Search results for: James Marco

Authors: Marco Picco, Mahmood Alam

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Improving the energy performance of existing buildings can be challenging, particularly when facades cannot be modified, and the only available option is internal insulation. In such cases, the choice of the most suitable material becomes increasingly complex, as in addition to thermal transmittance and capital cost, the designer needs to account for the impact of the intervention on the internal spaces, and in particular the loss of usable space due to the additional layers of materials installed. This paper explores this issue by analyzing a case study of an average office building needing to go through a refurbishment in order to reach the limits imposed by current regulations to achieve energy efficiency in buildings. The building is simulated through dynamic performance simulation under three different climate conditions in order to evaluate its energy needs. The use of Vacuum Insulated Panels as an option for energy refurbishment is compared to traditional insulation materials (XPS, Mineral Wool). For each scenario, energy consumptions are calculated and, in combination with their expected capital costs, used to perform a financial feasibility analysis. A holistic approach is proposed, taking into account the impact of the intervention on internal space by quantifying the value of the lost usable space and used in the financial feasibility analysis. The proposed approach highlights how taking into account different drivers will lead to the choice of different insulation materials, showing how accounting for the economic value of space can make VIPs an attractive solution for energy retrofitting under various climate conditions.

Keywords: Vacuum insulated panels, building performance simulation, payback period, building energy retrofit.

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Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are  routinely used in patients with conductive or mixed hearing loss, e.g.  if conventional air conduction hearing aids cannot be used. New  sound processors and new fitting software now allow the adjustment  of parameters such as loudness compression ratios or maximum  power output separately. Today it is unclear, how the choice of these  parameters influences aided speech understanding in BAHI users.  In this prospective experimental study, the effect of varying the  compression ratio and lowering the maximum power output in a  BAHI were investigated.  Twelve experienced adult subjects with a mixed hearing loss  participated in this study. Four different compression ratios (1.0; 1.3;  1.6; 2.0) were tested along with two different maximum power output  settings, resulting in a total of eight different programs. Each  participant tested each program during two weeks. A blinded Latin  square design was used to minimize bias.  For each of the eight programs, speech understanding in quiet and  in noise was assessed. For speech in quiet, the Freiburg number test  and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL  were used. For speech in noise, the Oldenburg sentence test was  administered.  Speech understanding in quiet and in noise was improved  significantly in the aided condition in any program, when compared  to the unaided condition. However, no significant differences were  found between any of the eight programs. In contrast, on a subjective  level there was a significant preference for medium compression  ratios of 1.3 to 1.6 and higher maximum power output.

 

Keywords: Bone Anchored Hearing Implant, Compression, Maximum Power Output, Speech understanding.

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Authors: Marco Antonio Lara De la Calleja, María Catalina Ovando Chico, Eduardo Lopez Ruiz

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Community empowerment has been proved to be a key element in the solution of the food security problem. As a result of a conceptual analysis, it was found that agricultural production, economic development and governance, are the traditional basis of food security models. Although the literature points to social inclusion as an important factor for food security, no model has considered it as the basis of it. The aim of this research is to identify different dimensions that make an integral model for food security, with emphasis on community empowerment. A diagnosis was made in the study community (Tatoxcac, Zacapoaxtla, Puebla), to know the aspects that impact the level of food insecurity. With a statistical sample integrated by 200 families, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, finding that: in households composed by adults and children, have moderated food insecurity, (ELCSA scale has three levels, low, moderated and high); that result is produced mainly by the economic income capacity and the diversity of the diet on its food. With that being said, a model was developed to promote food security through five dimensions: 1. Regional context of the community; 2. Structure and system of local food; 3. Health and nutrition; 4. Information and technology access; and 5. Self-awareness and empowerment. The specific actions on each axis of the model, allowed a systemic approach needed to attend food security in the community, through the empowerment of society. It is concluded that the self-awareness of local communities is an area of extreme importance, which must be taken into account for participatory schemes to improve food security. In the long term, the model requires the integrated participation of different actors, such as government, companies and universities, to solve something such vital as food security.

Keywords: Community empowerment, food security, model, systemic approach.

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Authors: Maha ALjohani, James Blustein

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Communicating users' needs, goals and problems help designers and developers overcome challenges faced by end users. Personas are used to represent end users’ needs. In our research, creating personas allowed the following questions to be answered: Who are the potential user groups? What do they want to achieve by using the service? What are the problems that users face? What should the service provide to them? To develop realistic personas, we conducted a focus group discussion with undergraduate and graduate students and also interviewed a university librarian. The personas were created to help evaluating the Institutional Repository that is based on the DSpace system. The profiles helped to communicate users' needs, abilities, tasks, and problems, and the task scenarios used in the heuristic evaluation were based on these personas. Four personas resulted of a focus group discussion with undergraduate and graduate students and from interviewing a university librarian. We then used these personas to create focused task-scenarios for a heuristic evaluation on the system interface to ensure that it met users' needs, goals, problems and desires. In this paper, we present the process that we used to create the personas that led to devise the task scenarios used in the heuristic evaluation as a follow up study of the DSpace university repository.

Keywords: Heuristic Evaluation, Institutional Repositories, User Experience, Human Computer Interaction, User Profiles, Personas, Task Scenarios, Heuristics.

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Authors: Enrique Claver Cortés, Bartolomé Marco Lajara, Eduardo Sánchez García, Pedro Seva Larrosa, Encarnación Manresa Marhuenda, Lorena Ruiz Fernández, Esther Poveda Pareja

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In recent decades, the analysis of the effects of clustering as an essential factor for the development of innovations and the competitiveness of enterprises has raised great interest in different areas. Nowadays, companies have access to almost all tangible and intangible resources located and/or developed in any country in the world. However, despite the obvious advantages that this situation entails for companies, their geographical location has shown itself, increasingly clearly, to be a fundamental factor that positively influences their innovative performance and competitiveness. Industrial clusters could represent a unique level of analysis, positioned between the individual company and the industry, which makes them an ideal unit of analysis to determine the effects derived from company membership of a cluster. Also, the absorptive capacity (hereinafter 'AC') can mediate the process of innovation development by companies located in a cluster. The transformation and exploitation of knowledge could have a mediating effect between knowledge acquisition and innovative performance. The main objective of this work is to determine the key factors that affect the degree of generation and use of knowledge from the environment by companies and, consequently, their innovative performance and competitiveness. The elements analyzed are the companies' membership of a cluster and the AC. To this end, 30 most relevant papers published on this subject in the "Web of Science" database have been reviewed. Our findings show that, within a cluster, the knowledge coming from the companies' environment can significantly influence their innovative performance and competitiveness, although in this relationship, the degree of access and exploitation of the companies to this knowledge plays a fundamental role, which depends on a series of elements both internal and external to the company.

Keywords: Absorptive capacity, clusters, innovation, knowledge.

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Authors: Reza Keihani, Ali Bahadori-Jahromi, Timothy James Clacy

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Plastic as an environmental burden is a well-rehearsed topic in the research area. This is due to its global demand and destructive impacts on the environment, which has been a significant concern to the governments. Typically, the use of plastic in the construction industry is seen across low-density, non-structural applications due to its diverse range of benefits including high strength-to-weight ratios, manipulability and durability. It can be said that with the level of plastic consumption experienced in the construction industry, an ongoing responsibility is shown for this sector to continually innovate alternatives for application of recycled plastic waste such as using plastic made replacement from polyethylene, polystyrene, polyvinyl and polypropylene in the concrete mix design. In this study, the impact of partially replaced fine aggregate with polypropylene in the concrete mix design was investigated to evaluate the concrete’s compressive strength by conducting an experimental work which comprises of six concrete mix batches with polypropylene replacements ranging from 0.5 to 3.0%. The results demonstrated a typical decline in the compressive strength with the addition of plastic aggregate, despite this reduction generally mitigated as the level of plastic in the concrete mix increased. Furthermore, two of the six plastic-containing concrete mixes tested in the current study exceeded the ST5 standardised prescribed concrete mix compressive strength requirement at 28-days containing 1.50% and 2.50% plastic aggregates, which demonstrated the potential for use of recycled polypropylene in structural applications, as a partial by mass, fine aggregate replacement in the concrete mix.

Keywords: Compressive strength, concrete, polypropylene, sustainability.

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Authors: Joseph E. Estevez, Mahdi Ghazizadeh, James G. Ryan, Ajit D. Kelkar

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Radiation shielding is an obstacle in long duration space exploration. Boron Nitride Nanotubes (BNNTs) have attracted attention as an additive to radiation shielding material due to B¹⁰’s large neutron capture cross section. The B¹⁰ has an effective neutron capture cross section suitable for low energy neutrons ranging from 10^-5 to 10⁴ eV and hydrogen is effective at slowing down high energy neutrons. Hydrogenated BNNTs are potentially an ideal nanofiller for radiation shielding composites. We use Molecular Dynamics (MD) Simulation via Material Studios Accelrys 6.0 to model the Young’s Modulus of Hydrogenated BNNTs. An extrapolation technique was employed to determine the Young’s Modulus due to the deformation of the nanostructure at its theoretical density. A linear regression was used to extrapolate the data to the theoretical density of 2.62g/cm³. Simulation data shows that the hydrogenated BNNTs will experience a 11% decrease in the Young’s Modulus for (6,6) BNNTs and 8.5% decrease for (8,8) BNNTs compared to non-hydrogenated BNNT’s. Hydrogenated BNNTs are a viable option as a nanofiller for radiation shielding nanocomposite materials for long range and long duration space exploration.

Keywords: Boron Nitride Nanotube, Radiation Shielding, Young Modulus, Atomistic Modeling.

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Authors: Giulia Sarego, Lorenzo Olivieri, Andrea Valmorbida, Carlo Bettanini, Giacomo Colombatti, Marco Pertile, Enrico C. Lorenzini

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International guidelines recommend removing any artificial body in Low Earth Orbit (LEO) within 25 years from mission completion. Among disposal strategies, electrodynamic tethers appear to be a promising option for LEO, thanks to the limited storage mass and the minimum interface requirements to the host spacecraft. In particular, recent technological advances make it feasible to deorbit large objects with tether lengths of a few kilometers or less. To further investigate such an innovative passive system, the European Union is currently funding the project E.T.PACK – Electrodynamic Tether Technology for Passive Consumable-less Deorbit Kit in the framework of the H2020 Future Emerging Technologies (FET) Open program. The project focuses on the design of an end of life disposal kit for LEO satellites. This kit aims to deploy a taped tether that can be activated at the spacecraft end of life to perform autonomous deorbit within the international guidelines. In this paper, the orbital performance of the E.T.PACK deorbiting kit is compared to other disposal methods. Besides, the orbital decay prediction is parametrized as a function of spacecraft mass and tether system performance. Different values of length, width, and thickness of the tether will be evaluated for various scenarios (i.e., different initial orbital parameters). The results will be compared to other end-of-life disposal methods with similar allocated resources. The analysis of the more innovative system’s performance with the tape coated with a thermionic material, which has a low work-function (LWT), for which no active component for the cathode is required, will also be briefly discussed. The results show that the electrodynamic tether option can be a competitive and performant solution for satellite disposal compared to other deorbit technologies.

Keywords: Deorbiting performance, H2020, spacecraft disposal, space electrodynamic tethers.

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Authors: Shirin Shafaei, James R. Bolton, Mohamed Gamal El Din

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Ultraviolet (UV) disinfection causes damage to the DNA or RNA of microorganisms, but many microorganisms can repair this damage after exposure to near-UV or visible wavelengths (310–480 nm) by a mechanism called photoreactivation. Photoreactivation is gaining more attention because it can reduce the efficiency of UV disinfection of wastewater several hours after treatment. The focus of many photoreactivation research activities on the single species has caused a considerable lack in knowledge about complex natural communities of microorganisms and their response to UV treatment. In this research, photoreactivation experiments were carried out on the influent of the UV disinfection unit at a municipal wastewater treatment plant (WWTP) in Edmonton, Alberta after exposure to a Medium-Pressure (MP) UV lamp system to evaluate the effect of environmental factors on photoreactivation of microorganisms in the actual municipal wastewater. The effect of reactivation fluence, temperature, and river water on photoreactivation of total coliforms was examined under indoor conditions. The results showed that higher effective reactivation fluence values (up to 20 J/cm²) and higher temperatures (up to 25 °C) increased the photoreactivation of total coliforms. However, increasing the percentage of river in the mixtures of the effluent and river water decreased the photoreactivation of the mixtures. The results of this research can help the municipal wastewater treatment industry to examine the environmental effects of discharging their effluents into receiving waters.

Keywords: Photoreactivation, reactivation fluence, river water, temperature, ultraviolet disinfection, wastewater effluent.

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Authors: Umberto Di Staso, Marco Soave, Alessio Giori, Federico Prandi, Raffaele De Amicis

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The increasing availability of information about earth surface elevation (Digital Elevation Models DEM) generated from different sources (remote sensing, Aerial Images, Lidar) poses the question about how to integrate and make available to the most than possible audience this huge amount of data. In order to exploit the potential of 3D elevation representation the quality of data management plays a fundamental role. Due to the high acquisition costs and the huge amount of generated data, highresolution terrain surveys tend to be small or medium sized and available on limited portion of earth. Here comes the need to merge large-scale height maps that typically are made available for free at worldwide level, with very specific high resolute datasets. One the other hand, the third dimension increases the user experience and the data representation quality, unlocking new possibilities in data analysis for civil protection, real estate, urban planning, environment monitoring, etc. The open-source 3D virtual globes, which are trending topics in Geovisual Analytics, aim at improving the visualization of geographical data provided by standard web services or with proprietary formats. Typically, 3D Virtual globes like do not offer an open-source tool that allows the generation of a terrain elevation data structure starting from heterogeneous-resolution terrain datasets. This paper describes a technological solution aimed to set up a so-called “Terrain Builder”. This tool is able to merge heterogeneous-resolution datasets, and to provide a multi-resolution worldwide terrain services fully compatible with CesiumJS and therefore accessible via web using traditional browser without any additional plug-in.

Keywords: Terrain builder, WebGL, virtual globe, CesiumJS, tiled map service, TMS, height-map, regular grid, Geovisual analytics, DTM.

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Authors: James Kuria, John Kihiu

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This work presents a numerical model developed to simulate the dynamics and vibrations of a multistage tractor gearbox. The effect of time varying mesh stiffness, time varying frictional torque on the gear teeth, lateral and torsional flexibility of the shafts and flexibility of the bearings were included in the model. The model was developed by using the Lagrangian method, and it was applied to study the effect of three design variables on the vibration and stress levels on the gears. The first design variable, module, had little effect on the vibration levels but a higher module resulted to higher bending stress levels. The second design variable, pressure angle, had little effect on the vibration levels, but had a strong effect on the stress levels on the pinion of a high reduction ratio gear pair. A pressure angle of 25o resulted to lower stress levels for a pinion with 14 teeth than a pressure angle of 20o. The third design variable, contact ratio, had a very strong effect on both the vibration levels and bending stress levels. Increasing the contact ratio to 2.0 reduced both the vibration levels and bending stress levels significantly. For the gear train design used in this study, a module of 2.5 and contact ratio of 2.0 for the various meshes was found to yield the best combination of low vibration levels and low bending stresses. The model can therefore be used as a tool for obtaining the optimum gear design parameters for a given multistage spur gear train.

Keywords: bending stress levels, frictional torque, gear designparameters, mesh stiffness, multistage gear train, vibration levels.

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Authors: Nadeem Ehsan, Ebtisam Mirza, Muhammad Ahmad

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In a complex project environment, project teams face multi-dimensional communication problems that can ultimately lead to project breakdown. Team Performance varies in Face-to-Face (FTF) environment versus groups working remotely in a computermediated communication (CMC) environment. A brief review of the Input_Process_Output model suggested by James E. Driskell, Paul H. Radtke and Eduardo Salas in “Virtual Teams: Effects of Technological Mediation on Team Performance (2003)", has been done to develop the basis of this research. This model theoretically analyzes the effects of technological mediation on team processes, such as, cohesiveness, status and authority relations, counternormative behavior and communication. An empirical study described in this paper has been undertaken to test the “cohesiveness" of diverse project teams in a multi-national organization. This study uses both quantitative and qualitative techniques for data gathering and analysis. These techniques include interviews, questionnaires for data collection and graphical data representation for analyzing the collected data. Computer-mediated technology may impact team performance because of difference in cohesiveness among teams and this difference may be moderated by factors, such as, the type of communication environment, the type of task and the temporal context of the team. Based on the reviewed model, sets of hypotheses are devised and tested. This research, reports on a study that compared team cohesiveness among virtual teams using CMC and non-CMC communication mediums. The findings suggest that CMC can help virtual teams increase team cohesiveness among their members, making CMC an effective medium for increasing productivity and team performance.

Keywords: Computer-mediated Communication, Virtual Teams, Team Performance, Team Cohesiveness.

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Authors: James Patrick A. Diaz, Raul E. Ramboyong

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Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: Antihypertensive, exercise test, hypertension, hypertensive response.

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Authors: Keith D. Nare, Mohau J. Phiri, James Carson, Chris D. Woolard, Shanganyane P. Hlangothi

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In an energy-intensive world, minimizing energy consumption is paramount to cost saving and reducing the carbon footprint. Improving mixture procedures utilizing warm mix additive Fischer-Tropsch (FT) wax in ethylene vinyl acetate (EVA) and modified bitumen highlights a greener and sustainable approach to modified bitumen. In this study, the impact of FT wax on optimized EVA/waste crumb rubber modified bitumen is assayed with a maximum loading of 2.5%. The rationale of the FT wax loading is to maintain the original maximum loading of EVA in the optimized mixture. The phase change abilities of FT wax enable EVA co-crystallization with the support of the elastomeric backbone of crumb rubber. Less than 1% loading of FT wax worked in the EVA/crumb rubber modified bitumen energy-sustainability nexus. Response surface methodology approach to the mixture design is implemented amongst the different loadings of FT wax, EVA for a consistent amount of crumb rubber and bitumen. Rheological parameters (complex shear modulus, phase angle and rutting parameter) were the factors used as performance indicators of the different optimized mixtures. The low temperature chemistry of the optimized mixtures is analyzed using elementary beam theory and the elastic-viscoelastic correspondence principle. Master curves and black space diagrams are developed and used to predict age-induced cracking of the different long term aged mixtures. Modified binder rheology reveals that the strain response is not linear and that there is substantial re-arrangement of polymer chains as stress is increased, this is based on the age state of the mixture and the FT wax and EVA loadings. Dominance of individual effects is evident over effects of synergy in co-interaction of EVA and FT wax. All-inclusive FT wax and EVA formulations were best optimized in mixture 4 with mixture 7 reflecting increase in ease of workability. Findings show that interaction chemistry of bitumen, crumb rubber EVA, and FT wax is first and second order in all cases involving individual contributions and co-interaction amongst the components of the mixture.

Keywords: Bitumen, crumb rubber, ethylene vinyl acetate, FT wax.

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Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

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An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: Accuracy, design-stage, elemental cost plan, final tender sum, New Zealand.

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Authors: Gideon J. Bonthuys, Marco van Dijk, Jay N. Bhagwan

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Small scale hydropower used to play a very important role in the provision of energy to urban and rural areas of South Africa. The national electricity grid, however, expanded and offered cheap, coal generated electricity and a large number of hydropower systems were decommissioned. Unfortunately, large numbers of households and communities will not be connected to the national electricity grid for the foreseeable future due to high cost of transmission and distribution systems to remote communities due to the relatively low electricity demand within rural communities and the allocation of current expenditure on upgrading and constructing of new coal fired power stations. This necessitates the development of feasible alternative power generation technologies. A feasibility and implementation model was developed to assist in designing and financially evaluating small-scale hydropower (SSHP) plants. Several sites were identified using the model. The SSHP plants were designed for the selected sites and the designs for the different selected sites were priced using pricing models (civil, mechanical and electrical aspects). Following feasibility studies done on the designed and priced SSHP plants, a feasibility analysis was done and a design chart developed for future similar potential SSHP plant projects. The methodology followed in conducting the feasibility analysis for other potential sites consisted of developing cost and income/saving formulae, developing net present value (NPV) formulae, Capital Cost Comparison Ratio (CCCR) and levelised cost formulae for SSHP projects for the different types of plant installations. It included setting up a model for the development of a design chart for a SSHP, calculating the NPV, CCCR and levelised cost for the different scenarios within the model by varying different parameters within the developed formulae, setting up the design chart for the different scenarios within the model and analyzing and interpreting results. From the interpretation of the develop design charts for feasible SSHP in can be seen that turbine and distribution line cost are the major influences on the cost and feasibility of SSHP. High head, short transmission line and islanded mini-grid SSHP installations are the most feasible and that the levelised cost of SSHP is high for low power generation sites. The main conclusion from the study is that the levelised cost of SSHP projects indicate that the cost of SSHP for low energy generation is high compared to the levelised cost of grid connected electricity supply; however, the remoteness of SSHP for rural electrification and the cost of infrastructure to connect remote rural communities to the local or national electricity grid provides a low CCCR and renders SSHP for rural electrification feasible on this basis.

Keywords: Feasibility, cost, rural electrification, small-scale hydropower.

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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