An invisible operational mortar

The contribution seeks to apply the principles of J. L. Austin’s speech-act theories to the study of local business segregation in the Jim Crow South. In particular, it borrows the notions of illocutionary and perlocutionary force when examining the seemingly bland and prosaic statements that are often used to normalise segregation within the business of commercial entertainment. For purposes of expanding the complexity of typical Manichaean (i.e., Black vs White) ethnic studies, this analysis was developed within the context of tri-racial segregation as applied to rural moviegoing within Robeson County, North Carolina during the first half of the twentieth century. Notably, the development of Robeson’s historical cinema-exhibition spaces eventually resulted in a highly unusual venue – i.e., the three-entrance theatre – whose physical architecture reflected tensions between local ethnic demographics and desired social hierarchies. Yet even in the face of these unusual physical constructs, this study contends that seemingly everyday objective/descriptive and non-demonising language remained an essential component in enforcing segregation.

Oppositional Identity and Back-Vowel Fronting in a Tri-ethnic Context

This study considers the dynamic trajectory of the back-vowel fronting of the BOOT and BOAT vowels for 27 speakers in a unique, longstanding context of a substantive, tri-ethnic contact situation involving American Indians, European Americans, and African Americans over three disparate generations in Robeson County, North Carolina. The results indicate that the earlier status of Lumbee English fronting united them with the African American vowel system, particularly for the BOOT vowel, but that more recent generations have shifted towards alignment with European American speakers. Given the biracial Southeastern U.S. that historically identified Lumbee Indians as “free persons of color” and the persistent skepticism about the Lumbee Indians as merely a mixed group of European Americans and African Americans, the movement away from the African American pattern towards the European American pattern was interpreted as a case of oppositional identity in which Lumbee Indians disassociate themselves from African American vowel norms in subtle but socially meaningful ways.

Colorectal cancer: Improving screening in rural clinic.

e19215 Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. From 2010 to 2014, CRC was also the second leading cause of cancer deaths in North Carolina (NC). Between 2012-2016, the age adjusted mortality rate was 18-25 per 100,000 persons in Robeson County, NC. During this timeframe, it is estimated that if all people aged 50 and older in NC were routinely screened, 40 out of 100 deaths from late stage CRC can be prevented. A chart review in a rural primary care clinic identified patients not being appropriately screened for targeted intervention. Methods: Retrospective chart review at Lumberton Medical Clinic, a rural outpatient Internal Medicine Clinic, reviewed 1622 records from adults 50-75 years old during the timeframe September 2017 - August 2018 for phase I and 1588 records from September 2018-August 2019 for phase II. Patients with history of CRC or status-post colectomy for other reasons were excluded from this study. Patient records were assessed for compliance with USPTF CRC screening guidelines – adults aged 50 to 75 years receive screening as follows: 1) Fecal occult blood testing (FOBT) annually 2) Flexible sigmoidoscopy every 5 years 3) Colonoscopy every 10 years OR 4) Combined FOBT (every 3 years) + flexible sigmoidoscopy (every 5 years). Following data analysis in phase I, interventions to increase screening rates were initiated – provider education, posters hung in exam rooms, and individualized letters mailed to patients found deficient. The success of this effort was measured in phase II. Results: For phase I, the review showed 56% of patients received appropriate screening and 44% were found with no documentation of screening. Following interventions, 76% received appropriate screening and 24% with no documentation. Thus, there is ~35% improvement in screening rate. Conclusions: The mortality rate from CRC is higher in Robeson County compared to the NC state rate. Additionally, 40% of deaths from late-stage CRC may be prevented by doing a routine screening. It is the responsibility of providers to emphasize the importance of proper screening. This retrospective review showed ~ 35% improvement in screening rates following interventions. The result might not be as high as expected due to several factors: 1) new resident physicians and faculty 2) few posters were taking down due to disagreement with the guidelines by one of the 3 main providers 3) patients might not receive the letters. To further increase the screening rate, we are implementing the “Preventive Maintenance” tab in our electronic medical record system at the end of clinic visits.

Using Resilience in Risk-Based Asset Management Plans

Each state in the U.S.A. is required to develop and maintain a risk-based transportation asset management plan for the National Highway System (NHS) to improve or preserve the condition of the assets and the performance of the system. Awareness of natural hazards and extreme weather events has also increased with recent catastrophic hurricanes, such as Matthew (October, 2016) and Harvey (August, 2017), which caused significant inland floods in Robeson County, North Carolina, and Houston, Texas, respectively. These recent events and the damage to transportation infrastructure has also focused attention on the resilience of transportation networks. However, an integrated, consistent, well-understood method to assess or quantify the resilience of transportation networks is still lacking. This paper reviews the relevant concepts, legislative requirements that link asset management, risk and resilience, and tools available to support risk-based asset management. Based on a review of the transportation asset management plans developed by 49 state departments of transportation in 2018 and 2019, the paper summarizes the approaches to the risk management section of these asset management plans and the role resilience plays. Opportunities to better integrate resilience into the risk-based asset management plans are then identified. Examples are presented that demonstrate the role of resilience-related technical performance measures that reflect decisions related to flooding in the various stages of the disaster cycle (preparedness, response, recovery, and mitigation).

Assessment of Open-source Software, QGIS, To Estimate Hurricane Matthew Flood Extent in Robeson County, North Carolina, Using Unsupervised Classification

ABSTRACT The spatial extent of flooding caused by Hurricane Matthew in Robeson County, NC, in October 2016 was investigated by comparing two Landsat-8 images (one flood and one non-flood) following K-means unsupervised classification for each in both ENVI, a proprietary software, and QGIS with Orfeo Toolbox, a free and open-source software. In this study, unsupervised classification was capable of rapidly producing regional maps, but poor accuracy constrained practical application. Of particular note, the open-source setup performed on par with the proprietary option for each of the classifications. Overall, remote sensing techniques using open-source software show promise in helping aid workers to cost-effectively conduct post-event analyses and relief efforts.

Colorectal cancer: Improving screening in a rural clinic.

e13054 Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Between 2012-2016, the age adjusted mortality rate was 18-25 per 100,000 persons in Robeson County, North Carolina. During this timeframe, it is estimated that if all people aged 50 and older in NC were routinely screened, 40 out of 100 deaths from late stage CRC can be prevented. A chart review in a rural primary care clinic identified patients not being appropriately screened for targeted intervention. Methods: Our retrospective chart review at Lumberton Medical Clinic, a rural outpatient Internal Medicine Clinic, reviewed 1622 records from adults 50-75 years old during the timeframe September 2017 through August 2018. Patients with history of CRC or status-post colectomy for other reasons were excluded from this study. Patient records were assessed for compliance with USPTF CRC screening guidelines. USPTF recommends adults aged 50 to 75 years receive screening as follows: 1) Fecal occult blood testing (FOBT) annually 2) Flexible sigmoidoscopy every 5 years 3) Colonoscopy every 10 years OR 4) Combined FOBT (every 3 years) plus flexible sigmoidoscopy (every 5 years). Results: The review showed that during the timeframe studied, 56% of patients received appropriate screening, 44% were found with no documentation of screening, and 17% were never offered screening or informed about current guidelines. Following data analysis, intervention to increase screening rates has been initiated. This involves provider education, posters in clinic, and individualized letters mailed to patients found deficient during the study. The success of this direct patient outreach effort will be measured over six months. Conclusions: The mortality rate from CRC cancer is higher in Robeson County compared to the NC state rate. Additionally, 40% of deaths from late-stage CRC may be prevented by doing a routine screening. It is the responsibility of providers to emphasize the importance of proper screening. This retrospective review found that a large percentage (44%) of adults are not being adequately screened in our rural clinic. Direct outreach is underway to increase compliance rates in this high-risk population served by our rural clinic.

Integration or Disintegration

For Robeson County Indians, choosing the tribal name “Lumbee” for themselves was a monumental act of self-determination. The “Lumbee” bill in 1956 granted the Robeson County a form of official, yet limited, federal acknowledgement. In Robeson County, World War II sparked exposure, awareness, and change. At its zenith as an Indian place in the 1950s, the town of Pembroke was remarkable in the otherwise biracial South as its Indian residents continuously found new ways to make the place more their own. Some Indians opposed school integration because it meant sacrificing their distinct independence, control over their identity, and the primary institution—the schools—that had sustained the recognition of that identity for a century. Indians expressed pride in their heritage through their actions and words. With the court case Maynor v. Morton, Tuscaroras defied the federal government’s insistence that they were not deserving of federal recognition. The legal victory against double voting showed that Indians would not be silenced at the ballot box. Rebuilding the Old Main heritage building at Pembroke State College, creating Lumbee Homecoming, and opening Lumbee Guaranty Bank showed that Indians would continue asserting control over their own affairs and celebrating themselves.