America Project Research Articles

From Comrades to Subversives: Mexican Secret Police and ‘Undesirable’ Spanish Exiles, 1939–60

AbstractThis article examines the Mexican state's surveillance of Spanish political exiles. As the Mexican government publicly welcomed over 20,000 political refugees fleeing the Spanish Civil War (1936–9), its intelligence apparatus characterised anarchist and communist refugees as subversive threats to the Mexican nation. Despite these efforts, the Mexican secret police failed to prevent the emergence of new political bonds between the two countries’ popular classes. This article shows the consequences of the Mexican secret police's campaign against radical exiles while also highlighting instances in which Spaniards evaded the state's purview and contributed to revolutionary projects in Mexico, Latin America and Spain.

REDES DE INFRAESTRUTURAS E A INTEGRAÇÃO REGIONAL NA AMÉRICA DO SUL: PROJETOS, CONTRADIÇÕES E INTENCIONALIDADES

As redes técnicas de infraestruturas são fundamentais para compreender as novas dinâmicas territoriais e o duplo movimento de integração e desintegração, fruto das contradições da fase atual do capitalismo flexível. O objetivo deste artigo é refletir sobre o papel dos projetos de integração regional na América do Sul, elaborados no âmbito do COSIPLAN/IIRSA para a expansão das redes de infraestruturas de transportes, considerando a demanda de circulação e acumulação de capital, bem como os entraves para a execução desses projetos.

A Taxonomic Analysis of Smart City Projects in North America and Europe

In recent years, the concept of a “Smart City” became central in the agenda of researchers, practitioners, and stakeholders. Although the application of information and communication technologies on city management has advanced exponentially, also other components would be needed for building a truly sustainable urban environment. Researchers from different domains debated the definition of a smart city and the conceptual variants. However, a broad view of the smart city field is still missing. This paper attempts to fill this gap by proposing a taxonomic classification of the most 105 outstanding smart city projects in Europe and North America. Collected data are then processed by statistical tools for clearly highlighting the success factors, trends and future paths in which all these projects are moving, along with different aspects (e.g., business model, purpose, industry). We then investigate the European and the North American Smart City concepts, illustrating the key role of mixed public and private partnerships in creating successful projects and the focus on the urban transportation, and freight and last-mile delivery in particular. Moreover, it emerges how the business modeling and the exploitation aspects have still low integration in the projects.

Review: The Chinese and the Iron Road: Building the Transcontinental Railroad, edited by Gordon H. Chang and Shelley Fisher Fiskin; Ghosts of Gold Mountain: The Epic Story of the Chinese Who Built the Transcontinental Railroad, by Gordon H. Chang; Chinese Railroad Workers in North America Project, by Gordon H. Chang et al.

Review: The Chinese and the Iron Road: Building the Transcontinental Railroad, edited by Gordon H. Chang and Shelley Fisher Fiskin; Ghosts of Gold Mountain: The Epic Story of the Chinese Who Built the Transcontinental Railroad, by Gordon H. Chang; Chinese Railroad Workers in North America Project, by Gordon H. Chang et al.

Fabricating (Other) Computations: Digital Fabrication and Technological Appropriation in Latin America

This paper introduces and examines the latest and current background of digital fabrication in the context of Latin American architecture and presents updated information from the Homo Faber: Digital Fabrication in Latin America Project, which focuses on laboratories exploring the application of manufacturing technologies in architectural experiments and design objects. The results point to a context including several dynamics involving the emergence of digital craft in communities, the redesign of standard building components, the creation of mobile laboratories, experiments connecting low and high technologies, hacking practices, as well as bottom-up strategies to implement these technologies in the industry. The overall conclusion is that technology transfer and technological appropriation processes are still being carried out in the region.

Evaluation of OCO‐2 X Variability at Local and Synoptic Scales using Lidar and In Situ Observations from the ACT‐America Campaigns

AbstractWith nearly 1 million observations of column‐mean carbon dioxide concentration (X) per day, the Orbiting Carbon Observatory 2 (OCO‐2) presents exciting possibilities for monitoring the global carbon cycle, including the detection of subcontinental column CO2variations. While the OCO‐2 data set has been shown to achieve target precision and accuracy on a single‐sounding level, the validation of Xspatial gradients on subcontinental scales remains challenging. In this work, we investigate the use of an integrated path differential absorption (IPDA) lidar for evaluation of OCO‐2 observations via NASA's Atmospheric Carbon and Transport (ACT)‐America project. The project has completed eight clear‐sky underflights of OCO‐2 with the Multifunctional Fiber Laser Lidar (MFLL)—along with a suite of in situ instruments—giving a precisely colocated, high‐resolution validation data set spanning nearly 3,800 km across four seasons. We explore the challenges and opportunities involved in comparing the MFLL and OCO‐2 Xdata sets and evaluate their agreement on synoptic and local scales. We find that OCO‐2 synoptic‐scale gradients generally agree with those derived from the lidar, typically to ±0.1 ppm per degree latitude for gradients ranging in strength from 0 to 1 ppm per degree latitude. CO2reanalysis products also typically agree to ±0.25 ppm per degree when compared with an in situ‐informed CO2“curtain.” Real Xfeatures at local scales, however, remain challenging to observe and validate from space, with correlation coefficients typically below 0.35 between OCO‐2 and the MFLL. Even so, ACT‐America data have helped investigate interesting local Xpatterns and identify systematic spurious cloud‐related features in the OCO‐2 data set.

MP43-19 PERSISTENTLY HIGH LEVELS OF OPIOID UTILIZATION AMONG PATIENTS WITH URINARY STONE DISEASE

INTRODUCTION AND OBJECTIVE: Urinary stone disease (USD) is painful, and its surgical treatment is oftentimes associated with pain as well. The scope of opioid utilization to mitigate USD associated pain is not well understood. As part of the Urological Diseases in America project, we assessed the prescription of opioid agents among a national sample of USD patients over an 8-year period. METHODS: Two insurance claims databases were analyzed over the 2006-2013 study period: the Centers for Medicare & Medicaid Services Medicare 5% Sample for beneficiaries aged ≥65 years with USD (N≈21,000 annually) and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured adults aged 18-64 years with USD (N≈61,000 annually). The percentage of patients receiving opioid agent prescriptions was assessed annually over the study period. RESULTS: Approximately three-fourths of USD patients filled a prescription of any kind in the course of their treatment. Opioid agents were the most common pharmaceutical prescribed, followed by alpha blockers and calcium channel blockers (Figure 1). The prevalence of opioid agonist prescription fills was higher among privately insured USD patients (range: 65-67%) compared to Medicare USD patients (range: 55-58%). Among both study populations, the high prevalence of opioid agent prescription fills persisted throughout the 8-year study period. CONCLUSIONS: Opioid agents are commonly prescribed to USD patients, and this practice persisted over the study period. An understanding of the scope of the opioid prescribing among stone patients is the first step in a pathway towards reducing reliance on this medication. Given how commonly opioids are utilized among USD patients, and given the recognized health risks associated with these agents, developing clinical pathways that decrease reliance on opioid agents is particularly important.Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems.

PD29-04 EVOLUTION OF HEALTHCARE COSTS FOR LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (PD29)1 Apr 2020PD29-04 EVOLUTION OF HEALTHCARE COSTS FOR LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA Charles Welliver*, Julia B. Ward, Lydia Feinstein, Kevin C. Abbott, Tamara Bavendam, Ziya Kirkali, Erline Martinez-Miller, Brian R. Matlaga, and Kevin McVary Charles Welliver*Charles Welliver* More articles by this author , Julia B. WardJulia B. Ward More articles by this author , Lydia FeinsteinLydia Feinstein More articles by this author , Kevin C. AbbottKevin C. Abbott More articles by this author , Tamara BavendamTamara Bavendam More articles by this author , Ziya KirkaliZiya Kirkali More articles by this author , Erline Martinez-MillerErline Martinez-Miller More articles by this author , Brian R. MatlagaBrian R. Matlaga More articles by this author , and Kevin McVaryKevin McVary More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000893.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evolving management of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) has changed the distribution of healthcare spending. Our understanding of recent trends in LUTS/BPH management costs is incomplete given prior studies have been limited to older men, small datasets, and inpatient procedures. We characterized LUTS/BPH-related Medicare and private insurance expenditures over 10 years. METHODS: As part of the Urologic Diseases in America project, we analyzed two insurance claims databases: the Centers for Medicare & Medicaid Services Medicare 5% Sample for male Medicare beneficiaries aged ≥65 years with LUTS/BPH (N≈147,800 annually) and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured males aged 40-64 years with LUTS/BPH (N≈100,300 annually). Annual LUTS/BPH-related expenditures from 2004-2013 were examined by service location: inpatient, hospital-based outpatient, and physician office. RESULTS: The average annual LUTS/BPH-related expenditures were $305 and $248 per LUTS/BPH patient in CDM and Medicare, respectively. Over the 10-year study period, inpatient care accounted for a decreasing percentage of total dollars spent on managing LUTS/BPH by Medicare (30% to 15%) and private insurance (37% to 15%). Outpatient LUTS/BPH-related expenditures rose for both insurer groups, especially for private insurance (61% to 83%). Expenditures for hospital-based outpatient care rose over the study period and exceeded physician office expenditures from 2007 onward for patients with private insurance, and from 2010 onward for Medicare patients (Figure). CONCLUSIONS: The distribution of healthcare expenditures for LUTS/BPH shifted across practice settings from 2004-2013, with increasing outpatient relative to inpatient expenditures. Hospital-based outpatient expenses exceeded physician office expenses, likely due to increased use of ambulatory surgical procedures for LUTS/BPH. In-office minimally invasive surgical therapies will likely lead to higher physician office costs in the future. Differences in expenditures between the study populations may be due to differential reimbursement practices between private insurance and Medicare. Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e619-e619 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Welliver* More articles by this author Julia B. Ward More articles by this author Lydia Feinstein More articles by this author Kevin C. Abbott More articles by this author Tamara Bavendam More articles by this author Ziya Kirkali More articles by this author Erline Martinez-Miller More articles by this author Brian R. Matlaga More articles by this author Kevin McVary More articles by this author Expand All Advertisement PDF downloadLoading ...

PD33-04 COMPARISON OF MEDICATION PRESCRIBING FOR LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA AMONG SEXAGENARIANS WITH MEDICARE AND PRIVATE INSURANCE

INTRODUCTION AND OBJECTIVE: Medication use for lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) increases with patient age. However, little is known about prescribing patterns as men in their 60’s transition from private insurance to Medicare coverage. We characterized differences in LUTS/BPH medication prescribing patterns among a large, national sample of 60- to 69-year-olds. METHODS: As part of the Urologic Diseases in America project, two insurance claims databases were analyzed over the 2006-2013 study period: the Centers for Medicare & Medicaid Services Medicare (CMS) 5% Sample for Medicare beneficiaries and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured adults. We compared patterns for LUTS/BPH prescription fills between privately insured men aged 60-64 years with LUTS/BPH (N≈38,300 annually) and Medicare beneficiaries aged 65-69 years with LUTS/BPH (N≈28,700 annually). CMS data for 2012 was unavailable. RESULTS: Prescribing of any LUTS/BPH medication was higher among Medicare beneficiaries (range: 50-55%) than among privately insured men (range: 41-49%), but there was a greater rise in prescribing over time for the privately insured group (17% vs. 5%). The largest difference in medication use was with α-blocker therapy, which was 20% higher on average in the Medicare group (range: 41-45%) compared to the privately insured group (range: 32-38%). Anticholinergic prescribing was uncommon (6% for Medicare vs. 3-4% for private insurance) and remained relatively steady over the study period. 5αRI prescribing increased up to 2010, then decreased in both groups, with a less pronounced decline among Medicare beneficiaries (9% vs. 14%). Tadalafil prescribing was more common in privately insured patients (5-8%) than among Medicare beneficiaries (0.1-3%). CONCLUSIONS: Overall, there was a rise in LUTS/BPH pharmacotherapy for sexagenarians from 2006-2013, with a greater rise among privately insured enrollees relative to Medicare beneficiaries. The decline in 5αRI prescribing correlates to the FDA “black box” warning on finasteride in 2011. Tadalafil coverage was rarely prescribed to Medicare beneficiaries.Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems.

PD33-06 NATIONAL PRESCRIBING TRENDS IN LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA

INTRODUCTION AND OBJECTIVE: Lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is a chronic disease causing significant morbidity and quality of life impairment among adult men. Pharmacotherapy is the most common initial intervention, but our current understanding of medication usage trends for LUTS/BPH is incomplete and prior studies have relied on limited datasets that have predominantly focused on older men. We assessed trends in the pharmacological management of LUTS/BPH among a national sample of men with private and Medicare insurance over an 8-year period. METHODS: As part of the Urologic Diseases in America project, two insurance claims databases were analyzed over the 2006-2013 study period: the Centers for Medicare & Medicaid Services Medicare (CMS) 5% Sample for an annual average of 105,180 male Medicare beneficiaries aged ≥65 years with LUTS/BPH and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for an annual average of 104,766 privately insured males aged 40-64 years with LUTS/BPH. The percentage of patients receiving LUTS/BPH-related prescriptions was assessed annually over the study period and stratified by 5-year age groups. RESULTS: Use of prescription medications for LUTS/BPH increased throughout the study period (see Figure). The increase was greater for men with private insurance as compared to Medicare (14% vs 5% increase). The proportion of patients who filled prescriptions increased with increasing age, with up to 67% of LUTS/BPH patients aged 85+ years filling prescriptions in 2013. CONCLUSIONS: Over an 8-year study period, BPH was increasingly managed with pharmacotherapy. This increase was especially pronounced among younger men with private insurance. This analysis is unique in that the utilization of administrative claims data allowed for assessment of prescribing trends across different care delivery settings and among a large national sample of men as young as 40 years of age.Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems.

Balancing growth and collegiality: reflections on the inaugural Rhetoric Society of America Summer Project at the University of Nevada, Reno

ABSTRACTThe 2019 Rhetoric Society of America Project on Power, Place, and Publics at the University of Nevada, Reno (RSA Project) served several objectives for its participants, organizers, and RSA. It was also an occasion to study the University of Nevada, Reno's Campus Master Plan and its impact on communities and students. It provided intensive instruction in field methods for those who attended the event. It was also a chance to experiment with a format that might ameliorate the pressure that growth has created for RSA. RSA's expansion since 2000 has begun to diversify the association and extend the subjects and methods of academic research in rhetoric. At the same time, this growth has made it difficult to create small, informal, and/or collaborative settings for intellectual growth. The inaugural RSA Project's focus on a common theme and shared encounters in the field recaptured the spirit that characterized RSA's past. In addition, the 2019 RSA Project in Reno set the stage for future projects that will retain the collaborative and intimate learning experience of the inaugural event.

PD29-02 HEALTH INFORMATION SOUGHT ON BPH – ARE NEWER THERAPIES REPLACING THE OLD?

INTRODUCTION AND OBJECTIVE:The Urologic Disease in America project found the prevalence of benign prostatic hyperplasia (BPH) grew over time (24.5% in 2004 to 28% in 2013 – a 14.3% increase). Given...

Rhetorical cartographic story maps as public work

ABSTRACTThis essay details the process of creating an interactive visual aid—a digital story map—for the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno. In addition to reviewing story maps and their potential for communicating persuasive messages more generally, this essay also reflects on the utility and challenges involved with integrating online data-visualization tools into multiauthored, applied, public-facing projects specifically.

The biggest little ways toward access: thinking with disability in site-specific rhetorical work

ABSTRACTThis essay examines what thinking with disability brings to site-specific rhetorical work, which is work where rhetoricians gather to study location-related texts. Adapting the rhetorical triangle, I suggest that this work is fundamentally about the relationships between communicators, texts, and audiences, and my focus on the importance of including the perspectives of disabled and/or disability activists adds the “angle” of access. This “angle” requires reconsideration of how texts, speakers, and audiences connect and interact, as inaccessibility hinders and/or excludes some communicators, disregards some audiences, and renders some texts illegible. At the same time, thinking with disability in site-specific rhetorical work provides opportunities to support communities of disability scholars and scholarship, to create and implement accessible rhetorical methods, and to imagine inclusion as an iterative and fluid process. To examine these ideas, the essay shifts between articulating general principles and methodologies and offering specific examples from the Disability and Accessibility working group at the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno.

“Loose production but great cause!!”: a response to the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno

ABSTRACTThe 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno is a nice case study of how interactions between the academy and American Indian tribes demonstrate the persistent challenges of bridging our nation's entrenched cultural and racial divisions. The unspoken tensions between our tribal communities and our country's corporate/government/higher education institutions continue to result in individual spokespeople having to account for and speak for the entire vastness of our Native American populations.

Into the Gateway: the Rhetoric Society of America Project on Power, Place, and Publics

ABSTRACTThis is the Guest Editors’ Introduction to a themed issue that reflects on the inaugural Rhetoric Society of America Project, which, in 2019, hosted a range of rhetorical investigations into the University of Nevada, Reno’s Campus Master Plan and its Gateway Precinct. It argues that the recent field orientation to rhetoric pushes rhetoricians to think about how their scholarship might participate in immanent negotiations, mixing slow, deliberate, and thoughtful rhetorical analyses with fast, spontaneous, and instinctual demands. Using the Project as an example, it suggests that the participatory act of being in the field cannot be removed from the rubric of power, place, and publics.

A note of appreciation for the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno

ABSTRACTUniversity of Nevada, Reno Executive Vice President and Provost expresses his appreciation to organizers of and participants in the 2019 Rhetoric Society of America Project in Power, Place, and Publics (RSA Project), which was hosted on the University of Nevada, Reno campus. The RSA Project critically evaluated the 2014 UNR Campus Master Plan (CMP) and provided insights on how future updates of the CMP can be more responsive to community stakeholders whose voices are often not heard.

Unearthing deep roots: tapping rhetoric’s generative power to improve community and urban development projects

ABSTRACTSeveral key questions about evaluating the University of Nevada, Reno’s Campus Master Plan from a “deep roots” perspective are worth considering, both in relation to the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno (RSA Project) and in relation to others that gather rhetorical scholars and community leaders for the purpose of developing productive outcomes: What methodologies are needed for rhetorical scholars to explore and assess the collective and historic identity of groups situated in urban place and space? How can we interrogate the practices associated with an immersive cultural experience in a scholarly working group? How can a deliberative framework inform similar future projects? In this article, we advance three essential tasks for rhetorical scholars to engage in when undertaking such projects: (1) use more of rhetoric’s generative power and less of its critical/analytical power in order to articulate multiple possible avenues for developing places and spaces; (2) conduct extensive on-the-ground research to uncover the “collective identity” of various stakeholders and to show how those identities can productively inform planning; and (3) identify common ground as well as intractable differences among stakeholder positions and provide inventive ideas for managing both.

The unbuilt city of Reno

ABSTRACTThis essay suggests that colleges and universities incorporate settler technologies, as discursive, mathematical, spatial tools, that further settler colonialism in our economic moment. These tools become advantageous when the territories of the campus and the city desire to merge residential and economic interests. My writing derives from a plenary address at the 2019 Rhetoric Society of America Project in Power, Place, and Publics at the University of Nevada, Reno (RSA Project), which was rooted in four kinds of evidence: walking the city as a vested stranger, reading closely a compendium of planning documents, speaking and listening to local residents and officials as well as the RSA Project participants, and then going home. My motive for this work has less to do with accusing the University of Nevada, Reno or the city of Reno of settler coloniality and more with comprehending how settler technologies promote economic models that favor “innovation” and “entrepreneurialism” so popular in U.S. academia and elsewhere. Whenever we travel, we may come across these tools, but when that happens, we might also note our cosmopolitan entitlements. If so, then what we can learn as visitors will be more forcefully applied at our campuses and homelands.

Strategies to Leverage Contractor Experience

AbstractThe construction manager/general contractor project delivery method is a relatively new approach for contracting public infrastructure projects in America. While added later to the Federal ...