Culturally Competent Nursing in an Ever Changing Diverse World Essay

In nursing and healthcare the issue of culture is more pronounced than anywhere else. This is because many people various ethnic, religious, racial and cultural backgrounds come forth to hospitals and healthcare centres in search of health solutions. Due to these cultural disparities, patients often fail to receive quality services because of practices that are lacking in cultural competence. Cultural competence in nursing and healthcare refers to the efficiency with which a healthcare provider is able to offer quality service in a cross-cultural setting thus enhancing the system’s or institution’s capacity to function in effective manners (Dolhun, E. P. et al 2003). Culture influences an individual’s values, perceptions, beliefs and opinions. It influences how patients respond to healthcare givers and the medication prescribed to them. Therefore it is very important that nurses and other medical practitioners seek to improve their awareness towards the issues raised by cultural diversity in order to improve on service delivery. This paper examines ways in which a nurse can be more culturally competent. It also examines the opportunities in the work place and nursing school that requires culturally focused health practices. Additionally the paper discusses the issues of self-assessment and client assessment that is geared towards the delivery of culturally competent health solutions. Importance of Culture to Nursing. The US is comprised of the most culturally diverse population. A big percentage of the world’s ethnic, religious and cultural groups are represented in this population. This has created a most unique opportunity as well as challenge to many organizations in the service delivery sector. This is because people from all cultures get ill at one point in time and they have to seek treatment. Nurses are thus presented with patients from very diverse cultural backgrounds. Culture influences how different people will respond to the different ways of health service delivery, interventions and treatment (Dolhun, E. P et al. 2003). It is therefore important for nurses to move towards achieving cultural competence in order to effectively deal with the challenges that come with the cultural reality. Because of the demographic situation in America service providers are under pressure to provide more culturally correct services. The nursing profession cannot be left behind and therefore the need to comply with the changing needs is overwhelming. Language limitations are also another issue of concern in attaining cultural competence. Ethical Factor One ethical principle that guides nurses in their endeavour to provide culturally appropriate care is the appreciating that everyone regardless of their cultural persuasion is entitled to receive quality health care. Cultural differences can influence the caregiver’s prejudices and bias towards a patient (Galanti G. A. 1997). In a similar way a patient can misconstrue the caregiver’s actions and words. This can serve to lower the quality of care given to this particular patient. Professional ethics require that there be no form of discrimination in the provision of health care but in a situation where there is prejudice on either party, then the quality of care is compromised. Similarly what is considered ethical may have serious consequences when viewed from a cultural context. A fitting example is when the doctor feels obliged to divulge some information to a patient or a certain member of the family, because in some cultures it is believed that giving certain information to a sick person is unacceptable, the doctors ‘ethical’ actions may be viewed in very bad light Nurse’s responsibility Nurses are usually supposed to care for the general well being of a patient, they ought to be able to understand and empathize with the patient in order to cater for their physical and emotional needs. On an individual level, a nurse has a responsibility to learn the practices that are in accordance to cultural competence. It is important that nurses should have an attitude that goes further than just learning acceptable cultural behaviours. Nurses must be motivated by compassion to the patients and driven by moral responsibility (Tervalon M. Murray-Garcia J. 1998). This allows them to display a genuine concern and is thus motivated to internalize harmonious attitudes towards achieving cultural competence. In a hospital setting a nurse is required to be able to anticipate the issues that may arise due to cultural disparities and lack of proficiency in certain languages. They are also to understand the others’ points of view as well as appreciating the strengths and weaknesses of these points of view. In addition to this, respecting the cultural differences is key to the ability to provide culturally appropriate care. Since the issues raised by cultural diversity are multi-faceted in nature, they require a holistic approach that calls for a total overhaul in the nurses’ ways of thinking. There is no one culture that is the standard of what is good or bad and therefore an open mind is important as nurses move towards delivering health care that exemplifies cultural competence. Achieving this kind of competence is only possible if one comes to self-awareness and recognizes their own values, beliefs, opinions, prejudices and biases (Dolhun, E. P. 2003). From here, they can be able to understand how they respond to different points of view from other. Inorder to come to self-awareness one needs to examine their own cultural and environmental backgrounds. An underlying ethnocentricity is part most people where one is protective and to an extent defensive when it comes to cultural differences (Switzer, G. E et al 1998). However in the nursing practice each nurse should be flexible and work towards developing skills of responding to varied cultural settings and situations. Nursing Schools Similarly in nursing schools one is required to meet most of the aforementioned standards. In addition to that communication skills are developed in school. Learning to communicate effectively in a cultural context entails being open-minded, respectful and shunning any form of prejudice or bias (Robins, L. et al 1998). It is a great opportunity to learn form and about other cultures. Other communication skills that are essential are listening skills that enable one to establish a rapport with the others. Language skills also play an important role in communication and as such each student nurse has a responsibility to learn other languages. Ofcourse it is not possible to learn all the languages there are but one can do their best and that is what is required of them. In the same way nurses should have skills that would enable them to assess the patient in a cultural context. This would entail finding out as much detail on the patient as possible. It would help to understand their ethnic background, socio-economic class, religion, age group and other social entities that they identify with. Learning about their experiences could also aid in establishing biases. Impact of culture on health care In the year 2010 more than 45% of all patients in the US will come from minority cultures. This is due to immigration that is the greatest contributor to the cultural diversity (Tervalon M. Murray-Garcia J. 1998). The health sector has realized the reality of these facts and medical practitioners are now given incentives to encourage them to take up learning on cultural diversity. This is changing the entire medical profession. Many initiatives have been put in place in order to bridge health differences that exist between minority groups and the white Americans. The existence of cultural difference may impact negatively on the care given. Cultural factor do affect the response to the different methods of treatment and diagnosis. Some ideas are perceived differently in different cultures and in some extreme cases family members can react in ways that may seem bizarre in the western world. Conclusion The issue of culture is increasingly attaining great importance with the ever-changing cultural mixture. The provision of healthcare is now taking cognizance of the effects of culture on the delivery of these vital services. It has been realized that cultural differences have been an impact on the quality of care given. Nurses and other medical practitioner are now under increased pressure to attain cultural competence in order to achieve high standards of quality. This paper opines the achievement of an all round cultural competence is a long journey. It will take a collective as well as an individual effort to achieve. Nurses have a personal responsibility to seek to understand the cultural factor. Additionally each one of them needs to appreciate their moral duty to seek self-awareness inorder to understand their own behaviour in response to other people with a differing opinion. Respect and a non-judgemental attitude are important if one is to overcome the ethnocentricity that is part of every human being. This awareness cultivates interest and inquiry. Once this point has been reached cultural differences will be viewed as learning opportunities that will spur personal growth. Reference Dolhun, E. P. Munoz, C. and Grumbach, K. (2003). â€Å"Cross-cultural education in U. S. medical schools: Development of an assessment tool. † Academic Medicine. Galanti G. A. (1997). Caring for Patients from Different Cultures: Case studies from American hospitals. 2nd ed. University of Philadelphia Press. Philadelphia, PA. Riddick S. (1998). Improving access for limited English-speaking consumers: A review of strategies in health care settings. J Health Care Poor Underserved. Supp vol 9: Robins, L. S. Alexander, G. L. , Wolf, F. M. , Fantone, J. C. , & Davis, W. K. (1998). â€Å"Development and evaluation of an instrument to assess medical students’ cultural attitudes. † Journal of the American Medical Women’s Association, Switzer, G. E. Scholle, S. H. , Johnson, B. A. , & Kelleher, K. J. (1998). â€Å"The Client Cultural Competence Inventory: An instrument for assessing cultural competence in behavioral managed care organizations. † Journal of Child and Family Studies, Tervalon M. Murray-Garcia J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved.

Community Levels Of Physical Activity Health And Social Care Essay

NHS Western Cheshire Primary Care Trust ( PCT ) is the administration that commissions wellness services for the population of Western Cheshire ensuring that services run into local demands. The trust leads the local NHS ( infirmaries, general practicians, tooth doctors, oculists and community staff ) and works in partnership with other administrations, such as local governments and both public and voluntary sector administrations, to better the wellness and well-being of occupants ( 3 ) . Within the PCT the Public Health Department is headed by the Director of Public Health, a joint assignment between the PCT and the local authorization. The section ‘s function within the PCT is to enable and back up the PCT and its spouses to better the wellness of the population and cut down wellness inequalities that exist in Western Cheshire. The section has a duty for wellness protection, instruction and betterment in the part, including proviso for immunization and showing services and exigency planning for epidemics, e.g. swine grippe. The section is responsible for development and bringing of wellness schemes, based upon local demands, to implement both national and regional policy. Within the section the Specialist Health Improvement Team has a duty for the commissioning and bringing of wellness instruction and betterment services, e.g. smoking surcease and weight direction, based upon national, regional and local policies, schemes and needs appraisals. For the intent of this paper Western Cheshire is assumed to hold a population of 150,000 with a mix of societal category, cultural and age groups mirroring the national norm. This paper proposes a two twelvemonth evidence-based scheme to increase degrees of exercising in the population. There are five attacks to wellness publicity ; Medical or Preventive ; Behaviour Change ; Educational ; Empowerment ; and Social Change, and, it might be said that, for wellness publicity to be genuinely effectual it should use aspects of each of these attacks ( 6 ) . Although possibly one or two attacks would look to be most suited to specific schemes or intercessions, for illustration behaviors alteration might be an appropriate attack for increasing degrees of physical activity but, in truth, will probably be doomed to failure without at least some part from most, if non all, other attacks. Therefore this scheme proposes a holistic methodological analysis, including actions embracing all five of th ese attacks.Evidence BasePhysical inaction is a important, independent hazard factor for a scope of chronic wellness conditions impacting society today ( 7 ) and there is a compelling instance for implanting the publicity of physical activity in the NHS to procure the future wellness of the state ( 8 ) . In fact it has been said that if a drug or intervention was developed that had the possible to forestall as many wellness conditions as physical activity ( see fig. 1 ) it would be proclaimed a ‘miracle remedy ‘ or ‘wonder drug ‘ ( 7 ) . But physical inaction besides has far-reaching deductions for the wider populace sector, such as societal attention. For illustration: of grownups aged over 65, 12 % are unable to walk outside on their ain, and 9 % can non pull off stepss unaided ( 2 ) Figure 1. The impact of physical activity on many chronic wellness conditions Evidence shows that an active life style: has a significant impact on the hazard of major non-communicable disease, including coronary bosom disease, high blood pressure and some malignant neoplastic diseases ( 2 ) can cut down the hazard of shot, and modify cardiovascular disease hazard factors such as high blood force per unit area and high cholesterin ( 2 ) protects against malignant neoplastic diseases of the colon, chest ( post-maturity ) and endometrium ( 5 ) reduces the hazard of and helps pull off musculo-skeletal wellness conditions, including osteoporosis and degenerative arthritis ( 2 ) reduces the hazard of depression and promotes many other positive mental wellness benefits, including cut downing anxiousness ; bettering self-pride ; and assist cut down physiological reactions to emphasize ( 2 ) has been found to be as effectual in the intervention of mental sick wellness as anti-depressant drugs and psychotherapeutics ( 9, 10 ) supports weight direction – ensuing in modest weight loss of around 0.5-1kg per month ( 2 ) by the age of 70, 25 % of adult females and 7 % of work forces have deficient leg strength to acquire out of a chair without utilizing their weaponries ( 2 ) . Physical activity is portion of the solution to back uping the publicity of independent life in older grownups, thereby cut downing the cost of societal attention. Fallss are a prima cause of inadvertent decease of older people and fractured hips, as a consequence of falls, cost the NHS and societal services ?1.8 billion each twelvemonth in England ( 11 ) . Physical activity, peculiarly preparation to better strength, balance and coordination, can be extremely effectual in cut downing the incidence of falls ( 2 ) . Regular exercising has besides been shown to protect against the oncoming of depressive symptoms and anxiousness ( 12 ) . In mid-life and older grownups, physical activity can decelerate or forestall age-related cognitive diminution, and is associated with a lower hazard of developing dementedness ( 13 ) . Despite the multiple wellness additions associated with a physically active life style, merely 40 % of grownup work forces and 28 % of big adult females meet the Chief Medical Officers ( CMO ) recommendations for wellness ( 14 ) , nevertheless, the existent challenge is that 75 % of work forces and 67 % of adult females believe that they are active plenty ( 15 ) . There is a acknowledgment across the NHS that active life styles are now an intrinsic portion of twenty-first century health care and that advancing active life styles is a simple reply to many of the wellness challenges confronting our state today ( 8 ) . The load of sick wellness from inaction is clear and the statistics farther highlight the potency for important decreases in morbidity and mortality, which could be achieved if we consistently and actively promote engagement in physical activity through the NHS ( 8 ) . Equally good as holding the potency to better the wellness of the state, advancing physical activity could besides salvage the NHS money, cut downing the load of chronic disease on the ague sector and public services ( 8 ) . Using Primary Care to advance physical activity can assist the NHS move towards lower costs, more efficient and effectual services in primary attention and cut down the demand for, and costs of, acute attention ( 7 ) . Investing in the bar docket by implanting the publicity of physical activity in NHS services has the ability to significantly cut down the fiscal load of inaction on the economic system. Allender et Al. ( 16 ) estimated that for merely five conditions, post-menopausal chest malignant neoplastic disease, lower GI malignant neoplastic disease, cerebrovascular disease, cardiovascular disease and type 2 diabetes, in one twelvemonth entirely, the load of physical inaction: caused over 35,000 deceases ; caused 3.1 % of morbidity and mortality in the UK added over ?1.8 billion to the direct wellness cost load on the NHS. For a pattern population of 10,000 the cost of these five conditions attributable to physical inaction norms ?50,000 per twelvemonth ( 17 ) . Adding indirect costs to the wider economic system, such as working yearss lost due to sickness and premature mortality, produces a entire measure associating to physical inaction that may be every bit high as ?8.3 billion every twelvemonth ( 17 ) .SchemeThe long term purpose of wellness publicity is to cut down morbidity and premature mortality ( 18 ) , to accomplish this intercessions are likely to be targeted towards whole populations or high hazard groups, with three degrees of bar ; Primary, aimed at forestalling the oncoming of disease ; Secondary, aimed at forestalling the patterned advance of disease ; and Tertiary, aimed at cut downing farther disablement or helping rehabilitation ( 18 ) . A cardinal purpose of this scheme is to aim intercessions at pre-school and school age kids, promoting them to be active in line with current recommendations. This will hold two effects ; foremost, by promoting kids to be more active, will be good in cut downing the prevalence of inaction related conditions in the hereafter ; and secondly, will assist to develop a civilization of taking regular physical activity. It has been shown that sedentary behaviors track from adolescence into maturity ( 19 ) and, although grounds is limited, it is believed that active kids are more likely to stay active into maturity ( 20 ) , besides when kids are taught appropriate wellness behaviors early, these are more likely to go accustomed and go on into maturity ( 21 ) . To accomplish this we must work closely with kids ‘s Centres, to guarantee that active drama forms a regular portion of their activities, and schools to guarantee that regular physical activity is incorporated into their course o f study, including activities which are non traditionally seen as school athleticss, which will besides promote the ‘Not Sporty ‘ kid to take part, activities such as Dance and Cheerleading, for illustration, have been shown to increase engagement in school based activity ( 22 ) . It is good that the National authorities have reviewed their support for the School Sports Partnership programme, which has done much to promote and advance activity in schools across the part, and we will go on to buttonhole, both locally and nationally, through Public Health England, for continued support for this programme and other programmes which will better entree to feature and activities within our schools. Many kids and immature people say that they would prefer to walk or rhythm to school ( 23 ) , and we will work with Local Education Authorities ( LEA ) and Local Governments to assist and back up schools to develop and advance active conveyance programs for both staff and students, including walking coachs, peculiarly for primary school students, which have been shown to be effectual in increasing degrees of physical activity in primary school kids ( 24 ) . But holding active conveyance programs is non sufficient to guarantee increased activity among staff and students, we besides need to guarantee the handiness of safe paths to schools, unafraid storage for rhythms and accoutrements etc. within schools and the support of parents to promote their kids to utilize active conveyance methods to acquire to and from school. To this terminal we will work with and buttonhole the Local Authority to guarantee that active conveyance is the easier pick for people to do and the LEA to guarantee s chools have the resources to supply secure storage installations. Persons diagnosed with many medical conditions may profit from increasing the sum of physical activity they do in order to forestall the patterned advance of their status. Working closely with GP ‘s these persons will be referred into activities which will assist forestall or cut down the patterned advance of their status. In many instances a first measure will be to supply information, particular to their status, about the principle for going more active and the hazards associated with non making so. As many of these people are likely to populate in countries of want ( 25, 26 ) the accent will be on advancing no-cost/low-cost activities, such as walking and cycling, which have been shown to be an appropriate method of advancing physical activity ( 1 ) . Walk is besides a suited activity for older people, every bit good as the physical benefits of improved or maintained musculus strength, joint mobility and proprioception, which can cut down falls in older grownups ( 2 ) , walk ing, peculiarly in a group, such as on a wellness walk, besides offers benefits which contribute to the societal and psychological wellbeing of persons ( 27 ) . We already have a web of wellness walks across the part, through the ‘Walking for Health ‘ programme and a figure of local groups presently provide a scope of cycling activities, including adaptative cycling, community rhythm drives and rhythm tuition. These activities will supply the back bone of our scheme but we need to guarantee they are accessible to people that need them. We will confer with with patient and support groups to guarantee that activities provided are activities of pick and are at a clip and topographic point where they can be accessed by the mark population. Many people with bing medical conditions require entree to specialised exercising proviso, aimed at cut downing farther disablement or helping rehabilitation ( 18 ) . We will look to use our bing exercising referral programme, working with qualified physical therapists and exercising professionals, from both the populace and private sectors, guaranting that patients are guided into suited activities and supported in their attempts to go more active. Activities will necessitate to be suited for Phase IV cardiac rehabilitation and/or rehabilitation from musculoskeletal hurt, among other conditions. Many of these activities already exist, through the public, private and voluntary sectors, and we will go on to work closely with suppliers to guarantee activities are suited for the referral programme, i.e. run by suitably qualified teachers and hazard assessed. Harmonizing to the 2006 Health Survey for England ( 14 ) one in four people said they would be far more active if they were advised to be so by a wellness professional. Therefore, based on the recommendations of NICE counsel ( 1 ) we will work closely with GP patterns to supply brief intercessions, based upon the â€Å" Lets Get Moving † ( LGM ) programme, for patients to assist promote them to be more physically active. This programme has been tried and tested in a figure of GP patterns in London and has been found to supply a cost effectual scheme for increasing population degrees of physical activity ( 4 ) . However, such work will be dependant on the suppliers of the brief intercession being able to signpost patients onto suited activities that they would wish to, or are willing to seek. The Change 4 Life web site has an activity hunt tool which is appropriate for this intent, although a elaborate function exercising will be required before manus, to guarantee as broad a s cope of local activities is included in the database and that information is current and correct. Although instruction entirely is improbable to hold a positive consequence on wellness behaviors, coupled with other attacks can take to the desired results. Evidence shows that old media runs to advance physical activity have been successful in raising consciousness and cognition, but non of increasing activity degrees ( 28, 29 ) , nevertheless, instruction is likely to play a cardinal function in the initial phases of many wellness publicity programmes ( 30 ) . Using societal selling techniques has been shown to be an effectual method of making difficult to make groups ( 31 ) , but instruction runs should be based upon positive messages, such as improved functional capacity or improved sleep forms, for illustration, instead than negative messages or panic tactics, which have been shown to be uneffective in arousing wellness behavior alteration ( 32 ) . The Change 4 Life programme is a national run, launched in 2009, which aims to assist persons and households to â€Å" eat good, travel more and unrecorded thirster † . We will seek to construct on the work that this programme has done, and continues to make, in advancing the benefits of an active life style. In add-on we will include physical activity information and the Change 4 Life activity hunt tool on the PCT web site and will promote our spouses, local authorization every bit good as other public, private and voluntary sector suppliers to make the same. Many administrations, such as the British Heart Foundation and Cancer UK, for illustration, bring forth a broad scope of literature on the benefits of physical activity in relation to specific wellness conditions and there is no purpose to re-invent the wheel. We do, nevertheless need to do certain that this information is made more widely available. We will therefore work closely with the local authorization libraries service, GP ‘s, tooth doctors, pharmaceuticss and supermarkets etc. to guarantee that these stuffs are available in the topographic points that people attend. We will besides set up a figure of awareness raising events across the part, supplying information and advice for the populace. These events will be specifically targeted in countries of greatest demand, i.e. countries of high want or countries where there is grounds of low consumption of physical activity, and will be held in topographic points where people congregate, i.e. supermarkets, station office, ca fe or public house for illustration. We will besides transport out media runs in partnership with local suppliers to advance specific activities at times of increased national involvement, associating into the 2012 Olympic Legacy programme, for illustration, or to bind in with other promotional events and national runs, such as National Walk 4 Life Day or National Older Person ‘s Day. Although there is limited grounds of wellness benefits of community engagement, it is suggested that persons have a better opportunity of accomplishing their ends if they participate with other people who are affected by, or portion, the same, or similar, fortunes ( 33 ) . There is good grounds to demo that authorization has the possible to bring forth improved wellness impacts, peculiarly when aiming specific community groups, such as adult females and people from deprived communities ( 34 ) . At the bosom of authorization is the construct that people can be equipped with the cognition, assurance and accomplishments to do a difference in their communities ( 35 ) . Involving members of the populace in back uping others within their ain communities to do positive wellness alterations in their lives is based on a sound apprehension of the value of life experience and community support systems that can be within vicinities ( 36, 37 ) . We will enroll people from different strands of the community and specific mark groups to go community Healthy Activity Champions. These persons will have preparation, support and counsel enabling them to transport out voluntary activities in their ain communities. However, engagement in physical activity within communities, particularly those in disadvantaged countries, is likely to be mostly dependent on the handiness and propinquity of installations and safe environments ( 38 ) . Having easy entree to safe community countries, such as resort areas or playing Fieldss, and doing local vicinities safe for out-of-door activity has a major consequence on bettering activity wonts, peculiarly among deprived populations, who by and large report lower degrees of physical activity ( 38 ) . Therefore we will work with bing community groups, particularly those in disadvantaged countries, to assist them convey about the alterations they want to see in their communities, assisting to pull support for local undertakings etc. In this we will wor k as a facilitator, non taking but back uping the community, supplying counsel and advice, as needed or requested, to enable them to accomplish their ain results, instead than those placed upon them by outside bureaus. Although, over recent old ages, there have been several authorities policies, schemes and studies either entirely aimed at, or at least integrating physical activity counsel and policy to some grade ( 7, 8, 17 ) , even the latest public wellness white paper ( 39 ) includes mention to the consequence physical activity can hold on the wellness of the state. We will go on to buttonhole, both locally, regionally and nationally, through the new Public Health England construction, for a wider consideration of physical activity in all authorities policies and schemes. We see a peculiar accent of this attack in buttonholing local authorities around the cardinal countries of local conveyance policy, to do active conveyance the easier pick, for both wellness and environmental sustainability. We will work closely with be aftering sections to guarantee that new developments incorporate programs to include safe countries for out-of-door activities and to travel off from the â€Å" No Ball Games † civilization that has developed in this state towards a civilization where we promote and encourage regular activity for all people, from cradle to sculpt.CostingFigure 2. Premises made in the preparation of declarative costing. Based on the NICE counsel ( 1 ) and the LGM feasibleness survey ( 4 ) , the undermentioned premises underlie this declarative costing. aˆ? Workforce cost premises: PCT Staff – ?25 per hr. ( Assume 20 proceedingss per patient ) aˆ? Training ; 6 PCT Staff for 3 hours ( module 1 ) – ?450.00 commissioning external preparation to present Module 2 preparation to 6 ( soap. 12 ) PCT staff – approx. ?2,500 ongoing pattern support – approx. ?200 per GP Practice per twelvemonth. aˆ? Premises ; Appraisal and brief intercession takes 15 to 20 proceedingss. Support activity following brief intercession and follow-up costs, ?5 per patient project intercession. The mean QALY gained per referral is 0.17 ( 1 ) ; ensuing from approx. 6 % of patients referred for interview accomplishing an addition in the figure of moderate activity Sessionss. Much of the work outlined by this scheme is already taking topographic point, although more attempt is needed to guarantee the success of this scheme. They key cost involved with this scheme will be for the puting up of the LGM programme and the rating procedure and declarative costs for this are given here. Areas where the PCT can anticipate to incur direct costs for puting up LGM are detailed in the programme commissioning usher ( 8 ) . Although, at this phase, elaborate costing has non been carried out for this programme, the Department of Health has provided an analysis of declarative costs ( 8 ) . However it should be noted that this economic analysis is intended to be declarative merely and will change harmonizing to the bringing methodological analysis chosen and the figure and features of the pati ents targeted ( see fig. 2 for premises made ) .Indicative set up costsCost of staff preparation: ?3,000 Selling and Promotion: ?1,000 Staff costs involved with execution: ?5,000Entire estimated set up costs: ?9,000Indicative operating costs ( based upon 500 patients per pattern per twelvemonth ) Practice staff enrolling patients, finishing GPPAQ and mentioning for brief intercession ( Assuming ?5 per patient ) ?2,500 Brief intercession carried out by PCT staff ( Assuming 20 infinitesimal audience and ?25 per hr staff cost ) ?4,167Assuming 80 % of patients undertake the intercession ( 400 patients )Cost of support activity following brief intercession and followup ( based on ?5.00 per patient ) ?2,000Entire cost per pattern for 1 twelvemonth ?8667On this footing, with 15 patterns, each averaging 10,000 patients, covering the PCT country the entire jutting one-year costs are: – Year one ( including set-up costs ) ?139,005 Year two ( including 5 % cost addition ) ?136,505Entire cost for two old ages ?275,510The cost of rating for this scheme has yet to be finalised, nevertheless counsel suggests that around 10 % of the programme cost should be allocated to the rating procedure. Therefore leting between ?25,000 and ?30,000 would be appropriate for this scheme, giving a entire programme cost of around ?300,000. Based on NICE counsel ( 1 ) the estimated cost per QALY saved is ?295, good below the suggested threshold of ?30,000 per QALY ( 8 ) .EvaluationMeasuring wellness publicity is non straightforward because it normally involves changing activities, long term aims and several spouses ( 18 ) . Health publicity argues for a holistic appraising attack, embracing qualitative research methodological analysiss, taking history of the changing contextual characteristics of many programmes ( 18 ) . The RE-AIM ( range, effectivity, acceptance, execution, care ) model ( 40 ) was developed to heighten the impact of wellness publicity intercessions by measuring the dimensions considered most relevant to real-world execution, such as the capacity to make underserved populations and to be adopted within diverse scenes ( 41 ) . The theoretical account was intended to steer planning and rating of evidence-based intercessions ( 42, 43 ) that address the different degrees of the socio-ecological theoretical account, such as those that target single wellness behavior alteration by increasing intrapersonal, organizational, and community resource support ( 44 ) ( see figure 3 for typical research inquiries ) . It has been used to measure a scope of wellness behavior alteration programmes, including physical activity, dietetic behavior, and smoke ( 45-47 ) . It is hence believed that this will be an ideal rating model for this scheme. Figure 3. RE-AIM Dimensions and Template Questions for Evaluating Health Education and Health Behaviour ResearchRE-AIM DimensionQuestionsRange( Individual Level )What per centum of potentially eligible participants a ) were excluded, B ) took portion and degree Celsius ) how representative were they?Efficacy or Effectiveness( Individual Level )What impact did the intercession have on a ) all participants who began the plan ; b ) on procedure intermediate and primary results ; and c ) on both positive and negative ( unintended ) , outcomes including quality of life?Adoption( Puting Level )What per centum of scenes and intercession agents within these scenes ( e.g. , schools/educators, medical offices/physicians ) a ) were excluded, B ) participated and degree Celsiuss ) how representative were they?Execution( Setting/agent Level )To what extent were the assorted intercession constituents delivered as intended ( in the protocol ) , particularly when conducted by different ( non-researc h ) staff members in applied scenes?Care( Individual Level )What were the long-run effects ( lower limit of 6-12 months following intercession ) ? B ) What was the abrasion rate ; were drop-outs representative ; and how did abrasion impact decisions about effectivity?Care( Puting Level )a ) To what extent were different intercession constituents continued or institutionalised? B ) How was the original plan modified? Beginning: www.re-aim.org It is import that rating of programmes, such as this, is built in from the beginning so that all involved know and acknowledge the end products and results that they are working toward ( 43 ) . We are presently working closely with local academic establishments to develop this rating procedure based upon the RE-AIM model.DecisionIt is widely accepted that physical inaction is a major subscriber to the load of ill-health that we face nationally today and that advancing and promoting an active life style is a simple, yet effectual, manner of cut downing this load for future coevalss. A behaviour alteration attack is likely to be most appropriate to increase population degrees of physical activity, and hence this is the chief attack used in this scheme. However, it must be recognised that a one size fits all scheme is improbable to be successful, hence, we have proposed a holistic attack to advancing active life styles. It should besides be recognised that many of the wellness results from schemes such as this are long term and are non likely to be realised within the life-time of the scheme. Therefore a robust rating model must be employed from the beginning so that advancement can be measured against programme end products, which grounds has shown to be effectual in accomplishing the anticipate wellness results. The RE-AIM model has been successfully used in assorted scenes, against a scope of behaviour alteration enterprises, including physical activity, hence it is ideal to be used for this scheme. Although this scheme is aimed at bettering the wellness of the population of Western Cheshire through increased activity degrees, if it is to be successful it will necessitate a conjunct attempt from the whole Public Health Department, from the Director of Public Health down, to guarantee that the scheme is accepted by all spouse administrations, both locally and nationally, peculiarly local and national authorities, to guarantee that physical activity is embedded in all policy, non merely regarded as a wellness or sport/community issue.Part 2.Behaviour ChangeThe behavior alteration attack is popular in wellness publicity because it places wellness as the belongings of the person and assumes that people can do existent betterments to their wellness by taking to do appropriate life styles alterations ( 18 ) . Although behaviour alteration programmes tend to be an expert led, exceed down attack ( 18 ) , this scheme proposes a client led, bottom up attack. The programme is based on the healthcare professional supplying a brief intercession with persons, identified as person who would profit from increased activity. The procedure of behavior alteration is simply facilitated by the healthcare professional, through the proviso of appropriate information and advice particular to the person in the initial phase of the procedure. Then steering and back uping them, utilizing motivational interviewing techniques, instead than taking, through the behaviour alteration procedure. Critical to the bringing of these brief intercessions is the manner they are implemented. Nice counsel on behavior alteration intercessions delivered to persons recommends that practicians select intercessions that will actuate and back up patients to believe about the effects of their current behavior, see the positive effects of altering and program for alteration in little stairss ( 48 ) . NICE Public Health Guidance ( 1 ) recommends ; â€Å" Primary attention practicians should take the chance, whenever possible, to place inactive grownups and rede them to take for 30 proceedingss of moderate activity on 5 yearss of the hebdomad ( or more ) . They should utilize their opinion to find when this would be inappropriate ( for illustration, because of medical conditions or personal fortunes ) . They should utilize a validated tool, such as the Department of Health ‘s general practician physical activity questionnaire ( GPPAQ ) , to place inactive persons. When supplying physical activity advice, primary attention practicians should take into history the person ‘s demands, penchants and fortunes. They should hold ends with them. They should besides supply written information about the benefits of activity and the local chances to be active. They should follow them up at appropriate intervals over a 3 to 6 month period. † Brief intercessions have become the intercession of pick for many wellness publicity runs ( 18 ) and are by and large based upon the transtheoretical, or phases of alteration, theoretical account of behavioral alteration and, on occasion, the theory of self-government ( 49 ) . The transtheoretical theoretical account was foremost proposed by Prochaska and DiClemente in 1982 ( 50 ) , taking history of concepts from several theories from the field of psychological science, such as the theory of reasoned action ( 51 ) , and theory of planned behavior ( 52 ) . Sniehotta suggests that while these theories advanced apprehension of motive with respect to behaviour alteration they made small part to the scientific discipline of behavior alteration because they did non include a agencies for altering behavior or did non account for non-motivational behavior alteration techniques ( 53 ) . The construct of phases of alteration emerged during research into the procedures that persons use to alte r their troubled behavior ( 50 ) but the theoretical account has since been successfully used for many wellness behaviors change intercessions, including smoke ( 54, 55 ) , intoxicant ( 56, 57 ) , dietetic ( 58 ) , every bit good as physical activity ( 49 ) . A recent reappraisal indicated that motivational interviewing, based upon a ‘stages of alteration ‘ theoretical account, efficaciously helps clients to positively alter their behavior and exceeded results of advice merely intercessions in 80 % of the surveies included in the reappraisal ( 59 ) . The writers of the reappraisal farther suggest that, although some alterations may non be clinically important, it was of import to maintain in head that the procedure is based upon doing the patients cognizant of the potency for behavior alteration ensuing in improved wellness results and that the little alterations made within the period of survey may besides be of long term involvement if they mark the beginning of a long term procedure of alteration for the person ( 59 ) . The Lets Get Moving attack is a behaviour alteration intercession that has been designed to supply a systematic attack to placing and back uping grownups who are non run intoing the current recommendations for physical activity to go more active ( 8 ) . The attack is based upon NICE Public Health Guidance ( 1 ) , which endorses the usage of brief intercessions for physical activity publicity in primary attention as being both clinically and be effectual in the long term. The programme draws upon motivational questioning techniques to foreground the wellness benefits of physical activity, working through cardinal behaviors alteration phases and reasoning with a clear physical activity end, which is set by the person, and the designation of suited local chances to be active, including exercising referral, if appropriate ( 8 ) . Motivational interviewing is a patient centred attack, which fits in with the current authorities mantra â€Å" No determination about me, without me † . The procedure aims to arouse and beef up an persons intrinsic motive to alter lifestyle behaviors ( 8 ) and has been used by a assortment of health care professionals, across a scope of primary attention scenes, to present improved wellness results ( 60 ) . The active constituents of motivational interviewing are increasing preparedness to alter, utilizing empathetic listening techniques, increasing self-efficacy and increasing the sensed disagreement between existent and ideal behavior ( 61 ) . A recent reappraisal has shown that motivational interviewing in primary attention can hold a positive consequence on a scope of wellness behaviors, including diet and physical activity ( 62 ) . The construct of motivational questioning evolved from the experience of handling alcohol addiction, and was foremost described by Miller in 1983 ( 63 ) . This basic experience was developed into a coherent theory, and a elaborate description of the clinical process was provided by Miller and Rollnick ( 64 ) , who defined motivational interviewing as a ‘directive, client centred counselling manner for arousing behaviour alteration by assisting clients to research and decide ambivalency ‘ . The schemes of motivational interviewing are more persuasive than coercive, more supportive than argumentative, and the overall end is to increase the client ‘s intrinsic motive so that alteration arises from within instead than being imposed from without ( 65 ) . The motivational interviewing manner is a collaborative method utilizing distinguishable rules and techniques, while utilizing client centred techniques to construct trust and cut down opposition, the supplier focuses di rectively on increasing preparedness for alteration ( 61 ) . Reappraisals of physical activity intercessions have identified the scene of general pattern as a potentially effectual scene for population degree of physical activity publicity schemes ( 66, 67 ) . A written prescription is a familiar manner for patients to have advice from their GP, normally in the signifier of medicine ( 68 ) , and research has shown that supplying patients with a written prescription to take more exercising has been effectual, at least in the short term ( 6 to 10 hebdomads ) ( 69-71 ) . However grounds suggests that long term attachment to exert programmes may necessitate multiple contacts with the wellness professional and that GP ‘s, in peculiar, have expressed concern about deficiency of clip, assurance or skill to present separately tailored exercising advice ( 68 ) . It is suggested that one manner of get the better ofing these barriers is for other allied wellness professionals to supply the brief intercession following designation of suited campaign ers by the GP or pattern nurse ( 66, 69, 72 ) utilizing a validated tool, such as GPPAQ, to measure current activity degrees ( 1 ) . This is the attack proposed in this scheme, using allied wellness workers, such as wellness trainers, for illustration, appropriately trained to present the initial brief intercession and motivational interview audiences, following on from the referral by the healthcare professional, either at the GP pattern or in a separate location. Promoting physical activity in primary attention is recognised as an of import and potentially effectual attack for increasing population degrees of physical activity ( 1, 73, 74 ) . With assorted attacks being tried over recent old ages, including giving advice or guidance ( 75, 76 ) , supplying written resources ( advice brochures etc. ) ( 71 ) and exercise referral programmes ( 1, 77 ) . There is an increasing sum of grounds for the impact of wellness professionals promoting physical activity within primary attention ( 78 ) . A recent Australian survey suggests that merely three to five proceedingss of brief advice from a General Practitioner, supported with appropriate written stuffs, could take to an addition in the proportion of patients run intoing recommended degrees of physical activity 24 hebdomads after the intercession ( 68 ) . Similarly a survey on the effects of three brief intercession and reding attacks conducted by pattern nurses on patients with hazard factors assoc iating to cardiovascular disease besides showed a important addition in reported activity degrees four months after the intercession ( 75 ) . In 2009 the Department for Health launched the ‘Be Active, Be Healthy ‘ policy which proposed the phased airing of the ‘Lets Get Traveling ‘ programme, and the new authorities public wellness white paper ( 39 ) endorses the programme within the new public wellness construction.DecisionBehaviour alteration intercessions are by and large seen as one of the most appropriate attack to increasing population degrees of physical activity and, among these, brief intercessions appear to be a popular pick among wellness publicity staff. Evidence suggests that the add-on of motivational interview techniques to the intercession has served to increase the effectivity of these intercessions in a assortment of wellness publicity scenes. The usage of the ‘Lets Get Traveling ‘ protocol for increasing activity degrees has bee n tried and tested and found to be both clinically and be effectual in a primary attention scene and is hence seen to be an appropriate attack to utilize for this scheme. This attack was endorsed by the old Labour authorities and this support has been re-iterated by the current Lib Dem/Conservative alliance authorities in the latest public wellness white paper and back uping paperss.

Foreign Review of Related Literature Essay

Students who get the system of studying know that good grades lead to more freedom and responsibility in life. Some only want to have fun and focus on other things but it is said that their refusal to study did not fulfill them that is why they feel guilty and realize a need to change. This being said, all students are encouraged to take their studies seriously. Because in our generation, the youth tend to give in to the things that will give them immediate yet temporary happiness than happiness that might take long to have yet it will last longer. Students must all know that every moment of education is important because the pleasures of today have no assurance that they will still exist tomorrow. We might say that we have attained freedom through our reckless acts as a child, through our ignorance towards studies but these will all backfire on us in the future. They consequences that will be put upon us will be sevenfold. As the saying goes, â€Å"What goes around, comes around.â €  same with our present to future education. A study plan has to be made. Students should use their time wisely in everything that they do. They should study in a place that will be suitable and comfortable for them. There must be enough space for the students to be able to place and move their books freely while studying. Perhaps studying a very general topic that needs a lot of references, a student needs enough space to be able to open the important pages that relates to their topic without it being a burden. At the same time, they should be comfortable enough to be able to focus on their studies properly and not have to worry about having neck/back aches, or even poor eyesight. There must be a fair lighting to prevent blurring of the eyes. Most importantly, they should establish a study plan to have an orderly routine in studying and also to have proper distribution of time with studies and resting. Time management is one of the greatest factors to consider in attaining high grades. All students must learn good study habits that will help them keep record of their assignments and the things that are need to be done. Students must also learn to stop cramming and procrastinating. Students must all complete their tasks immediately to avoid passing assignments or requirements after the deadline. They should also study immediately after school hours to keep their mastery over the said lessons and to be able to pass the exams with flying colors. Also every student is encouraged or most probably required to understand and learn their lessons than to just memorize what they have read. Some knowledge of research methods of the logic of research analysis is necessary both to avoid being misled by bad research and to help in interpreting the findings that are presented. Analyzing rather than memorizing, that’s the main point of this statement. It is to let the readers and the students know that mastery does not come from what the writings in the book say but from the way we understood what we have read. Lastly, everyone not only students must know that the same intelligence which is in you is also in the things that you desire. That the human person must believe in his/her own self and not repeat words or formulas but his/her power to do something. It’s not always the bookish and academic things that will define our intelligence or performance, but mostly in our attitude towards studies. It’s not always about being book smart, but it is also about the perseverance and the things we do to strive for success, the efforts that we make to achieve our goals and the sacrifices that we make for the assurance of success. It only means that everything is up to us, on the way we perceive things, the way we take things through, and the way we approach things. We must always keep a positive attitude because this is the first big step towards becoming what we want to be in the future.

Leonardo da Vinci Research Paper Example | Topics and Well Written Essays - 1000 words - 2

Leonardo da Vinci - Research Paper Example This research paper examines Leonardo da Vinci's life. He was born on April 15th, 1452 to Piero da Vinci, a notary, and Caterina, a peasant woman, at the hill town of Vinci, Italy. Even though not much is known about his early life, this has been the topic of historical conjecture In his numerous notebooks, Leonardo struggled with differentiating between the perception and painting of a scene which he summarized as the difference between monocular and binocular vision. Leonardo da Vinci could not create on canvas, in Ames’ terminology, an equivalent of configuration. He may have had little knowledge of ocular anatomy but his use of optics to the eye is spectacular. In addition, Leonardo possessed observational skills that had no match and his ability to generate virtual reality on canvas was without equal. Leonardo da Vinci (1721) noted that even though a painting may be carried out with the best art and finished perfectly, with consideration of its lights, contours, colors, s hadows, it can never show the relief possessed by a natural object unless these qualities are looked at from a distance with a single eye. In other words, the perception of deepness in a painting is not as complete as that of a natural scene seen with both eyes. He struggled for long with the contrast between binocular and monocular vision. In one of his notebooks, Leonardo wrote down how he had to repeat his experiments several times before coming to a conclusion. The reason he gave for this was that the subjects of study were numerous.

Systems and Processes Deployed within Organization Essay

Systems and Processes Deployed within Organization - Essay Example This is the reason why these systems and processes have been openly debated for their usage and viability in the times gone by and even today when their need has been all the more significant. The effectiveness of the systems and processes can be judged from the different ideological bases which exist within an organization and the manner under which decisions are taken to boost them up with the changing time dimensions (Thomas, 1999). The management domains also play a quintessential role and this would be discussed here within the length of this paper nonetheless. Also a theoretical comprehension of how alternatives could be studied, analyzed and implemented within the relevant thick of things would be made here in this paper. What remains to be seen are the future considerations and the amendments which will play a huge role at changing beliefs and opinions as far as the different systems and processes are concerned, and which are linked with the organization’s performance objectives. The organization chosen for this paper is Walmart. The reason for choosing Walmart is because it is one of the world’s biggest organizations. Its revenues have exceeded expectations and it is growing at a phenomenal rate over the years. Walmart has given tough time to some of the world’s biggest retailers and it is due to this fact that it has achieved immense success. What is even more interesting to note is the fact that the systems and processes within Walmart are geared in such a way that success seems to be the middle name of this organization. There is reason enough to believe such a premise, more so because Walmart has been able to shape up new ideas and turn beliefs in its right. Walmart has given tough time to some of the world’s biggest retailers and it is due to this fact that it has achieved immense success. The systems and processes being followed within Walmart are driven in such a way that there is success for just about every intermed iary who is involved (Ingram, 2010). This allows the retail giant to extract as much benefit as possible from varied processes, systems and undertakings. It also gives the company the liberty to move ahead by outlining the most basic steps, time and time again. Moving ahead with the discussion of the systems and processes, these need to be discussed in-depth before one could actually know what kind of requirements there are to suffice them. This would mean that these systems and processes need to be properly analyzed and then only incorporated within the relevant scheme of things. The requirement therefore is to differentiate what the true systems and processes are and what kind of elements are not in line with what one calling them the systems and processes or mistaken by people on a number of different counts. When one discusses the tangent of Walmart, it is a given that there is a dire need to understand that Walmart’s performance objectives shall remain supreme no matter how tough it is to gather support, and these systems and processes can only work wonders when they are given a chance to highlight the grey areas which must be tapped and paint the strengths as and when required. This could be in the form of Walmart’s different undertakings that happen within the intermediary roles, the supplier side concerns or even the customers’

Investigating the impact of Information Technology on a career Assignment - 1

Investigating the impact of Information Technology on a career - Assignment Example Owing to information technologies, advanced proficiency can be acquired by any tourism manager (Frew 138). Information technology transforms how business is carried out in the tourism industry. More particularly, marketing prospects are growing; modernization in customer service personalization and service technology takes place; and information on every tourist service is accessible virtually across the globe. Wireless communication technologies, data and text communication among guests, managers, and employees are currently being implemented by the hospitality industry (Yeoman & McMahon-Beattie 274). Consisting of expert systems and portable communication devices, these technologies enable tourism personnel to provide the finest customer service. Therefore, in order to remain competitive in the future and to meet tourism demands sustainably and securely there is no other alternative but to integrate IT and improve the interactivity with the customer base and the bigger market. Moreover, top management dedication and groundbreaking business process restructuring are needed with a long-term strategy planning throughout the organization (Lee 155). At present, information and choices are accessible on the Internet and customers can select the best from these choices to transact. This has lessened the needless haste of customers in travel

The Urban Schools in the United States Essay Example | Topics and Well Written Essays - 4500 words

The Urban Schools in the United States - Essay Example tion in schools apart from the disparity in the enrollment rates of students as well as the availability of teachers belonging to different races and ethnic origins. â€Å"Equity is central to the current reform movement in science education. Although all students are capable of understanding and doing science, persistent and widespread differences continue to exist in students’ access, retention, and achievement, depending on their culture, gender, race, and socioeconomic status† (WCER, 2007). Besides, teachers and students are exposed to a lot of challenges in the urban schools. Background of Urban Schools In the United States, the education sector has been a major priority, with numerous efforts on reform being implemented to improve students’ performance. Urban schools in the United States are located in urban areas, where there are relatively high rates of poverty. Besides, the student population here possesses limited English proficiency and is, therefore r egarded as high need areas (Ruso, 2004). Gaskell (2012) claims that in the early years, wealth was accumulated by a limited number of individuals and, as a result, poverty levels in the urban areas increased significantly. The urban population in the United States increased as well, resulting in many differences, such as racism and inequality. The funding of schools among the wealthy and the poor districts remained fraught with inequality. The urban schools in the United States have, over the years, faced a declining level of test scores and high rates of violence. According to Stark (2011), urban schools in the 1800s have been started with an aim of providing immigrant parents with affordable places for their children to stay during the day as they worked in mills, factories or shops. By 1920, the urban... This essay approves that research on teacher turnover is examined and the situation in urban schools is related to the factors for teacher turnover that have emerged from the research. Finally, the review also presents factors that contribute to teachers’ motivation to stay in urban schools despite the difficult conditions. The researcher hopes that by looking at both the challenges and the motivating factors, this study will be contribute to the understanding of teacher retention in urban schools. There appears to exist a whole range of factors that demotivate teachers in general and science teachers in particular from continuing with the profession of teaching. While teachers receive only low salaries, the job is extremely demanding both in terms of time and physical as well as emotional stress it entails. The most unfortunate aspect of the job of teaching is the fact that a teacher is held wholly responsible and accountable for the behavior and results of students. The prof ession of teaching is too taxing, which prevents a teacher from attaining a balance between his or her personal and work life. This report makes a conclusion that teacher turnover is a particular problem in most of the urban schools. Negative reports about urban settings have discouraged properly qualified teachers from taking up teaching jobs in these schools. The high level of stress and exhaustion experienced in these schools also result in high teacher turnover. Despite the negative factors, however, there are some teachers that remain in the urban schools and they are motivated to provide quality education. The literature also reviews some of the teacher qualities that motivate teachers to teach in urban schools.

Tone, Rhyme, and Irony in Thomas Hardy's the workbox Essay

Tone, Rhyme, and Irony in Thomas Hardy's the workbox - Essay Example The tone of the poem is set as aggressive and menacing in the first line of the poem with the forceful and demeaning words, â€Å"See, here’s the workbox, little wife,† (Hardy 374). The opening words of the poem, where the husband greets his wife, are seemingly innocent enough unless the reader close reads and notices an almost overpowering sense of control. The husband’s intentions were never to give a gift to his wife, but a reminder of an issue she has caused for him. The overall tone can be mistaken for a happy and light conversation between the man and his wife until further read into, when the reader can tell there is a hidden fact they both know of. The narrator announces in the aggressive tone that he has made something for his wife to take a look at. In the following stanza, it is revealed that the workbox the narrator constructed of polished oak is a present to his wife. Gifts signify gratitude and rewarding. However, the tone in which the husband opens to present his wife with the gift is aggressive and angry in its tone. The combined tone of anger and control shows that the giving of the gift is ironical because it is not a present the husband gives in joy and thankfulness to his wife. A sense of irony comes into play in the first stanza when the tone set by the first two lines is taken into consideration. The aggressive tone of the opening words along with the context that the rest of the stanza carries is enough to reveal a large amount of ironic quality.â€Å" ‘See, here’s the workbox, little wife, that I made of polished oak.’ He was joiner, of village life, She came from borough folk† Throughout the rest of the poem we learn details about the source of the materials and the wife’s past life which reveal the nature of the relationship through the real intentions of the husband and his wifes silence. Throughout the poem, irony intertwines in the theme to show that a gift from a loved one can be an act that is

Report of the Field Week at Wiston Coursework Example | Topics and Well Written Essays - 5250 words

Report of the Field Week at Wiston - Coursework Example Surveys are very important while carrying out all types of construction and land planning. The various applications of surveys include the plotting of a land and marking of boundaries for planning and ownership purposes, the correct orientation of the building, the leveling of an unduly ground surface, for setting out gradient of a road or field, for marking the center line of the roads, railways and transmission lines, for setting out horizontal as well as vertical curves for various purpose etc. So surveying can be deemed of as the very first step of any type of construction work and it also defines the accuracy of the construction (Schofield and Breach, 2007). Incorrect surveys lead to various complications during the construction because the project drawings are made according to the surveys carried out. Moreover surveys are also very important in the economics of a project because the estimates of a project are based on the drawings prepared through surveying. The various differ ent branches and disciplines of science on which surveying is based include trigonometry, geometry, physics and mathematics (Ghilani and Wolf, 2008). With the technological advancements in all other fields of science, surveying has also been developed and various new surveying instruments have been developed which provide high level of accuracy in work. There are various surveying techniques which have been classified on the basis of the type of land where they can be adopted and also on the basis of the objective of survey. This report elaborates the various tasks carried out during surveying work at Wiston and also explains the use of various instruments which were used for carrying out the various tasks. The major tasks carried out at Wiston provided an idea about the basics of surveys and the use of surveying instruments like theodolite and auto level. The various techniques which were studied and practiced include traversing, which is one the very basic techniques of surveying and involves the measurement of the distances and angles between various points on a close traverse. The setting out of a curve using chords and offsets was also studied and practiced. Chapter 2: Theodolites and Levels The instruments used during the surveying included Theodolites and Levels. The functioning, use and applications of these two instruments is described in this chapter. Theodolite Theodolite is one of the most widely used instruments in land surveying because of

Fast food restaurant Essay Example for Free

Fast food restaurant Essay Introduction Fast food is very common in Hong Kong. We can find at least one fast-food restaurant nearby. McDonald, KFC, Burger King, Triple O’s, Cafe de Carol can be found everywhere in Hong Kong. Fast food means that the food can be prepared and served very quickly. It can save us time and is convenient. [pic][pic][pic] The aim of this report is to investigate fast food culture in Hong Kong nowadays. Firstly, trend of fast food culture in Hong Kong would be given in order to get further understanding of fast food. Secondly, negative impacts of fast food would be discussed. Thirdly, despite the fact that Hong Kong people are more aware of their health, fast food restaurants have emerged. Lastly, comparison between fast food shops and fast-service shops would be mentioned to find out how these two types of shops affect customers’ choice of catering. Mr. Victor Chan, the Managing Director of the Triple O’s, Hong Kong franchise, was interviewed to find out the answer. Current situation [pic]Fig. 1 Top 10 Global Markets for weekly Fast Food. According to the survey from ACNielsen (Refer to figure1), Hong Kong has the highest percentage of eating fast food in the world, with 61 per cent of people eating fast food at least once a week. The survey was conducted in October 2004 over the internet in 28 countries and regions across the Asia-Pacific, Europe and the US. It showed that more and more people are obsessed with fast food. Nine per cent of Hong Kong people visited fast-food restaurants at least once a day; 86 per cent of people visited at least twice a month. In the first nine months of this 2004, Hong Kong people visited fast-food restaurants on average seven times a month and spent $ 160. The survey revealed fast food has become a part of Hong Kong people’s lives. Hong Kong people are in fast pace of life. People have less time to eat and are busy to work. It makes fast food become more and more popular because it is convenient and comfortable. It replaces the position of traditional restaurants and these fast food shops have dominated our society gradually. Negative impacts of traditional fast food There are thousands of fast food shops in Hong Kong. They have totally changed eating habit and daily life of Hong Kong people. Albeit fast food is delicious and tasty, it brings several health problems. Fast food contains lots of fats and high calories. For example, McDonald’s provides a Big Mac, large fries and a large Coca-Cola drink which have 1430 calories. In fact, 2000 calories is the maximum amount a person needs in each day. Big Macs in Hong Kong contains more fat and cholesterol than those in the world. According to nutritional information on the companys website, each Hong Kong burger weighed 560 calories but 80 calories is more than Australia, 67 calories more than Britain and 60 calories more than the Middle East. Obviously, fast food leads to obesity and diabetes, and increases the risk of heart disease and high blood pressure. Apparently, fast food contains high calories and lack in nutrition. Fast food is not proper meal that people can eat every day. Besides this, facing the influence of mass media and the trend in Hong Kong, slim body figures are encouraged. Therefore, Hong Kong people realize the importance of health. They are willing to eat healthy food with low calories and fats. In order to meet the demand of healthy and higher nutritional food from Hong Kong people, fast food shops start to provide healthy food to customers. For example, McDonald’s try to give more choice to customers by providing healthier food, likes fresh salad and low fat yogurt. Fast food culture in Hong Kong has changed. Emergence of Fast-service food shops in Hong Kong Interview with Triple O’s – White Spot Because of the rise in living standard and change in eating habits of Hong Kong customers, traditional fast food shops, such as McDonald’s and KFC, can no longer meet the demands of customers. The emergence of a brand new type of catering choice – fast-service food shops, introduces a new dining experience to Hong Kong customers, thus, bringing a positive and striking impact to the catering industry. One of the most successful fast-service food shops in Hong Kong is Triple O’s – White Spot, which was founded in Vancouver, British Columbia in 1928, best known for its hamburgers In 2003, Triple O’s expanded its business to Hong Kong, setting up the first shop in the Great food hall in the basement of Pacific Place, Admiralty. Until 2010, there are already 5 Triple O’s established throughout Hong Kong, in which the franchises each record more than twice as many sales as the average location in BC. In order to know more about fast-service food shops, an interview has been conducted with the managing director of the Triple O’s, Hong Kong franchise, Mr. Victor Chan. [pic] [pic] Triple O’s – White Spot aims to provide high quality, home-made and healthy fast food and family-friendly services to create a new kind of dining experience to customers. According to Mr. Chan, Triple O’s’ in Hong Kong have to follow strictly the menu and ingredients set by the Canadian headquarters to ensure its high food quality. For instance, unlike traditional fast food shops that only focus in lowering their production cost, Triple O’s’ milkshakes are made of fresh milk and premium ice-cream. Burger beef is from Australia, delivered fresh to Triple O’s in Hong Kong, not frozen. Mr. Chan added that Triple O’s’ menu will not change in order to suit the appetite of Hong Kong customers, therefore resulting in a limited choices of food in their menu compared to other fast food shops. In order to provide freshly made burgers, it usually takes up to 5 to complete a whole meal set. That is why customer-friendly service is provided in Triple O’s. Instead of ‘self-help’ service in traditional fast food shops, waiters will deliver meals to customers in person, offering customers efficient dining services. Besides that, because of the insistence of high quality ingredients, price of food is again higher than that of fast food shops. Yet, it does not affect customer’s choice of catering since they are now enjoying a higher living standard, willing to spend more for the return of good food and nice service. Triple O’s’ success is also a result of change in eating habits and perceptions of Hong Kong customers. The idea of ‘thin is in’ is widely spread by the mass media, people are getting more conscious about their physique and health, leading to the rise of a new kind of eating habit – healthy eating. Believing that traditional fast food shops’ only provision of deep-fried food, customers tend to look for healthy, yet, delicious fast food for substitution. Triple O’s hit the exact demand of customers. ‘Food in Triple O’s is generally low in fat and that no preservatives and artificial flavours are added in. Vegetarian burgers and lots of vegetables are included in every meal set in order for customers to achieve a balance diet,’ said Mr. Chan, ‘healthy cooking methods are also used, such as roasting and grilling of burger beef and chicken stripes with refined olive oil rather than deep-frying. Fries with potato skins are again intended to provide dietary fibre for better digestion of customers. † Customers are free to choose according to their personal preference, having a custom-made burger in any way they want, like whether to add in any dressing in their burgers. Another special feature of Triple O’s is that there is no advertisement about it at all. â€Å"We rather spend our money in purchasing high quality ingredients than wasting them on advertising. We believe that with our food and service, reputation can be build up in no time. Once again, we prove ourselves right! † said Mr. Chan. Marketing is clearly not the major concern of Triple O’s. â€Å"From the fast food shops’ point of view, we (fast-service food shops) have become a huge competitor to the traditional fast-service shops. Like McDonald’s, they are, in fact, following our way in preparing food and provision of service. However, since there is vast difference between us and traditional fast food shops, we don’t treat them as a direct competitor. Our aim is not only to provide fast food to customers, but a new dining experience, which makes us unique in the catering industry. † Mr. Chan concluded by the end of the interview. Comparison between Fast food shops and Fast-service food shops Fast food shops have always been one of the dominating choices of catering. Yet, in recent years, there are a definite increasing number of fast-service food shops in Hong Kong, which result in an intense competition between the two. In the following table, we use the example of McDonald’s (fast food shops) and Triple O’s (fast-service food shops) to show the major differences between fast food shops and fast-service food shops, which affect customers’ choice of catering. [pic] [pic] |Differences |Fast food shops (McDonald’s) |Fast-service food shops (Triple O’s) | |Quality of food |Low |High | |Ingredients used |Use of low quality ingredients to cut off production cost| Strictly follow the Canadian headquarters’ use of high | | |e. g. |quality ingredients e. g. | ||milkshakes – milk, water, and milk |milkshakes – fresh milk and premium | | |powder |ice-cream | | |burger meat – organ meat mixed with |Burger meat – Australian imported, | | |bread crumbs and onion |pure beef | |Method of cooking |Deep-frying |Grilling and Roasting | |Health consciousness |Less |More | | |- lack of vegetables and fruits in the menu |- inclusion of vegetarian food choices | | |- unhealthy cooking method used |- healthier cooking methods used | | Flexibility of ordered food |Standardized food |Immediate, Custom-made e.g. | | |- Burgers are pre-made for purchase, which follow a |- Customers may add in more vegetables in their burgers or | | |uniform standard. |choose not to add any dressings at all. | |Food choices |Wide variety |Limited as it must follow the menu of their headquarters in | | |- Burgers, fries, ice-cream, different types of |Canada | | |fried-food, soft drinks, pies†¦ |- burgers, fries, onion rings, chicken stripes, milkshakes | |Characteristics |Fast, convenient | High quality of food, | | | |brand new type of dining experience | |No.of shops in HK |More |Less | |Cost |Low |High due to the high quality of ingredients used | |Services |Less |More | | |- provides only ordering services in the cashier |- provides not only ordering and packing up services, but | | | |also delivery of meals to customers like restaurants | |Advertisements |More |None | | |- wide coverage via the mass media (e. g. TV ads, the |- building up reputation by customers’ word of mouth | | |Internet, newspaper) |- money used in quality ingredients rather than in | | | |advertisements | From the above comparison, we can see that fast-service food shops introduces a brand new kind of catering experience to Hong Kong by providing high quality of food and efficient, customer-friendly services. As customers are being more health conscious, fast-service food shops seem to have hit the market, drawing enormous attention from customers of other types of catering choices, especially those of fast-food shops. Customers also enjoyed the idea of ‘immediate and custom-made’. Customers are able to order in according with their preferences. Burgers are freshly made with A-grade ingredients immediately upon order, which freshness of food can be completely guaranteed. Together with the efficient and friendly service provided, fast-service food shops seem to fulfill and satisfy the demands of picky customers. The success of a few fast-service shops in Hong Kong is inevitably bringing in a competitor to traditional fast-food shops. Conclusion In the past two decades, Hong Kong has inevitably been an international city under the great influence of fast food culture. As the only demand for food is efficiency, the mere provision of fast and convenient food could already satisfy the demands of most customers. Yet, with the improvement in economic level, living standard and change in eating habits of customers, fast food shop could no longer provide them with what they want. Customers are more willing to enjoy quality and healthy food and nice service when dining, thereby, leading to the introduction of fast-service food shops to Hong Kong. Fast-service food shops bring in huge impacts and brand new ideas to the fast food world. Not only efficiency, quality of food, provision of service and health consciousness should be brought into considerations in order to fulfill the demands of customers. The emergence of fast-service food shops provides a new choice of catering for customers, which leads to intense competition between fast food shops and them. Competition between the two definitely brings positive impacts to the catering industry. Traditional fast food shops seem to realize their shortcomings and need of change, now even McDonald’s follow the way of fast-service food shops by providing immediate-made burgers instead of pre-made ones. Because of the vast difference between fast food shops and fast-service food shops, it is difficult to determine at this stage that which one of them can dominate the fast food industry. The only thing for sure is that customers are, always and forever, the winner in this match, having to enjoy the great food! Reference OWikipedia OOfficial homepage of Triple Os Hong Kong OSouth China Morning Post OHong Kong Yahoo OACNielsen OHKUSPACE [pic] [pic] [pic] Vocabulary Sheet – Fast Food Culture |Word (parts of speech) |Meaning | |Dietician (n) |a person who is an expert in nutrition or dietetics | |Fast-food addict (n) |a person who is addicted to fast-food | |Americanization (n) |assimilate to the customs and institutions of the U. S. | |Delicacies (n) |something delightful or pleasing, esp. a choice food considered | | |with regard to its rarity, costliness | |Sedentary (adj) |characterized by or requiring a sitting posture | |Coronary (adj) |of or pertaining to the human heart, with respect to health | |Superficial (adj) |shallow; not profound or thorough | |Standardize (v) |to bring to or make of an established standard size, weight, | | |quality, strength | |Unpalatable (adj) |not palatable; unpleasant to the taste | |Franchise (n) |the right or license granted by a company to an individual or group| | |to market its products or services in a specific territory | |Variant (adj) |tending to change or alter; exhibiting variety or diversity | | Proliferate (v) |to increase in number or spread rapidly and often excessively | |prominent (adj) |standing out so as to be seen easily; conspicuous; particularly | | |noticeable | |Prevalent (n) |widespread; of wide extent or occurrence; in general use or | | |acceptance | |Ubiquity (n) |the state or capacity of being everywhere, esp. at the same time | |Detrimental (adj) |causing detriment; damaging; harmful | |Umpteen (adj) |innumerable; many | |Flavor-enhancing (adj) |enhancing the flavor of food | |Paramount (adj) |chief in importance or impact; supreme; preeminent | |Consumer-friendliness (n) |products of non-harmful elements to consumers |

Design Liability under National Engineering Contract (NEC)

Design Liability under National Engineering Contract (NEC) Design Liability under NEC Problem Every construction or engineering project is generally designed and occasionally defects occur as a result of defective design. These defects if possible then have to be rectified and this has associated costs. Where interested parties cannot agree on which of them is responsible for the defect they often seek a legal remedy to allocate costs. To avoid this legal entanglement the majority of construction projects are carried out under the relative control of a contract that identifies the party that is responsible for the design. The degree of liability depends on how the design responsibility has been allocated under the contract. However, the complicated interaction of various legal elements with contractual provisions can consequently make this difficult to determine. For practical use a contract should allow for the incorporation of clear acceptable levels of liability to both parties. Research by Gaafar and Perry (1998) suggests using a contract that allows for a spectrum of liability such as the NEC/ECC. This allows the level of responsibility to be tailored to the individual project by the inclusion of secondary clauses. Another consideration that must be investigated is that even if the design responsibility is not allocated under the contract, or no written contract exists, a level of responsibility under tort almost always exists. This responsibility is often forgotten and is rarely referenced in the contracts text. The level of design liability differs depending on what type of organisation the designer works for. For example, the level of design liability is the same in tort for a consultancys designer and a contractors designer, however, under a contract the level of liability may be different. In tort, the nature of the designers obligation is to exercise reasonable skill and care irrespective of the designers organisation. In contract, a consultancys designers liability is to exercise reasonable skill and care unless they know the purpose for which they are designing in which case a fitness for purpose liability is implied. Because of this risk of suffering an implied liability terms of engagement for a consultancys designer usually contract out fitness for purpose requirement. This is useful as no level of Professional Indemnity insurance exists to cover a consultancys designer for fitness for purpose liability and it is unlikely the consultancy would be able to independently cover the ris k. Even if a fitness for purpose liability is excluded, a consultancys designer could still be liable for not delivering the end result, if it can be proved that they did not use reasonable skill and care and has ultimately committed professional negligence under tort as well as being in breach of contract. As the tort of negligence is implied into both written and none written contracts, wherever a situation arises where one party owes another a duty of care, it is essential to look at its meaning. The Institution of Civil Engineers (2006) defines negligence as being based on the inflicting of injury or loss upon another person by failure to take such care as the law requires. A contractors designer suffers risk by reference to the statutory implied terms, under the Sales of Goods Act 1972 and the Supply of Goods and Services Act 1982, which will impose certain contractual warranties relating to merchantable quality and fitness for purpose, irrespective of what the contract says. The statutory implied terms give rise to risk for the designers contractor in that a contract which is silent on the point will impose on him a strict liability for all the obligations he has undertaken, including his design obligation. It is also worth noting that because of this, if a contractor chooses to appoint a consultancy designer under a subcontract, even if he is using the relevant standard subcontract form of the main contract, they may open themselves up to considerable risk. This is because they still have an obligation to deliver the end result that is fit for purpose, unless there are express provisions to limit liability. This why most Design and Build standard for m contracts limit the liability of the contractor for design to that of an architect under a traditional build contract. However, if there are express provisions in the contract to impose an explicit fitness for purpose liability on the contractor these provisions will then be subject to the Unfair Contract Terms Act 1977. As already stated, there are two levels of design reasonable skill and care and fitness for purpose. These two terms are the most commonly used and even though they are an over simplification it is important to define them in more detail. Fitness for purpose is just that, it should satisfy and/or deliver the clients requirements whereas reasonable skill and care can be further split into professional skill and duty of care. As well as carrying out their specialist skill competently the construction professionals have to exercise a defined level of care. This duty of care is based on foreseeability, where one must take reasonable care to avoid acts, omissions or statements, which could reasonably be foreseen to be likely to result in injury or loss to other people. The standard of care to be exercised is that of the ordinary, prudent person and will depend on the particular circumstances of each individual case. In the context of this proposal it would be the construction professionals, working for the contractor who must exercise due care to highlight errors when reading and implementing the clients design, or the contractors own designer who must exercise due care when creating and developing a design (Institution of Civil Engineers, 2006). The element of skill required by a construction professional, whether they are an engineer, designer, quantity surveyor or project manager is to carry out their own specialist skill competently. The courts have defined the specialist skill and competence on many occasions and the following direction to the jury in Bolam v Friern Hospital Management Committee [1957], has been adopted by the House of Lords and is frequently cited:- Where you get a situation which involves some special skill or competence the test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill it is sufficient if he exercises the ordinary skill of the ordinary competent man exercising that particular art (Institution of Civil Engineers, 2006). As previous research by Gaafar and Perry (1998) suggests, the NEC/ECC contract is an acceptable document that can be tailored to individual projects and remain workable and acceptable to both client and contractor. These advantages could explain why it has rapidly become the contract of choice for public sector work. Due to the economic situation that exists in the construction and engineering industry at present the majority of work is in the public sector and as a result is under NEC3 the most recent version of NEC/ECC form of contract. According to the Bank of England the current economic situation is going to continue for at least the next 6 months before signs of recovery start to filter through to the construction industry in the form of private investment. Because of this, more disagreements over design defects carried out under the NEC3 form of contract are probably going to go before the courts. It would be useful then for contractors construction professionals to know what design liabilities the contractor could be exposed to so that they can take steps to avoid any legal entanglement. This is especially prudent as the NEC3 contract does not include the term fitness for purpose in its text and instead relies on the works information given by the client to specify the performance requirements and secondary clauses to limit a contractors liability. When this information is incomplete or missing it creates a situation where the responsibilities and the end requirements are unclear and the contract reverts back to a silent position as discussed earlier and imposes a strict liability upon the contractor, unless secondary clauses to expressly limit liability are included within the contract document. Even where these clauses are included contractual warranties implied by the Sales of Goods Act 1972 and the Supply of Goods and Services Act 1982 may take precedence. It is important to note that in this silent position a contractor would not be liable for desi gn works carried out by subcontractors even if appointed by them under the relevant NEC3 subcontract form. The aim of the dissertation then, is to carry out primary and secondary research to determine whether, and if so, how, a contractors design liability can be limited to reasonable skill and care under the NEC3 suite of contracts. Your problem specification specifies the problem alright, but it does not indicate what can be done to resolve the problem or what issues need to be addressed in resolving this problem. These issues would form the basis of the ensuing chapters of the dissertation. There is a decided lack (although not a total absence) of appropriate citation to substantiate your many authoritative statements in the problem spec. Literature Review Current literature on the National Engineering Contract 3 (NEC3) includes legal cases, commentary or how to use guides and finally but not exhaustively research by construction and engineering academics and/or professionals. This literature individually covers the different aspects of design liability and the NEC3. Need to make more substantial to provide a structured overview. The NEC3 is endorsed and recommended by the UK Governmental Office of Government Commerce for use on all public sector construction projects. And because the majority of current construction and engineering work is in the public sector at present it is getting a lot of use and therefore it is important that those using it fully understand it. To that end Eggleston (2006) has written a comprehensive commentary on the NEC3. His commentary explains how each NEC3 contract is uniquely put together to meet the employers needs by assembling clauses from the option structure and by particularisation in accompanying documents. This commentary is particularly useful in that it helps the reader use the contract by providing step by step instructions to ensure the basic building blocks of the contract are set up correctly. A good example of this is the five steps that an employer must follow in order to create a set of NEC3 conditions for a particular contract. Egglestons (2006) commentary is an overview of the entire suite of NEC3 contract documents and gives a brief definition of the clauses. It does not give instruction of which combination of options and clauses to use but instead informs the user how to incorporate their chosen selection into a working document. On the down side the book does not give you enough legal analysis and only refers to a handful of cases and to this end does not highlight sufficiently what the repercussions of not getting it right are. This means unless the professional using it is fully versed or doesnt follow a commentary such as Egglestons to the letter they could end up in hot water regardless of what secondary clauses they think are in place to limit liability. Using Egglestons (2006) definitions of clauses and with cross reference to an NEC3 contract it is apparent that it is the secondary options X15 limitation of contractors liability for design and X18 limitation of liability are the most relevant to this proposal. This is because they are the clauses that can be included if agreed between the client and contractor to pre-determine the level of liability. Need to insert what Eggleston says Difference between two clauses and what they limitContradiction with works information Express catch all sentences added under Option Z or included in works info Egglestons thoughts on silent position Gaafar and Perry (1998) have written an insightful paper that is relevant to the proposed aim of this proposal. They based some of their findings on communication with an unnamed author involved in the development of the NEC. From this they discovered that these optional clauses came about due to legal advice that was given to avoid the term fitness for purpose and to the eventual adoption of the notion that the employer would either define the extent of his requirements for performance through the works information or would limit the liability through the choice of an optional clause. The term fit for purpose is very open to interpretation and could be a reason why it was left for the employer to fully define their requirements. Gaafar and Perry (1998) were unable to find a precise definition for the term fitness for purpose and concluded from comparing correspondence and discussion with unnamed legal academics and professionals that no such definition exists. This is hard to accept as regardless how many legal academics and professionals were contacted it is precedence set in the courts that establishes a meaning for the term not the legal academics and professionals opinion. It may be the case that these legal academics and professionals are unaware of any relevant case law and it is unlikely that they exhausted all published volumes. In addition Gaafar and Perry (1998) may have narrowed the question posed to the legal academics and professionals too much and a definition may exist in a non construction and engineering context that could be applied if the princi ples are the same. In addition to correspondence and discussion Gaafar and Perry (1998) also carried out a survey to determine the desirability to be able to adjust the level of liability. They highlight that 30% of clients questioned in the survey said that a fitness for purpose liability is not desirable as they recognise the practical and commercial problems it can cause. Gaafar and Perry (1998) expand on the description of these problems reiterating that professional designers do not have to carry a professional liability higher than reasonable skill and care and therefore no higher level of insurance cover exists. This means that the contractor can not obtain cover either and because of this if a fitness for purpose obligation exists and the design is carried out by a professional designer under a subcontract, the contractor can not pass this liability down to them. This leaves the contractor carrying a large uninsured risk. This unexpected result in their findings gives strong support to their re commendation of using a contract that allows liability to be tailored to an individual contractual situation. The theory and supporting research is comprehensive, however, the raw data is not given and it undermines their reasoning, as it is impossible to determine the significance of the results without knowing the sample size, methods used, the context and appropriateness of the questions. Gaafar and Perry (1998) was published in the International Journal of Project Management and looks at a number of problems associated with the interaction of legal elements and contractual provisions. They look at, but do not directly compare, a number of standard forms of contract and their individual advantages and disadvantages when the limitation of design liability is the key issue. The paper concludes by recommending the use of the NEC contract as they suggest it provides a spectrum of liability. Despite their suggestion of using a contract that allows a spectrum of liability they importantly acknowledge that a strict liability and obligations under the Sales of Goods Act 1972 and the Supply of Goods and Services Act 1982 exists and is difficult to sign away. This difficulty in signing away rights is also made reference to when they discuss liability under tort and the inclusion of express clauses to limit liability. These important points included by Gaafar and Perry (1998) are relevant to this proposal as they have a bearing on how effectively liability can be limited. Professor J. Perry and Dr H. K. Gaafar are academics at the School of Civil Engineering, the University of Birmingham and for this reason their assumptions on NEC3 in practice are likely to be based on 3rd part information and not their own practical experience within the construction and engineering environment. It is also worth noting that The Housing Grants, Construction and Regeneration Act 1996 (HGCRA) states that parties cannot sign away certain rights under UK law and current precedence will determine what obligations exist regardless of whether a clause was included to limit liability. The HGCRA forms the basis of the current UK law and as such must be treated seriously and acknowledged as the presiding authority on set aspects of construction projects. It is also important to note that the HGCRA is 13 years old and largely based on the report by Latham (1994), as such developments have happened in the way contracts are worded to either incorporate it or find ways around it. Egan (1998) suggests that a move to partnering and mutual cooperation will do away with a need for contracts. In this situation a strict liability will be implied by current UK law and legislation and as discussed a fit for purpose obligation will be the default situation. If clauses intended to limit design liability are not effective then Eagans (1998) view that; designers should work in close collaboration with other participants in the project will protect the contractors and reduce the risk as they will be fully aware of the requirements and ultimately able to deliver the end product that is fit for purpose. This work by Egan (1998) is a very theoretical academic view and 11 years on has not fully been adopted despite moves to create more trust through partnering, however, it does provide an alternative view to the confrontational and aggressive stand many contractors and clients are adopting in the economic down turn. Wallace (1995) states his opinion that the obligation to construct a work capable of carrying out its intended use overrides the obligations to comply with specification given in the works information. If this is the case even though a contractor may have produced a design that complied with all the works information, if the end result is not fit for purpose they are then responsible. This goes back to the implied obligation discussed earlier and responsibility of the contractor to request more information and highlight lack of clarity in the works information. They may have done everything including reasonable skill and care to produce a design that complies with the works information but if the works information was inadequate they were liable for not correcting this fault and therefore liable for not producing a design that could deliver. Wallace (1995) published this work a year after Latham (1994) and in a climate where a more progressive approach to construction was the new way of thinking, however, it ignores this work and focuses on fact and the law as it stood at the time. This is not a bad thing but when applying Wallaces work to contracts such as the NEC3 it does not always directly apply and extrapolation of the legal principles is necessary, however most are still the same and the book is still widely accepted and used. Jackson and Powel (1992) conclude that the particular obligations of a contractor to his client are generally of a different nature from those owed by a professional man to his client. They make the point that this does not expressly state that the contractors obligations amount to a fitness for purpose requirement. However they imply in the passage, my complaint against him is not that he has failed to exercise reasonable skill and care in carrying out the work but that he has failed to supply what was contracted for, that a higher level of liability than reasonable skill and care exists and that the precise level of liability is governed by what is stated in the totality of the contract. Jackson and Powel (1992) is considered to be an accepted legal text and the authors experts in their field. This opinion is supported by the fact that the book has been quoted in the courts. A good example being; Lady Justice Butler-Sloss in the Court of Appeal regarding the case of Sansom and Mona ghan v. Metcalf Hambleton Co (1997) (Was it a construction law case? Was the case to do with design liability?) EGCS 185 who quoted the book as being a helpful summary. This use in 1997 is important as it is post HGCRA and although it is 17 years old has many useful interpretations that are still relevant. For example, the concept mentioned above regarding totality of the contract is very similar to the commentary detailed in Eggleston (2006) 14 years later regarding liabilities imposed by the entire contract. In relevance to this proposal then, if the book and the authors are deemed to be an authority on the subject of negligence their implications above regarding totality of the contract carry significant weight. This would suggest that secondary clauses under NEC3 are not necessarily going to limit a contractors liability to reasonable skill and care. In addition to the above works, NEC itself provides literature in both on its website and in published form, and despite the inherent bias it may carries is worth reviewing. The bias is there because the NEC has an invested interested in portraying the NEC3 in a positive light to increase sales, however, it is useful for reference to clarify technical points and attain original copies of contract wording. What is clear is that each of these commentaries focuses on a particular area of a contract or takes a view from one particular party and at present there is nothing comprehensive to show all the interrelationships of NEC3 contractual clauses and UK law and legislation. As a result unless the employer compiling the contract or contractor entering into an NEC3 contract fully understands the full ramifications of the options and clauses chosen they should seek professional legal advice. As described by Gaafar and Perry (1998) these interrelationships are very complicated especially to the non legal professional. Gaafar and Perry (1998) try to bypass the need to understand all these complicated interrelationships by developing and suggesting the use of a Spectrum of Liability, however, as acknowledged by them no contract currently exists that fully allows for this. As stressed by Latham (1996) though and indeed acknowledged by Gaafar and Perry (1998) there are certain obligations and im plied responsibilities that cannot be signed away and a strict liability is imposed unless express clauses are used to support this flexible spectrum. Only the NEC3 contract comes close, however, the effectiveness of secondary clauses to control levels of liability is difficult to determine due to the complex legal interrelationships mentioned above. To establish whether liability can be controlled in an NEC3 contract this dissertation will use arguably the main aspect that has most bearing design liability and seek to demonstrate the following conjecture: A contractors design liability can be limited to reasonable skill and care under NEC3 by use of secondary clauses. Can expand to 2500 or 3000 words In final submission should include a statement in the summary to the literature review as to where the dissertation sits in relation to the main authors outlined in the introduction to the literature review. Methodology To manage the presentation of this dissertation it has been split into a number of chapters. The overall dissertation will form a piece of work that can be useful to all construction and engineering professionals who are considering entering into an NEC3 form of contract. Chapter 1 will be derived from the problem specification, literature review and methodology that form this dissertation proposal. Chapter 2 involves carrying out extensive secondary research. This will take the form of investigation into legal precedence that exists for cases with relevance to a contractors design responsibility and associated liability under NEC3. In addition to this, investigation into accepted academic views, professional interpretation of NEC3 clauses and commentary on UK statute and legislation is necessary. Combined this will form a theoretical perfect world view of design liability and act as the control for this research. Chapter 3 will explore construction professionals understanding of design liability under an NEC3 form of contract. To do this a statistically sufficient number of construction professionals will be interviewed. The questions are designed to be comprehensive enough to generate the desired responses but have been deliberately left open ended to ensure they do not lead the interviewees in a certain direction or stifle responses. The benefit of this is that a greater insight into the interviewees experience and knowledge is gained and helps determine how much weight to assign the responses. The results will then be summarised and initial statistical processing carried out to allow them to be analysed. The open ended nature of the interview questions also gives the opportunity for contractors problems that are not covered by the interview questions to be picked up and acknowledged and be compiled into the summary conclusions. Chapter 4 will seek to substantiate or disprove the conjecture made in Chapter 1 by comparing the differences between the control in Chapter 2 and the summary conclusions made from the interview results in Chapter 3. Depending on the outcome of this comparison will determine the recommendations made in this dissertation that aim to benefit construction professionals thinking of entering into an NEC3 form of contract. Chapter 5, the final chapter seeks to bring together all the conclusions made in the above chapters into a final summary. The outcome of the comparison in Chapter 4 should identify how effective the NEC3 form of contracts intentions are in regards creating a contract that is able to limit design liability by the inclusion of secondary clauses or whether other factors come into play and greater care and legal advice is needed before a contractor signs up to an NEC3 form of contract. The comparison will also determine whether any of the additional problems or negative experiences identified by the construction professionals in the interviews is real or merely perceived due to lack of understanding of UK law and of the NEC3 contract in general. If they are merely perceived, the recommendations made in this work should allow them more confidence when deciding whether or not to sign up to a given NEC3 contract. They would then be able to make an informed decision as to whether an included clauses attempt to limit liability under NEC3 would safeguard them or whether they would be exposed and need to adjust their price to suit the increased risk of what is effectively an imposed fit for purpose design liability. Need to justify research method. This justification is done by reference to established research methods authors. You make only one reference to Blaxter et al but it does not really get to the bottom of what you are doing and why. You do not eliminate other methodologies. Do other authors agree? A good methodology will compare the recommendations of three or four research methods texts. You might like to look at some of the following: 1) Dissertation Research and Writing for Construction Students Dr S.G. Naoum Butterworth Heinneman 808.066624 NAO 2) Research Methods in Construction Fellows Lui 3) Hart, C. 2005, Doing Your Masters Dissertation, SAGE Publications Ltd., London 4) Preece, R. 1994, Starting Research: An Introduction to Academic Research and Dissertation Writing, A Cassell Imprint, London 5) Blaxter, Hughes Tight 2006, How to Research, Open University 6) Questionnaire Design, Interview and Attitude Measurement A.N.Oppenheim Continuum 300.723 OPP The methodology should be introduced by a statement about the theoretical perspectives being employed, e.g. you are approaching this dissertation from a legal and contractual perspective by way of offering appropriate practical advice to the industry Need to justify structure. Justification for the structure requires cerebral argument and includes some linking text between your discussion on the content and format of each chapter. Remember the chapters should be based on the issues to be addressed as identified in the problem specification, so your justification of the structure could be based upon the logic of dealing with those issues. References Blaxter, L., Hughes, C. and Tight, M. (2006). How to Research 3rd Ed. Open University Press. Maidenhead. Eagan (1998). Rethinking Construction. Department of the Environment, Transport and the Regions. London. Eggleston, B. (2006). The NEC3 Engineering and Construction Contract 2nd Ed. A Commentary. Blackwell Publishing. [Online] Available from: http://books.google.co.uk/books Accessed 07.07.09 Gaafar, H, K. and Perry, J, G. (1998). Limitation of design liability for contractors. International Journal of Project Management Vol. 17, No. 5, pp. 301-308. Elsevier Science Ltd. Institution of Civil Engineers (2006). ICE Legal Note Liability for Latent Defects. Institution of Civil Engineers. London. Jackson and Powell (1992). Professional Negligence 3rd Ed. Sweet and Maxwell. London. Latham (1996). Housing Grants and Regeneration Act 1996. London. Available from: http://www.opsi.gov.uk/ Accessed 22.08.09 Murdoch, J. and Hughes, W. (2005). Construction Contracts 3rd Ed. Law and Management. Spon Press. Oxon. Wallace, D. (1995). Hudsons Building and Engineering Contracts, Volume 1, 11th Ed. Sweet and Maxwell. London. Uff, J. (2005). Construction Law 9th Ed. Sweet and Maxwell. London. Bibliography Blaxter, L., Hughes, C. and Tight, M. (2006). How to Research 3rd Ed. Open University Press. Maidenhead. Dissertation Creation. Dissertation Help How to Write and Structure a Dissertation Proposal [Online] Available from: http://www.ukdissertations.com Accessed 07.07.09 Eagan (1998). Rethinking Construction. Department of the Environment, Transport and the Regions. London. Eggleston, B. (2006). The NEC3 Engineering and Construction Contract 2nd Ed. A Commentary. Blackwell Publishing. [Online] Available from: http://books.google.co.uk/books Accessed 07.07.09 Gaafar, H, K. and Perry, J, G. (1998). Limitation of design liability for contractors. International Journal of Project Management Vol. 17, No. 5, pp. 301-308. Elsevier Science Ltd. Institution of Civil Engineers (2006). ICE Legal Note Liability for Latent Defects. Institution of Civil Engineers. London. Latham (1996). Housing Grants and Regeneration Act 1996. London. Available from: http://www.opsi.gov.uk/ Accessed 22.08.09 Murdoch, J. and Hughes, W. (2005). Construction Contracts 3rd Ed. Law and Management. Spon Press. Oxon. The Guild of Architectural Ironmongers (2004). Commercial and Contract Law. Uff, J. (2005). Construction Law 9th Ed. Sweet and Maxwell. London. Additional useful paragraphs; If the NEC3 contract is set up for the contractor to have design responsibility, then the contractors design must comply with the works information. Even if the optional clause to limit liability is used, the performance specification given in the works information will override it and therefore the contractors liability may or may not be interpreted as fitness for purpose depending on how the works information has been drafted with a strict liability imposed. Results Ques