There is a paucity of literature into the first-person account of hearing voices (HV)1, particularly from diverse cultural groups. This research aimed to explore the meaning-making of African-Caribbean men who have heard voices, within a social constructionist framework. Five participants were recruited via community networks and individually interviewed. Narrative analysis was employed to illustrate both individual and collective stories of HV. Four emerging storylines were constructed: 'Storylines of the changing understandings of hearing voices over time', 'Recovery: Reformation, Redemption and Restoration', 'Storylines of family life and understandings of culture and race', and 'From Silence to Freedom: Speaking Out and Reaching Out'. Findings of this research suggest re-storying HV outside of a medical framework, with voice-hearers' meaning-making of the voices an integral part of understanding the phenomenon, in the context of psycho-social and cultural factors. Implications for de-mystifying voice-hearing, particularly in African-Caribbean communities, are considered in the context of promoting education and awareness of HV through community-based approaches, cross-cultural working and supporting the voice of expert by experience, in the hope of challenging dominant discourses attached to HV. Future research suggestions are discussed and researcher reflexivity concludes the study.

abstract: With the establishment of "the special period in times of peace" in the nineties, there was in Cuba a series of transformations that affected its artistic and literary production. Therefore, gradually, a thematic opening emerged focused on deconstructing the idealized sociopolitical reality of the island allowing for the reformulation of the ways in which women were depicted. The main objective of this study is to initiate a dialogue with the short fiction produced during this period in order to shed light on the fragmentary representation of female characters. In regards to said objective, the approach selected centers on the observation and analysis of violence, humor and national memory as recurring thematic elements in the texts. With that finality, the aesthetic proposals present in the work of Aida Bahr, Ena Lucía Portela, and Marilyn Bobes, will be analyzed using current literary and cultural theory. Among these the most noteworthy are Josephine Gattuso Hendin's theory of violence and the representations of women, Henri Bergson's theory of humor, and the critical works of numerous scholars specializing in Cuban fiction produced in the last two decades. As has been concluded, through the protagonists and their discourse, thematic and stylistic components contribute to creating new representations of women allowing for new responses and ways of coexisting that cast doubt on the stereotype of the revolutionary woman. These components, likewise, question the relationship between the characters in the stories and the concept of nation, which in the words of Nara Araújo, will allow us to reveal the different ways of reading the world of the present generation. Therefore, through the analysis of the configuration of these reactionary representations, a contribution is made to the study of the current narrative produced by women in Cuba. / Dissertation/Thesis / M.A. Spanish 2012

As fronteiras são linhas imaginárias, foram desenhadas como resultado de vários processos sociais de índole política, econômica ou cultural. Geralmente são reconhecidas como áreas dinâmicas e de tensão, especialmente em territórios com herança colonial. Entre Colômbia e Nicarágua há uma tensão histórica da fronteira que envolve a solicitação do exercício de soberania tanto em uma área marinha quanto no arquipélago de San Andrés, Providencia e Santa Catarina, no Mar do Caribe. Tal impasse acabou resolvendo-se por uma delimitação feita através de uma sentença do Tribunal Internacional de Justiça de Haia, em 2012, como resultado de um processo de pouco mais de uma década, e que redefiniu a área suscetível de usufruto no mar em ambos os países. A bacia do Caribe ocidental, no âmbito de tensão da fronteira, posiciona-se como uma área de interesse do mercado global dado o progresso de ambos os países para abrir espaços para a concessão à exploração de hidrocarbonetos no mar a empresas não nacionais; vale lembrar que dentro da região encontra-se o Canal de Panamá, uma das vias de transporte de matérias-primas e mercadorias mais importantes do mundo, e um futuro segundo canal transoceânico que irá atravessar a parte sul da Nicarágua. A posição do petróleo no cenário global de energia, bem como em vários processos industriais, faz com que ocupe um lugar de destaque no sistema econômico contemporâneo e represente ainda um dos motores do modo de vida de uma grande parte da sociedade; a iminente diminuição das reservas resultou no desenvolvimento de técnicas de exploração para extração nas áreas mais profundas, incluindo o fundo do mar, tais explorações fora da costa são chamadas de offshore, e se apresentam como uma alternativa à crise do petróleo. A constante procura de recursos naturais, especialmente de petróleo em várias regiões do planeta tem se traduzido em diversas crises, com ênfase naquelas que geram grandes impactos socioambientais, tais como as mudanças climáticas e a devastação de ecossistemas locais que merecem uma abordagem geopolítica ambiental. O resultado desta pesquisa é dividida em duas partes, cada uma delas com dois capítulos, onde são abordadas as questões de soberania, fronteira, mercado global de petróleo e as posições da Colômbia e da Nicarágua ante a possibilidade de extrair petróleo na zona fronteiriça do mar. / Las fronteras son líneas imaginarias trazadas a partir del resultado de diferentes procesos sociales de índole político, económico o cultural. Generalmente son reconocidas como áreas dinâmicas de tensión, especialmente en territorios con herencias coloniales. Entre Colombia y Nicaragua há existido una histórica tensión fronteriza que incluye el interés por el ejercicio de soberanía en el archipiélago de San Andrés, Providencia y Santa Catalina, y en el área marítima subyacente, en el mar Caribe; dicha frontera fue delimitada por la Corte Internacional de Justicia de La Haya em 2012, como resultado de un proceso de un poco más de una década; lo que redefinió el área susceptible de usufructo en el mar, de ambos países. La cuenca del Caribe occidental, en este marco de tensión fronteriza se posiciona como área de interés del mercado global dado el avance de ambos países en abrir espacios a empresas no nacionales para la concesión de exploración/explotación de hidrocarburos en el mar; es importante considerar que en la región se localiza el canal de Panamá, una de las vías de transporte de mercancías y materias primas más importante del mundo, a la vez que se está gestando la construcción de un segundo canal transoceánico que atravesaría la zona sur de Nicaragua, ambos puntos de importancia geoestratégica del comercio global. El lugar del petróleo en el panorama energético global, hace que ocupe un lugar destacado en el sistema económico contemporáneo. La inminente disminución de las reservas de combustibles fósiles ha permitido el desarrollo de técnicas de exploración en áreas de mayor profundidad, que incluyen los lechos marinos, denominadas offshore, las cuales se presentan como alternativa a la crisis petrolera. En relación a lo anterior y dada la exhaustiva búsqueda de recursos naturales a lo largo de la historia, especialmente de petróleo, en áreas del planeta diversas, ha desencadenado diferentes crisis, entre ellos impactos socio-ambientales complejos, como el Cambio Climático y la devastación de ecosistemas locales, los cuales merecen un abordaje geopolítico ambiental. Esta investigación evidencia como el petróleo continua siendo un recurso estratégico a pesar de las recientes crisis de precio y disponibilidad, a su vez que demuestra que el interés binacional, tanto de Colombia como de Nicaragua, de entrar en el mercado offshore de producción de petróleo, de forma que el área de tensión binacional cobra importancia global. Los resultados de la investigación se presentan en dos partes en las cuales son tratados los asuntos de soberanía, frontera, mercado global y las posiciones de ambos países frente al mercado global de petróleo

<p> <b>Scope of Study:</b> The scope of this theoretical study is comprised of an extensive review and interpretation of published studies by governmental organizations such as the World Health Organization (WHO); non-governmental organizations (NGOs); and individuals detailing the theories, concepts, and relationships that exist regarding the social and economic effects of the global burden of mental health disorders and the substantial treatment gap of mental health conditions in low-resourced settings such as Haiti. Humanitarian emergencies are presented as opportunities to build better mental health systems in low-income countries (LICs). Exploring Haiti&rsquo;s trauma signature (TSIG) identified risk factors for post-disaster mental health consequences to include posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) within the adult population. Three culturally relevant community-based mental health programs Soulaje Lespri Moun (SLM), Partners in Health/Zanmi Lasante (PIH/ZL), and Pwogwam Sante&acute; Mantal (PSM), and one hospital-centered program, Project Medishare Hospital, are highlighted to demonstrate the implementation of successful mental health care services in post-earthquake Haiti. This project is focused on confronting the barriers to mental health services in Haiti with the goal of developing a long-term sustainable mental health system. </p><p> <b>Findings and Conclusions:</b> This research project&rsquo;s findings are congruent with previous research, which described coordinating with local leadership and integrating culturally relevant, community-focused, and evidence-based mental health care with existing health services. These elements are essential in the development of long-term sustainable services in LICs. </p><p> The final chapter is a presentation of recommendations for future areas of inquiry to contribute to greater understanding of global mental health needs, prevention, and delivery of services in LICs before and after complex humanitarian crises. Expanding sustainable mental health care for Haiti will reduce disability and suffering from mental illnesses and build a stronger and more resilient society.</p><p>

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Research question: What is the difference in prevalence of LARCs between women living in urban and rural areas of Latin America and the Caribbean (LAC)? Background, significance, and rationale: While LARCs have been shown to be effective, approved for long duration of use, and cost-effective there is an unmet need for this type contraception in rural areas. The LAC region has a need for improved family planning services, evidenced by the high percentage of maternal deaths due to unsafe abortions. Methods: Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2010 and 2015 in LAC countries were reviewed and analyzed to determine difference in prevalence of LARC use between women living in urban versus rural areas. Additionally, a systematic literature review was performed resulting in selection of 11 primary research articles evaluated for LARC prevalence and sociodemographic factors associated with LARC use.

Nous traiterons successivement des circonstances de l'émergence du Panama depuis la période précolombienne, les premières expéditions espagnoles à la recherche d'un détroit vers les Indes, de l'indépendance du Panama. Dans la première partie, nous traiteront de l'Isthme du Panama comme terre de passage et de son Canal de1880 à 1914, du rêve séculaire à la réalité où, successivement, nous étudierons son destin français, sa position entre intérêts français et aspirations américaines. Les États-Unis et le Panama nous conduiront à traiter de l'installation des Américains, la construction du Canal (1904-1914) ; les traités Carter-Torrijos, entre compromis et ambiguïtés. La deuxième partie traitera des stratégies de développement du Panama; l'importance des facteurs socioéconomiques et la dynamique des structures sociopolitiques seront mises en exergue. L'intégration des Antillais de Guadeloupe et de Martinique dans le cercle communautaire panaméen de 1914 à nos jours. Àcet égard, nous traiterons des apports de la culture antillaise dans la représentation panaméenne, un brassage culturel. En troisième lieu, leur contribution à l'essor de la nation. Il s'agira ici d'étudier les arts et la culture, la musique et les danses, la littérature et la linguistique de même que les revendications culturelles des minorités ethniques. Enfin, nous orienterons nos recherches sur la question de l'unité panaméenne à l'aube du Ille millénaire, l'organisation des diverses communautés et l'installation européenne au Panama. / We will successively deal with the circumstances of the emergence of Panama since the pre-Colum bian period, the first Spanish shipping expeditions in search of a strait towards India, and the independence of Panama. ln the first part, we shall deal with the Isthmus of Panama as a land of passage and with its Channel from 1880 to 1914, from the secular dream to reality where, successively, we shall study its French fate, its position in regards to French interests and American aspiration. The relationship between the United States and Panama will lead us to deal with the settling of the Americans, the construction of the Channel (1904-1914), the "Carter-Torrijos" treaties, between compromises and ambiguities. The second part will deal with strategies of development for Panama; the importance of socioeconomic factors and the dynamics of the sociopolitical structures will be highlighted. The integration of the people of Guadeloupe and Martinique in the Panamanian community circle from 1914 to nowadays. In this respect, we shall treat contributions of the French West Indian culture within the Panamanian representation; the cultural admixture. In the third part, their contribution at the development of the Panamanian nation. The issue will be to study arts and culture, music and dances, Iiterature and Iinguistics as weil as the cultural demands from ethnic minorities. Finally, we shall direct our researches towards the question of Panamanian unity at the dawn of the third millennium, the organization of the diverse communities and the European settling in Panama

<p> Los objetivos de esta investigaci&oacute;n fueron: establecer las dimensiones culturales para Puerto Rico, determinar la existencia o no de diferencias culturales entre Puerto Rico y la Rep&uacute;blica Dominicana. Adem&aacute;s, se midi&oacute; el impacto de los factores demogr&aacute;ficos y las dimensiones culturales en la felicidad colectiva de una sociedad. Una muestra de 596 adultos en Puerto Rico y 404 en Rep&uacute;blica Dominicana fue recopilada para calcular las dimensiones culturales de Hofstede para Puerto Rico seg&uacute;n el <i> Values Survey Module</i> 2013 y el desarrollo de un modelo de regresi&oacute;n m&uacute;ltiple. La investigaci&oacute;n concluy&oacute; que Puerto Rico es una sociedad principalmente jer&aacute;rquica (PDI = 68), colectivista (IDV = 27), masculina con rasgos femeninos (MAS = 56), pragm&aacute;tica con planes para todo pero improvisa cuando hay incertidumbre (UAI=38), enfocada a corto plazo (LTO = 19) y de las m&aacute;s indulgentes del mundo (IVR = 99). Los resultados indicaron que la dimensi&oacute;n cultural de Indulgencia versus Restricci&oacute;n (IVR) tuvo un efecto significativo en la felicidad colectiva en Puerto Rico y la Rep&uacute;blica Dominicana. En otro hallazgo, la salud como variable demogr&aacute;fica tuvo un efecto significativo en la felicidad colectiva en Puerto Rico.</p><p>

<p> The Spanish-American War of 1898 ended Spain&rsquo;s colonial empire in the Western Hemisphere, and represented the symbolic pinnacle of U.S. imperialism throughout the Caribbean and the Pacific. During this historical juncture, the U.S. launched the invasion of Puerto Rico and established itself as the governing power. My analysis of this defining event in Puerto Rico&rsquo;s history focuses on the &lsquo;discursive&rsquo; and &lsquo;representational&rsquo; practices through which the dominant representations and interpretations of the Puerto Rican campaign were constructed. In revisiting the U.S. &lsquo;imperial texts&rsquo; of &rsquo;98, most of which have not been studied extensively, it is my intent to approach these narratives critically, studying their ideological and political significance regarding the U.S. acquisition of Puerto Rico as a colony. </p><p> The &lsquo;War of &rsquo;98&rsquo; has been typically represented as an inter-metropolitan conflict, thus relegating to a secondary place the contestatory discourses produced within the colonies. It is the purpose of my dissertation to examine &lsquo;dialectically&rsquo; the cultural counter-discourse produced by the Puerto Rican Creole elite alongside the U.S. official discourses on Puerto Rico, concerning its colonial past under Spanish domination, the military occupation of the island, and its political and economical future under the American flag. With this purpose in mind, I chose to study four post-1898 Puerto Rican novels, specifically Jos&eacute; P&eacute;rez Losada&rsquo;s <i> La patulea</i> (1906) and <i>El manglar</i> (1907), and Ram&oacute;n Juli&aacute; Mar&iacute;n&rsquo;s <i>Tierra adentro</i> (1912) and <i> La gleba</i> (1913), all of which have been underestimated and understudied by literary scholars. </p><p> As a gesture of resistance in the face of the disruption of the old social order (that is, the old patterns of life, customs, traditions and standards of value) caused by the U.S. invasion and occupation of Puerto Rico in 1898, the island&rsquo;s intellectual elite&mdash;most of which were descendant of the displaced coffee <i>hacendado</i> families&mdash;responded by fabricating an ideology-driven national imaginary and iconography that proposed a hispanophile, nostalgic, and romanticized rendering of the late-19th century coffee landscape (i.e. the pre-invasion period) as an idyllic <i> locus amoenus</i>, thus becoming an emblem of national and cultural identity and values against American capitalist imperialism, the &lsquo;Americanization&rsquo; of Puerto Rico&rsquo;s economy and political system, and the rapid expansion of U.S. corporate sugar interests. </p><p> This dissertation has two distinct yet complementary purposes: first, it examines critically the imperial/colonial power relations between the United States and Puerto Rico since 1898, while questioning the hegemonic discourses both by the Americans and the Puerto Rican cultural elite regarding Puerto Rico&rsquo;s historical and political paths; secondly, it is an attempt to do justice to the literary works of two overlooked Puerto Rican novelists, approaching them critically on several levels (historical, literary, and ideological) and bringing their works out of the shadows and into today&rsquo;s renewed debates around Puerto Rico&rsquo;s unresolved colonial status and U.S. colonial practices still prevalent today.</p><p>

The distinctive karstic, freshwater wetlands of the northern Caribbean and Central American region support the prolific growth of calcite-rich periphyton mats. Aside from the Everglades, very little research has been conducted in these karstic wetlands, which are increasingly threatened by eutrophication. This study sought to (i) test the hypothesis that water depth and periphyton total phosphorus (TP) content are both drivers of periphyton biomass in karstic wetland habitats in Belize, Mexico and Jamaica, (ii) provide a taxonomic inventory of the periphytic diatom species in these wetlands and (iii) examine the relationship between periphyton mat TP concentration and diatom assemblage at Everglades and Caribbean locations. Periphyton biomass, nutrient and diatom assemblage data were generated from periphyton mat samples collected from shallow, marl-based wetlands in Belize, Mexico and Jamaica. These data were compared to a larger dataset collected from comparable sites within Everglades National Park. A diatom taxonomic inventory was conducted on the Caribbean samples and a combination of ordination and weighted-averaging modeling techniques were used to compare relationships between periphyton TP concentration, periphyton biomass and diatom assemblage composition among the locations. Within the Everglades, periphyton biomass showed a negative correlation with water depth and mat TP, while periphyton mat percent organic content was positively correlated with these two variables. These patterns were also exhibited within the Belize, Mexico and Jamaica locations, suggesting that water depth and periphyton TP content are both drivers of periphyton biomass in karstic wetland systems within the northern Caribbean region. A total of 146 diatom species representing 39 genera were recorded from the three Caribbean locations, including a distinct core group of species that may be endemic to this habitat type. Weighted averaging models were produced that effectively predicted mat TP concentration from diatom assemblages for both Everglades (R2=0.56) and Caribbean (R2=0.85) locations. There were, however, significant differences among Everglades and Caribbean locations with respect to species TP optima and indicator species. This suggests that although diatoms are effective indicators of water quality in these wetlands, differences in species response to water quality changes can reduce the predictive power of these indices when applied across systems.

This dissertation examined the effect of United States counter-drug policy on nationalism in small states, focusing on Jamaica and Trinidad and Tobago. The states were selected for their roles and geostrategic importance in the illegal drug trade; Jamaica being the largest drug producing country in the Anglophone Caribbean and having strong links to the trade of Colombian cocaine, and Trinidad being a mere seven miles from the South American coast. Since U.S. counterdrug policies have frequently been viewed in the region as imperialistic, this dovetails into ideas on the perceptions of smallness and powerlessness of Caribbean nations. Hence, U.S. drug policies affect every vulnerability faced by the Caribbean, individually and collectively. Thus, U.S. drug policy was deemed the most appropriate independent variable, with nationalism as the dependent variable. In both countries four Focus Groups and one Delphi Study were conducted resulting in a total of 60 participants. Focus Group participants, recruited from the general population, were asked about their perception of the illegal drug trade in the country and the policies their government had created. They were also asked their perception on how deeply involved the U.S. was in the creation of these policies and their opinions on whether this involvement was positive or negative. The Delphi Study participants were experts in the field of local drug policies and also gave their interpretations of the role the U.S. played in local policy creation. Coupled with this data, content analysis was conducted on various newspaper articles, press releases, and speeches made regarding the topic. In comparing both countries, it was found that there is a disconnect between government actions and the knowledge and perceptions of the general public. In Trinidad and Tobago this disconnect was more apparent given the lack of awareness of local drug policies and the utter lack of faith in government solutions. The emerging conclusion was that the impact of U.S. drug policy on nationalism was more visible in Trinidad and Tobago where there was a weaker civil society-government relationship, while the impact on nationalism was more obscure in Jamaica, which had a stronger civil-society government relationship.