Monday, September 30, 2019

Deltoid Intramuscular Injection and Obesity Essay

Deltoid Intramuscular Injection and Obesity Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According the World Health Organizations and Centers for Disease Control and prevention in United States, approximately one –third of adults are considered obese. This has raised the no of intramuscular injections with approximate rate of 16 billion per year. Despite complex skills in administering, IM injections into deltoid muscle for administering the vaccine is best considered. IM injections is injection in which the needle pierces the muscle at least by 5mm, Zayback (2007).This has raised a great concern to the health sector whether the standard needle of 25-38 mm used, is able to deposit the medication to the muscle of obese individual. For the last six years, this has pushed researchers to address the issue of IM needle length in obesity. Further, the research based its findings reached conclusion 1.5 inches needle is the best as opposed to 1-inch needle. Further, it was discovered that there is no commonly accepted method if IM injection for a person with high BMI (Plotkin, 2008). Implication on leadership and management   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The procedure for administering the vaccine by use of IM injections in obese individuals has not been an easy go to the leadership and management of health care in United States. With increased number of patients, the cases of incapability of vaccine causing a reaction(reactogenicity),wrong vaccine injection techniques and incorrect needle length used for IM injection in obese individuals has been of major concern. According to World Health Organization, the concerns have been associated to patient’s discomforts and increased cases of risks. It is therefore imperative to the leadership of medical-surgical nurses find an appropriate solution to the above raised concerns.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Also according to WHO (2009), administration of IM injection has for long been a complex challenge .Perhaps it has been found that the nurses when giving IM injections, use techniques that are little more ritualistic procedure but based on tradition ,which is passed from one nurse to another, generation to another. It is in great concern it has been addressed to the management and the leadership .This is because the skills not only requires dexterity in manipulating needle and syringe, but also knowledge in deciding the appropriate needle, syringe type and appropriate location of the injection ( Coco man & Murray 2008).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Following this, timely reaction from management and leadership of health care in U.S is of great essence. This is because wrong IM injection technique and incorrect needle length can result to complications such, as are muscle fibrosis, abscess, gangrene, nerve injury and contracture. On the other side, unsafe injection technique may result in many of infections, such as HIV (6-8) and hepatitis B and C. According to Cocoman & Murray (2008), Detroid IM injection has resulted to permanent disability and in some cases to legal actions due to inappropriate injection techniques. In additional, this has problems to health care management in imparting proper knowledge to its nurses despite continued iatrogenic complications. Implications of issues for nursing practice   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Based from the questions, concerns, statistics and issues raised, there has been increased awareness to the nurses’ and other health care professionals carry out the appropriate techniques of intramuscular injections, appropriate vaccine and identification of appropriate needle length for injection in obese patients.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Following the effects of injecting vaccine into the subcutaneous tissue, complications such as granulomas and abscesses, injecting the vaccine into the deltoid muscle was more recommended .Further (Walters & Furyk, 2010) describes that although Obese patients still receive the injections into subcutaneous tissue there are more harm. This is because there is slower rate of absorption and medication efficiency can be compromised, resulting to vaccine failure.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In determining the correct needle length, for the past six years the research based on issues of intramuscular needle –length in obesity begun. A research by Zaybak and colleagues (2007) was conducted to measure SCT in ventrogluteal and dorsogluteal sites to determine the optimum injections. In determining the optimum injection for IM injections, Weight was the key factor to the research whereby the BMI for extremely obese was greater than 35, for obese 30-30.5 and for overweight the BIM ranged 25 -29.9 in adults. Following the research, 16mm long needle in adolescents less than 60kg is recommended. It is acceptable for those adults weighing 60-70 kg when using flattened technique or bunch. However, it was agreed 1.5 inches needle to use as standard in Detroid IM injection of vaccine in obese patients. To the question of common method of Detroid IM injection, it was discovered that there is no commonly accepted method of IM injectio n for a person with high BMI. Strengthening of nursing practice   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   From above review, there are many discrepancies in the practice of IM administration. There is because there is no standard method of detroid IM injection and needle length as. This has further created gaps in nursing education as well as the nursing practice (Cook, 2006).There is therefore need to apply the above currently evidence –based research guideline to harmonize the practice and the nursing education in United states. References Cook, I.F., Williamson, M., & Pond, D. (2006).Definition of needle length required for intramuscular deltoid injection in elderlyadults: An ultrasonographic study.Voccine, 24(7), 937-940. Cocoman, A., & Murray, J. (2008). Intramuscularinjections: A review of bestpractice for mental liealtii nurses.Journalof Psychiatric & Mental Health Nursing,/ 5(5), 424-434. Zaybak.A., Gà ¼nes,Y.,Tamsel, S., Khorshid, L, &Eser, I. (2007). Does obesity prevent theneedle from reaching muscle in intramuscular injections? journal ofAdvanced Nursing, 58(6), 552-556 Plotkin, S., Orenstein, W, & Offit, P (2008).Vaccines (5* ed.). Philadelphia: SaundersElsevier. Source document

Sunday, September 29, 2019

Extreme Sports

One of the most Important things that a port or activity must have to be even being considered extreme Is a large amount of danger and In this case, the more the better. Other factors that go hand In hand with extreme danger are extreme levels of speed , outrageous heights and a high level of physical fitness as well as anything else that could be factored Into not normal. Most extreme sports do however have several common characteristics. They're not Just for today's youth and younger generation, but they do tend to draw a younger audience. Ere rarely will you find an extreme sport endorsed, or promoted by any popular porting company like Nikkei for example. Extreme sports and activities are mostly for individuals and unlike traditional sports; the term team doesn't apply or exist. Extreme sport individuals are also different in that they have a will and attitude to take risk and welcome danger and even possible injury. They seem to have a adrenaline drive when the outcome is uncert ain as to what will happen, always going for more speed, more height and bigger tricks under extreme conditions.This unquestionable drive gives these individuals the ability to surpass the limits of where others fear to go and do. They also tend to master their sport of choice alone or in the company of other extreme sporting individuals very rarely seeking coaching or training. Environments also play a large role in making extreme sports extreme. Extreme sports have a much higher certainty of uncontrolled factors than traditional sports.Extreme sports environments are most often in outdoor settings where weather and terrain can't be controlled thus making it more dangerous. The canvas extreme sport individuals use to paint their art on tends to be mountains and oceans. Using such elements like snow, wind and rain to heighten the levels of fisticuff and danger as well as the odds of succeeding. Some people may feel that extreme sports are nothing more than gatherings for the trouble d youths who reject authority and are bored with the â€Å"normal† or traditional sports.This statement may have been true fifteen to twenty years ago, but nothing could be farther from the truth that today's extreme sports and activities are growing ever more popular In the world than the traditional sports of baseball, football and basketball. Extreme Sports By canvasbacks extreme sport or activity is still questionable. One of the most important things that a port or activity must have to be even being considered extreme is a large amount of danger and in this case, the more the better.Other factors that go hand in hand with physical fitness as well as anything else that could be factored into not normal. Most extreme sports do however have several common characteristics. They're not Just for Very rarely will you find an extreme sport endorsed, or promoted by any popular weather and terrain can't be controlled thus making it more dangerous. The canvas truth that today's ex treme sports and activities are growing ever more popular in the Extreme Sports One of the most Important things that a port or activity must have to be even being considered extreme Is a large amount of danger and In this case, the more the better. Other factors that go hand In hand with extreme danger are extreme levels of speed , outrageous heights and a high level of physical fitness as well as anything else that could be factored Into not normal. Most extreme sports do however have several common characteristics. They're not Just for today's youth and younger generation, but they do tend to draw a younger audience. Ere rarely will you find an extreme sport endorsed, or promoted by any popular porting company like Nikkei for example. Extreme sports and activities are mostly for individuals and unlike traditional sports; the term team doesn't apply or exist. Extreme sport individuals are also different in that they have a will and attitude to take risk and welcome danger and even possible injury. They seem to have a adrenaline drive when the outcome is uncert ain as to what will happen, always going for more speed, more height and bigger tricks under extreme conditions.This unquestionable drive gives these individuals the ability to surpass the limits of where others fear to go and do. They also tend to master their sport of choice alone or in the company of other extreme sporting individuals very rarely seeking coaching or training. Environments also play a large role in making extreme sports extreme. Extreme sports have a much higher certainty of uncontrolled factors than traditional sports.Extreme sports environments are most often in outdoor settings where weather and terrain can't be controlled thus making it more dangerous. The canvas extreme sport individuals use to paint their art on tends to be mountains and oceans. Using such elements like snow, wind and rain to heighten the levels of fisticuff and danger as well as the odds of succeeding. Some people may feel that extreme sports are nothing more than gatherings for the trouble d youths who reject authority and are bored with the â€Å"normal† or traditional sports.This statement may have been true fifteen to twenty years ago, but nothing could be farther from the truth that today's extreme sports and activities are growing ever more popular In the world than the traditional sports of baseball, football and basketball. Extreme Sports By canvasbacks extreme sport or activity is still questionable. One of the most important things that a port or activity must have to be even being considered extreme is a large amount of danger and in this case, the more the better.Other factors that go hand in hand with physical fitness as well as anything else that could be factored into not normal. Most extreme sports do however have several common characteristics. They're not Just for Very rarely will you find an extreme sport endorsed, or promoted by any popular weather and terrain can't be controlled thus making it more dangerous. The canvas truth that today's ex treme sports and activities are growing ever more popular in the

Saturday, September 28, 2019

Aortic Grafts

A paper which examines the diagnosis and treatment of an aortic graft to a duodenum fistula as a cause for upper GI bleeding. This paper examines the connection between an aortic graft to a duodenum fistula as a cause for upper GI bleeding. Generally, aortic grafts are used to treat abdominal aortic aneurysms. The paper defines aortic aneurysms as a weak area in the wall of the abdominal aorta, the artery that carries blood from the heart to the rest of the body. The paper concludes that aortic grafting can be a major cause of GI bleeding as an after effect of treating an abdominal aortic aneurysm and a method of treatment requires replacement of the stent-graft. Treatment of abdominal aortic aneurysms may require surgery but for some patients, a new non-surgical treatment called stent-graft repair can be performed. The following is the results of a prospective, nonrandomized, multicenter clinical trial that compared endovascular stent graft exclusion of abdominal aortic aneurysms with open surgical repair. During an 18-month period, 250 patients with infrarenal aneurysms underwent treatment at 12 study sites. 190 patients underwent endovascular repair using the Medtronic AneuRx stent graft (Sunnyvale, California), and 60 underwent open surgical repair. There was no significant difference in operative mortality rates between the groups. The patients who underwent stent grafting had significant reductions in blood loss and days in the intensive care unit and in the hospital, with an earlier return to function. Primary technical success at the time of discharge for the patients with stent grafts was 77%, largely as a result of a 21% endoleak rate. At one month, the endoleak rate had decreased to 9%.

Friday, September 27, 2019

Romanticism and Classical Music Styles Essay Example | Topics and Well Written Essays - 500 words

Romanticism and Classical Music Styles - Essay Example To find out more concerning the music of the two periods, we shall in this essay focus on Haydn’s Symphony No. 40 in F major and Beethoven’s Symphony No. 9 in D major. Symphony No. 40 in F major is composed of almost the same properties as symphony no. 13. This period marked the final time Haydn made use of fugue in his work of symphonies. Important to note also is the tempo mark, andante, which ensured that a passage never rose above the piano. Violoncellos were also being doubled by the violas and the second violins doubling the first, all being directed by Haydn to play ‘sempre staccato†. In a recording by Fischer, he uses both the versions of the trio that includes: bassoon, oboes and horns and the other, horns, oboes and strings. This is because he finds it impossible to figure out the one he liked most. In his original presentation, he uses the horns, oboes and strings and bassoon, oboes and horns in the in his areas of repeat. As for the symphony no. 9 D major, it consisted of a very large orchestra, an alto-tenor-bass solo quartet and a choir. At its beginning, what can be heard is a frightful combination of notes that is very l oud, and equally acknowledges the themes used in previous movements. The section producing the bass sound comes up with music that sounds as if it is being recited.

Thursday, September 26, 2019

Should English be made the official language of the United States Research Paper

Should English be made the official language of the United States Consider Amy Tans article "Mother Tongue" - Research Paper Example English should be made the official language of the United States because a majority of the Americans speak English, this will encourage cultural assimilation and unity in the nation and it is economical to have only one official language. English does need to be made the official language of the United States because a majority of the Americans can and do speak English. English happens to be the most popular and most spoken language in the nation (Bailey 128). If English is not given a predominant status in the United States, it will give way to chaos because most of the people here can only speak English. Besides, not only in America, but English after Mandarin also happens to be the most used and spoken language in the world. The other thing is that the United States is the home to an array of cultures, ethnicities and races. In other words this nation is the land of diversity. In the presence of such rich diversity, it is important that the country does have a unifying factor that unites its entire population hailing from diverse linguistic backgrounds (Mair 170). Thereby declaring English to be the official language of the United States will aid assimilation and unity in the nation. It will encourage the varied people affiliated to diverse cultural and linguistic backgrounds to learn English so that they could become an integral part of this great nation. Yes, it is understandable that one needs to respect and encourage diversity. Yet, it is also important that there exist unifying influences that bring in cohesion amongst diversity and multiculturalism. In that context the English language could act as the unifying factor that could bind the whole nation together. Every year the nation spends millions of dollars translating the public and private documents into varied languages because it does not have an official language and â€Å"trimming the translation budget (Crystal 12)† is a big problem.

Personal reflection Term Paper Example | Topics and Well Written Essays - 2000 words

Personal reflection - Term Paper Example Also, the manager is expected to provide expert support to high profile or difficult customers through analyzing the root-cause of specific problems and offering viable corrective planning direction in the service delivery process. As an effective Service delivery manager, I will build strong relationships with customers and maintaining service improvement plans, as noted in literature (Collier 1998). Short term and long-term goals In order to attain my learning goals and succeed in my preferred future career, there are certain short-term and long-term goals that I will attain. These goals will not only make me a better employee, but will guide me towards advancement throughout my career. My short-term goals have a time frame of one year and include the ability to cultivate effective study skills. According to popular research, in my position, I will need to understand different teaching methods used by lecturers and learn skills such as academic research and revision (Guskey 2003). In the same light, I will need to improve my time management skills within one year in order to finish assignments within the stipulated deadlines. I must improve my grammatical and proofreading skills in order to deliver excellent, error-free essays during my course work. Similarly, I need to gain enough knowledge of service delivery in order to excel at the use of information systems in service management, project management, personal development, research method skills and academic communication knowledge (Guskey 2003). My long-term goal is planned to be accomplished over a period of five years. My long-term goal is to attain my dream career of service delivery manager. In order to attain the goal, I have to dedicate a copious amount of time to learning, revision and research. Through this work, I will complete all course modules and seek internship and training opportunities that will enable me to gain practical knowledge in service and project management. In addition, during my advancement closer to my goal, I will take time to evaluate my progression and productive ways to overcome obstacles that encumber my path. Belbin test analysis Knowledge of my capacity to succeed in my career is imperative to understand and select the most viable role I would occupy on a team. As a result, I have conducted a Belbin test in order to assess my skills inventory. The Belbin test enables individuals to form good working relationships and gain self-awareness on individual effectiveness in the workplace. According to the results of the Belbin test that I took, my highest score, was 14 as a company worker (CW). My Score Worker Type 14 Company Worker 13 Chairman 10 Sharper 10 Resource Investigator 9 Team Worker 5 Monitor-Evaluator 3 Completer-Finisher Figure1. Types of Team Roles – Belbin Test Results As a Sharper (SH), I believe I can use my personality attributes to challenge team members to make improvements to their work (and turn obstacles in to opportunities). As a Completer-finisher (CF), I am concerned about tight deadlines and I will ensure that projects are completed within the stipulated deadlines. However, currently, I have a weakness in managing time and meeting deadlines. As a Team worker (TW), I believe that I will enhance group cohesion and facilitate negotiation with team members in

Wednesday, September 25, 2019

Community Counseling Essay Example | Topics and Well Written Essays - 750 words

Community Counseling - Essay Example An important aspect of modern counseling philosophy is that the clients remain in control of their own treatment program. This is a recognition of the importance of cooperation in the counseling relationship and gives the client a sense of responsibility in there own lives. This freedom of choice for the client increases their stake in the interventions and the outcome. This puts the client in the driver's seat. The counselor does not dictate actions, but merely acts as a facilitator for change. The philosophy of counseling is client oriented, and the role of the counselor is to promote a since of wellness and show a commitment to improving the lives of their clients. The overriding principles that drive the counseling relationship are genuineness, respect, dignity, and client self-worth. This idea is open to all individuals regardless of ethnic, cultural, racial, sexual and special needs. Counseling emphasizes unconditional positive regard, respect, a safe and caring therapeutic relationship, individual strengths, and taking control over choices. Professional organizations set up accrediting agencies to promote, evaluate, audit, and certify institutions and programs that meet professionally recognized criteria. Programs that meet accreditation standards reassure the university faculty and students that they are being taught the skills that are needed to the current industry acceptable standards. This makes it easier for a student that goes through a CACREP program to be recognized as having the necessary skills and knowledge to pass a certification test. One of the benefits of this program is that you know that you would be going through a well-rounded educational experience. Another benefit is that the program is monitored and set up in a way that has a strategic plan that is oriented for the success of the students. Membership in a professional association and credentialing is an excellent method for the profession to remain ethical and well regulated. It is sometimes easy to forget our ethics and fail to act in the best interest of our clients. Personal gain, self-aggrandizement, and lack of ethical education can all contribute to problems of professionalism. While credentials are a necessary part of career advancement and certification, they should not be used as a substitute for competence and caring. In the counseling profession, the law will occasionally come into conflict with the code of ethics. This means that you may have to violate the law to remain true to your own sense of morality. The counselor must be able to justify their ethical decisions and be prepared to suffer any professional or legal consequences that may arise. Community Work Settings Community counselors work in settings that may range from individual sessions, families, groups, and communities. Community counselors can perform many tasks that include vocational, psychological, emotional, prevention, and intervention activities. Community counselors take a role as a community activist to promote positive social change within the society. Community counselors confront issues such as drug and alcohol abuse, domestic violence, and sexual abuse. This may occur in a hospital, community center, or a correctional facility. The value of early intervention has highlighted the importance of counseling moving into the school system. This would be

Tuesday, September 24, 2019

Human Resource of Google Inc Research Paper Example | Topics and Well Written Essays - 2000 words

Human Resource of Google Inc - Research Paper Example Google Inc. is a technology company focused on improving the way people connect with information. Google Inc. was founded in 1998 by two students from Stanford University, Larry Page, and Sergey Brin. They turned Google Inc. into a global technology leader, overruling its international competitors in providing search engines like Yahoo, Gmail, Baidu, and Microsoft. The Organization mission is, â€Å"To organize the world`s information and make it universally accessible and useful†. Several goals have been setup to help in the company`s growth; the company plans to advance infrastructure so as to make their engineers more productive, to be the best search company in the world, to make sure that their tools are running everywhere and to focus on innovation. The company`s culture is entirely made by the people in it. They focus on hiring smart, determined people with experience. However, googlers share acceptable goals and mission for the organization and speak multiple languages, this reflects the kind of audience they serve. The organization strives to maintain an open-culture, but there are establishments associated with this culture, in which everyone is a contributor and there is freedom of opinion, and idea sharing. Researchers have the liberty to directly ask the founders, Larry &Sergey, questions about any company issues. The offices are setup to encourage interaction among the googlers and others. Google`s plan for the environment is to invest in a clean energy corporation, which uses kites to trap wind power., and they plan to invest largely on renewable sources that generate more electricity. Google Inc. operates enormous data centers around the world that uses a great deal of power, their primary concern is to search data fast, which means a lot of energy burns. Google infrastructure sends data from data that answers fast, nevertheless the system minimizes delays that raise energy consumption. If a Google employee dies his/her spouse gets half of his/her salaries for the next 10 years, new policies have been introduced to cater for widowers of Google employees. No administration is required to receive this benefit, and everyone is eligible to receive these benefits, regardless of how long they have worked in Google. Other than the half salary, the spouse receives stock benefits and the children receive $1,000 per month until they turn 19(Love, Business Insider, 2012). These benefits also apply to same sex couples. These benefits show that the Human Resource is concerned, not only about its employee, but also about the employees’ family. Expectant mothers and husbands also have benefits like: 18weeks maternity leave and 6 weeks paternity

Monday, September 23, 2019

Accountability and Outcomes in the Counseling Profession Assignment

Accountability and Outcomes in the Counseling Profession - Assignment Example Most therapy is also not conducted on a quick basis and often takes multiple sessions over a given length of time in order to address the problem. With healthcare reform and the declining economy, many third parties and governmental agencies question whether the counseling they are funding is effective or not. The field of program evaluation aims to attempt to provide a systematic approach to evaluating the methods to determine the efficiency and effectiveness of counseling techniques and strategies. Increasing pressure for efficiency has lead many to question the accountability of therapy techniques used on clients. Is there a way in order to gauge the effectiveness of counselors when they conduct therapy on clients? Many people are interested in a way of showing this effectiveness, but therapists often argue that it is impractical to measure one’s improvement in therapy due to success being really immeasurable (Sexton, 1999). It depends on why the person is coming in for cou nseling. Some are in so that they can get a quick fix to their problems while others continually come in for support; this poses a problem when looking at counseling effectiveness. When looking at counseling programs, we are focusing on the outcomes which can be divided into process objectives and outcome objectives.

Friday, September 20, 2019

Lean Principles in Construction

Lean Principles in Construction Executive Summary Toyota is a name that when seen brings an image of high quality, durability, cost/fuel efficient and best value for money in the car industry. The reason for such a high standard is that Toyota Production System has Pioneered and Implemented Lean Principles in Production system. These principles didnt have the effect immediately in the start but at the last stages, it proved to have a greater worth for it. By implementation of Lean Theories and Philosophy, Toyota had got rid of much wasteful activities using Just In Time approach. The understudy report consists of the Implementation of Lean Principles on a Construction Project which was significantly delayed due to lack of managerial qualities. The Client built a new Head office to shift all the activities from the previous offices in to the new one, but a delay to all activities was observed. It has been analyzed that the construction companies fail to give proper time to the initial Pre-Design and Design Phases and are more reluctant towards starting their construction. The current method of working of the company is mapped and explained with the possible issues and problems are being enlisted. The Design Build approach of Procurement was appraised and further improvements have been suggested. The second part of the report consists of the major and applicable Lean Principles and how they can be implemented in Construction Projects. This not only reduces the wasteful activities but also prove to be cost efficient as mapped. Lastly some merits of Lean Implementation on the construction project have been enlisted and conclusions are drawn. NEW HEAD OFFICE OF COMMERCIAL BANK OF KUWAIT (CBK) Introduction The Commercial Bank of Kuwait is a well known Bank in Kuwait having its roots back in 1960s. It began with a simple minded policy from just a small part of the property with the aim to handle the financial burden on the main bank of Kuwait; the National Bank of Kuwait. Being an old player in the country, the CBK decided to shift its old head office to the new location as the old building had many issues like less working space creating hurdles in modernizing the banking facilities. The old office was in the region of Maidan Hawally which is considerably famous for foreigners living in the region. The new head office of CBK is in the Centre of Kuwait i.e. Kuwait City which is the economic hub of overall State of Kuwait. In this project, Commercial Bank of Kuwait was the main funding source. The Project began in January 2007 and the construction of the Bank lasted till March 2009. Although the project was expected to be completed by June 2008 whereas only the construction phase had jus t finished till March 2009 and the final building being handed over by September 2009. The study of the project indicated that the Project was not only delayed yet was significantly over budgeted. The Project was approximately 30 % over budget and 15 months delayed. Moreover not only these issues affected the project but too many changes by the client were also a reason for the delay. The delay in the completion of the CBK Project was due to two reasons. One being that the Chief Executive Officer of the CBK resigned due to some personal issues with Managing Director of the Bank and the other reason was due to the Financial Crunch throughout the globe. These two reasons caused changes in the project after a long halt to the construction till the new CEO was assigned as the requirements of the project were altered accordingly. Therefore only one person cannot be held responsible for the overall delay caused in the CBK Project. According to Tucker (1998), a high level of management in Construction is very much essential for smooth flow of project. Thus it can be said that there were flaws in the design phase of the project and the lack of good management resulted in overall failed on-time delivery of the project. The Procurement method of the project was Design Build keeping in view the needs and outcomes of the project. The Client (CBK itself) had future plans for further development which all seemed to be left in vain of further initiation due to such a mess created. There fore the Client took keen interest to map the overall processes of the project in order to learn the flaws that delayed the Project so as to further smoothen up its activities. Working Philosophy in the CBK Project Being appointed as an Assistant Project Manager by the Client (Commercial Bank of Kuwait), the task allocated was to analyze the overall performance of the CBK Headquarters project and prepare a report to learn the flaws and outcomes of the project. Such an exercise was done in order to generate preventive measures so that future projects may not be delayed much. The report consists of a comprehensive analysis of methodology used for the Development of Headquarter of CBK and the maximum emphasize is given to the changes in the design i.e. the overall management of the design. The first step taken into consideration is the feasibility report or the outline of the project which is the first process in a project. A detailed approach in investigation is taken therefore, the Contractor (Ahmadiah Contracting-Kuwait), the team of Client (CBK), stakeholders and other parties involved in the project were consulted. All the processes are shown are Appendix 1. Method of Procurement The method of procurement in this project was Design and Build. It is very much necessary to understand what this approach is by analyzing the method. From the clients point of view, the success of the project is nearly decided by choosing appropriate method of procurement in the beginning. The common layout of the system can be seen in the figure below. Fig.2 indicates that this system is very much suited for clients who typically pass their risk to the contractor and a close coordination is developed between the design and the contractor team. This enables to synchronize the time, cost and quality of the project in the true sense of good project management perspective. As the cost is pretty much decided in the beginning, the client is confident that all the further process is smoothen up. But the point to be concerned is that all teams should have proper knowledge of design and build approach. Mostly clients which have Design Build approach new into their project end up with the sentence that the contractor has made a lot of money out of this project. This can be true only if the client finds that the things mentioned in the proposal are not same as they should have been. According to Morledge et.al (2006), client should be in notice that: * Design and Build method may change the formal aspect of most of the parties involved throughout the project. * The contractual accountability of the involved parties can change according to the environment and need of the project. Therefore according to Morledge et.al (2006), the client should study the procurement route to be selected from the technical, financial and legal angle, well in advance before the commencement of the bidding stage. By this not only the client but also the other stakeholders involved in the project can proceed safely which having loose much money. From the explained context it can be seen that before initiating any step into the start of the project, if the client spends some time in understanding the possible pros and cons of the selection of procurement method, much discrepancies can be tackled easily. Moreover, the early involvement of the clients design team can lend a helping hand to the client in correct decision making. This type of activity seems to be very scarce in the CBK Project. Processes of CBK Project The working of the CBK Project can be seen in the form of a process map with each activity corresponding to a task. It can be seen that the working standard of the overall project is in the form of a three phase Design Build method. The three phases can be as: a. Pre-Tender Phase b. Tendering Phase c. Implementation Phase The three phases of the project are mapped as processes and sub processes and the roles of different parties involved in the overall project are elaborated (Appendix -1). This exercise enables to understand the whole process easily. Detailed Analysis of Processes The main processes of the New Headquarters of Commercial Bank of Kuwait are discussed as follows:  § Concept of the Project The Chief Executive of Commercial Bank of Kuwait had a vision towards modernization in the country and the Bank it self. Therefore in order to compete the competitive banks in Kuwait the decision was taken to develop a state of the art building which will serve as an headquarter and economic backbone for the organization. Modernization was in the sense that latest high performance computers with ultra high-tech security were to be operated in the building.  § Financial Issues The Commercial Bank of Kuwait being the client as well as the funding authority finalized the concept of the project in order to have a brief overview of required budget of the project. For this, closed group meetings and seminars were arranged in order to clear any queries in the mind of the staff of the bank.  § Planning Phase The top management of the Commercial Bank of Kuwait was keen to modernize its new headquarters. For this to happen, special sessions were arranged in collaboration with Ministry of Planning, Kuwait and State Bank of Kuwait. International Banks like Barclays and HSBC were taken as role model and one model being finalized for the future development. This was a good step as to bring Western standards into an Arab Country.  § Consultant Team The consultant team (Al-Injaz Architects and Engineers) selected by the client was through competition and the team selected was an experienced one in modern construction.  § Feasibility Report A feasibility report was made in order to study the potential outcomes of the project and what could be the difficulties faced by the teams.  § Integrating Clients Objective The Consultant team enlisted the requirements of the client and steps were taken to meet the clients goals. Mainly the clients focus was a state of the art modern building and the whole project to be finished quickly without compromising Quality Standards. Therefore quality standards were also a must for the client. Through critical analysis of the data, the consultant team came out with the Design Build approach of procurement.  § Design Phase The consultant team started their work in the perspective of Design Build approach so that the tendering process can take place on time. Initial plan setup, architectural designs along with structural designs, cost estimation; all were done right on time.  § Project Documents The Projects brief long with all the details of the project including deadline of the project, estimated cost, drawings and plan etc are documented.  § Document Review The first document review meeting was held in which the top management of the CBK took part. All the project documents were critically analyzed and the Chief Executive and Chairman of Commercial Bank of Kuwait were briefed by the Project Manager about the findings of the report. It was decided that the design of the bank was little more luxurious as per the standard set and was exceeding the budget. So minor changes were made and final documents were setup.  § Tendering Process After finalizing the Project documents, pre-qualification of contractors was done and tenders were called for the development of New Headquarters of Commercial Bank of Kuwait. This was done by the Bidding Committee assigned by the Client which was in close contact with the client during the tendering process.  § Bidding Documents Confidential bidding documents were received before the deadline and handed over to the client.  § Bid Evaluation The client selected the contractor with the lowest bid and consulted the consultant team and the project management team in order to approve the bid. Upon the approval from the teams, the client approved the Contractor (Ahmadiah Contracting, Kuwait) and informed the bidding committee.  § Contract Sign The Bidding Committee arranged a contract signing session in which the contract was signed between the two parties. It was assured that the detailed design would start immediately and the project would be finished on time and in budget.  § Initial Design The design team of the Contractor (Ahmadiah) started the initial design of the development of New Headquarters of Commercial Bank of Kuwait. The consultant team and the project manager of the client were also involved in this phase and regular meetings with the client were taking place. During this phase proper site survey and investigation was done and the design aspects were altered accordingly.  § Interior Design The interior designing of the CBK was given much more importance in order to meet the quality standards set by the client. The other reason was to meet the maximum security levels of the requirements of the project.  § Provision for restaurant In order to serve the employees of the CBK, it was mentioned in the objectives of the client to provide the catering service to the staff so that at lunch time, the staff can enjoy the atmosphere and have a chat and meeting at the same time along with lunch.  § Design Proposal After finalizing the initial design of the CBK, a design proposal was prepared along with the time and cost estimates for approval from the Client.  § Final Review The client, consultant team and the project manager set up a meeting in order to critically analyze the proposal and upon approval from the client, the contractor proceeds further.  § Final Design Plan Layout Once the proposal was finalized, the design team of the contractor started to work on the detailed and comprehensive design of the project. The HVAC, electrical works, the building services including CCTV arrangements, the infrastructure of the building, all were done according to the sub-contractors co-ordination. The final layout of what is to be developed appeared on drawing charts and Auto-Cad drawing were prepared. The Step wise proceedings of the design phase of the CBK project starting from the Clients input and ending at the Contractors output can be seen in the Fig.3.  § Final Agreement With slight alterations in design and requirement by the client, the contract was review and the construction phase was to be started.  § Construction Phase The first step of the construction phase was the site acquisition, construction of temporary offices for the staff as well as design team. For this to happen the sub-contractors were put on job and the heavy construction machinery was brought on site.  § Final Drawings Implemented on Site With the start of working on the construction site, the first step was to excavate the area to be constructed upon. The construction phase started to be as smooth as predicted.  § Time Quality Checks The project manager of the client (CBK) had frequent visits to the site which resulted in strict control over the time and quality issues. A few incidents took place in which the contractor was not up to the mark as stated in the detailed drawing specifications. For instance, the project manager managed to have a look at the steel standards adopted and found that in the beams, low quality steel was used and was further sent for testing in the laboratory. The overall view of the working of the teams in the CBK Project can be seen in Fig.3.  § Documentation and Review A very important aspect of the CBK project was that every thing was documented and latest computer software such as Primavera was used on the site. The Clients project manager had an access to it. Some clashes went up due to delay in the project beyond the critical path which was referred to the client. Possible Issues with the Current Method of Working Different types of issues arose during the project life cycle that lead to certain unexpected failures during the project. Following table enlists the main issues: The above mentioned issues were found to have a significant impact on the working of the CBK project. The need of the future and to be successful in the field of construction is by analyzing the short comings of previously done processes. To enhance the working and construction processes by the client in the future, the forth coming recommendations in the form of Lean perspective in construction have been defined. All the working can be seen in Appendix -1. ENHANCED WAY OF HANDLING COMMERCIAL BANK OF KUWAIT PROJECT Introduction to Lean According to Egan (1998) and Latham (1994), the construction industry has changed significantly in the past decade, especially the UKs construction industry. Much emphasis is now given to improve the construction industry by analysis the working methodology of the industry. By analyzing, one can rectify the short comings and further improve that to make a win-win situation. According to Koskela (1997), construction industry cannot be a regarded as a â€Å"rich cultured† industry, because the way of doing work, the procedures and outcomes are nearly same as they were years ago. To improve this, the construction industry had to be linked with production and manufacturing industry. The reason is that although the end product of both the industries is entirely different, yet if the working principles of both industries are studied, they can be regarded as identical. According to Egbu (2010) and Towill (1997), construction industry can be regarded as a manufacturing industry. If we look at the production or manufacturing industry, for instance a car industry, the end product is a car, which was the project of the factory (Muhlemann et al., 1992). In construction industry, the end product is a building, house, a dam etc, which is the project for the construction factory/industry. Taking this, approach, Koskela (2000) introduced Lean principles in construction industrys perspective. He argued that the manufacturing industry has set of production theories which when applied to the construction industry, the results can be significant. When seen the time-line of the car manufacturing industry, for instance, we can see that the car manufacturing has changed drastically over the past century. The reason being that the working principles adopted by production industry has polished itself over time again and again, when such principle be defined and impl emented on construction industry, the end product can be enhanced (Koskela, 1992). Lean thinking is the concept put forward by Womack and Daniel (1996) in which he describes to think every possible aspect in a leaner way. Thus by minimizing single repetitive step can be a step forward towards implementing lean in our daily life. Lean production system was adopted and implemented by Toyota Production System through out its time-line of production activities. Liker (1998) recognizes Toyota as the pioneers of lean principles which have brought a revolution in its production activities for more than a century. This is done by proper planning the supply chain activities, minimizing the wasteful activities, etc. By the introduction of 5S technique, Kanban and others, Toyota has flourished significantly in the production industry, whereas, the construction industry is far away from these concepts. Summary of 14 points as set by Toyota Production System and enlisted by Liker (2004), are as follows: 1. Base Your Management Decisions on a Long-Term Philosophy, Even at the Expense of Short-Term Financial Goals. 2. Create Continuous Process Flow to Bring Problems to the Surface. 3. Use â€Å"Pull† System to Avoid Overproduction. 4. Level Out the Workload (Heijunka). 5. Build a Culture of Stopping to Fix Problems, to Get Quality Right for the First Time. 6. Standardizes Tasks are the Foundation for Continuous Improvement and Employee Empowerment. 7. Use Visual Controls so no Problems are Hidden. 8. Use Only Reliable, Thoroughly Tested Technology That Serves your People and Processes. 9. Grow Leaders who Thoroughly Understand the Work, Live the Philosophy, and Take it to Others. 10. Develop Exceptional People and Teams who Follow your Companys Philosophy. 11. Respect Your Extended Network of Partners and Suppliers by Challenging Them and Helping them Improve. 12. Go and See for Yourself to Thoroughly Understand the Situation (Genchi Genbutsu). 13. Make Decisions Slowly by Consensus, Thoroughly Considering All options; Implement Decisions Rapidly (Nemawashi). 14. Become a Learning Organization Through Relentless Reflection (Hansei) and Continuous Improvement (Kaizen). Thus by closely looking and understanding the above mentioned principles, we can judge that how successful a company can be when adopted such principles. By using Kanban, much of the waste can be removed. The fact is to carefully see and analyse the company performance and take out the shortcomings. Integrating Lean with the CBK Project Construction industry is now in a phase of adapting new procedures and methods for its improvement and to increase its efficiency. This can easily be done by integrating lean philosophy in the construction industry (Jorgensen and Emmitt, 2008 2009). Liker (2004) has condensed the above enlisted 14 key principles of Toyota Production System into 4 main categories/sections according to their nature. These are: 1. Long-Term Philosophy 2. Selection of Right Process 3. People and Parners development can lead to value generation 4. Gradually problem solving These 14 points of Toyota Production System are very well condensed in the above mentioned four points. When thinking about construction, Long-term philosophy can very much help in implementation of lean principles. According to Arbulu and Zabelle (2006), to standardize work it is very much necessary to follow a guideline. The five stages vision, skills, incentives, resources and action plan can be idealized according to the CBK Project. Thinking Lean while keeping in view these 5 stages can very well prove to be successful in the project. Vision Defining a vision is the first step towards the start of a project. These not only assist in the further journey, but also remove any questions that may arise in the overall team in the project. This exercise was found to be completely during the construction of New Head office of Central Bank of Kuwait Project because everything was mixed and jumbled up during the last stages of the project. Defining a vision thus give a road map towards success and the vision is usually giving for the next couple of years, which elaborates the broad thing of the company in front of others. Only thing that matters is the top management team to be strong to take decisions which lacked through out the CBK Project. Skills Skills come first after a vision is set. In fact a vision cannot be defined without the proper knowledge of the skills that a company possesses. In order to be successful in implementation of Lean in the construction industry, the company has to design or upgrade its staff development program. Thus skills very much distinguishes between the current adopted working methodology with the new working method i.e.; Lean. Furthermore, proper knowledge of the companies profile is also very beneficial in perusing successful projects. Although the staff of the CBK Project is very much skilled yet some lack in understanding of basics in construction industry is found, for instance the top management dealing first time with the Design Build procurement method. Incentive Incentives are good in the sense that they keep the workers at work motivated. The incentives can be in the form of money or by applauding someones good work, this make the worker feel happing. To implement lean into the construction industry is something to make a great change into the system, thus by introducing incentives can encourage workers at work and be happy to work and accept the change. Resources Resources can be regarded as the backbone of a project. Insufficient resources and funds may load to a halt during a project. In order to smoothen the working and progress of the project, it should be made assure well in advance that there are enough funds to support the working. The financial crunch appeared during the construction of the CBK project which significantly halted the progress of construction activities. Action Plan Like setting up a clear vision right in the start of the project, a good action plan is also equally important as a right action plan sets up guidelines for the project team. Working on the correct action plan, incorporates any unsubstantial changes and alterations in a project. A good action plan cannot be seen in the CBK project which lead to some unwanted results in the last stages of the project. Improvement by Implementation of Lean Principles The 14 principles of Lean Production system used by Toyota Production System and stated by Liker (2004) are being implemented into the CBK Project which gives a more Leaner and good value of money look to the project. Not only the cost of the overall project is properly utilized but also it is a quicker approach Womack and Daniel (2005). The enlisted problems in the CBK Project (as stated in the start) can be resolved using the Lean Principles. Following are the Lean principles directly implemented to the improvement of CBK Project. 1. Long-Term Philosophy The long term philosophy in the context of lean can be explained as: I. Base Your Management Decisions on Long-Term Philosophy Long term philosophy gives a plate form for an organization to initialize the start of future prospects. Long term approaches are usually declared in the form of upcoming 5, 10, 15 or 20 years in which it is clearly briefed about the future plans of the organization. Commercial Bank of Kuwait should introduce this approach right from the start of future projects. This will enhance the managerial skills of the organization and an approach to solve all the problems will be upgraded (Carroll, 2002) and hence shown in Fig.4 after application. 2. Process Improvement The process improvement section of the Lean principles consists of following aspects: II. Create Continuous Process Flow to Bring Problems to the Surface This principle of Lean suggests that the working criteria of the company should be such that it is running smoothly, fast and in an accurate manner. In this way any problem that arises during the process, may be handled quite easily. This principle can be implemented in the design and the planning phase as it removes many problems which are caused by starting different activities at same time. Such exercise was completely missing in the CBK Project. Multiple tasks were started at the same time, which lead to misunderstandings in the project. Smooth flow of work was least found and by implementing this technique the smooth flow of work can be seen. III. Use â€Å"Pull† System Pull system helps to reduce the un-necessary work that is done during the project. The use of pull system can be used in the pre-project and pre-construction phases during the design phases as this will help to control the time lapsed between the completion of the drawings and the designing. Un-necessary meetings and suggestions were found during the execution of the Pre-Tender phase whose burden, the overall project planning had to face. By introducing Pull system, much waste full activities can be overcome. IV. Level out the Workload The workers at work shouldnt be overburdened at any time of the project. This not only applies to the Labor but also to the Design Team. When it comes to the labor, it should be taken care off that every labor has equal work allocated to him and work load should be calculated according to the time available. Similarly the Design team should be Lean Principles in Construction Lean Principles in Construction Executive Summary Toyota is a name that when seen brings an image of high quality, durability, cost/fuel efficient and best value for money in the car industry. The reason for such a high standard is that Toyota Production System has Pioneered and Implemented Lean Principles in Production system. These principles didnt have the effect immediately in the start but at the last stages, it proved to have a greater worth for it. By implementation of Lean Theories and Philosophy, Toyota had got rid of much wasteful activities using Just In Time approach. The understudy report consists of the Implementation of Lean Principles on a Construction Project which was significantly delayed due to lack of managerial qualities. The Client built a new Head office to shift all the activities from the previous offices in to the new one, but a delay to all activities was observed. It has been analyzed that the construction companies fail to give proper time to the initial Pre-Design and Design Phases and are more reluctant towards starting their construction. The current method of working of the company is mapped and explained with the possible issues and problems are being enlisted. The Design Build approach of Procurement was appraised and further improvements have been suggested. The second part of the report consists of the major and applicable Lean Principles and how they can be implemented in Construction Projects. This not only reduces the wasteful activities but also prove to be cost efficient as mapped. Lastly some merits of Lean Implementation on the construction project have been enlisted and conclusions are drawn. NEW HEAD OFFICE OF COMMERCIAL BANK OF KUWAIT (CBK) Introduction The Commercial Bank of Kuwait is a well known Bank in Kuwait having its roots back in 1960s. It began with a simple minded policy from just a small part of the property with the aim to handle the financial burden on the main bank of Kuwait; the National Bank of Kuwait. Being an old player in the country, the CBK decided to shift its old head office to the new location as the old building had many issues like less working space creating hurdles in modernizing the banking facilities. The old office was in the region of Maidan Hawally which is considerably famous for foreigners living in the region. The new head office of CBK is in the Centre of Kuwait i.e. Kuwait City which is the economic hub of overall State of Kuwait. In this project, Commercial Bank of Kuwait was the main funding source. The Project began in January 2007 and the construction of the Bank lasted till March 2009. Although the project was expected to be completed by June 2008 whereas only the construction phase had jus t finished till March 2009 and the final building being handed over by September 2009. The study of the project indicated that the Project was not only delayed yet was significantly over budgeted. The Project was approximately 30 % over budget and 15 months delayed. Moreover not only these issues affected the project but too many changes by the client were also a reason for the delay. The delay in the completion of the CBK Project was due to two reasons. One being that the Chief Executive Officer of the CBK resigned due to some personal issues with Managing Director of the Bank and the other reason was due to the Financial Crunch throughout the globe. These two reasons caused changes in the project after a long halt to the construction till the new CEO was assigned as the requirements of the project were altered accordingly. Therefore only one person cannot be held responsible for the overall delay caused in the CBK Project. According to Tucker (1998), a high level of management in Construction is very much essential for smooth flow of project. Thus it can be said that there were flaws in the design phase of the project and the lack of good management resulted in overall failed on-time delivery of the project. The Procurement method of the project was Design Build keeping in view the needs and outcomes of the project. The Client (CBK itself) had future plans for further development which all seemed to be left in vain of further initiation due to such a mess created. There fore the Client took keen interest to map the overall processes of the project in order to learn the flaws that delayed the Project so as to further smoothen up its activities. Working Philosophy in the CBK Project Being appointed as an Assistant Project Manager by the Client (Commercial Bank of Kuwait), the task allocated was to analyze the overall performance of the CBK Headquarters project and prepare a report to learn the flaws and outcomes of the project. Such an exercise was done in order to generate preventive measures so that future projects may not be delayed much. The report consists of a comprehensive analysis of methodology used for the Development of Headquarter of CBK and the maximum emphasize is given to the changes in the design i.e. the overall management of the design. The first step taken into consideration is the feasibility report or the outline of the project which is the first process in a project. A detailed approach in investigation is taken therefore, the Contractor (Ahmadiah Contracting-Kuwait), the team of Client (CBK), stakeholders and other parties involved in the project were consulted. All the processes are shown are Appendix 1. Method of Procurement The method of procurement in this project was Design and Build. It is very much necessary to understand what this approach is by analyzing the method. From the clients point of view, the success of the project is nearly decided by choosing appropriate method of procurement in the beginning. The common layout of the system can be seen in the figure below. Fig.2 indicates that this system is very much suited for clients who typically pass their risk to the contractor and a close coordination is developed between the design and the contractor team. This enables to synchronize the time, cost and quality of the project in the true sense of good project management perspective. As the cost is pretty much decided in the beginning, the client is confident that all the further process is smoothen up. But the point to be concerned is that all teams should have proper knowledge of design and build approach. Mostly clients which have Design Build approach new into their project end up with the sentence that the contractor has made a lot of money out of this project. This can be true only if the client finds that the things mentioned in the proposal are not same as they should have been. According to Morledge et.al (2006), client should be in notice that: * Design and Build method may change the formal aspect of most of the parties involved throughout the project. * The contractual accountability of the involved parties can change according to the environment and need of the project. Therefore according to Morledge et.al (2006), the client should study the procurement route to be selected from the technical, financial and legal angle, well in advance before the commencement of the bidding stage. By this not only the client but also the other stakeholders involved in the project can proceed safely which having loose much money. From the explained context it can be seen that before initiating any step into the start of the project, if the client spends some time in understanding the possible pros and cons of the selection of procurement method, much discrepancies can be tackled easily. Moreover, the early involvement of the clients design team can lend a helping hand to the client in correct decision making. This type of activity seems to be very scarce in the CBK Project. Processes of CBK Project The working of the CBK Project can be seen in the form of a process map with each activity corresponding to a task. It can be seen that the working standard of the overall project is in the form of a three phase Design Build method. The three phases can be as: a. Pre-Tender Phase b. Tendering Phase c. Implementation Phase The three phases of the project are mapped as processes and sub processes and the roles of different parties involved in the overall project are elaborated (Appendix -1). This exercise enables to understand the whole process easily. Detailed Analysis of Processes The main processes of the New Headquarters of Commercial Bank of Kuwait are discussed as follows:  § Concept of the Project The Chief Executive of Commercial Bank of Kuwait had a vision towards modernization in the country and the Bank it self. Therefore in order to compete the competitive banks in Kuwait the decision was taken to develop a state of the art building which will serve as an headquarter and economic backbone for the organization. Modernization was in the sense that latest high performance computers with ultra high-tech security were to be operated in the building.  § Financial Issues The Commercial Bank of Kuwait being the client as well as the funding authority finalized the concept of the project in order to have a brief overview of required budget of the project. For this, closed group meetings and seminars were arranged in order to clear any queries in the mind of the staff of the bank.  § Planning Phase The top management of the Commercial Bank of Kuwait was keen to modernize its new headquarters. For this to happen, special sessions were arranged in collaboration with Ministry of Planning, Kuwait and State Bank of Kuwait. International Banks like Barclays and HSBC were taken as role model and one model being finalized for the future development. This was a good step as to bring Western standards into an Arab Country.  § Consultant Team The consultant team (Al-Injaz Architects and Engineers) selected by the client was through competition and the team selected was an experienced one in modern construction.  § Feasibility Report A feasibility report was made in order to study the potential outcomes of the project and what could be the difficulties faced by the teams.  § Integrating Clients Objective The Consultant team enlisted the requirements of the client and steps were taken to meet the clients goals. Mainly the clients focus was a state of the art modern building and the whole project to be finished quickly without compromising Quality Standards. Therefore quality standards were also a must for the client. Through critical analysis of the data, the consultant team came out with the Design Build approach of procurement.  § Design Phase The consultant team started their work in the perspective of Design Build approach so that the tendering process can take place on time. Initial plan setup, architectural designs along with structural designs, cost estimation; all were done right on time.  § Project Documents The Projects brief long with all the details of the project including deadline of the project, estimated cost, drawings and plan etc are documented.  § Document Review The first document review meeting was held in which the top management of the CBK took part. All the project documents were critically analyzed and the Chief Executive and Chairman of Commercial Bank of Kuwait were briefed by the Project Manager about the findings of the report. It was decided that the design of the bank was little more luxurious as per the standard set and was exceeding the budget. So minor changes were made and final documents were setup.  § Tendering Process After finalizing the Project documents, pre-qualification of contractors was done and tenders were called for the development of New Headquarters of Commercial Bank of Kuwait. This was done by the Bidding Committee assigned by the Client which was in close contact with the client during the tendering process.  § Bidding Documents Confidential bidding documents were received before the deadline and handed over to the client.  § Bid Evaluation The client selected the contractor with the lowest bid and consulted the consultant team and the project management team in order to approve the bid. Upon the approval from the teams, the client approved the Contractor (Ahmadiah Contracting, Kuwait) and informed the bidding committee.  § Contract Sign The Bidding Committee arranged a contract signing session in which the contract was signed between the two parties. It was assured that the detailed design would start immediately and the project would be finished on time and in budget.  § Initial Design The design team of the Contractor (Ahmadiah) started the initial design of the development of New Headquarters of Commercial Bank of Kuwait. The consultant team and the project manager of the client were also involved in this phase and regular meetings with the client were taking place. During this phase proper site survey and investigation was done and the design aspects were altered accordingly.  § Interior Design The interior designing of the CBK was given much more importance in order to meet the quality standards set by the client. The other reason was to meet the maximum security levels of the requirements of the project.  § Provision for restaurant In order to serve the employees of the CBK, it was mentioned in the objectives of the client to provide the catering service to the staff so that at lunch time, the staff can enjoy the atmosphere and have a chat and meeting at the same time along with lunch.  § Design Proposal After finalizing the initial design of the CBK, a design proposal was prepared along with the time and cost estimates for approval from the Client.  § Final Review The client, consultant team and the project manager set up a meeting in order to critically analyze the proposal and upon approval from the client, the contractor proceeds further.  § Final Design Plan Layout Once the proposal was finalized, the design team of the contractor started to work on the detailed and comprehensive design of the project. The HVAC, electrical works, the building services including CCTV arrangements, the infrastructure of the building, all were done according to the sub-contractors co-ordination. The final layout of what is to be developed appeared on drawing charts and Auto-Cad drawing were prepared. The Step wise proceedings of the design phase of the CBK project starting from the Clients input and ending at the Contractors output can be seen in the Fig.3.  § Final Agreement With slight alterations in design and requirement by the client, the contract was review and the construction phase was to be started.  § Construction Phase The first step of the construction phase was the site acquisition, construction of temporary offices for the staff as well as design team. For this to happen the sub-contractors were put on job and the heavy construction machinery was brought on site.  § Final Drawings Implemented on Site With the start of working on the construction site, the first step was to excavate the area to be constructed upon. The construction phase started to be as smooth as predicted.  § Time Quality Checks The project manager of the client (CBK) had frequent visits to the site which resulted in strict control over the time and quality issues. A few incidents took place in which the contractor was not up to the mark as stated in the detailed drawing specifications. For instance, the project manager managed to have a look at the steel standards adopted and found that in the beams, low quality steel was used and was further sent for testing in the laboratory. The overall view of the working of the teams in the CBK Project can be seen in Fig.3.  § Documentation and Review A very important aspect of the CBK project was that every thing was documented and latest computer software such as Primavera was used on the site. The Clients project manager had an access to it. Some clashes went up due to delay in the project beyond the critical path which was referred to the client. Possible Issues with the Current Method of Working Different types of issues arose during the project life cycle that lead to certain unexpected failures during the project. Following table enlists the main issues: The above mentioned issues were found to have a significant impact on the working of the CBK project. The need of the future and to be successful in the field of construction is by analyzing the short comings of previously done processes. To enhance the working and construction processes by the client in the future, the forth coming recommendations in the form of Lean perspective in construction have been defined. All the working can be seen in Appendix -1. ENHANCED WAY OF HANDLING COMMERCIAL BANK OF KUWAIT PROJECT Introduction to Lean According to Egan (1998) and Latham (1994), the construction industry has changed significantly in the past decade, especially the UKs construction industry. Much emphasis is now given to improve the construction industry by analysis the working methodology of the industry. By analyzing, one can rectify the short comings and further improve that to make a win-win situation. According to Koskela (1997), construction industry cannot be a regarded as a â€Å"rich cultured† industry, because the way of doing work, the procedures and outcomes are nearly same as they were years ago. To improve this, the construction industry had to be linked with production and manufacturing industry. The reason is that although the end product of both the industries is entirely different, yet if the working principles of both industries are studied, they can be regarded as identical. According to Egbu (2010) and Towill (1997), construction industry can be regarded as a manufacturing industry. If we look at the production or manufacturing industry, for instance a car industry, the end product is a car, which was the project of the factory (Muhlemann et al., 1992). In construction industry, the end product is a building, house, a dam etc, which is the project for the construction factory/industry. Taking this, approach, Koskela (2000) introduced Lean principles in construction industrys perspective. He argued that the manufacturing industry has set of production theories which when applied to the construction industry, the results can be significant. When seen the time-line of the car manufacturing industry, for instance, we can see that the car manufacturing has changed drastically over the past century. The reason being that the working principles adopted by production industry has polished itself over time again and again, when such principle be defined and impl emented on construction industry, the end product can be enhanced (Koskela, 1992). Lean thinking is the concept put forward by Womack and Daniel (1996) in which he describes to think every possible aspect in a leaner way. Thus by minimizing single repetitive step can be a step forward towards implementing lean in our daily life. Lean production system was adopted and implemented by Toyota Production System through out its time-line of production activities. Liker (1998) recognizes Toyota as the pioneers of lean principles which have brought a revolution in its production activities for more than a century. This is done by proper planning the supply chain activities, minimizing the wasteful activities, etc. By the introduction of 5S technique, Kanban and others, Toyota has flourished significantly in the production industry, whereas, the construction industry is far away from these concepts. Summary of 14 points as set by Toyota Production System and enlisted by Liker (2004), are as follows: 1. Base Your Management Decisions on a Long-Term Philosophy, Even at the Expense of Short-Term Financial Goals. 2. Create Continuous Process Flow to Bring Problems to the Surface. 3. Use â€Å"Pull† System to Avoid Overproduction. 4. Level Out the Workload (Heijunka). 5. Build a Culture of Stopping to Fix Problems, to Get Quality Right for the First Time. 6. Standardizes Tasks are the Foundation for Continuous Improvement and Employee Empowerment. 7. Use Visual Controls so no Problems are Hidden. 8. Use Only Reliable, Thoroughly Tested Technology That Serves your People and Processes. 9. Grow Leaders who Thoroughly Understand the Work, Live the Philosophy, and Take it to Others. 10. Develop Exceptional People and Teams who Follow your Companys Philosophy. 11. Respect Your Extended Network of Partners and Suppliers by Challenging Them and Helping them Improve. 12. Go and See for Yourself to Thoroughly Understand the Situation (Genchi Genbutsu). 13. Make Decisions Slowly by Consensus, Thoroughly Considering All options; Implement Decisions Rapidly (Nemawashi). 14. Become a Learning Organization Through Relentless Reflection (Hansei) and Continuous Improvement (Kaizen). Thus by closely looking and understanding the above mentioned principles, we can judge that how successful a company can be when adopted such principles. By using Kanban, much of the waste can be removed. The fact is to carefully see and analyse the company performance and take out the shortcomings. Integrating Lean with the CBK Project Construction industry is now in a phase of adapting new procedures and methods for its improvement and to increase its efficiency. This can easily be done by integrating lean philosophy in the construction industry (Jorgensen and Emmitt, 2008 2009). Liker (2004) has condensed the above enlisted 14 key principles of Toyota Production System into 4 main categories/sections according to their nature. These are: 1. Long-Term Philosophy 2. Selection of Right Process 3. People and Parners development can lead to value generation 4. Gradually problem solving These 14 points of Toyota Production System are very well condensed in the above mentioned four points. When thinking about construction, Long-term philosophy can very much help in implementation of lean principles. According to Arbulu and Zabelle (2006), to standardize work it is very much necessary to follow a guideline. The five stages vision, skills, incentives, resources and action plan can be idealized according to the CBK Project. Thinking Lean while keeping in view these 5 stages can very well prove to be successful in the project. Vision Defining a vision is the first step towards the start of a project. These not only assist in the further journey, but also remove any questions that may arise in the overall team in the project. This exercise was found to be completely during the construction of New Head office of Central Bank of Kuwait Project because everything was mixed and jumbled up during the last stages of the project. Defining a vision thus give a road map towards success and the vision is usually giving for the next couple of years, which elaborates the broad thing of the company in front of others. Only thing that matters is the top management team to be strong to take decisions which lacked through out the CBK Project. Skills Skills come first after a vision is set. In fact a vision cannot be defined without the proper knowledge of the skills that a company possesses. In order to be successful in implementation of Lean in the construction industry, the company has to design or upgrade its staff development program. Thus skills very much distinguishes between the current adopted working methodology with the new working method i.e.; Lean. Furthermore, proper knowledge of the companies profile is also very beneficial in perusing successful projects. Although the staff of the CBK Project is very much skilled yet some lack in understanding of basics in construction industry is found, for instance the top management dealing first time with the Design Build procurement method. Incentive Incentives are good in the sense that they keep the workers at work motivated. The incentives can be in the form of money or by applauding someones good work, this make the worker feel happing. To implement lean into the construction industry is something to make a great change into the system, thus by introducing incentives can encourage workers at work and be happy to work and accept the change. Resources Resources can be regarded as the backbone of a project. Insufficient resources and funds may load to a halt during a project. In order to smoothen the working and progress of the project, it should be made assure well in advance that there are enough funds to support the working. The financial crunch appeared during the construction of the CBK project which significantly halted the progress of construction activities. Action Plan Like setting up a clear vision right in the start of the project, a good action plan is also equally important as a right action plan sets up guidelines for the project team. Working on the correct action plan, incorporates any unsubstantial changes and alterations in a project. A good action plan cannot be seen in the CBK project which lead to some unwanted results in the last stages of the project. Improvement by Implementation of Lean Principles The 14 principles of Lean Production system used by Toyota Production System and stated by Liker (2004) are being implemented into the CBK Project which gives a more Leaner and good value of money look to the project. Not only the cost of the overall project is properly utilized but also it is a quicker approach Womack and Daniel (2005). The enlisted problems in the CBK Project (as stated in the start) can be resolved using the Lean Principles. Following are the Lean principles directly implemented to the improvement of CBK Project. 1. Long-Term Philosophy The long term philosophy in the context of lean can be explained as: I. Base Your Management Decisions on Long-Term Philosophy Long term philosophy gives a plate form for an organization to initialize the start of future prospects. Long term approaches are usually declared in the form of upcoming 5, 10, 15 or 20 years in which it is clearly briefed about the future plans of the organization. Commercial Bank of Kuwait should introduce this approach right from the start of future projects. This will enhance the managerial skills of the organization and an approach to solve all the problems will be upgraded (Carroll, 2002) and hence shown in Fig.4 after application. 2. Process Improvement The process improvement section of the Lean principles consists of following aspects: II. Create Continuous Process Flow to Bring Problems to the Surface This principle of Lean suggests that the working criteria of the company should be such that it is running smoothly, fast and in an accurate manner. In this way any problem that arises during the process, may be handled quite easily. This principle can be implemented in the design and the planning phase as it removes many problems which are caused by starting different activities at same time. Such exercise was completely missing in the CBK Project. Multiple tasks were started at the same time, which lead to misunderstandings in the project. Smooth flow of work was least found and by implementing this technique the smooth flow of work can be seen. III. Use â€Å"Pull† System Pull system helps to reduce the un-necessary work that is done during the project. The use of pull system can be used in the pre-project and pre-construction phases during the design phases as this will help to control the time lapsed between the completion of the drawings and the designing. Un-necessary meetings and suggestions were found during the execution of the Pre-Tender phase whose burden, the overall project planning had to face. By introducing Pull system, much waste full activities can be overcome. IV. Level out the Workload The workers at work shouldnt be overburdened at any time of the project. This not only applies to the Labor but also to the Design Team. When it comes to the labor, it should be taken care off that every labor has equal work allocated to him and work load should be calculated according to the time available. Similarly the Design team should be

Thursday, September 19, 2019

Ralph Vaughan Williams: Symphony Number Five :: essays research papers

Ralph Vaughan Williams: Symphony Number Five Ralph Vaughan Williams, descended from the famous Wedgwood and Darwin families, was born at Down Ampney, Gloucestershire in 1872. In 1890 he entered the Royal College of Music, and in 1892 he entered Trinity College, Cambridge. One of the greatest of the British composers, a prolific writer of music, folksong collector, and champion of British cultural heritage, he died aged 85 in 1958. His ashes are interred in Westminster Abbey alongside the nation's greatest artists and poets. Symphony No. 5 in D Introduction The symphony contains a lot of material from RVW's then unfinished opera, The Pilgrim's Progress. When he began the Fifth Symphony, RVW thought he may never finish the opera, and didn't want to waste any good ideas. The symphony does not have a programme, it is absolute music. It is in four movements: a "Preludio" first movement, a Scherzo, a "Romanza" slow movement, and a "Passacaglia" finale. First Movement : Preludio From the very beginning, RVW puts the key signature of this movement into doubt. The movement opens with a horn call in D, set against a firm base (or bass?) of octave C's. Could it be that in the great traditions of British musical 'amateurism', RVW got his transposition wrong? Or is this a deliberate feature of the music, intended to blur the tonality? Musicologists prefer the latter explanation. This is by no means an unusual feature of his music, when he was asked what the 4th symphony was about, RVW replied "It is about F-minor", alluding to his sometimes hazy tonalities, often augmented by his use of modal, mainly pentatonic melodies, which, with no leading note, often help to 'fudge' the tonality. Apart from the horn call, the brass is seldom used, and the texture is light and airy. The first violins then enter, high on the E string, doubled at the octave below by the seconds in an introduction, before their main theme at (1), doubled by flutes. The triplets add rhythmic variety, as well as providing a distinctly 'folkie' feel. During the course of the movement, the distinctive dotted rhythm of the horns hardly ever leaves us. There are some rather abrupt key changes. i.e. Eb to E at (5). We are taken into the Allegro by a sudden change in mood. The music darkens with a slightly sinister version of the horn call in the bassoons. We then enter the Allegro, with a scurrying in the strings, whilst the wind begins a downward progression of notes, which builds to a climax, with strings in semiquavers, until we reach the original

EMINEM: How Much Damage Can You Do With a Pen Essay -- Derogatory Lyri

EMINEM: How Much Damage Can You Do With a Pen "Damn how much damage can you do with a pen", says rapper Eminem in his song titled, Who Knew. This song is on Eminem’s most recent and most controversial album, The Marshall Mathers LP. If it possible for one single quote to sum up my research paper, then this quote does it. There exists an intense and extremely controversial set of circumstances surrounding Eminem and his music. Eminem’s lyrics have been intensely criticized lately and have been categorized as hate-filled and inappropriate by many gay organizations. The leading organization in this controversy is the Gay and Lesbian Alliance Against Defamation, more commonly referred to as GLAAD. Their primary focus is to create consciousness about Eminem’s inappropriate use of derogatory words against homosexuals. GLAAD is protesting Eminem’s album as well as his four Grammy nominations. Since GLAAD is a liberal gay organization, they are limited by definition; in terms of how much they can participate in the complex situation that surrounds Eminem’s lyrics. They see words as either derogatory or not. Therefore they can not truly take part in the discussion about the constant evolution of the meanings of words, that occurs in our society. Eminem is undoubtedly the best artist to use as an example to show the effect of artist’s lyrics upon society, especially upon the youths in our society. Whether or not Eminem’s lyrics are offensive enough to be banned is a discussion without a true answer. Therefore the major focus of my paper, the connection between music (particularly rap and Eminem) and our culture, is a subject which is greatly affected by whomever’s eyes you are looking out of. The most effective way of understanding... ...e beauty of language, and its many varying applications. Rap is a style of music unlike any other. Rap is competition in its rawest and most simple form. It is based on a set of traditions that promotes the besting of those who have just bested you. Doing damage is essential to excelling in rap. If you participate in rap and don’t do damage then you won’t be doing rap justice. If you participate in rap and don’t do damage then you are not sticking to the lofty traditions rap has and you are not helping to enhance language. Most importantly, if you participate rap, or even if you don’t and you voice your thoughts through another form of creative expression and you don’t do damage, then you are cheating yourself. And you will never be able to honestly answer the question of, How much damage can you do with a pen? And that is a lost opportunity that no person deserves.

Wednesday, September 18, 2019

Why Are People Migrating To Colorado :: essays research papers

Why people are migrating to Colorado   Ã‚  Ã‚  Ã‚  Ã‚  Migration and population growth is on the rise in Colorado especially in the center of the state as well as one of the four of the nation's fastest-growing counties in the 1990's due to many factors. Why is Colorado so popular to migrate to? Many people see the versatility the state is attributed with and how convenient it is for employment. People can live in the lifestyle associated with mountains and wildernesses while at the same time have access to a city filled with jobs with a minimal commute. Some also believe that people are drawn to Colorado and attracted to the state because of the typical image of the west, open space, and the old frontier vision that also creates an inviting atmosphere. Californians surprisingly lead the way in migration to Colorado averaging one in every seven residents moving to Colorado. Texas, Florida, Arizona, and Illinois were the following states after California in migration to Colorado in 1997. Although people are migrating to Colorado in large numbers recently, the population growth has taken its toll on the state affecting traffic, schools with overcrowding, and real estate prices. So what are people doing when they migrate to Colorado? Obviously people are becoming attracted to the state for various reasons including most importantly the family type setting in a small city lifestyle. The family setting that has lured people to migrate to Colorado contributes greatly to birthrates that have sky rocketed resulting in a tremendous increase in the state's population . With the increasing population growth Colorado experiences, the creation of jobs becomes a result and a cycle begins to form.

Tuesday, September 17, 2019

A Synopsis of the Documentary Live Nude Girls Unite Essay

Live Nude Girls Unite The film â€Å"Live Nude Girls Unite† is a documentary recorded by the exotic dancers themselves that takes their audience on their journey as they try to unionize their jobs. The dancers were fed up with the treatment and minimal pay they were receiving for their performances. They were not assigned a lawyer but had a negotiator that helped them with their bargaining agreement. These exotic dancers were not disrespected by their costumer’s but also by their employees. Dancers were not allowed sick days and sometimes lost their jobs because of their inability to find another look-a-like dancer to fill their slot. I think the unionization of the sex workers was a viable idea. These dancers deserve the same benefits many other employees receive such as sick pay, health insurance, and respect from their management. Because sex workers are usually stereotyped as sluts, society believes their work should not include benefits. Since they had many people against their request to form a union, it took them many months of negotiating to receive minimal benefits, but it was the start of a new revolution for other sex workers across the country. As word began to spread about the newly formed union in San Francisco, the formation of unions began to spread all over. Numerous exotic dancers now receive benefits through their employers and are getting the fair treatment they deserve. They are protected from unlawful dismal from their jobs and racial discrimination when it comes to who works certain shifts. If the sex workers had no taken a stance to improve their working system many would still be treated unfair.

Monday, September 16, 2019

Background Research Essay

Instructions: For each question, respond in one or more paragraphs of at least four complete sentences. Include supporting facts and details from your research in each response. Provide the sources for your supporting research. Using support from your research materials, identify and explain any political, social, economic, or cultural issues that may shape the story. The Holocaust was going on during this book, and this was a time when many children were vulnerable, and the Nazis killed many young kids, but the chances of survival for Jewish and non-jewish teenagers(13-18) were greater because they could be deployed at forced labor. Source: http://www.ushmm.org/wlc/en/article.php?ModuleId=10005142 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007820 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007817 Imagine what it would be like to live in this situation. Using supporting details from your research, discuss the greatest challenges people might face under these circumstances. When some people are asked about something in the past that somebody else went through, they say, â€Å"I can’t imagine†¦..† And in this case, I really can’t imagine how awful it would be to live in this situation. To be sent to a camp where you are stuffed on a train with hundreds of thousands of people, and you don’t know what is going on. You are separated from your family, the only thing you know. You are put into a gas chamber along with millions of other kids who are too young to work for the German’s, and elderly people who are too old to work. To make it easier on the Germans’, they tell you and your family that is going to be used for forced labor that you’re going to take a shower, and you’ll be back later. But, they never, ever, get to see you again. If you live in the ghetto, you are left without shelter and food because you are unproductive and, â€Å"useless eaters.† And finally, it all stopped when the Nazis surrendered, but it was too late for most, they already were gone, or had a important piece of them that was left in the camp chambers. Sources: http://www.ushmm.org/wlc/en/article.php?ModuleId=10005142 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007820 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007817 Based on your research, describe how these circumstances would affect a person’s identity development (crisis, commitment, diffusion, foreclosure, moratorium, achievement). The personal identities of people who were in the Nazi camps would be much, much more sophisticated than the average person now a days. In Nazi camps, the identity crisis of a lot of people was most likely, ‘how do I stay alive?’ while peoples identity crisis in todays world might be something as little as, ‘who is a good friend?’. Kids and elderly people didn’t have a commitment during this time period, because they didn’t have the chance to decide what they wanted to do. The Nazi’s decided for them. People in the Nazi camps didn’t have identity diffusion because they couldn’t make any decisions on their own, the German’s made them all for them. They didn’t have identity foreclosure either, because they were not able to commit to anything at the camps because they were just ordered to do whatever the German’s wanted. I suppose that some people in the camps could have an identity moratorium, and it might be, ‘Do I run away and risk being killed? Or should I just stay and work until this is over?’. The identity achievement of one in a Nazi camp might be, ‘after struggling to decide he wanted to stay and work, or run away and have the chance of being killed, he decided to wait, and finally when the war was over and the Nazi’s surrendered, he was set free.’ Sources: http://www.ushmm.org/wlc/en/article.php?ModuleId=10005142 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007820 http://www.ushmm.org/wlc/en/article.php?ModuleId=10007817

Sunday, September 15, 2019

Feminist Principles

Andrea’s difficulties and problems in her two worlds show that she could not able to perform her duties, obligations, plans, and goals in her life. The main issue about Andrea is that she wanted to have both worlds – having a perfect family and a successful career. However, this became her shadow of darkness because both of these worlds suffer right through her hands. That is why the most basic situation that happened to Andrea is to become depress with her situation as a person, a mother, a wife, and a career woman.1. Andrea’s marriage is merely the basic problem in this context. Her family and career life joined together to ruin her identity and individuality as a woman. Her husband did not support her anxieties and problems that occurred within her. That is why it can be said that her partner was a non-participant in her situation. † When marital arrangements are inequitable in terms of power and decision-making, and household workloads are unevenly dist ributed, women continue to be disadvantaged (Worrel and Remer, 182).† In opposition to what Andrea is trying to testify, she thought that she was discriminated and disadvantaged because she did not obtain what she think is ‘for her. ’ These issues are part of Andrea’s being and tangled situations. However, based on Andrea’s description of her present scenario, it can be seen that marriage for her in the beginning is not a major conflict for her goals and aspiration because she sets aside the needs of her partner for the thinking that he is just there by her side but her career could not wait.It is then a justification that Andrea tried so hard to eliminate the social idea or notion towards women. Nevertheless, she became unsuccessful because she herself could not able to undermine the stress and difficulties that she currently experiencing. There are several factors emerged to Andrea’s depression – her personality, her family, her caree r, and her social environment. All of these issues are part of her depression that led her to uncontrollable weeping. Based on my own observation, I have seen three main issues that should be addressed to Andrea’s situation.First, her personality – she wanted to level herself with the situation of her husband. In the field of Women Studies, it was said that women from the past and up to this generation are still behind or beneath men. Andrea wanted to deconstruct this idea so she strived hard to achieve her goal. However, nothing has change in the society because like Andrea’s case, the modern society still put women at the bottom of men’s victory and female prejudice. Second, her goals and plans in life – she wanted to aim and live higher than what she needs to expect.She wanted perfection to be able to gain power. She is in need of self-satisfaction to be able to prove that she has the capability to be more than what other women can. â€Å"The l ow rate of positive outcomes is assumed to result in increasingly passive behavior and dysphoric mood, as the individual feels incapable of reaching personal goals and reacts with withdrawal and despair (Ibid, 184). † Because of these factors, she became focused to her self-perfection and blinded by her personal plans and goals in life.Lastly, her social environment – because she wanted to pursue the standard of the society, she tends to forget that small details of her life. She transferred her mind into a notion that she can disregard her being a mother for a while because she is in the level of her success in her job. 2. Feminist Principles and therapy will help Andrea to understand the underlying factors in her situation as a woman. This is to make Andrea understand why she is experiencing difficulties in life that brought failure to her individuality as woman and a wife.The best principle that can be used towards Andrea’s issues is the Egalitarian relationsh ip. This principle helps her to recognize the differences of being a man and a woman in a society. This is also to recognize how a person is capable of being what she truly wanted despite of the dictations of the society towards or against her. However, the main conflict here is that the relationship between Andrea and her husband that cannot be avoided by Andrea because her husband is not part of her growth and circumstances.â€Å"In advocating egalitarian client–counselor relationships and counselor self-disclosure, Empowerment Feminist Therapy embraces a female perspective on the therapeutic process that conflicts with many beliefs of traditional therapies which are based on stereotyped male values (Feminist Transformation and Counseling Theories, 95). † 3. Based on my understanding to Andrea’s situation and the cognitive-behavioral procedures, the most relevant among all the procedures are the coping skills, self-instructions, and stress inoculation. These t hree procedures are the best ways to make Andrea become more comfortable with her situation.Because life is always a changing world, it shows that Andrea’s life and environment also changes. It only means that coping-skills, self-instructions, and stress inoculation will let Andrea feel her true side – her identity and the ways on how to ease the pain that she continue to comprehend. In coping skills, Andrea can have the understanding how she has gone through her life. She needs to strengthen her feelings and ideology to become aware of the things in her environment to be able to accept the facts of life. In self-instruction, Andrea needs to choose her path with freedom.She needs to accelerate her mind and thoughts towards her obligations and purpose in life not on what she needs to become. In stress inoculation, Andrea needs to realize that stress builds all her anxieties in life. Therefore, to be able to recover from extreme stress that she experienced, she needs to be vaccinated with good ambiance and aura coming from other people and her environment. 4. Because Andrea’s husband is a non-participant of her situation, it is a big circumstance or problem for her. However, the main thing that needs to consider is the need to know Andrea’s wholeness.The most basic thing that needs to construct in Andrea’s life is her being. It is more important that making her husband capable of knowing her as a wife and a woman. â€Å"Women are frequently unaware of how their automatic thoughts and behaviors are shaped and maintained by the gender-driven expectations of others (Ibid, 185). † It is true as what Worrel and Remer said in their research. Therefore, it is important to make Andrea feel that despite of her husband’s criticism and being a non-participant, she needs to move her life and exit from the darkness of stress and defeat. 5.I can say that based on Worell and Remer’s model of intervention, the best crisis intervention approach that fits to women who experience depression is the conflicted interpersonal behavior because it is a wide range that talks about the social conflicts and beings of a person within her environment. Feminist Principles become included in this crisis intervention because it gives the probability to gain the strength and new identity of women during their extreme stress. As the feminist principles work, the crisis intervention will make each understanding reliable and conducive to the patient.For me, the crisis intervention that might not fit is the material burden because this is not really a problem at all because big percentage of women are already stable because of their husband or partner. Therefore, it is less pressure for women to think of their finances rather than their personal needs and achievements. References Worrel and Remer. (date). Feminist Perspective in Therapy. pp. 171-194. (date). â€Å"A Feminist View of Counseling and Therapy. † pp. 91 -134.