successful in showcasing how an individual’s experiences, their clinical practice and societal aspects of empiricism can impact a person’s knowledge base and identity. The following paragraphs will showcase how Dr. Peplau’s theory and conceptual framework of interpersonal relations impacted clinical, conceptual and empirical knowledge and not just on the psychiatry front, but also to nursing in general. Generally, the theory describes the purpose of nursing as the capacity to aid others to identify their felt complicated and urges them to apply the values of human relations to issues that come up at all levels. Man in this theory is explained as a life form that “strives in its own way to reduce tension generated by needs.Generally, Dr. Peplau’s theory and the Nursing Process embrace a sequential aspect. This is highlighted by how they focus on the therapeutic relationship through a formulation of problem solving methods that nurses and their clients can collaborate on with the final goal being fulfilling and satisfying the client’s needs. Additionally, they both apply observation communication as well as recording as their fundamental tools

Nurses’ Experiences of Violence at the Workplace

Much has been said and written about the experiences of nurses in relation to violence at the workplace. The issue of violence in nursing is important because of its potential to undermine the quality of healthcare services and hamper positive patient outcomes. Current scholarly literature interrogates experiences of violence at the workplace meted out against nurses by either patients, colleagues, or other individuals within the healthcare setting. However, regardless of the extensive scholarly focus on this matter, the incidences and prevalence of this scourge continue to surge. It is possible that the endemic nature of this problem is caused by the lack of evidence-based interventions. This gap, therefore, makes the study of the experiences of workplace violence for nurses with a view to identifying an evidence-based intervention imperative. In that regard, a study to explore the occurrences of violence against nurses by patients, colleagues, or any other people within the healthcare setting is proposed to broaden the scope and perspectives underlying current literature on nursing and violence.

Violence in nursing is a systemic problem. Abbas, Fiala, Abdel Rahman, and Fahim [5] confirmed the extensive nature of the problem in a study almost ten years back that found a considerable portion of nurses in were verbally and physically abused by patients and their relatives, with males being more exposed to violence compared to women. This study revealed that workplace violence against nurses is a big problem and encouraged the need for further studies on the problem. This article sets the background on nurses’ experiences of violence at work.

In a comparison of violent incidents against emergency nurses and their non-emergency counterparts, Abou-ElWafa, El-Gilany, Abd-El-Raouf, Abd-Elmouty, and El-Sayed Hassan El-Sayed [9] assert that violence against nurses is common but neglected. This statement raises the question whether violence by nurses is also neglected in the same way. These researchers found that emergency nurses experience higher levels of violence with triggering factors including young age, work shift, and emergency specialty.

Nursing essay on Cost-Effective Care

When one hears of a patient being over-treated or undertreated, one thing that comes to mind is the new technology that is being used in healthcare. There have been mixed reactions to the technology being used in healthcare services in the United States. Some say that it saves lives, while others think it is too expensive. The following nursing essay explains the merits and demerits of cost-effective care about an acute illness that my father had, heart attack.

In an article that Jeanne Lenzer wrote in 2012, she explains hoe and intern watched as nursing professionals tried to resuscitate a patient who was almost 90 years old and was in the end-stage of congestive heart failure. The doctors worked for about one hour with equipment like pressor being injected into his heart, but the old man died (Lenzer, 2012). Although doctors have always insisted on doing everything they can to save lives, it sometimes becomes too painful for the patient as some of these procedures are done while the mind is still awake. My father had a heart attack, and when he got into the emergency room, they used the same procedures because his case was severe. I believe he was under a lot of pain during this period.

However, such nursing procedures have been known to save multiple lives not only in the United States but also the rest of the world. Overtreatment may be painful and expensive, but the result is sometimes worth it. My father was able to recover from the illness, and although he cannot perform stressful tasks like lifting heavy stuff, he sure is happy that he is still alive. In fact, the whole family is grateful to the hospital staff for saving his life. That is why one day, I would love to work as professional nurse.