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What are the health concerns for soldiers who have a diagnosis of Post-Traumatic Stress Disorder and Traumatic Brain Injury?

What are the health concerns for soldiers who have a diagnosis of Post-Traumatic Stress Disorder and Traumatic Brain Injury?

Setting and Population of Interest

The effects of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) are often considered as separate conditions, but for people living with the dual diagnosis of the two conditions, it may be difficult to separate the conditions.  PTSD and TBI are considered under DSM-5 as separate conditions, whereby PTSD is included as a new category under the Trauma and Stressor-Related Disorders requiring exposure to a traumatic or stressful event as a diagnostic criterion, and TBI is addressed in the chapter entitled Neurocognitive Disorders, with diagnostic criteria for mild or major Neurocognitive Disorder (American Psychological Association, 2013).

PTSD and TBI are common disorders in the US with highest prevalence rates among veterans. Given that the conditions are often sustained in traumatic experiences (Bryant, 2011), the number of veterans that have experienced TBI and PTSD increased significantly following conflicts in Iraq and Afghanistan (Summerall & McAllister, 2010).  According to the Defense and Veteran’s Brain Injury Center, about 22% of all combat casualties from such conflicts are brain injuries (Summerall & McAllister, 2010).  Summerall and McAllister also report that about 60% to 80% of soldiers with blast injuries may also experience traumatic brain injuries. Epidemiological studies indicate that in the US, 21% of women, and 8% of men develop PTSD (Bryant, 2011).  Similarly, studies focusing on Detroit alone indicate that 13% of women and 6% of men develop PTSD. This alone shows that while men are more exposed to traumatic events as compared to women, women have a higher risk of developing the condition compared to men.  It is also estimated that close to 5.3 million people in the US alone live with disabilities due to TBI, and the TBI risk among the military personnel is estimated to be between 10% and 20% (Bryant, 2011).  More studies indicate that PTSD can develop following a mild TBI (Cited by Bryant, 2011).

 

Rationale and Significance of the Problem

A common postwar experience across generations of veterans encompasses a range of symptoms involving fatigue, headaches, memory and concentration problems (Hoge, & Castro, 2014).  Service members returning from various peace-keeping missions and other military deployment have often experienced comparable to those of prior wars, and as Hoge and Castro report, the focus has now narrowed down to two concerns: PTSD and TBI.  While most TBI cases are mild, their screening, treatment, and research efforts have surrounded on the interactions of TBI and PTSD after exposure to combat events such as blasts (Bryant, 2011; Hoge, & Castro, 2014).

Post-Traumatic Stress Disorder and TBI are not limited to service members exposed to combat, but their prevalence rates among the military service members are much higher compared to civilians (Wall, 2012).  Besides, when PTSD co-exists with TBI, it becomes even more difficult to sort out what an individual is going through.  In the presence of the two conditions, one condition basically feeds and reinforces the other, resulting in a complex mix that is difficult to isolate. Individuals with these disorders tend to be hypervigilant to somatic cues since they believe that they represent a threat to their physical well-being (Bryant, 2011).  Therefore, to address the confusion due to the interaction of TBI and PTSD, it is crucial to explore the health concerns of soldiers with a dual diagnosis of TBI and PTSD.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishers.

Bryant, R. (2011). Post-traumatic stress disorder vs traumatic brain injury. Dialogues in clinical neuroscience13(3), 251.

Hoge, C. W., & Castro, C. A. (2014). Treatment of generalized war-related health concerns: placing TBI and PTSD in context. Jama312(16), 168g5-1686.

Summerall, E. L., & McAllister, T. W. (2010). Comorbid posttraumatic stress disorder and traumatic brain injury in the military population. Psychiatric Annals40(11), 563-580.

Wall, P. L. (2012). Posttraumatic stress disorder and traumatic brain injury in current military populations: a critical analysis. Journal of the American Psychiatric Nurses Association18(5), 278-298.

 

Website Evaluation In-Class Essay

 

Website Evaluation In-Class Essay

The ULTA Beauty website (www.ulta.com/) is as a premier beauty destination targeting women and women who seek different trending and classy beauty products. The website’s purpose is to offer premium beauty products including cosmetics, fragrance, skin, hair care products, and salon services from well-established and emerging beauty brands across all categories and price points. With more than 500 beauty brands, the website offers at least 25,000 products. Any new visitor vising the site for the first time can easily note that the site focuses on elegance and quality. Since the website mainly targets young people, the tone of voice is a fun and classy shopping store focused on offering trending and diverse beauty products.

The website has a header with the signup, rewards, search, and rewards sections. The left sidebar has a menu with different categories of beauty products. Most of the products target young women although there is a men’s section just before the different customer packages such as gifts, coupons, and allure winners section. The main content area includes pictures of different products and their prices with a slider. Finally, the lower tab before the footer includes a section of key components about the company, sitemap, and other services offered. This section provides users with crucial information, such as shipping procedures, how to track orders, different stores owned by the company, and payment options

The slider is the first noticeable feature as well as the pictures of different products offered. All products come with a different background that matches with the image. The white theme for the website also makes it easier to note different links. Finally, the website includes a streaming headline of Black Friday offers among other gifts and discounts offered. The visual features are attractive to the viewer and given the high quality of the images and the matching background, the user can only conclude that the products are elegant, quality, and classy.

The website is easy to navigate since it highlights different categories that users can easily choose from in the sidebar menus. The slider is also catchy and a user can easily explore more areas of the website. Additionally, the footer with “FREE SHIPPING on any $35 purchase” is also visible and attractive. Further, since the sidebar menu is static, one does not have to scroll to check the categories of products.

Although the main target is women, it would be better to make the Men’s section visible by rearranging the sidebar list. New visitors cannot easily see these attributes unless they are keen on checking the menu and may easily conclude that the website only targets women. The slider speed is also quite fast and a visitor may not get enough time to get a snapshot of common products. Further, given that the website does not have a live chat option, it would be better to include a contact us option that visitors can easily see. This can be included bottom right or the header.

Given its simple appeal but detailed menu, slides, footer, header, and content arrangement, the website is effective in conveying its underlying information. The first view and conclusion a visitor gets is that this is an online beauty products shop, which mainly targets young women. The quality of the images provides presents its classy nature and convinces the visitor to explore more options such as the categories in the sidebar and even use the search option in the header. However, it is important to focus on categorizing the sidebar into men’s and women’s collections.

Vision Analysis and Revision Process

 

Financial Needs Assessment: Vision Analysis and Revision Process

 

Xxxxamount in any organization. Because schools have limited financial resources, it is important to manage those resources well. An analysis of current financial processes and operations can identify challenges which require future consideration. By anticipating and planning for challenges, schools can position themselves for future success.

 

Keywords: school finance, strategic challenges, partnerships

 

Financial Needs Assessment: Vision Analysis and Revision Process

Xxxx is a private, Christian school in central Virginia. XXXX has an enrollment of approximately 2,000 students with 175 faculty and staff. The mission of XXXX is to provide opportunities for students to realize their God-given potential (Xxxx, n.d.). Because students are gifted in many areas, XXXX seeks to provide a wide variety of opportunities including academic, vocational, fine arts, applied arts, technology, and athletic programs. XXXX’s budgetary approach reflects the vision, mission, and goals of the school (Brimley, Verstegen, Garfield, 2016). XXXX has the benefits and challenges of a high level of autonomy, therefore, a careful analysis of financial processes and operations can provide insight for future planning. By anticipating challenges that may come, XXXX will be better prepared to counteract these challenges as they come.

Analysis of Financial Processes and Operations

There are several primary ways in which programs are funded at XXXX. The primary method of funding is through required tuition and fees families pay for attending XXXX. Another method is through optional fees paid by families to participate in specific programs. Some programs are funded through specific partnerships with either other organizations, private donations and endowments, or grants.

Required Fees

            One program at XXXX that is funded through required fees is the 1:1 iPad initiative. The program provides an iPad for all students in grades 8-12 and is intended to provide technology for greater engagement and differentiation. Danny Smith, the iPad coordinator at XXXX, explained the costs of the program, including $379 for the iPad, with additional costs for the management system, apps, teacher training, and maintenance (personal communication, November 1, 2016).  Families are charged $100 per year.

Optional Fees

Some programs at XXXX are funded through optional fees, paid only by families who participate in those programs. One program that is optional is Reading Intervention, a program for elementary students who would benefit from additional reading instruction and support. Families pay $250 per year for the pull-out program, with enrollment fluctuating between 40-50 students. The costs involved in the program include Reading Plus, a supplemental computer program, PALS testing to identify students, and other resources and supplies (Karen Barnhart, personal communication, November 4, 2016).

Another program at XXXX that is optional is STEM Nation, a STEM program for students in grades 2-5. Families pay $700 per year for student participation, with additional costs for field trips. Jennifer Stinnette, the STEM teacher, said most of this fee is for the consumable materials required for students to complete the design challenges (personal communication, November 2, 2016).

Partnerships

            XXXX also receives funding through partnerships. For example, the 1:1 iPad initiative was supplemented with a $100,000 donation from Sodexo (Danny Smith, personal communication, November 1, 2016). Sodexo made the donation to advance technology in partnering schools. The program is in the second year of implementation and has been successful thus far. M. H., an XXXX high school student, has enjoyed the organizational aspect of having notes, books, and tools for innovation in one device (personal communication, November 2, 2016). Nicole Griffin, the Elementary Assistant Principal at XXXX, secured a $500 grant through Agriculture in the Classroom, for an aquaponic gardening system for the STEM Nation program (November 4, 2016). This grant not only provides financial support for the program, but also expands the visibility and credibility of the program.

Strategic and Tactical Challenges

There are several strategic challenges that could affect the funding of programs at XXXX if not addressed, including training for teachers, program support and buy-in, and partnership development.

Training

            Training is a strategic challenge with any program. Charity Edwards, an XXXX English teacher, was originally resistant to the iPad initiative, but after training, believes the iPads have not only improved her classroom workflow, but have opened a wealth of resources and additional vehicles for instruction and assessment (personal communication, November 2, 2016). Effective training helps to maximize resources.

Program Support

Parental support and buy-in is especially important for the sustainability of programs at XXXX that are funded through optional fees. Karen Barnhart, said some students need the additional support, but do not participate for financial reasons (personal communication, November 4, 2016).  Dawn Thomas, the parent of a STEM Nation student, said she was willing to pay the fee for her son to participate because the program provided “hands-on experiences that showed how the content learned in the classroom applies to the real world” (personal communication, November 3, 2016). Parents will not be willing to pay for optional programs if they do not see the value.

Partnerships

Establishing financial partnerships is a strategic challenge for XXXX. Partnerships, in the form of donations or grants, help to offset costs for families. Partnerships also bring non-financial resources. Danny Smith described the partnership between XXXX and Liberty University, saying that much of the networking and installation of additional internet ports was completed by the LU IT Department, saving XXXX valuable financial and time resources (personal communication, November 1, 2016).

Prioritized Challenges Resulting in Operational Policies and Procedures

Program Support

One of the most important challenges to address first is parental support for programs. Beth Ackerman and Michelle Goodwin, parents of former Reading Intervention students, both felt the program was well-worth their financial investment, stating that the gains their children made as a result of Reading Intervention vastly outweighed the cost of participation (personal communication, November 2, 2016). Sharing parent testimonials in the review materials could help to grow support for the program. Parents often trust the opinions and perspectives of other parents. Another sustainable solution to increase parent support would be to collect and publish data on the success of the program. Dr. Ackerman said her son made 2 years growth in reading during his year in the program (personal communication, November 2, 2016). Parents are much more likely to be willing to spend the additional cost if they can see the data to justify the cost.

Partnerships

Partnerships, in the form of donations or grants, are another challenge that should be prioritized. The partnerships that XXXX has established have been successful, but intentional efforts should be made to grow this area. One operational procedure that could offer a solution is for each program to apply for at least one grant per year. Jennifer Stinnette, the STEM Nation teacher, said grant applications were going to be a priority for her this year (personal communication, November 2, 2016). Another operational policy to increase partnerships would be to increase networking and to ask for partnerships for programs such as STEM, iPads, and Reading. School-business partnerships are most effective at the local level, “where those who live in the community can work toward defining and solving the problems” (Brimley, Verstegen, & Garfield, 2016, p. 140). Athletic teams at XXXX have been successful in seeking out partnership opportunities and it is likely that organizations would be willing to partner with academic programs at XXXX as well.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Brimley, Jr., V., Verstegen, D. A., Garfield, R. R. (2016). Financing education in a climate of change (12th ed.). Upper Saddle River, NJ: Pearson.

 

Types of leadership models in healthcare

Types of leadership models in healthcare

Transactional leadership focuses on work supervision and measure of performance and thus aids in the motivation of a person’s team by use of rewards and punishment. Every action either can elicit a reward if it is recommendable and a punishment if it is deemed to be against the rules (Avolio, Bass & Jung, 2004). This type of leadership is responsive as it focuses on the quality of results. Such actions motivate people to put in more and improve on the quality of work they provide. Therefore, they are better motivated to take responsibility for action committed. It follows a strict set of rules that has no room for emotional consideration of employees because it focuses on following certain regulations that limit creativity. During execution of a project, each employee is held accountable for errors individually. It also derails motivation of the people as it portrays that the administration does not care for them. This kind of leadership makes people worry about their own well-being instead of everyone in the organization, as reward and punishment are individual, further limiting the unity of a group.

In transformational leadership, people lead by action. Leaders set an example to be followed by their employees. They focus on things that make small positive steps for an organization. Transformational leaders are led by a will to maintain morality and have a strong character. In this leadership style, administration is characterized by courage and the will to sacrifice for the ultimate gain of people being served. It does not follow any strict rules, which creates room for creativity and implementation of new ideas (Avolio, Bass & Jung, 2004). It also focuses on unity of a team and mutual concern for fellow employees. Transformational leaders relay information of their vision to all employees so that the organization has a common target. This leadership inspires enthusiasm within a team, which then optimizes quality of service provided. However, too much zeal portrayed by transformational leaders, is harmful in instances where they may fail to scrutinize and study the true situation of an organization and end up ignoring some existing flaws.

In visionary leadership, leaders constantly remind their team about the vision they intend to achieve. It involves relaying information as needed and listening to employees’ responses and incorporates their ideas into improving the state of an organization. This leadership enables individuals to take worthy risks and conduct sufficient planning which is essential in boosting development and new discoveries for any organization. This kind of leadership occurs as most visionaries take many risks, some of which do not have absolute certainty of succeeding.

Servant leadership emphasizes on team building and cohesion by giving a common base of mutual trust. Leaders are in the forefront leading by example providing services to their fellow workers. Servant leadership invests in people, making them better and likely to succeed as a unit (Salanova, Lorente & Chambel, 2011). It provides an environment where people being led are given a chance to have a sense of self-control and lead themselves without any strict guidance. Leaders apply policies by listening to what people want focusing on every individual’s feelings. However, servant leadership needs everyone to have a similar mentality in order for it to be successful. This has proved to be a challenge especially when dealing with groups where people have diverse perceptions and opinions (Salanova, Lorente & Chambel, 2011). Exercise of authority might turn out to be a challenge because by giving everyone in a group equal responsibility might make some people undermine existing authority.

Leadership in healthcare is very vital to ensure that its working staff is self-sufficient. This is made possible by having proper communication channels between upper and lower management. The importance of leadership is seen in team where unity as a team makes leaders focus on proper service provision to patients. Maximum attention should then be applied when choosing the type of model to apply in an organization.

 

 

 

 

 

 

 

References

Avolio. B, J., Bass, B, M., & Jung, D, I. (2004). Journal of occupational Leadership. Wiley Library.

Salanova, M., Lorente, L. & Chambel, M. J. (2011). Journal of Advanced Leadership Models.            Wiley Online LIbrary.

 

 Type II Diabetes

Type II Diabetes

 

 

Type II Diabetes is a progressive chronic disease stemming from multiple areas of metabolic dysfunction, including insulin resistance, declining insulin production, ineffective hepatic glucose production, and inappropriate hormone activity (Kahn et al., 2014). A healthy body has the ability to balance the neural, nutrient and hormonal components of glucose metabolism. The body has to adjust to altering metabolic demands, caloric intake and breakdown into glucose, with the subsequent uptake of glucose into muscle and adipose by means of insulin. The liver plays a role in gluconeogenesis or the production of glucose, which regulates the amount of glucose released into the bloodstream. Prominent hormone modulators in this process include insulin and glucagon, which work to perform opposite tasks (Kahn et al., 2014). Insulin originates from pancreatic beta cells and is responsible for the uptake of glucose into cells, while also delaying hepatic production of glucose and preventing hyperglycemia (Skyler et al., 2017). Glucagon, however, is from pancreatic alpha cells and stimulates the liver to undergo gluconeogenesis to increase glucose in the bloodstream and protect the body from entering hypoglycemic state (Kahn et al., 2014). In diabetes, however, the system is broken and the mechanism is altered.

The primary faults in the glucose metabolism is insulin resistance of body cells which leaves glucose in the blood stream and beta cell dysfunction resulting in decreasing amounts of insulin production (Kahn et al., 2014). In early stages, the insulin resistance causes the beta cells to go into overdrive to produce more insulin in response to the elevated serum glucose levels (Skyler et al., 2017). Over time, the beta cells lose functionality and insulin production becomes minimal. Due to insulin’s role in inactivating gluconeogenesis, the decline of insulin production leads to hepatic glucose production, increasing serum glucose even more. In sum, insulin resistance, insulin reduction, and hepatic glucagon secretion are the culprits in the unfortunate progression of type 2 diabetes (Kahn et al., 2014).

 

 

 

Reference:

Dodds, S. (2017). The How-To for Type 2 An Overview of Diagnosis and Management of

Type 2 Diabetes Meilitus. Nursing Clinics Of North America52(4), 513-522.

Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Review: Pathophysiology and treatment

of type 2 diabetes: perspectives on the past, present, and future. The Lancet3831068-1083.

Laight, D. (2014). The pharmacology of oral antidiabetic agents. Nurse Prescribing12(12),

604-607.

Saenz, A. (2015). Metformin monotherapy for type 2 diabetes mellitus. Cochrane Database

Of Systematic Reviews, (9),

Skyler, J. S., Bakris, G. L., Bonifacio, E., Darsow, T., Eckel, R. H., Groop, L., & … Ratner,

  1. E. (2017). Differentiation of Diabetes by Pathophysiology, Natural History, and Prognosis. Diabetes66(2), 241.

 

An Analysis of The Research Approaches Taken by The Authors

An Analysis of The Research Approaches Taken by The Authors

Introduction

In the business discussion of leadership, there exists little congruence on the characteristics of a leader (Hersey, Blanchard & Johnson, 2007). The description of leadership, however, can not be attributed to business roots. While it seems hindsight mundanely to base the effectiveness of an organizational leadership based on the accomplishments made, making determinations on whether or not such leadership will be effective before their ascension to leadership stardom is insurmountable. The description of the roles of leadership is extensive in literature, more so in helping, organizations determine the right people assume these roles. Then Aithal and Kumar, (2016a) in their study approach extensively explain five main approaches to help organizations understand leadership, including the traits approach, the situational approach, the functional approach, the relational approach, and the transformational approach.

Brown (2011) postulates that the Trait Approach to leadership exposits on a series of personality, mental, and physical traits possessed by effective leaders. It ranks both as the earliest and one of the primarily predominant approaches to management. Leadership approaches using this style is extensively described using terms such as social influence, ability, and intelligence, task-related, personality, physical and social background.

The literature approaches leaderships then coined the Situational Approach to leadership which theorizes effective leaders on a contingent variety of situational factors (such as follower commitment/motivation, task to be achieved, relationships between the followers and the leader) (Hersey, 1984). Aithal and Kumar, (2016a) among other leadership theorists’ literature extensively use this approach, more so in their description being a relationship or task oriented. Whereas task-oriented leaderships have tendencies to focus on accomplishing tasks and achieving organizational objectives (Brown, 2011) leadership that is a relationship-oriented focus on the creation of positive interactions with the workforce based on mutual respect, confidence and trust (Vroom & Jago, 2007).

While the Situational and Trait Approaches to leadership focus on the primary outcomes of characteristic the help create the leadership concepts, the Functional Approach to Leadership postulates that leadership are not a series of leader characteristics, but rather leaders are persons who communicate like, acts like and looks like a leader (Morgeson et al., 2010). Under this approach, the three basic functions of leadership are the Formulation of an organization’s objectives and purposes, establishment and maintenance of a communication system and securing essential services form the workforce. The Relational Approach to leadership neither tools its focus on the functions, characteristics, and traits of followers nor their leadership, but rather on the relationships that develop between these leaders and the workforces they lead (Uhl-Bien, 2006). A Managerial Grid is used in ranking how they focus on both tasks and relationships. The five types of management under this approach are middle of the road, authority compliance, impoverished, team, and country club.

The Transformational Approach to leadership is popularized by the researchers, more so as it exposits on the two sides of leadership: transformational and transactional (Leithwood & Jantzi, 2005). A transactional approach to leadership focuses on the myriad of exchanges that between a leader and the followers – it popularizes pay raises and promotions to workforces meeting or exceeding an organization’s goals (Shin & Zhou, 2003). Transformational leadership foster engagements that promote connections which raise the leader’s and follower’s levels of morality (Leithwood & Jantzi, 2005). It exceeds the mere reward of employees who exceed organizational exceptions. The three major factors of this approach include inspirational and charismatic leadership, individual consideration and intellectual stimulation (Shin & Zhou, 2003).

The Extent to Which the Researchers Followed the Research Lifecycle

Research methods allow for an organized and systematic way of approaching research questions. Where there exist no singular official research methods, the steps of each research methods usually continuously blend. The outline presented is a description of the research steps followed by the researchers. The research problems were clearly stated and specified based on initial observations. Precisely stating the research problem allowed for the eventuality of the theoretical exposition. The researchers then further collected and analyzed available information on the study question. The stated hypothesis was good as they related to and explained known facts. The hypotheses were stated in such a way that they would be tested by either further observation or by experimentation thus allowing the reader to determin one its falsifiability. The researchers gathered observations, analyzed them and drew conclusions based on hypothesis developed.

An Alternative Approach, How It Supplements or Extends the Literature Presented and What Could Go Wrong

While management and organization researchers continue to emphasize on the development and testing of theories on these topics with little due concern for the impacts of these theories on management practice, there has risen a new voice for concern on the relevance of their research (Mohrman & Lawler, 2011). As the area continues to experience an expansion in literature rapidly, there tandemly continues to be an increase in the number of voices advocating for change. These voices of change have continued highlighting the numerous apparent rationales for closing the existent gaps between research and practice, including pragmatic and instrumental arguments, epistemological and methodological arguments and values-based positions (Hersey et al. 2007). While these rationales cannot be termed mutually exclusive, each offers different windows on the reasons and methods to seek relevance and make differences in organizational practice, more so dependent on how researchers position their work in the broader landscape of knowledge generators.

One of these approaches is the continuously expanding Systems Approach defining effective management in the wider contexts of the external and internal organization’s environment (Aithal & Kumar, 2016a). The approach serves as supplementation, and an extension of the leadership approaches described in the papers presented as it seeks to view an organization as a symbiotic entity where leaders have to deal with both external and internal aspects that affect organizational behavior (Mohrmam & Lawler, 2011). Maintaining a balance between the human and nonhuman inputs that an organization depends on allows for effective leadership. The perspectives of generating actionable knowledge on complex phenomena prerequisites the combinations of various knowledge sources form varying societies rather than linearly informing practice by a set of research recommendations. Efforts to understand phenomena not be fruitful if knowledge perspectives continue to remain narrow, limited and partial within the frameworks in which it operates.

Evaluation of A Management Theory Picked Based on The Bacharach’s Critical Evaluation Scheme

The Theory of Accountability (A) on organizational performance by Aithal and Kumar, (2016a) seeks to challenge the present propositions on how the workforce is motivated to behave. The theory is premised on today’s world employee mindset that has greatly changed due to technological advancements, improved means production means, societal and customer perceptions, relations to production and their individualistic expectations. Quests for organizational creativity propels employees to draw upon their positive energies from their innate potential and models of tuned best performance around these workforces through the exploration of themselves (St. John, 2013). Management approaches based on this theory hold beliefs in target delivery as feelings of creativity, responsibilities, and contributions to motivations and the identifications to organizational accountability and commitment – all the hallmarks of efficiency. Then, the ABCD analyzing technique developed refers to examining a system, model, or concept through focusing on its advantages, benefits, constraints, disadvantages by narrowing to determinant factors, key factors, and critical constituent element (Aithal & Kumar, 2016a). Determinant factors form the overall frame of reference while key factors represent the dimensions on which its advantages, benefits, constraints, and disadvantages are reflected.

Theory A explains the processes by which an organization’s, managerial leadership accomplishes tasks through eight steps of employee influencing. According to Bacharach, (1989) criteria, the theory delineates its theoretical boundaries and explains the assumptions (time, values and scope) that bound the theory. The theory specifies distinctions between hypotheses and proposition, outlines the relationships implied by them and ensures a common language of a common language of constructs and variables across its levels. Thus, the theory, on analysis, meets the theoretical criteria postulated by Bacharach.

Usefulness: the failure of theorists to not seriously consider rules on the formulation of theories they on eventually end up clinging to theories like cultists. Going over such clinging behaviors, which undeniably tend to drive research theorists from fad to foible, prerequisites for a precise discourse, one that allows the theorists to focus on the specific strengths and weaknesses of particular theories. If nothing else, Bacharach’s criteria enhance the accuracy of discourses on theory evaluation.

 

 

References

Aithal, P. S., & Kumar, P. M. (2016a). Organizational Behavior in 21st Century–’Theory A’ for Managing People for Performance. Srinivas Institute of Management Studies, Pandeshwar, Mangalore, INDIA

Aithal, P. S., & Kumar, P. M. (2016b). CCE Approach through ABCD Analysis of ‘Theory A’ on Organizational Performance. International Journal of Current Research and Modern Education (IJCRME), 1(2), 2455 – 5428.

Bacharach, S. B. (1989). Organizational theories: Some criteria for evaluation. Academy of management review, 14(4), 496-515.

Brown, K. G. (2011). Trait approach to leadership. Psychology, 37, 651-665.

Hersey, P. (1984). The situational leader. Center for Leadership Studies.

Hersey, P., Blanchard, K. H., & Johnson, D. E. (2007). Management of organizational behavior (Vol. 9). Upper Saddle River, NJ: Prentice Hall.

Leithwood, K., & Jantzi, D. (2005). Transformational leadership. The essentials of school leadership, 31-43.

Mohrman, S. A., & Lawler, E. E. (2011). Useful research: Advancing theory and practice. San Francisco, CA: Berrett-Koehler Publishers.

Morgeson, F. P., DeRue, D. S., & Karam, E. P. (2010). Leadership in teams: A functional approach to understanding leadership structures and processes. Journal of management, 36(1), 5-39.

Shin, S. J., & Zhou, J. (2003). Transformational leadership, conservation, and creativity: Evidence from Korea. Academy of Management Journal, 46(6), 703-714.

St John, E. P. (2013). Research, actionable knowledge and social change: Reclaiming social responsibility through research partnerships. Sterling, Virginia: Stylus.

Uhl-Bien, M. (2006). Relational leadership theory: Exploring the social processes of leadership and organizing. The leadership quarterly, 17(6), 654-676.

Vroom, V. H., & Jago, A. G. (2007). The role of the situation in leadership. American Psychologist, 62(1), 17.

Theorist Application to Role Stressor

Theorist Application to Role Stressor

 

Acknowledgement

I am very grateful to have the opportunity to study at Spring Arbor University, College of Nursing. I will forever be grateful to my instructor Patricia Shedd for guiding me through this journey. I would also like to thank Dr. Roberts for taking his time to volunteer to help me and also provide guidance in writing papers.

 

 

Section 1

Professionalism in Nursing

Professionalism is said to be the skill, knowledge and behavior pattern portrayed in a structured field. It relates to how individuals explain the meaning of their actions. Professionalism according to Fantahun (2012), is defined as the conceptualization of obligations, attributes, interactions, attitudes, and role behaviors required of professionals in relationship to individual clients and to society. It can also be viewed as a process by which a person acquires the knowledge, skills, and sense of occupational identity characteristic of a professional and involves the internalization of the values and norms of a professional group (Alidina, 2013). It is an important characteristic of in service careers.  For this paper, I will be discussing, what professionalism in nursing is, the value/important of professionalism in nursing practice and the importance of maintaining a good public image of nursing to professional practice. An analysis would be given on Compassion fatigue as a common role stressor and why self-care is important to maintaining professionalism in nursing. Lastly, I will be answering relevant questions to the Roy’s Adaptation Model as well the questions in Section 4 of this assignment as it aligns to requirements of the instructor.

Nursing as an occupation has a history virtually as old as humanity. When told to identify the core values in the nursing profession, virtually everyone in it shares the same values which include, honesty, responsibility, the pursuit of new knowledge, belief in human dignity, equality of all patients and the desire to prevent and alleviate suffering. Thus, professionalism in nursing focuses on helping those in need and improving the quality of life for everyone. It encompasses the responsibilities of nurturing, attention to hygiene, food, comfort, and safety (DeAngelis, 2014). It involves putting patients first, providing them with holistic care while educating patients and their families. It reflects nurses’ behavior, roles, and responsibilities towards ensuring every patient’s safety and wellness. The concept of professionalism in nursing refers to attitudes representing levels of identification with, and commitment to, the profession.

The Value/Importance of Professionalism in Nursing Practice

The nursing profession has been rated as one of the most trusted professions as nurses contribute to health care system through different specialties and skills. Professionalism is an important aspect in every career path most importantly in the nursing field. According to DeAngelis (2014) working with a team of healthcare professionals to provide care for patients in need requires discipline, internal and external composure that stays steady throughout the day. The nursing standard of practice governs and is accountable for every nurses’ action. It provides written guidelines that nurses are required to comply with and if they do not, there are sanctioned appropriately (DeAngelis, 2014). The level of professionalism demonstrated by nurses, and the image created, is crucial in attracting clients. As professional nurses, we are autonomous and accountable for our nursing practice. The practice is based on evidence, research and standards. We are empowered to make decisions about our nursing practice through our shared governance model. Our clinical practice is caring, comprehensive, accurate and reliable (Duffy, 2016).

The Importance of Maintaining a Good Public Image of Nursing to Professional Practice

Nurses play an important role in the healthcare system even though their competence, skill, knowledge, judgment, actions, and roles are sometimes invisible to the public. The public views of nursing and nurses are mostly based on people’s personal experiences with nurses, situations and sometimes the clinic they are dealing with. Duffy (2016) suggested that this experience may not provide an accurate picture of all that nurses can and do provide in the healthcare delivery process. In addition, this view is influenced by the fact that we as humans respond to things and situations differently. The public generally views nurses as good people who care others. For instance, when a person states that he or she is a nurse the reaction is generally positive. Nurses also represent the profession in their personal lives as soon as they say that they are Registered nurses. Nurses are cultivating a professional image through the way they present and represent the profession. Duffy (2016) emphasized the image of the profession is communicated through dress, appearance, name tags, and credential identification, how one communicates and introduces oneself, and how one performs and provides care, this increases visibility and professional growth.

Nurses improve the image of nursing with other healthcare professionals, they represent the profession in a variety of settings. This includes professional meetings, typically nursing meetings, participating in interprofessional meetings. Nurses are encouraged to take an active role in the profession to provide recognition in the healthcare system. According to Hoeve (2014), each year there is a National Nurses Week, and during this week there is a designated National Nurses Day, May 6, just as there is an annual recognition week for many other workers and professionals. This period was chosen because it coincides with Florence Nightingale’s birthday, May 12, which is International Nurses Day.

 

 

 

Section 2

Compassion fatigue

Compassion fatigue is a syndrome that caregivers may develop when they internalize pain or anguish related to other people in their work environment.  Compassion fatigue has been described as the “natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced by a significant other – the stress resulting from helping, or wanting to help, a traumatized or suffering person” (Sabo & Figley, 2012). As nurses, the quality of patient care is important to us and is considered a prerequisite for contentment. Nurses are not robots as we all have a sense of feelings. A little connection to patients could build a sense of contentment in nurses, making them feel the service they provide is valued and appreciated. However, when performance exceeds capacity, connection with patients might become useless as nurses just like professionals in other fields, could get overwhelmed and jeopardize the well-being of their patients.

Ashton (2015) stated that the acute phase of compassion fatigue may impact performance while chronic compassion fatigue may weaken commitment to work which may potentially create negative effects on patient safety and quality of care.  Nurses working mostly in intensive care unit (ICU) and emergency department experience traumatic event frequently, whether or not they acknowledge it. Nurses in these departments go through a higher level of stress compared to others as they are faced with unexpected crisis daily.  What may be considered traumatic to one nurse may not be to another. Traumatic stressors are described as those things that might contribute to the development of the syndromes of compassion fatigue and burnout, and they can be primary or secondary in nature Todaro-Franceschi (2013).

To know if a person is traumatized, it is important to look out for some certain signs. Nurses are especially vulnerable to developing compassion fatigue because we are continually bearing witness to the suffering of others. An indication that one is experiencing compassion fatigue is feeling heart heavy and overburdened while continuing to do the work. Nursing staff at the workplace are faced with lots of pressure from work, high case load, and low staffing turnover. The feeling of overload that may arise from one’s work and which lead to the development of burnout can, and frequently do, spill over into our personal lives.

Mental

Repeated or prolonged exposure to trauma can affect nurses mentally. According to Todaro-Franceschi (2013), witnessing the suffering of others is considered secondary trauma. It has been noted that “all of us who attempt to heal the wounds of others, might be wounded ourselves; it is, after all, inherent in the relationship”. When nurses are unable to maintain balance of empathy and objectivity, it will result in depression

Emotions

Some emotional result of compassion fatigue according to Todaro-Franceschi (2013) includes: anger, blaming, irritability, chronic lateness, overworking, difficulty focusing or concentrating, substance abuse, eating disturbances, disrupted sleep patterns, avoiding or dreading work, calling out sick more often, low self-esteem, high self-expectations, helplessness, and hopelessness.

Physical

Physical changes resulting from compassion fatigue noted by Todaro-Franceschi (2013) includes: chronic fatigue exhaustion (physical, emotional, or both), frequent headaches, gastrointestinal complaint, hypertension, cardiac symptoms such as chest pain or tachycardia, sleep disturbances, muscle tension, aches, and pains, frequent or lingering illness, difficulty focusing and anxiety.

Why Self-Care is Important to Maintaining Professionalism in Nursing

Taking care of others is the most important duty of a nurse. However, to take care of others, nurses must be in a good health state themselves. When nurses are unable to care for themselves they end up becoming patients. Nurses experience work-related stress that may be related to moral issues and dilemmas and how they cope and adapt impacts their practice and overall sense of wellbeing.  According to Ashton (2015), Coping is the process with which an individual respond to a threat to one’s self. How some individuals cope with situations and others, can have a major impact in all they do. The way nurses deal positively with situations at work can help them develop long lasting relationship with their co-workers as well as their patients.

Ashton (2015), discussed how moral distress can have a lasting effect on nurses. She recommends that nurses be guided and encouraged to do things to promote their personal self-care and rejuvenate themselves. If nurses are unable to utilize positive coping with the daily stressors, it could lead to poor outcomes and performances at work which affects both the patients, the well-being of nurses and their career, as well as the reputation of the healthcare center they work for.

Section 3

Roy’s Model

To understand how nurses, respond to compassion fatigue at work we can apply Roy’s adaptation model to provide a theoretical overview. The goal of nursing is the promotion of adaptation in each of the four adaptive modes defined by Roy, thereby contributing to health, quality of life, or dying with dignity. According to Ashton, (2015) adaptation is not the same as health which Roy defines as a “process and a state of being integrated and whole”. Nurses work in environments that are intense, these environments present nurses with many challenges that are both anticipated and unanticipated. Challenges that could occur because of overcrowding, short staffing, high acuity, unpredictable levels of care, violence, and the need to respond to rapidly changing situations. Regardless of the population of nurses studied evidence suggests that there are negative consequences of moral distress that include but are not limited to anger, frustration, sadness, depression, and helplessness

Physiological mode:  Nurses work in environments that are highly charged and unpredictable in nature which makes them sometimes neglect self-care such as lack of adequate nutrition, elimination, activity, and rest. An unconducive work environment can lead to pain, either an acute or chronic.  Roy’s model suggests when there’s an imbalance the physiological integrity of the body is compromised.

Self-concept mode:  An individual self-concept is connected to their physical being. The physical well-being relates to other function of an individual and it can affect interactions with others in the environment. According to Ashton (2015), pleasant or unpleasant events that produce a response in the self-concept or role function mode have the capacity to cause a response in the physical being.  Nursing sometimes finds alternative habits to deal with compassion fatigue they face at work. An example of such a habit is smoking cigarettes, drinking and even over eating as methods of distressing.

Role function mode: This involves the position one occupies in the society. A role consists of a set of expectations how a person in a position will behave in relation to a person who holds another position. Work related compassion fatigue hinders nurse who is attempting to progress into other roles such as leadership, continuity of education, culture, spirituality, the level of physical function, family dynamics. It can also affect decision making and fulfilling expected responsibilities.

Interdependence Mode: The interdependence mode applies to adaptive behavior for both individuals and co-workers. It is associated with one’s relationships and interactions with others. Compassion fatigue can affect intimate relationships (spouse, parent, God).

Assessment of stimuli

Focal stimulus affecting nurses

  • Malnutrition, elimination, activity, and rest

Contextual Stimuli

  • Culture, spirituality, level of physical function, family dynamics, economic status, knowledge base, values, support systems in place

Interventions to Alleviate Coping fatigue

Ashton (2015) indicated both providers and recipients of health care, are all stakeholders when it comes to safety and quality in health care. The nursing obligation to support safety and quality in health care is non-negotiable. Ackley and Ladwig (2014), suggested assisting nurses in the identification of stress overload in a stressful situation.  Evidence-Based Nursing (EBN): Research suggests that role overload, associated with high-stress levels, among nurses and volunteer caregivers may negatively impact health, well-being, and job performance (Kath and Akintola, 2013). A change in diet, exercise, decreasing stress and not smoking will help restore the body to normal functions.  According to Roy’s model, nurses coping processes are both innate and acquired that are used to respond to and influence the environment. Acquired coping mechanisms are learned through experience or chosen consciously (Ashton, 2015). It recommended that nurses be provided with guidance on how to manage their feelings related to self-concept. Self-care is vital to everyone and just like others, nurses should be encouraged to address various stimulus. Nurses are individuals that have five basic needs: oxygenation, nutrition, elimination, activity and rest, and protection.

Section 4

Roy was chosen because of her work.  Her model emphasizes the importance of the connection of human being and the environment. It reveals that awareness of oneself and environment can be linked to the way we think and feel. Humans by their decisions are accountable for the integration of creative processes. Roy’s Adaptation Model can be easily applied to assess compassion fatigue encountered by individuals, nurses and patient’s behavior and several potential influences on that behavior. The model was reviewed for its qualitative work that has contributed to the understanding of compassion fatigue. Overall, the model demonstrated reliability and validity of compassion fatigue experienced by nurses. Roy’s model presents a unique nursing science concept of the control mechanism.

Utilizing Roy’s adaptation model, nurses can make decisions about how well adaptation is proceeding. A judgment is made after an assessment of behavior in the first step of Roy’s nursing process. The second step of the nursing process after assessment of stimuli, nurses can form a nursing diagnosis that provides a professional identification of the problem. Working together with patients, the nurse can develop goals that enhance adaptation. According to Ashton (2015), nurses intervene by manipulating the environment to facilitate positive responses. An evaluation of the effectiveness of the nursing intervention is necessary. When the nursing intervention is unsuccessful the nursing process needs to be repeated.

Conclusion

What can individual nurses do to influence the image of nursing? It is often easy to assume that professional issues, such as the image of nursing, are only the concern of the profession. The image of nursing comes from the day-to-day personal contact that the public has with nurses and other healthcare professionals in the workplace. The following are some actions that individual nurses should consider that might impact the image of nursing: assess the actions you take, maintain dress standards that communicate a professional image, consider how we respond to questions, and present ourselves to patients and family members.

Compassion fatigue can be reduced when administrators create work environments that provide staff with access to opportunity, information, resources, and support. It empowers nurse to take control of stressors. In this paper, I have discussed, what professionalism in nursing is, the value/important of professionalism in nursing practice and the importance of maintaining a good public image of nursing to professional practice. Analyzed Compassion fatigue as a common role stressor and why self-care is important to maintaining professionalism in nursing. I also answered relevant questions to the Roy’s Adaptation Model as well the questions in Section 4 of this assignment.

 

References

Ackley, B. J., & Ladwig, G. B. (2014). Nursing diagnosis handbook (10th ed.). New York, NY:            Elsevier.

Akintola, O., Hlengwa, W., & Dageid, W. (2013). Perceived stress and burnout among volunteer caregivers working in AIDS care in South Africa. Journal of Advanced Nursing, 69, 2738–2749

Alidina, K., 2013. Professionalism in post-licensure nurses in developed countries. Journal of Nursing Education and Practice, 3(5), pp. 128-137.

Ashton, K. (2015) The Orientation Period: Essential for New Registered Nurses’ Adaptation.

Nursing Science Quarterly Volume: 28 Issue 2 ISSN: 0894-3184

Dikmen, Y. (2016). The Level of Professionalism of Nurses Working in a Hospital in Turkey retrieved from

Dubree M. (2017). Nurses’ essential role in supporting professionalism what’s your part in maintaining high standards Vanderbilt University Medical Center in Nashville, Tennessee

Duffy, J. R. (2016). Professional Practice Models in Nursing: Successful Health System Integration. New York, NY: Springer Publishing Company.

Hoeve, Y. (2014). The nursing profession: public image, self-concept, and professional identity. Discussion papers Journal of Advanced Nursing.

Sabo, B., Figley c. (2012) “Reflecting on the Concept of Compassion Fatigue” OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 1.

Todaro-Franceschi, V. (2013). Compassion Fatigue and Burnout in Nursing: Enhancing Professional Quality of Life. New York: Springer Publishing Company.

 

 

 

The Role of Technology in Children’s Education

The Role of Technology in Children’s Education

The 21st century is predominantly technology driven. Children have access from all kinds of technology including mobile phones, computers, and TV sets. Indeed, the exposure to all these devices can shape the way children develop. In accepting this fact, parents, teachers, and other relevant stakeholders should find ways of integrating these gadgets in the education curriculum.

Different technology can play a vital role in the education process. Devices like smartphones, iPads, tablets, and even computers make access to information relatively simple due to their connection to the internet (Sung, Chang & Liu, 2016). A lot of information can be easily stored in these devices making them even more convenient. In turn, children can access an array of educational material packaged in different forms. In fact, there are software, programs, and applications specifically designed to aid preschool and middle school pupils in their learning. Research indicates that technology makes the development process incredibly complicated and multi-sided (Sung et al., 2016). Therefore, if properly utilized, technology can play a central role in the education process of children.

However, there are downsides to exposure to technology. Sung et al. (2016) assert that research has shown that these devices can significantly alter human behavior. They can also expose children to predators on the internet or even harmful graphic content. The challenge, therefore, is how to purposefully directly technology’s abilities to produce the desired outcomes. The best place to start is a thorough revision of policies guiding technology-based learning. Research and development could also play a central role in this journey. As such, although technology may pose a threat, there is a need to find a way to assimilate it into the learning process.

References

Sung, Y., Chang, K., & Liu, T. (2016). The effects of integrating mobile devices with teaching and learning on students’ learning performance: A meta-analysis and research synthesis. Computers & Education, 94(1), 252-275.

THE IMPACT THAT BIM HAS HAD ON THE CONSTRUCTION INDUSTRY

THE IMPACT THAT BIM HAS HAD ON THE CONSTRUCTION INDUSTRY

 

1.     Abstract

This study aimed at determining the current situation in the utilization of BIM in the building and construction industry. The study looked to determine the impact of BIM on various stages of the construction process and the to determine the reasons for the current rate of utilization of BIM in the industry. To achieve their objectives, the researcher embarked on a qualitative study utilizing grounded theory as the study design. The researcher utilized purposeful sampling to select three participants from whom they collected data using semi-structured interviews. The researcher later utilized a computer software to aid them in coding data during data analysis and used tabulation to express the major thematic concerns of the data. The study found that the utilization of BIM has positive impacts on all phases of the construction process. The study also found that the cost of initial BIM installation and the inadequacy of expertise are the major limitations that derail widespread uptake of BIM. The findings of the study imply that BIM is good for the future of the construction industry.

 

 

 

THE IMPACT THAT BIM HAS HAD ON THE CONSTRUCTION INDUSTRY

2.     Introduction

Building Information Modelling (BIM) is a concept that emerged in the late twentieth century. The emergence of this concept came a few years after the emergence and widespread popularization of another concept –supply chain. Even though supply chain was not strictly a concept for the Architecture, Engineering, and Construction (AEC) industry, it had numerous applications in this industry (Mahdjoubi et al. 2015 p. 28). As a result, the two concepts developed concurrently albeit at different rates. Even though it is difficult to consider one of these concepts without considering the other in modern AEC, this paper focuses mainly on the impact that the application of BIM has had on the AEC industry. The initial framers of BIM were looking to solve some issues in the construction industry. Although BIM seemed to be a breakthrough in providing a solution to these issues, its applicability still presented numerous issues. Thus, as a result of various challenges in applying the concepts of BIM and many other factors that determine the general landscape of the construction industry, BIM, which is a concept of the 1980s, only started to have a significant impact of the construction industry in recent times. This study thus looks to follow up the results presented in the National BIM report of the UK in 2017; this paper looks to confirm if indeed BIM impacts the construction industry positively. The study, therefore, aims to understand the impacts of BIM on the construction industry by analyzing its impact in shaping the culture of the industry; exploring its socio-technical impact on supply chain; explaining its impact on the construction industry; and explaining its advantages for the operational team. The study has shown that the BIM has markedly enhanced the functioning of the core construction team but is yet to impact greatly on the individuals who are outside the core construction team.

2.1.Background

The construction industry is an industry with huge potential. However, it is largely evident and acknowledgeable that the industry has failed terribly to reach its full potential. In other words, the construction industry has consistently failed and underachieved (Edum-Fotwe and McCaffer 2000 p. 121; Arditi et al. 2001 p.122; Egan 2002 p.11). Egan (2002 p.12) suggests that the overall performance of the construction industry overwhelmingly dissatisfies numerous clients of the industry. Crotty (2016 p.41) also echoes the same as they describe various shortcomings of the construction industry; of these shortcomings, the two that the author sees as most fundamental are the industry’s failure to deliver projects predictably and the inability of most firms in the industry to make an amount of profit that keeps them surviving. The failure of the industry to deliver projects to the required quality, at the required time, and within the stipulated budget herald the industry’s unpredictability. One disturbing fact is that these shortcomings of the industry have remained the same over the last 50 years; the critiques of the industry over this period have been essentially the same.

Numerous reports on the performance of the construction industry relay the current rhetoric that the construction industry is much more dormant and laggard than it should be. Harty et al. (2007 p.480) further suggest that this stagnation of the industry has led to its chronic underperformance. Even though there have been improvements in the industry in recent times, it is still evident that the industry is yet to achieve its full potential (Holti et al. 2000 p.31).

The adversarial and fragmented culture of the industry is at the center of the causation of many of the problems that the industry faces. Egan (2002) adds that the inefficiency of communication and information that forms part of this retrogressive culture of the industry plays a role in causing the industry’s failures. Higgin and Jessop (2013) also allude to the inefficiency of communication in the causation of the stagnation of the construction industry. Thus, for the industry to grow and become as productive as it should be, there is need to address and manage these long-standing problems effectively and aggressively.

BIM emerges as a potential driver in changing the culture of the construction industry. BIM can effectively foster an integrated and collaborative culture which is ideal for the construction industry (Papadonikolaki et al. 2016 p.482). The National Building Specification of August 2016 defines BIM as a process for the creation and management of information on a construction project across its lifecycle. Papadonikolaki et al. (2016 p. 483) define BIM as a set of technologies that enable various AEC actors to generate, manage, and share consistent building information. Among the key outputs of this process is a digital description of every aspect of the built asset. The model utilizes updated information whose collection is dependent on the collaboration of the many players in the construction process. Creation of a digital BIM enables those the persons who interact with the building at various levels to optimize their actions hence resulting in a greater life-value of the asset under construction.  BIM offers fluent visualization, accurate interference detection, fast coding, and coherent shop drawings among other built-in features that have effectively revolutionized the process of designing buildings (Papadonikolaki et al. 2016 p.483). The technology is also able to estimate the costs of various processes of building hence making the work of quantity surveyors and contractors easier. The embrace of ICT systems, include systems other than BIM, has been central to the rapid dev elopement of industries such as automobile and retail. Crotty (2016 p. 37) also alludes to the importance of ICT in industrialization when they refer to the high success of the Electronic Point of Sale (EPOS) system.

Despite its perceived benefits, the AEC industry has been paradoxically slow in their adoption of BIM. Historically, the AEC industry has been slow in adopting various Information Communication Technology (ICT) systems. Despite the size and potential of the industry, it has lagged behind industries like finance, manufacturing, and retail in the rate of ICT uptake (Wong and Sloan 2004). Papadonikolaki et al. (2016 p. 480) tend to blame the involvement of numerous actors in BIM for the slow adoption of BIM in the construction industry. Further, the dynamic of the frequency and intensity of interaction between the various actors of the project in the course of the project impedes successful adoption of the technology.

From a critical point of view, however, BIM is not just a technology. BIM is a new way of working; the findings in the national BIM report of 2017 echo these sentiments. According to this report, many individuals in the AEC sector see BIM as future of project information. Even though BIM involves new software, it is much more than just the implementation of this new software. BIM is a different way of thinking that requires a break away from the traditional workflow (Gu 2010 p. 993). With BIM, all the parties of a building project including contractors, surveyors, and architects share and effectively work on a common information pool (Grilo and Jardim-Goncalves 2010 p.524).

The researcher, as a fan of BIM, views this new way of working as a suitable vehicle that can bring the cultural changes that the construction industry needs for it to achieve its great potential. It is in this light that the researcher will look to explore the impact of BIM and its implementation on the construction industry. The researcher will focus this exploration on the impact of BIM on the supply chain in the construction industry. Khalfan et al. (2015 p. 913) assert that BIM can greatly influence the efficiency of the supply chain in the construction industry.

2.2.Rationale

The researcher derives the rationale of this study from a study that was initially conducted by Bui et al. (2016). The study reveals that the construction has rapidly progressed since the stakeholders’ move to rethink the current state and the future of the industry. In the study, Bui et al. (2016 p. 491) also blame the adversarial and fragmented nature of the construction industry for its failure to achieve its full potential. Further, the findings of Eastman (2011 p.51) that even though BIM has been with humanity for close to forty years now, it only started to significantly impact the construction industry recently inform the aims of this study. These recent developments are evident in the national BIM report of 2017 as in the chart below:

 

 

 

 

 

Figure 1. Sourced from NBS National BIM Report 2017 | NBS

According to statistics in the report, the utilization and impacts of BIM have rapidly changed over the last four years. The report demonstrates a rapid rise in both the awareness and the utilization of BIM. In 2011, only 13% of AEC stakeholders were aware of BIM and were using it while in 2017, a massive 62% of AEC stakeholders were aware of BIM and were utilizing it. Because the UK government made BIM compulsory for all projects in the private sector, which cost more than £5 million, the researcher anticipates a further increase in both the awareness and the utilization of BIM (Vernikos et al. 2013 p.152).

Apart from the study by Bui et al. (2016), the researcher also found numerous literature that discuss the possible benefits of BIM. However, the researcher was wary of the possibility that the incentive by the UK government to make BIM compulsory could potentially lead to production and publication of papers revealing the benefits of BIM without having true data but rather propagating bias and propaganda. Thus, the researcher intended to examine whether or not the benefits of BIM as Bui et al. (2016) discuss them have aided in shaping the culture of the construction industry in the last eight years or not. The researcher also wanted to explore the usefulness of BIM in fostering change from the adversarial and fragmented culture of the industry in the realization of the numerous benefits of BIM discussed by various authors.

The researcher is also wary of the fact that the most of the potential benefits of BIM discussed by various authors focus on the benefits of the technology to the core team of a construction project (Vernikos et al. 2013 p.157). The researcher, thus, posited that there is a possibility that previous researcher has failed to identify the undesirable effects of BIM. The researcher thus extended their study to consider the impact that BIM potentially has on the entire supply chain. It is only in this way that the study could determine if BIM could potentially adversely affect any individuals within the AEC industry.

Despite the recent improvements in the uptake of BIM, its scale of implementation in the construction industry is still relatively small. For this reason, the researcher was interested in determining the impact of BIM on the culture of the construction industry in the last few years. Also, the researcher set out to determine the current impact of BIM on the supply chain in the construction industry and the most likely position on BIM in the future of the construction industry.

2.3.Aims, Objectives, and Research Questions

 

2.4.Overview of Work Done and Methodology

The researcher started the study by identifying a problematic area in the AEC industry which stakeholders needed to address. This area was the fact that the AEC industry had an adversarial and fragmented culture which tended to impede its performance and achievement. The researcher hypothesized that BIM, as a new way of working, impacted on the culture of the industry and set out to test their hypothesis. The literature review that the researcher conducted revealed a gap as the reviewed literature revealed little about the impact of BIM on the supply chain in the AEC industry.

In choosing a suitable methodology, the researcher identified their assumptions to prevent the assumptions from forming a basis for bias. The researcher adopted a qualitative research approach utilizing grounded theory as the research design and an inductive approach. They also utilized purposeful sampling to achieve a representational sample that could enable the researcher to generalize their finding to the construction industry.

The researcher chose one-to-one interviews as their suitable data collection tool. The interview questions were semi-structured. The questions were designed specifically to enable the researcher to discover pertinent issues about the implementation of BIM and its impacts on organizational culture and supply chain.

Like in any other research involving an inductive approach, the interviews were analyzed thematically. Thematic analysis of the interviews included categorization and coding of the interview responses into themes. The researcher then analyzed and discussed these themes deeply. It is from this deep analysis and discussion that the researcher was able to draw conclusions and theoretical constructs. These constructs then formed the basis for the implications of the study and its recommendations for further research.

2.5.Overview of Main Conclusions

The researcher determined that BIM has positively impacted on the culture change and productivity of the AEC industry. However, the researcher also determined that the impacts of BIM are still limited to the core actors of projects. Thus, the researcher asserted that they believe BIM can have an even greater impact on the industry than its current impact. BIM has positively impacted on the interaction between chief actors in the construction industry. However, it will be important for future studies to assess the impacts of BIM on organizational culture.

2.6.Guide to the Report

Chapter 1: Introduction

            This chapter introduces the research topic and states the aim and rationale of the research. The chapter also includes the research questions and objectives. The chapter also gives an overview of the work already done, the methodology used, and the conclusions of the study.

Chapter 2: Literature Review

            This chapter includes a detailed review of past literature that is relevant to the study topic (Naoum 2013 p. 18). The literature review first focuses on the past failures of the construction industry and the need for cultural change in the industry. The review then focuses on BIM and the potential of BIM as a vehicle for cultural change in the AEC industry.

Chapter 3: Methodology

            This chapter describes the research process. The chapter restates the rationale for the study and how this relates to the paradigms and approaches utilized in the study (Naoum 2013 p. 25). The chapter also justifies the use of inductive approaches and grounded theory as the study design. The chapter also discusses the researcher’s attempts to mitigate bias including their assumptions and how these relate to the reliability and validity of the findings. The chapter also justifies the data collection, sampling, and data analysis methods utilized in the study.

Chapter 4: Results, Analysis, and Evaluation

            This chapter is an in-depth analysis of the interview responses and the presentation of the results as supported by evidence.

Chapter 5: Conclusion and Recommendations

            This chapter summarizes the research findings and relates them to the research questions to answer them. The chapter then uses the researcher findings to state recommendations for both the construction industry and for future research (Naoum 2013 p. 27).

 

 

3.     Literature Review

            A literature review is a detailed and comprehensive study that looks to interpret previous literature relating to a certain topic (Randolph 2009 p. 3). In a literature review, a researcher appreciates what other authors and researchers had done and written about their area of interest (Naoum 2013 p. 17). The literature review is also an evaluation and a synthesis of literary works that previous researchers completed and recorded (Ridley, 2012).

3.1.Purpose of the Literature Review

A literature review is a critical step in the completion of a dissertation. It is the literature review that justifies the researcher’s choice of the topic and the need for them to conduct the study. The literature review is not a compilation of abstracts of previous studies; rather, it is a deep analysis of the thematic concerns, the strengths, and the weaknesses of past studies in a particular area (Bruce 1994 p.223). Apart from enabling the researcher to determine information gaps that either their study or other future studies should fill, the literature review is an opportunity for the researcher to demonstrate their understanding of the subject that they chose to study (Boote and Baile 2005 p. 9).

3.2.Definition of BIM

BIM, Building Information Modelling, also referred to as Building Information Management, is defined as the use of virtual building information models for the purposes of developing design documentation, design solutions and to analyze the various existing construction processes (Construction Skills Queensland, 2014). BIM focuses on the subject of knowledge management which is essential in the modern construction industry. According to Construction Skills Queensland (2014), the use of BIM in the construction industry has enabled better asset management and sustainability of construction projects, which depicts the positive nature of BIM’s impact on the construction industry in the UK.

According to Ajibode (2016), the definition of BIM depends on the goals or what the individual wants to achieve in a construction project. This is in regard to the traditional challenges construction projects have faced in the past. As such, one of the most prolific challenges of traditional construction management has always been early engagement and collaboration amongst project participants. In view of this, Ajibode (2016) defines BIM as a technology that enables various information processes which are built on the positive development of early engagement and collaboration amongst construction project participants.

3.3.The Construction Industry

The construction industry has been faced with the issue of a culture that does not allow collaboration and effective communication amongst participants. This has been one of the existing challenges of the construction industry. However, there is a huge potential for the success of the construction industry in the adoption of BIM. The fragmented nature of the traditional construction industry was faced by conflict situation which is largely addressed by the collaborative efforts that are enhanced through the implementation of BIM (Terreno et al., 2015).

3.4.How BIM Works

BIM is an information-based approach that seeks to make use of technology to solve different challenges that often face the design process of a construction project. The use of BIM in a construction project enabled the professionals to manage all aspects of the construction throughout the building’s lifecycle (Doumbouya, Gao and Guan, 2016). The use of BIM, therefore, enabled enhanced communication and collaboration of activities of all participants during the initial phase of the project. As such, BIM facilitates the sharing of information that is crucial in enabling the analysis and evaluation of the design to minimize future flaws and risks that may occur (Azhar, Khalfan and Maqsood, 2015). The use of BIM transforms the culture of the construction industry and involved supply chain from a non-collaborative and highly adversarial to a collaborative and one of effective communication and integration amongst participants (Demirkesen and Ozorhon, 2017). This is achieved through technological means with fundamental significance placed on information sharing.

3.5.Culture Change of the Construction Industry

In the traditional outlook of the culture of the construction industry, information and communication were lacking. As such, Terreno et al. (2015) argue that the biggest flaw of the traditional linear building process was defined as lack of initial communication amongst all the involved parties in the industry. The construction industry was experiencing more conflicts and challenges in the design process. Apart from the construction industry, the related supply chain was experiencing even more significant challenges due to the lack of effective communication. Therefore, more time was being wasted before all participants cooperated meaning the costs of the construction project were increasing rapidly. House (2015) illustrates that the use of BIM technology enabled the adoption of an integrated approach. This new approach enabled better coordination at the initial phases of the project, the design process. Therefore, by increasing communication in the initial phase of the construction project, participants were able to reach higher levels of coordination, which translated into more perceived benefits of the use of BIM.

3.6.Increased Communication and Collaboration

Communication is a vital part of any project management practice in the world. Even so, project management in the construction industry is critical to the success of the project. Mesaros and Mandicak (2017) elaborate that the element of communication in the modern construction industry has been made efficient through the continuous use of BIM. BIM has enabled the use of progressive communication and information technologies which support management of the construction project and cost management in the construction industry as well as the involved supply chain. This has resulted in significant benefits through efficient communication within the given processes of construction project management (Mesaros and Mandicak 2017).

According to Allen and Shakantu (2016), the impact of the use of BIM in the construction industry in the UK is bound to provide a higher degree of standardization as well as increasing communication of information between project participants. Allenand and Shakantu (2016) argue that for long the construction industry has been faced with challenges regarding the existence of ineffective communication which limits cooperation within a given construction project. However, the mandatory use of IBM in UK’s construction industry is bound to increase the issue of communication to enable a strong foundation for interactions within the sector. Interactions that are structured deal with the communication of information and delivery of results on different construction projects.

3.7.Socio-Technical Impact of BIM

According to McGraw Hill Construction’s (2012) Smart Market, a report titled the Business Value of BIM in North America, the users of BIM in the construction sector have witnessed a lot of benefits. Often, the most common benefit is increased profits with every single construction project that is carried out. As such, BIM has been witnessed to impact the construction industry as the driver of sustainable benefits. Furthermore, other benefits including high returns on investment with the focus of companies which have a higher skills expertise, implementation and experience levels. Therefore, companies engaging in the use of BIM have reported increased maintenance of repeat business with past clients due to the use of BIM in the completion of the construction projects.

According to Joblot et al. (2017), the use of BIM has immensely benefited the construction industry. One of the benefits the author focuses on is that including the renovation of completed buildings. Once the features of an existing building are reconstructed to provide a digital model, BIM may provide opportunities for energy and time management as resources are allocated appropriately through proper planning. Therefore, companies using BIM in the construction industry are able to offer more competitive renovation services making them have a sustainable competitive advantage over others.

Other significant benefits of BIM are considered to be the reduction of time in preparing the construction project schedule. Barlish & Sullivan (2012) state that one can reduce the time used for preparing the construction project plan through the use of BIM technology. The research conducted by the two authors depicts the nature of exploitation and benefits gained through the use of BIM technology. The authors present findings of their research, which include the benefits of BIM. These benefits as listed by Barlish & Sullivan (2012) include changes to processes, business performance improvements, IT investments to supported improvements, and improved ROI (Returns on Investments) and profits.

Bryde, Broquetas and Volm (2013) present findings from collecting secondary data that proved various significant benefits of BIM in the construction industry. Some of the most significant benefits throughout the project cycle as noted in their research findings included time savings, cost reduction and management. The authors present viable information which suggests that the increased use of BIM in the modern global construction industry is bound to positively affect the nature of construction projects. However, the implementation of BIM in the construction industry still faced significant challenges which are addressable through awareness raising, cost/benefit analysis and training and education.

The implementation of BIM technology has largely been noted to impact positively on the construction industry. These benefits cannot be perceived only in the area of materialistic benefits but also process benefits. Onugwa et al. (2017) argue that the use of BIM has potential positive impacts on the enhancement of construction management. One of the notable benefits of BIM that encompasses the whole lifecycle of the project is illustrated as the development of a model that is utilized for the initial design, construction up to the occupancy of the building. These process changes witnessed through the use of BIM have created better instances of construction management by enabling effective supervision of construction projects. Furthermore, BIM has enabled solutions to challenges facing different processes within construction projects by enhanced programming and resolution of conflicting during construction.

Tomek and Matejka (2014) focused on another perspective on the benefits of BIM. While most authors focused on the process and materialistic benefits of BIM, Tomek & Matejka perceived risk management as one of the most significant benefits of the use of BIM in the construction industry. BIM is involved with the analyses and evaluation of information concerning the construction project. As such, the use of BIM facilitates the perception of the existing risks and different ways to mitigate them. The significance of BIM application is risk identification and mitigation which is the basic factor for the other perceived benefits of BIM. As such, by identifying and mitigating risks in a timely fashion, construction project managers achieve positive results which translate to better time management, increased profits and ROI and a higher degree of maintenance of return businesses of past construction projects.

3.8.Changes in the Construction Industry and the Supply Chain

The use of BIM in the construction industry has resulted in the better development of expertise. Since the age of information and technology took over the global business environment, key changes have been witnessed in various sectors of the global economy. These changes have resulted in the adaptation of information and technology in the most intricate aspects of the construction industry through the use of BIM technology. As such, both contractors, employers and professional construction teams have been faced with the issue of education and training to keep up with the skill level required to implement BIM technology. Therefore, the use of BIM has resulted in an instance of increased skill sets among different professionals in the construction industry and across the supply chain (Getuli et al., 2016).

3.9.Government Policies on Use of BIM

Another significant aspect of change that has occurred in the construction industry since the initial use of BIM technology in increased standardization and coordination of construction projects. As mentioned earlier, traditional construction projects were faced with the significant challenge of lack of communication and coordination. However, with governments such as the UK making the use of BIM technology mandatory to all key players the construction industry, the level of standardization and coordination has significantly increased (Ajibode, 2016). The use of technology that facilitates effective communication of information has enabled most projects to follow set standards and adhere to given policies and regulations set forth in the construction industry and across the supply chain.

3.10.                 Potential Implications of BIM

One of the most observed impacts of BIM on the supply chain in the construction industry has been the implementation of the legal framework and how it is used in different construction projects. The use of BIM has facilitated increased collaboration within the project, especially on the important aspect of project design. As such any legal issues such as liability of the project design are passed down the existing supply chain (Cabral and Grilo, 2018). The impact might be that the suppliers might not possess the required specification s to be carrying out the design in the first place. BIM enables the identification of any design clashes thereby reducing the overall risk to the construction project.

All the perceived benefits due to the use of BIM in the construction industry are depictive of the improvement of services provided therein. These benefits portray the better situation of the construction industry with emphasis on the advancement of project delivery and coordination of construction projects. Alwan, Jones and Holgate (2017) argue that the use of BIM has resulted in better service delivery, cost and schedule optimization, high level of customization and flexibility, fast drafting without loss of quality, conflict detection and risk mitigation, better coordination and collaboration and easy maintenance of the building life cycle. All these perceived benefits work towards creating a brighter future for the construction industry.

 

 

4.     Research Methodology

This chapter of the dissertation describes the study process. The chapter describes the methods of starting with the study design. The study then discusses the process of sampling, modes of data collection, and the process of data analysis (Naoum 2013 p. 18). This chapter also discusses the limitations of the study methods that the researcher utilized. Owing to the nature of the study, the researcher opted for qualitative study methods. The study aimed to understand the impacts of BIM on the construction industry by analyzing its impact in shaping the culture of the industry; exploring its socio-technical impact on supply chain; explaining its impact on the construction industry; and explaining its advantages for the operational team. Since the researcher is not interested in numerical data but rather in the opinions of the key stakeholders in the industry with a view of explaining certain aspects in the interaction between BIM and the building industry, a qualitative method was most suitable.

4.1. Study Design

Of the qualitative study designs, the researcher preferred grounded theory for their study.  Grounded theory is the best qualitative method in this case since the researcher is interested in explaining various phenomenon on the various impacts of BIM on the building industry; in other words, the researcher is looking to examine the effectiveness and the advantage that BIM offers to the building industry (Lewis 2015 p. 474). Even though the researcher looks to explore the culture of the building industry, the research is not anthropological hence the unsuitability of an ethnographic study. Considering the size of the construction industry and the need to incorporate the views of a large number of individuals, a narrative qualitative study was inappropriate (Lewis 2015 p. 474). Also, the scope of the study was too wide for either a phenomenological study or a case study to be appropriate.

4.2. Sampling

The researcher utilized purposive sampling as their sampling strategy. In this strategy, the sampling frame included all the stake-holders in the building and construction industry. Purposeful sampling offered the advantage of allowing the researcher to select participants from various levels in the industry considering the fact that the construction industry is wide and has many levels (Palinkas et al. 2015 p. 538). The researcher classified the industry into three levels – the lowest level consisting of workers in construction sites; top level management including contractors, engineers, and architects; and the highest level which includes government policy makers. With their experienced in the field, the researcher carefully selected only one participant at each of the three levels. However, the main limitation for this sampling strategy was the fact that it was subject to heavy impact of the researcher’s bias and prejudice (Palinkas et al. 2015 p. 538). Also, the fact that the researcher selected only 3 participants for a grounded theory; such studies often require slightly larger sample sizes (Lewis 2015 p. 474).

4.3. Data Collection

Like any other grounded theory, interviewing was a key method of getting primary data; the researcher also analyzed documents to get secondary data (Lewis 2015 p. 474). The researcher utilized semi-structured one-on-one interviews. The interviews had leading questions; however, depending on the interviewee’s responses, the interviewer had the allowance to trigger an in-depth discussion of emerging issues (Jamshed 2014 p. 87).  The main advantage of this method of data analysis is that it allowed the researcher to exploit emerging issues extensively. The researcher utilized secondary data to compare and explain trends rather than use it separately to realize trends.

4.4. Data Analysis and Presentation

Being a qualitative study, data analysis mainly concentrated on the identification of various thematic concerns in the data available. To determine these thematic concerns, coding was used (Miles at al. 2014 p. 33). Considering the small nature of the data collected, manual coding was possible. However, the researcher preferred to use, Nvivo9, a computer software to aid them in determining the key thematic concerns in their data (Zamawe 2015 p. 14). The researcher then utilized secondary sources to make sense of the thematic concerns. The researcher utilized tabulation as their main method of data presentation.

 

 

5.     Study Results, Analysis, and Evaluation

This chapter provides a breakdown of the results of the interviews the researcher conducted. The chapter then interprets these results in the context of the study. This chapter then provides an in-depth discussion of the findings in light of other previous studies and uses this discussion as a basis for evaluating the impact of BIM on the construction industry.

5.1. Study Findings

The researcher aimed to understand the impacts of BIM on the construction industry by analyzing its impact in shaping the culture of the industry; exploring its socio-technical impact on supply chain; explaining its impact on the construction industry; and explaining its advantages for the operational team. To achieve their target, the researcher utilized a semi-structured interview with three key questions. In the questions, the researcher looked to determine the advantages and disadvantages of utilizing BIM is the building and construction industry; to determine the impact that increased utilization of BIM has had on the relationship between supply chain and contractors; to understand the adaptations that construction companies have had to undergo to be more BIM-friendly; and to explore the exact ways in which BIM has eased the construction process.

Advantages of using BIM in the building and construction industry

According to the three participants of the study, these are the key advantages of BIM in the construction industry:

ADVATAGEFREQUENCY OF RESPONSE
It helps the construction team to capture reality, especially through the use of 3D models3
Saves time2
Improves collaboration between the various teams3
It makes it easier to maintain control of the project to sequence the steps of the construction process1
Resolves conflict1
Avoids fragmentation of the project1
Reduced rates of rework and avoidance of errors2
In the long-term, BIM lowers the cost of construction1
Energy efficiency and increased productivity1

Table 1: A table showing the main advantages of BIM in the construction industry and the number of respondents who identified the various advantages

Disadvantages of BIM in the construction industry

DISADVANTAGES OF BIMREQUENCY OF RESPONSE
Incompatibility with some partners2
Unresolved legal issues1
High cost of the software2
Inadequacy of experts1

Table 2: A table showing the key disadvantages of BIM and the number of participants who identified them

Other key findings

The participants of the study all seemed to agree that BIM has had massive positive impact of the building and construction industry. They also noted that increased utilization of BIM has largely enhanced the relationship between the supply chain and contractors; with BIM, there is far better communication and collaboration between the parties. By enhancing communication, reducing turn-over time, and decreasing the rate of errors, the three participants were certain that BIM has significantly eased the process of construction. The participants also identified various ways in which their companies have had to adopt in order to allow for increased utilization of BIM, especially in light with the new legislation that makes the uptake of BIM in the construction industry compulsory.

5.2. Discussion and Evaluation

BIM has greatly impacted on the building and construction industry. The utilization of BIM tends to impact greatly on all levels and stages of an AEC project. In fact, the utilization of BIM allows all the participants of a project to see and understand all steps of the project (Masood et al. 2014 p. 231). This discussion analyses the positive and negative impacts of BIM on the various stages of the construction process and the adaptations that various construction companies have had to undergo to enhance their compatibility with BIM.

Impact of BIM at the designing stage

The first step in the construction process is the decision on a suitable design for the building that a customer looks to construct. The design process is an intensive stage of the construction process that involves multiple key participants. The most important participants at this stage are the architect and the engineer. The consumer is also a key determiner of the goals and the outcomes of the design process. BIM has strongly impacted the design stage of building. With BIM, it is much easier for engineers and architects to graphically represent a plan in as many dimensions; this offers a key advantage the traditional pencil and paper presentation which was limited to a 2-dimesnional view of the building (Wong and Fan 2013 p. 143). In fact, using a BI platform to present a proposed design of a building gives the consumer a better understanding of the building before they can make a decision. Also, apart from graphic representation, modern-day architects and engineers can directly use BIM and other computer software to design buildings (Gerrish et al. 2017 p.192). Gerrish et al. (2017 p. 196) go ahead to explain that designing buildings using BIM platforms enhances the accuracy of the design. In other words, buildings designed via BIM platforms are likely to be much stronger and resilient than those designed in other ways. Using BIM to design a building, one automates the calculation of the building’s energy performance hence making it easier for them to identify flaws and weaknesses in their design and correct them promptly. Further, BIM platforms limit mistakes in the designing process.

One of the key ways in which BIM both prevents and resolves conflicts that could arise among various parties in the building process is by enhancing the perfectness of a study design and allowing the input of as many stakeholders in the design as possible. For instance, the piping and electrical installation teams have a chance to look at the building and determine the pathways for their pipes and cables and share this with the architecture and engineering teams to avoid later conflict (Gerrish et al. 2017 p. 200). As one of the study participants correctly noted, the utilization of BIM has significantly reduced the emergence of conflicts between the piping team and the engineering team. An automated system makes it much easier to identify and correct clashes.

Furthermore, utilization of BIM from the first step of a building project effectively enhances communication between the parties involved. BIM gives a truly global view of the entire project. BIM, thus, improves collaboration and communication among all the teams involved in the building process by putting all the key documents on a building in one place that is easily accessible (Azhar 2011 p. 246). Effectively, BIM does away with project fragmentation. In the past, project fragmentation was a major cause of time wastage in the construction process. The ability to put an entire project together and view it as one has thus reduced the amount of time that builders utilize. BIM has, therefore, effectively reduced turnover times as one of the study participants correctly identified. Another way in which utilization of BIM for design can enhance time management is the fact that BIM allows one to sequence the steps of the entire project at the start; it is, therefore, much easier for the team to transition from one stage of the construction process to the next (Bryde et al. 2013 p. 974). Further, visualization of the entire project as one enables all stakeholders to collaborate effectively from an early stage. Moreover, the BIM model means that there is one communication centre with is accessible to as many stakeholders as possible hence effectively enhancing the communication process (Bryde et al. 2013 p. 974). Additionally, by having the project information on a software that they can access from multiple electronic devices, BIM makes it much easier for the stakeholders as they can access their project from anywhere. Also key at this design and planning phase is that by ensuring perfect and proper planning and decreased wastage of time, the utilization of BIM effectively enhances the economization and conservation of energy which doubles as one of the ways in which BIM eventually lowers the cost of construction (Azhar 2011 p.247).

Impact of BIM on supply chain

The procurement process is an important aspect of the construction industry. Immediately after designing the building and completion of the planning phase, the procurement of materials required for the building process begins. The procurement of building materials perseverates throughout the entire building process as materials are needed for every stage in the process. In most modern constructions, the supply chain team are responsible for the procurement and supply of materials. As the participants of the study identified, BIM has positively impacted on the supply chain (Papadonikilaki 2016 p. 481). First as Papadonikolaki at al. (2015 p.265) had earlier proposed, BIM allows members of the supply chain to interact more closely with the project managers. Also, BIM allows members of the supply chain to communicate effectively with other members of the team since they all have a similar portal of communication. Additionally, the process of procuring building materials is arguably one of the most significantly areas in the construction process that plenty of time is lost (Papadonikolaki et al. 2015 p. 262). With the invention of BIM, it is possible for members of the supply chain to monitor the building process and know which materials and what amount of the materials are required for the next construction phase. Using this information, the supply chain can supply materials at a time when they are needed. Often in the building process, contractors only request for materials after the existing materials are finished hence leading to wastage of time as they await for more materials. However, BIM can enable a feed-forward response from the supply chain that can see the building process proceed much faster (Papanikolaki et al. 2015 p. 271).

However, there are some suppliers and partners who are incompatible with BIM systems. This aspect makes the utilization of BIM in the construction process difficult whilst awarding tenders to only those bidders who are compatible with BIM is unfair and in many cases unlawful. This issue is one of the few limitations of BIM; two participants identified it as a major limitation. It also partially explains the low rates of uptake of BIM, regardless of its perceived benefits, in the construction industry (Memon et al. 2014 p. 613).

BIM at the construction site

Despite is crucial utility in the earlier phases of the construction process, BIM has limited utilities at the construction site. Among this utilities are the facts that BIM greatly enhances productivity and lowers the cost of production in the long term. The increased productivity of the construction industry utilizing BIM are probably because of the decreased time of turn-over and the economization of energy. Further, because of a requirement of less time and greater efficiency in the supply chain, the utilization of BIM has proven to be cost-effective in the long term (Gerrish et al. 2017 p. 203).

However, as two of the participants of the study of the study observed, the utilization of BIM is majorly limited to the management level of the construction process; in fact, one of them argued that utilization of BIM on the construction site is more disastrous than it is supposed to be useful. First, most of the individuals on the construction site have little or no knowledge of BIM; some of them even find to difficult to use computers. There is also a widespread lack of experts who can translate the principles of BIM to the construction site and utilize them to enhance the effectiveness of the construction process (Memon et al. 2014 p. 613). It is the lack of experts that makes the concept of BIM too complex to be applicable on the construction site. Furthermore, as one participant rightly identified, there are a number of unresolved legal issues that tend to interfere with the free uptake of BIM is the UK at the moment hence the perceived hesitancy of companies to fully delve into BIM systems (Memon et al. 2014 p. 613). Other limitations that have derailed the active uptake of BIM at construction sites are the high cost of software and other infrastructure that one requires for the initial launch of a BIM system.

From the responses of the interviewees, it emerged that many companies are struggling with the incorporation of BIM in their operations. Many companies are having great difficulties in making BIM part of their day-to-day activities. However, a few companies are taking up training programs for their workers to make them BIM-competent. Other companies have resorted to computerization of all their operations. This is one area where which needs future improvement; companies need to determine ways of making better use of BIM without having to face much difficulties.

6.     Conclusion

In this study, the researcher aimed to understand the impacts of BIM on the construction industry by analyzing its impact in shaping the culture of the industry; exploring its socio-technical impact on supply chain; explaining its impact on the construction industry; and explaining its advantages for the operational team. To achieve their goals, the researcher collected primary data via semi-structured interviews whose lead questions looked to determine the advantages and disadvantages of utilizing BIM is the building and construction industry; to determine the impact that increased utilization of BIM has had on the relationship between supply chain and contractors; to understand the adaptations that construction companies have had to undergo to be more BIM-friendly; and to explore the exact ways in which BIM has eased the construction process. The study found that the utilization of BIM in the construction industry offered many advantages including a decrease in the cost of construction in the long-term, a decrease in the turn-over time, an increase in collaboration between the various operational teams, improved communication, better utilization of resources, and a decrease in the rates of errors and reworks. However, the utilization of BIM poses a few challenges; these challenges include an initial high cost of installation of the required software, lack of adequate expertise, certain unresolved legal issues, and incompatibility with some partners. The study also found that the utilization of BIM greatly enhanced and improved the interaction between contractors and supply chain to the good of the entire process. The study, however, determined that many companies have had difficulties in adapting to the requirements of a BIM market. In their struggle, a number of companies have looked to use more computer-based operations and to train their workers on matters BIM.

Considering the research findings and the discussion that followed, the researcher drew several conclusions. First, BIM is a good thing for the construction industry. BIM holds the future of the construction industry, not because of the UK’s legislations, but because it can massively improve the outcomes and widen the profit margins of construction companies. Despite its perceived limitations, especially in the beginning, BIM is ultimately advantageous to the industry. Also, construction companies can and should do more to make the use of BIM easier for them; currently, the low uptake of BIM is partially because of many companies’ maladaptation to this change. Based on this conclusions, the researcher recommends for a review of the industrial law regarding BIM; this step would help to identify and deal with any controversial clauses within the current law. On the same issue, it is important to have legislation that will set standards for the utilization of BIM in companies of various sizes now that BIM is becoming compulsory in the UK. The researcher also recommends that building and construction companies should play and active role in the development of BIM by preparing for the increased utilization of this model; the best way would be to ensure extensive training of their staff on matters BIM. Companies should also look to be more innovative and look for strategies of increasing the utilization of BIM on the construction site. On the part of policymakers, there is need to lobby for the incorporation of BIM in the curricula of various vocational studies that are related to the building and construction industries; these vocational studies include architecture and civil engineering.

Future stakeholders in the building and construction industry can refer to the findings of these paper as they are strong and valid. The major strength of this paper is just it is based on data which the researcher collected in the field and interpreted it in light with the findings of previous studies. However, the use of a purposeful sampling strategy and utilization of a small sample size are important limitations of this study. Future researchers in this field can enhance the validity and the usefulness of the findings by utilizing probability sampling strategies and using larger sample sizes for utmost representation. One key area in this field that requires future exploration is the utilization of BIM on the construction site. Also, future researchers might need to delve into finding more reasons why companies have been slow in taking up and BIM and the challenges that they face in adopting to the changes that BIM fosters.

 

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Mesároš, P. and Mandičák, T., 2017, October. Exploitation and Benefits of BIM in Construction Project Management. In IOP Conference Series: Materials Science and Engineering (Vol. 245, No. 6, p. 062056). IOP Publishing.

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Onungwa, I.O., Uduma-Olugu, N. and Igwe, J.M., 2017. Building Information Modelling as a Construction Management Tool in Nigeria. WIT Transactions on The Built Environment169, pp.25-33.

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The Contraceptive Methods

 

The Contraceptive Methods

It is of paramount importance to find the birth control method which best suits an individual. There is a large number of available contraceptive methods nowadays, and choosing birth control might seem difficult. There are some medicines that may stop hormonal contraception working. That is why a patient needs to pick extra contraception in order to avoid pregnancy, select another method of contraception, or use this contraceptive method in another way. The article under consideration is devoted to choosing treatment for the 26-year-old patient Claudia who has requested a reliable birth control. It is pertinent to point out that this patient suffers from seasonal allergies. It should be emphasized that the patient’s drug allergies, Sulfa, might cause a rash. These problems have also been taken into consideration in the process of establishing treatment goals. As the patient did not want to discuss sterilization, only those methods which might not influence the patient’s reproductive system has been investigated thoroughly.

  1. What are your treatment goals for Claudia today?

It should be highlighted that the main goal is to achieve reversible, effective, and accessible birth control for this patient. The right selection of contraceptive modality might help avoid the risks of unintended pregnancy. In addition to this, it is required to limit the seasonal allergies. Appropriate allergy treatment is based on the medical history of Claudia and her allergy tests. These two aims are significant in order to make Claudia sure that she has a normal life.

  1. What are two possible contraceptive methods for Claudia? Please give brief rationale for each.

The two contraceptive methods which might be proposed to Claudia are birth control ring and birth control shot. The birth control ring (AKA NuvaRing) is a safe, simple, and affordable birth control method that prevents pregnancy by releasing hormones into a body. It should be emphasized that the ring contains the hormones estrogen and progestin, which are similar to hormones a body makes naturally (Planned Parenthood, n.d.). The other contraceptive method is the birth control shot. The depo shot (AKA Depo-Provera) is an injection that a person gets every 3 months. Such injection has the hormone progestin, which helps patients to prevent ovulation. Moreover, it also works by making cervical mucus thicker (Planned Parenthood, n.d.). In a case if there is no egg in the tube, a woman cannot become pregnant.

  1. Pick one method and list five (5) patient-centered teaching points for the method you chose today.

The method that has been selected is the birth control ring. The five (5) patient-centered teaching points are the following:

  • This method is 99.7 per cent effective when a person wants to prevent pregnancy;
  • This method is a suitable alternative in a case when it is difficult to take a pill every day or when a patient is not comfortable to use implants or IUDs;
  • Unscheduled bleeding is less likely to happen;
  • The hormones are not digested. For this reason, there are no risks of it not working if a patient has diarrhea or vomiting;
  • Those who use the ring are less anemic because of iron deficiency, and those who have anemia might show an improvement (Better Health Channel, 2014).

The vaginal ring is a type of contraception which work in preventing pregnancy is similar to the oral contraceptive method (pill). It releases synthetic forms of the natural hormones estrogen and progestogen.

To sum up, the available evidence provides a premise to believe that birth control ring and birth control shot seem to be the most appropriate methods of contraceptive to a patient with the regard of her seasonal allergies. After analyzing the advantages and disadvantages of these methods, it was decided to select the birth control ring as the proposed contraceptive method.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Better Health Channel. (2014). Contraception – vaginal ring. The Victorian Government: Better Health Channel.

Planned Parenthood. (2018). Birth control ring. Planned Parenthood Website.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Contraceptive Methods

Student Name:

Institution:

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Contraceptive Methods

It is of paramount importance to find the birth control method which best suits an individual. There is a large number of available contraceptive methods nowadays, and choosing birth control might seem difficult. There are some medicines that may stop hormonal contraception working. That is why a patient needs to pick extra contraception in order to avoid pregnancy, select another method of contraception, or use this contraceptive method in another way. The article under consideration is devoted to choosing treatment for the 26-year-old patient Claudia who has requested a reliable birth control. It is pertinent to point out that this patient suffers from seasonal allergies. It should be emphasized that the patient’s drug allergies, Sulfa, might cause a rash. These problems have also been taken into consideration in the process of establishing treatment goals. As the patient did not want to discuss sterilization, only those methods which might not influence the patient’s reproductive system has been investigated thoroughly.

  1. What are your treatment goals for Claudia today?

It should be highlighted that the main goal is to achieve reversible, effective, and accessible birth control for this patient. The right selection of contraceptive modality might help avoid the risks of unintended pregnancy. In addition to this, it is required to limit the seasonal allergies. Appropriate allergy treatment is based on the medical history of Claudia and her allergy tests. These two aims are significant in order to make Claudia sure that she has a normal life.

  1. What are two possible contraceptive methods for Claudia? Please give brief rationale for each.

The two contraceptive methods which might be proposed to Claudia are birth control ring and birth control shot. The birth control ring (AKA NuvaRing) is a safe, simple, and affordable birth control method that prevents pregnancy by releasing hormones into a body. It should be emphasized that the ring contains the hormones estrogen and progestin, which are similar to hormones a body makes naturally (Planned Parenthood, n.d.). The other contraceptive method is the birth control shot. The depo shot (AKA Depo-Provera) is an injection that a person gets every 3 months. Such injection has the hormone progestin, which helps patients to prevent ovulation. Moreover, it also works by making cervical mucus thicker (Planned Parenthood, n.d.). In a case if there is no egg in the tube, a woman cannot become pregnant.

  1. Pick one method and list five (5) patient-centered teaching points for the method you chose today.

The method that has been selected is the birth control ring. The five (5) patient-centered teaching points are the following:

  • This method is 99.7 per cent effective when a person wants to prevent pregnancy;
  • This method is a suitable alternative in a case when it is difficult to take a pill every day or when a patient is not comfortable to use implants or IUDs;
  • Unscheduled bleeding is less likely to happen;
  • The hormones are not digested. For this reason, there are no risks of it not working if a patient has diarrhea or vomiting;
  • Those who use the ring are less anemic because of iron deficiency, and those who have anemia might show an improvement (Better Health Channel, 2014).

The vaginal ring is a type of contraception which work in preventing pregnancy is similar to the oral contraceptive method (pill). It releases synthetic forms of the natural hormones estrogen and progestogen.

To sum up, the available evidence provides a premise to believe that birth control ring and birth control shot seem to be the most appropriate methods of contraceptive to a patient with the regard of her seasonal allergies. After analyzing the advantages and disadvantages of these methods, it was decided to select the birth control ring as the proposed contraceptive method.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Better Health Channel. (2014). Contraception – vaginal ring. The Victorian Government: Better Health Channel. Retrieved from https://www.betterhealth.vic.gov.au/health/healthyliving/contraception-vaginal-ring

Planned Parenthood. (2018). Birth control ring. Planned Parenthood Website. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring