This dissertation will demonstrate that a variety of Dominican Spanish in contact with St. Thomas English Creole (STTEC) revealed many features which are consistent with Dominican Spanish in other contact environments and some new features which are emerging as the result of uniquely STTEC influences. The most notable feature is the appearance of the vowel [ɛ] in Dominican Spanish, which in STTEC is highly indexical to St. Thomian identity. In the present sociolinguistic analysis, it was found that the variability of [ɛ] was significantly influenced by the following phonological segment, syllable stress, the language of the token, and the speakers’ social network ties and self-ascribed identity. This dissertation also includes a socio-historical background of St Thomas, U.S. Virgin Islands, a description of St Thomas English Creole, and a history of immigration patterns of people from the Dominican Republic to St Thomas, U.S.V.I. / Spanish

Osteopathic Manipulative Treatment (OMT) has been used for more than 100 years to enhance the physiologic process of labor and delivery by normalizing pelvic structures and providing adequate blood supply to the uterus. Since maternal morbidity and mortality is a major health concern for developing countries, it was desirable to explore the benefits of OMT. After IRB approval by the Virginia College of Osteopathic Medicine and Virginia Tech, the research was conducted in Santo Domingo, Dominican Republic at Hospital Maternidad Nuestra Señora de la Altagracia to determine the relationship of OMT during labor and delivery on rates of cesarean section and perineal lacerations/ episiotomies. Qualifying candidates received the next sequentially numbered envelope with a randomized number assigning her to either the treatment or control group. Staff physicians at the hospital provided care to women in the control group according to their standard protocol. Four Osteopathic Physicians and one pre-doctoral OMM fellow performed OMT on women during the first and second stages of labor and performed their deliveries. There were 33 parturients in the OMT Treatment group and 32 in the control, for a total of 65 in the trial. The results of a logistic regression analysis using Wald criterion, with a statistical significance of alpha = 0.05, indicated treatment group reduction of rates of episiotomies in the primiparous (P = .04) and marginal significance in the combined primiparous and multiparous population (P = .05). The percentage of episiotomies in the primiparous treatment group was 35.29% and 75% in the control group. The percentage of episiotomies in the combined primiparous and multiparous groups were 15.15% in the treatment group and 37.5% in the control group. The cesarean rate for the treatment group was 9.09% and 18.75% for the control group (P = 0.098). The percentages of grade I & II perineal lacerations were 15.15% for the treatment group and 12.5% for the control group (P = 0.55) due to the extensive use of episiotomies in the control group. There were composite calculations made of the total number of parturients who had either a cesarean section, an episiotomy, or a perineal laceration so that overall maternal morbidity in each group could be compared. In the combined groups, there were fourteen total parturients (42.42%) who had undergone one of the three outcomes measures in the treatment group and twenty-one (65.63%) in the control group. This brings an odds ratio of 0.200 and a significant P value of 0.0235. Though cross-cultural issues made it difficult to perform the research as originally intended, there is evidence that Osteopathic Obstetrics provides benefit to parturients. A multi-institutional randomized controlled trial is proposed as the next step for the evaluation of OMT during labor and delivery. / Ph. D.

Teleradiology has far-reaching implications for the health of remote and underserved populations. With coordination of radiographic evaluation and diagnosis from a distance, teleradiology has the potential to raise the standard of patient care throughout the world. Perhaps the safest and most cost-effective mode of teleradiology today is telesonography. The current research determined that telesonography improves the standard of care at a rural, government-run primary clinic within the Dominican Republic. The work reported herein is intended to compare the use of telesonography to the current standard of sonographic examination which is referral to government hospital 60km from the clinic. the following research questions were addressed: When compared to the standard of care, (1) To what extent does the use of asynchronous telesonography increase the percentage of received sonographic reports based on the total number of ultrasound referrals (sonographic reports / total number of referrals)? (2) To what extent does the use of asynchronous telesonography increase the rate of successful follow-up visits based on the total number of ultrasound referrals? (3) To what extent does the elapsed time between ultrasound referral and sonographic report delivery decrease with the use of asynchronous telesonography? (4) To what extent does the elapsed time between ultrasound referral and patient follow-up decrease with the use of asynchronous telesonography? Research methodology included randomly assigning 100 patients with clinical indications for sonographic examination into experimental and control groups during a 9-week implementation period. Findings from this study indicate that the implemented telesonography system, along with patient awareness of such a system, while not having an appreciable effect on the time to patient follow-up, provided a 4-fold increase in the proportion of patient follow-ups and a 6-fold increase in the proportion of returned radiological reports, and delivered those reports to the referring physician 6-times faster than in the control group. This study demonstrates the feasibility of utilizing a store-and forward telesonography system within this setting. Additional research focusing on the impact of telesonography on patient outcomes within this setting is recommended. / Ph. D.

Background: Selected factors place Dominican female adolescent and adults at risk for sexually transmitted infections (STIs) such as Chlamydia, causative organism Chlamydia trachomatis, and Gonorrhea, causative organism Neisseria gonorrhoeae. The purpose of this study was to determine the prevalence of Chlamydia and Gonorrhea among adolescent and adult females that utilize the clinic in Veron, Dominican Republic. Clinical standards of care for these STIs and educational programs for prevention were developed from the data gathered from this study. Significance at 0.05 ά of the relationship of educational level, management of risk factors and other selected independent variables on prevalence rate of Chlamydia and Gonorrhea in the clinic population of Veron, Dominican Republic were determined. The objectives of the study were to 1) determine the prevalence of adolescent and young adult females diagnosed with Gonorrhea and Chlamydia who visit the clinic for prenatal visits, annual pap smear exams and gynecological complaints; 2) determine the extent to which educational level is a predictor of positive diagnosis or risk for infection of Chlamydia and Gonorrhea and; 3) determine which selected demographic and risk factors are associated with positive test results for Gonorrhea and Chlamydia. Methods: All adolescent and adult females ages 15 years and older visiting the clinic in Veron for prenatal exams, pap smear exams and gynecological complaints between January 28, 2008 – March 3, 2008 were invited to participate in this prevalence study. Of the 90 invited, the accepting sample was 90 who signed an informed consent form. Prior to STI testing each patient completed a verbal interview and questionnaire on sociodemographic characteristics as well as knowledge, attitudes, and beliefs related to Chlamydia and gonorrhea, sexual experiences and behaviors and illicit drugs use. Specimens collected from the endocervical canal of each female were tested and results provided within two hours, followed by immediate treatment by a licensed Dominican physician and follow-up care based on the guidelines and standards of care. The data were analyzed using descriptive statistics, chi square, t-test and logistic regression. Results: A total of ninety women participated in the study. Chlamydia was detected in 6.7% of the patient population and Gonorrhea was detected in 22.2% of the patient population. Co-infection of both Chlamydia and Gonorrhea was present in 2 cases. Among the positive Chlamydia tests results, 50% had less than a six-year education and 50% had more then six years of education. In addition, 83.3% of the patients with positive Chlamydia results answered "yes", they could read and 16.6% stated they could not read, while 83.3% of the patients with positive Chlamydia results stated they could write and 16.6% stated they could not write (P>0.05). Among the patients that tested positive for Gonorrhea, 55% stated they had less than six years of formal education and 45% had more than six years of formal education (P>0.05). There were 75% of the patients that tested positive for Gonorrhea that stated they could read and 25% who stated they could not read (P>0.05); while 85% of the patients with positive Gonorrhea results stated they could write and 15% stated they could not write (P> 0.05). Conclusion: Educational level and other selected demographic characteristics and risk factors in this study are not a significant predictor of positive diagnosis or risk of infection for Chlamydia or Gonorrhea. We cannot conclude that specific risk factors are associated with positive test results for Gonorrhea and Chlamydia. For the physicians involved in the clinical decision-making regarding the female patients at the Veron clinic, more data are needed to determine appropriate populations for screening of Gonorrhea and Chlamydia as well as appropriate educational tools on sexually transmitted infections. / Ph. D.

Gastrointestinal parasites impose a great and often silent burden of morbidity and mortality on poor populations in developing countries. Veron, Dominican Republic (DR), is a rural city in the southeastern corner of the country where many Dominicans and Haitians migrate to for work in support and expansion of the tourist industry of Punta Cana. Few studies of the prevalence of gastrointestinal (GI) parasitic infections have been published in the DR. Presently, there is a high prevalence of gastrointestinal parasitic infections throughout the poorest areas of the DR and Haiti. This study investigated the prevalence of GI protozoan and helminth parasites from children at the Rural Clinic of Veron during 2008. Participants provided a fecal sample that was examined microscopically for protozoan and helminth parasites using the fecal flotation technique to concentrate and isolate helminth ova and protozoan cysts. Of 108 fecal samples examined, 107 were positive for one or more parasites. Participant ages ranged from 2 to 15 years; 52 were males and 56 were females. Percent infection rates were 48.2% for Ascaris lumbricoides, 13.9% for Enterobius vermicularis, 24.1% for Entamoeba histolytica, and 22.2% for Giardia intestinalis. 9.3% had double infections. A survey of subject characteristics and risk factors was completed by each parent/guardian. Any plan to reduce GI parasites in children of this region will require a determined effort between international, national, and local health authorities combined with improved education of schools, child care providers, food handlers, and agricultural workers. A special effort must be made to reach out to immigrants and those not part of the public education system and to address microbial water quality. / Ph. D.

This thesis illustrates a design process which is dependent upon the investigation of context as a means to establish an order for the integration of a multifaceted urban environment into a cohesive whole. / Master of Architecture

The identity of Latin America is composed of elements inherited from Europe, Asia and Africa. This identity has been defined with a series of images, roles, behaviors and rules created to maintain a particular unification among the citizens of these societies. Cultural ideologies involving marriage, separation and divorce have been subjected to historical changes. Divorce in Latin America typically has had a negative connotation and communities have considered divorced women as outcasts. The purpose of this study is to examine Puerto Rican and Dominican women's perception of divorce with particular emphasis on divorced women's image and experience in these countries. There are similarities and differences between the two countries based on geographical, cultural, historical, economic and legal issues. Due to the cultural presence of the United States in Puerto Rico, many issues now separate the two countries. I consider this "duality" (Traditional/Latin American and Westernized/American) to be an interesting context for exploration particularly as it relates to women's perception of divorce. / Master of Arts

This thesis conducts an analysis of gay identity in Dominican poetry through a queer reading on Frank García’s poetry collection: Lo que escribí mientras esperabas en una habitación vacía (2023). The Dominican society in which the bildungsroman narrative takes place is contextualized as a tender culture, yet largely not acceptant of homosexuality and nonheteronormative forms of gender expression, with high levels of violence against gay people, including at the hands of police and militiamen. The aim of the investigation is to both expand the limited existing body of research analyzing gay Dominican literature, as well as identifying and exploring intersecting factors that detrimentally contribute to the homophobia that the author endures as reflected in his writing. It is concluded that such factors permeating his experience intersecting with homophobia are the peripherical position of Dominican Republic in Spanish-speaking literature and the world system, the relevance of Christianity in Dominican Republic, a vulnerable social class, and his mixed race. This investigation also acknowledges the construction of blackness in Dominican Republic in opposition to Haiti, and the subsequent rejection of several mixed race Dominicans to identify as black, but rather using terms such as trigueño, moreno, or mulato (even though the latter is pejorative) to refer to themselves instead. The author rejects colorist discourses and both claims and embraces his black queer Dominican identity in his writing, further humanizing a highly disregarded and marginalized demographic in mainstream literature and arguably the world system: black gay Dominican men.

No description available.

My thesis discusses the ways in which Julia Alvarez's In the Time of the Butterflies (1994) and In the Name of Salomé (2000) are revolutionary texts contesting traditional, male dominated history and redirecting historical and communal foci to the lives of Dominican women. I employ Walter Benjamin's theories found in his essays "The Storyteller" (1936) and "On the Concept of History" (1940) to assist my exploration of Alvarez's questions concerning the power and effect of storytelling, and the importance of reconstructing various historical voices and images, specifically, the importance of reconstructing female voices in male dominated cultures. I discuss the female-narrated component to Dominican history which Alvarez creates in her reconstruction of the lives of these women. Alvarez confronts the challenge of breaking these women out of their marginalized status by combining fiction with history in her reconstruction of their lives. Alvarez assumes the multifaceted role of mediator, story-teller, and historian as she remembers and re-presents Dominican history through the eyes of women who lived, experienced, and affected change within the Dominican Republic. Without merely act as a reporter of historical "facts," Alvarez reconstructs the lives of these women fictionally, applying her impressions and ideas about the personalities, feelings, and thoughts of these women, and historically, utilizing first and secondhand accounts and information about the women. Ultimately, the women are presented as individuals but are also connected to a collective memory and history. As individuals with human characteristics, the women are no longer inaccessible legends. As members of a collective memory and history, the women are redeemed from the isolating effect of their patriarchal society which would have women remain silent. Due to Alvarez's reconstruction, their stories finally have the potential for further dissemination in the future with the possibility to affect other oppressed peoples. Thus, Alvarez's reconstruction of the resistance of a few women in Dominican history produces the capacity for additional resistance by Alvarez's audience to the same forces that these women were combating which continue to exist today — forces such as patriarchy, dictatorial governments, fascism, and economic disparity.