Testing emotion regulation as a functional transdiagnostic construct

The polythetic criteria of the DSM and ICD generate high amount of symptom heterogeneity as there are clusters of symptoms within various diagnostic category that are heuristically similar, resulting in multiple, often confusing, ways of describing sequelae of symptoms presentation. This is because the DSM and ICD classification systems were developed based on the neo-Kraepelinian framework for classifying physical illnesses, which assumes that the underlying architecture of psychopathology, which manifest in disorder symptoms, are distinct and specific. Based on this, the categorical approach to describing psychopathology has been described as purely conceptual artefact with no empirical basis in research or practice. Studies indicate that conceptualizing disorders based on their underlying etiology would yield more valuable information, by highlighting the functional liabilities that portend risks for disorder symptom presentation. As a result, various transdiagnostic models of psychopathology have been proposed to explain the underlying mechanism of disorder symptoms. However, existing transdiagnostic models of psychopathology are mostly atheoretical, as there is absence of a well-grounded conceptual formulation backing their fundamental assumptions. This has resulted in an explanatory vacuum regarding the structure of psychopathology etiology, frequent symptom heterogeneity within disorders, and non-specificity of disorder symptoms. Current study sought to explore these limitations by testing emotion regulation difficulties as a functional transdiagnostic construct that underlie symptoms of anxiety- and mood-related disorders, using factor-mixture modeling. The results of the study indicated that the best fitting model of the structure of emotion regulation difficulties is a hybrid model, consisting of two categories and six factors. The class status differentially predicted experiences of anxiety- and mood-related disorders, even after controlling for education, age, and adverse life events. The dimensions of emotion regulation difficulties suggested that variations in the severity of psychopathology symptoms within the classes occurred based on six distinct factors, resulting in heterogeneity of symptoms within classes and comorbidity among symptoms of different disorders. Overall, the study results provide support for emotion regulation difficulties as a functional transdiagnostic construct across symptoms of psychopathology

A Sociotechnical Systems Analysis of Building Information Modelling (STSaBIM) Implementation in Construction Organisations

The concept of BIM is nascent but evolving rapidly, thus, its deployment has become the latest shibboleth amongst both academics and practitioners in the construction sector in the recent couple of years. Due to construction clients buy-in of the BIM concept, the entire industry is encouraged to pursue a vision of changing work practices in line with the BIM ideas. Also, existing research recognises that the implementation of BIM affects all areas of the construction process from design of the building, through the organisation of projects, to the way in which the construction process is executed and how the finished product is maintained. The problem however is that, existing research in technology utilisation in general, and BIM literature in particular, has offered limited help to practitioners trying to implement BIM, for focusing predominantly, on technology-centric views. Not surprisingly therefore, the current BIM literature emphasises on topics such as capability maturity models and anticipated outcomes of BIM rollouts. Rarely does the extant literature offer practitioners a cohesive approach to BIM implementation. Such technology-centric views inevitably represent a serious barrier to utilising the inscribed capabilities of BIM. This research therefore is predicated on the need to strengthen BIM implementation theory through monitoring and analysing its implementation in practice. Thus, the focus of this thesis is to carry out a sociotechnical systems (STS) analysis of BIM implementation in construction organisations. The concept of STS accommodates the dualism of the inscribed functions of BIM technologies and the contextual issues in the organisations and allows for the analysis of their interactive combination in producing the anticipated effect from BIM appropriation. An interpretive research methodology is adopted to study practitioners through a change process, involving the implementation of BIM in their work contexts. The study is based on constructivist ontological interpretations of participants. The study adopts an abductive research approach which ensures a back-and-forth movement between research sites and the theoretical phenomenon, effectively comparing the empirical findings with the existing theories and to eventually generate a new theoretical understanding and knowledge regarding the phenomenon under investigation. A two-stage process is also formulated for the empirical data collection - comprising: 1) initial exploratory study to help establish the framework for analysing BIM implementation in the construction context; and 2) case studies approach to provide a context for formulating novel understanding and validation of theory regarding BIM implementation in construction organisations. The analysis and interpretation of the empirical work follows the qualitative content analysis technique to observe and reflect on the results. The findings have shown that BIM implementation demands a complete breakaway from the status quo. Contrary to the prevailing understanding of a top-down approach to BIM utilisation, the study revealed that different organisations with plethora of visions, expectations and skills combine with artefacts to form or transform BIM practices. The rollout and appropriation of BIM occurs when organisations shape sociotechnical systems of institutions, processes and technologies to support certain practices over others. The study also showed that BIM implementation endures in a causal chain of influences as different project organisations with their localised BIM ambitions and expectations combine to develop holistic BIM-enabled project visions. Thus, distributed responsibilities on holistic BIM protocols among the different levels of influences are instituted and enforced under binding contractual obligations. The study has illuminated the centrality of both the technical challenges and sociological factors in shaping BIM deployment in construction. It is also one of the few studies that have produced accounts of BIM deployment that is strongly mediated by the institutional contexts of construction organisations. However, it is acknowledged that the focus of the research on qualitative interpretive enquiry does not have the hard and fast view of generalising from specific cases to broader population/contexts. Thus, it is suggested that further quantitative studies, using much larger data sample of BIM-enabled construction organisations could provide an interesting point of comparison to the conclusions derived from the research findings

Expansive learning in contemporary construction organisations

Purpose – The evolving roles of BIM and smart building technologies in the design and management of construction projects often present unexpected events and variabilities, which tend to erode professionals’ prior knowledge authority. The purpose of this paper is to explore how construction organisations can deploy knowledge and adapt to the requisite skills in order to make fitting responses to the ever evolving technological and organizational transformations to address the prevailing construction challenges. Design/methodology/approach – The paper opted for abductive research approach which ensures back-and-forth iterative dialogue between the empirical data and an amalgam of the theoretical proposition towards new understanding of the phenomenon under investigation. Multiple case study method was adopted to collate the empirical data from three separate construction organisations as they transitioned into BIM compliant work processes. Findings – The study has described new processes that not only mediate existing practices, but focuses on consistently resolving known tensions and contradictions between prior knowledge and the requirement of the changing work situation. The study also illustrates the cognitive synchronisation of the learning approaches within contemporary work organisations that align well with the merits and utilities entrenched within their niche technological choices. Research limitations/implications – Due to the chosen research methodology, it is acknowledged that future comparative studies using a much larger quantitative data sample to further elucidate the findings of this paper would be an interesting further step. Originality/value – The study contributes to construction management literature by providing new insights into expansive learning environments capable of addressing cognitive contradictions and ambiguities inherent in the changing contemporary work patterns in the construction context as a consequence of BIM deployment

Dynamics of empowerment in projects

Empowerment varies depending on the targeted population, the targeted setting and also fluctuates across time. These perspectives have rarely been examined simultaneously and no theoretical framework has as yet articulated such an integrative perspective in any specific setting. The complex and dynamic nature of the project environment and the project life cycle in particular have significant implications for understanding how empowerment manifests in projects. To better understand the implications of empowerment’s multifaceted nature in a complex setting such as the project environment, we invoke complexity paradigm as a theoretical lens that is well positioned to help capture the essence of empowerment. From this theoretical framework, the true nature of how empowerment can intertwine with the complex and uncertain project context can be captured and described from the perspective of the workforce or actors engaged in the creation, execution, and closure of the project. Three preeminent questions that can aid this line of enquiry emerge from this review; how can organisations empower employees at different levels simultaneously within the same project team and still achieve goal congruence?; how does the changing nature of the project life cycle impact on employee empowerment experiences?; and what does the multidimensional perspective on empowerment add to our knowledge of empowerment in organisations

A spatiotemporal perspective on empowerment

The complex and dynamic nature of project environments presents both opportunities and challenges for the empowerment of individuals and teams. Yet, empowerment is a complex concept in its own right, taking on multiple forms across people, is contextually embedded and shifts over time. As research on empowerment in projects continues to grow, pertinent questions are emerging aimed at promoting the growth of empowerment theory and its applicability in practice. For example, how do organizations empower employees at different levels and still be able to achieve goal congruence across the organization?; how does empowerment manifest itself across project phases?; and how does empowerment manifest across co-located or geographically/physically spaced individuals on the same or different projects/teams across the same organization? The multiplicity and dynamism of empowerment in projects across three aspects - space, time and levels, and their intersections are examined within the context of the complex, dynamic and uncertain operational realities of projects. It is argued that such a spatiotemporal agenda is better understood through the lens of chaos and complexity theory, a perspective that reveals the way in which empowerment is intertwined with other managerial interventions and business strategies for the successful delivery of projects

Spanning the multilevel boundaries of construction organisations: Towards the delivery of BIM-compliant projects

Purpose The purpose of this paper is to study the interdependent boundary-spanning activities that characterise the level of permeability of knowledge, information flow and learning among construction supply chains involved in the delivery of building information modelling (BIM)-compliant construction projects. Construction projects are mobilised through a number of interdependent processes and multi-functional activities by different practitioners with myriad specialised skills. Many of the difficulties that manifest in construction projects can be attributed to the fragmented work activities and inter-disciplinary nature of project teams. This is nevertheless becoming ever more pertinent with the rise of technology deployment in construction organisations. Design/methodology/approach The study combined experts’ sampling interviews and a case study research method to help offer better insights into the kind of emerging multilevel boundary practices as influenced by the rapidly evolving construction technological solutions. The experts’ sampling helped inform better understanding by unravelling the key changes in contemporary boundary configurations and related boundary-spanning practices within technology-mediated construction project settings. The case study also helped to establish the manifestation of best practices for managing multilevel boundaries in BIM-enabled construction project organisations. Findings The study has revealed that different generic organisational BIM strategies as developed in specialised boundaries are reconfigured as appropriate at the project level to produce project-specific BIM execution plan (BXP). The outcome of project BXP is dependent on the project organisational teams that cooperate in creating new solutions and on conceding space for negotiations and compromises which conflicting interests at the project level can find to be both desirable and feasible. The implementation effort is therefore contingent on mutual translation in which different actors with different insights instigate their practice through negotiation and persuasion which eventually are reinforced by contractual agreements and obligations. Originality/value The paper has presented a novel and well-timed empirical insight into BIM-enabled project delivery and best practices that span multilevel boundaries of construction organisations

Interplay between foetal haemoglobin, micronutrients and oxidative stress biomarkers in sickle cell anaemia children

Foetal haemoglobin (HbF) has been speculated to have an impact on the quantity of micronutrients and the latter also have a role to play in oxidative stress (OS) in sickle cell anaemia (SCA). No previous study in Ghana has examined the interplay of these factors together among SCA children. This study compared the levels of OS biomarkers (8-hydroxy-deoxyguanosine [8-OHdG] total antioxidant capacity [TAC]) and micronutrients (zinc and copper), and their relationship with HbF in SCA and sickle cell negative, apparently healthy children. This case-control study recruited 58 SCA (out-patients [n = 42] and in-patients [n = 16]) children aged 1–14 years as cases and 62 sickle cell negative children as controls from the Sickle Cell Unit at the Eastern Regional Hospital, Ghana. The micronutrients were measured using the atomic absorption spectrophotometer (AAS) whereas OS biomarkers and HbF were assayed using enzyme-linked immunosorbent assay (ELISA). SCA out-patients had a significantly higher level of HbF compared to HbA patients (p = 0.035). SCA in-patients had significantly increased levels of zinc, but a reduced 8-OHdG than SCA out-patients compared to control group (p \u3c 0.05). HbF correlated significantly (r = 0.318, p \u3c 0.038) with zinc in SCA out-patients. Micronutrients are essential in maintaining the redox status in SCA out-patients and HbF can influence some micronutrients

Coagulation factors and natural anticoagulants as surrogate markers of preeclampsia and its subtypes: A case-control study in a Ghanaian population

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case-control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (p \u3c .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 g/mL), PS (6.58 g/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥ 0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies

Biomarkers of oxidative stress and its nexus with haemoglobin variants and adverse foeto-maternal outcome among women with preeclampsia in a Ghanaian population: A multi-centre prospective study

Introduction Haemoglobin variants and preeclampsia (PE) are associated with adverse fatal events of which oxidative stress may be an underlying factor. Oxidative stress (OS) among preeclamptic women with haemoglobin variants has been well established. It is, however, unclear whether haemoglobin variants induce OS to aggravate the risk of adverse foeto-maternal outcomes in pregnant women with preeclampsia. We measured the levels of OS biomarkers and determined the association between haemoglobin variants, and adverse foeto-maternal outcomes among pregnant women with PE. Methods This multi-centre prospective study recruited 150 PE women from three major health facilities in both Bono and Bono east regions of Ghana from April to December 2019. Haemoglobin variants; HbAS, HbSS, HbSC, HbCC, and HbAC were determined by haemoglobin electrophoresis. OS biomarkers such as malondialdehyde (MDA), catalase (CAT), vitamin C, and uric acid (UA) along with haematological and biochemical parameters were estimated using standard protocol. Adverse pregnancy complications (APCs) such as post-partum haemorrhage (PPH), HELLP (Haemolysis, Elevated liver enzymes, Low platelet count) syndrome, preterm delivery, neonatal intensive care unit (NICU) admission, and neonatal jaundice were recorded. Results Of the 150 pregnant women with preeclampsia, the distribution of haemoglobin AA, AS, AC, CC, SS and SC phenotypes were 66.0%, 13.3%, 12.7%, 3.3%, 3.3% and 1.3%, respectively. The most prevalent foeto-maternal outcomes among PE women were NICU admission (32.0%) followed by PPH (24.0%), preterm delivery (21.3%), HELLP syndrome (18.7%), and neonatal jaundice (18.0%). Except for vitamin C level which was significantly higher in patients with at least a copy of Haemoglobin S variant than those with at least a copy of Haemoglobin C variant (5.52 vs 4.55; p = 0.014), levels of MDA, CAT, and UA were not statistically significantly different across the various haemoglobin variants. Multivariate logistic regression model showed that participants with HbAS, HbAC, having at least a copy of S or C and participants with HbCC, SC, SS had significantly higher odds of neonatal jaundice, NICU admission, PPH and HELLP syndrome compared to participants with HbAA. Conclusion Reduced levels of vitamin C are common among preeclamptics with at least one copy of the HbC variant. Haemoglobin variants in preeclampsia contribute to adverse foeto-maternal outcomes with Haemoglobin S variants being the most influencing factor for PPH, HELLP, preterm labour, NICU admission, and neonatal jaundice

Quality of glycemic control in type 2 diabetes mellitus (T2DM) and its association with markers of coagulation and inhibitors of fibrinolysis: A case–control study in the upper west region, Ghana

Background and Aims: Type 2 diabetes mellitus (T2DM) individuals are at a higher risk of developing diabetes complications, with approximately 80% complication-related mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis. Methods: This case–control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), prothrombin time (PT), calculated international normalized ratio (INR), and full blood count (FBC) were determined for each respondent. Plasma levels of plasminogen activator inhibitor-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) were determined using the solid-phase sandwich enzyme-linked immunosorbent assay method. Data were analyzed using R language software. Results: Plasma PAI-1 antigen levels were significantly higher in the participants with poor glycemic control as compared to participants with good glycemic control (p \u3c 0.0001). There was no significant difference in plasma TAFI levels between the participants with poor glycemic control as compared to participants with good glycemic control (p = 0.900). T2DM patients had significantly shorter APTT, PT, and INR than controls (p \u3c 0.05). At a cut-off of ≥ 161.70 pg/μL, PAI was independently associated with increasing odds (adjusted odds ratio = 13.71, 95% confidence interval: 3.67–51.26, p \u3c 0.0001) of poor glycemic control and showed the best diagnostic accuracy for poor glycemic control (area under the curve = 0.85, p \u3c 0.0001). Conclusion: PAI-1 levels were significantly increased in T2DM with poor glycemic control and emerged as the best predictor for poor glycemic control. Good glycemic management to control the plasma levels of PAI-1 is required to prevent hypercoagulability and thrombotic disorders