>Magister Scientiae - MSc / Health is considered as a sensitive marker of the sustainable development of a population. In Central America and Caribbean (CAC) region, the majority of countries are considered middle-income economies with significant inequalities mainly between the different types of health coverage and health expenditure.The main objective of the dissertation is to identify a possible relationship between universal health coverage and health investment in the main health and some sociodemographic determinants defined by the WHO/PAHO from 2009 to 2018. Additional characterizations of current types of health coverage, investment in health and the main health and socio-demographic indicators of the region were made.

Please note: creative writing theses are permanently embargoed in OpenBU. No public access is forecasted for these. To request private access, please click on the locked Download file link and fill out the appropriate web form. / Poetry / 2031-01-01

Most critical analyses of humor in postcolonial literary settings have focused on its power to critique and subvert dominant hegemonic systems in ways that tend to divide participants according to predictable dichotomies. Yet humor theorists have long recognized laughter's equivalent potential as a bonding mechanism. An examination of the rhetorical functions of humor in Andrea Levy'sSmall Islandreveals the extent to which these affiliative forms of humor can be successfully deployed across cultural divides within a migrant context, as well as the risks and limitations inherent to such an approach. Ultimately, the novel's gentle, inviting, and accessible humor provides the basis for a convincing, character-driven appeal to reduce racial prejudice.

Compared to non-immigrant families of children with autism spectrum disorders (ASD), immigrant families tend to experience more challenges securing an evaluation, obtaining a diagnosis, and accessing services for their child/children diagnosed with ASD. Several studies investigated the experiences of various groups of immigrant families. They found that the delays can be attributed to cultural differences in the way families interpret the meaning of ASD and their perceptions of the causes and treatment for ASD. Additionally, a lack of knowledge about ASD and fear of the stigma associated with ASD impacted immigrant parents' willingness to seek a diagnosis. However, few studies examined how Caribbean immigrants living in the United States experience a diagnosis of ASD for their child/children. This qualitative study explored Caribbean immigrant families' perceptions and experiences with ASD. A semi-structured, in-depth interview was used to collect data on families' experiences about symptoms, causes, and treatments of ASD, as well as their sources of support. The data were coded and analyzed using interpretative phenomenological analysis (IPA. Four themes were identified and discussed: A new world, emotional and physical burden caring for a child with ASD, attitudes about ASD in native cultures, and adapting to the new situation.

Statement of problem: Ottawa Public Health has expressed the need for accurate and complete data/information on HIV in the Black community from Africa and the Caribbean (ACB) in Ottawa. Method of investigation: A mixed methods approach was done. The first phase was a descriptive analysis of HIV diagnoses in the ACB population in Ottawa between 2005-2010. The second phase used qualitative interviews with people living with, and not living with HIV in ACB communities in Ottawa. Results: HIV diagnosis rates were higher in ACB in comparison to the non-ACB population. The issues that emerged from interviews touched on HIV-related stigma, the exacerbating effect of HIV, essential gaps in current programs and HIV-related services for ACB communities. Conclusion: The HIV diagnosis rates in the ACB communities in Ottawa provide reason for concern. OPH’s approach to reducing HIV rates in ACB communities must attempt to incorporate understandings of the cultural context of HIV in the ACB communities for the betterment of HIV-prevention programming.

The presence of a significant number of people who do not intend to be vaccinated could negatively impact efforts to control the COVID-19 pandemic. Therefore, this study sought to determine the prevalence of intention to be vaccinated against COVID-19 and associated sociodemographic and psychosocial factors in thirteen countries in Latin America and the Caribbean (LAC). A total of 5510 people from 13 LAC countries participated. Frequencies, percentages, bivariate analyses using chi-square tests, and Poisson regression analysis with robust variance were used. The countries with the highest prevalence of intention to be vaccinated were Brazil (96.94%), Cuba (89.59%), Chile (84.59%), and Mexico (78.33%). On the other hand, the countries with the lowest prevalence were El Salvador (54.01%), Paraguay (55.87%), and Uruguay (56.40%). Prevalence is also reported according to some sociodemographic and health variables. It was found that country, male sex, hours exposed to information about COVID-19, university education, living in an urban area, belief in the animal origin of the virus, perceived likelihood of contracting COVID-19, perceived severity of COVID-19, and concern about infecting others significantly predicted intention to be vaccinated in the 13 LAC countries. While most countries had a high prevalence of intention to be vaccinated, there are still subgroups that have levels of intention that may be insufficient to predict the presence of community immunity. In this sense, knowing the estimates of vaccination intention rates, as well as the associated sociodemographic and psychological factors, can be used to plan actions and interventions that will inform about the safety and benefits of vaccines, as well as strengthen trust in health authorities.

The neotropical genus Exostema comprises 25 species of trees and shrubs, ranging in distribution from Bolivia to Mexico and throughout the West Indies, with most species endemic to the Greater Antilles. Infrageneric relationships and species-level patterns of evolution were investigated in phylogenetic analyses using morphological, molecular, and combined data sets. All data sets resolved three main species groups which correspond to the three sections recognized by McDOWELL (1996). However, the analyses of ITS sequence data placed the two South American species basal to the three main clades. Otherwise, the morphological and molecular data are highly compatible, and produce a more robust yet consistent phylogeny in the combined data analysis. Morphological evolution in Exostema involves many specializations for xeric habitats, reflecting repeated ecological shifts from moist forest to exposed, seasonally dry environments during the diversification of the genus. Both moth and bee pollination syndromes are found in Exostema, and shifts in pollination ecology appear pivotal to the differentiation of the three sections. Biogeographically, Exostema likely originated in South America and migrated via Central America to the Greater Antilles, where the morphological diversification and speciation are most extensive.

The American plantation system, far from an idiosyncrasy of the southern United States, was a transnational formation that spread across the US South, the Caribbean, and parts of Latin America, forming a cross-border cultural sphere often called “Plantation America.” How have US and Caribbean writers understood the United States’ relationship to this broader landscape through its most alienated region, the South? And how did the South’s ties to the plantation zone impact how writers imagined the United States as an emerging global empire in the twentieth century? “Plantation America: The US South and the Caribbean in the Literary Culture of Empire, 1898-1959,” explores works by white American, African American, and Black Caribbean writers produced during a period of heightened US colonial intervention in the Americas, from the Spanish-American War of 1898, to the Cuban Revolution of 1959. It contributes to recent US-based scholarship on the plantation origins of Western modernity and draws on an older Black and Caribbean critical discourse on the plantation as a prototypically modern institution. Building on this scholarship, this project demonstrates that US expansion southward prompted writers to reckon with the South’s highly ambivalent relationship with Plantation America, and that doing so served as a fault line for deeply held anxieties over the modern United States’ indebtedness to the plantation complex and its creolized cultural legacies. Its chapters thus show how US empire provoked modern writers to respond to the plantation as a driver of racial capitalism and industrialized labor systems, a blueprint for modern empires, a key site for the emergence and repression of cross-culturality, and a root source for traumatic forms of psychic and spiritual alienation associated with modern subjecthood. Through the lens of Caribbean critical theory, including work by Édouard Glissant, Fernando Ortiz, and C. L. R. James, I examine Richard Wright’s postplantation perspective in his little studied Haitian manuscript, transculturation in Ernest Hemingway’s Key West and Cuban works, the modern plantation empire in stories of the Panama Canal Zone by the Caribbean-born writer Eric Walrond, and William Faulkner’s transnational plantation economy in The Sound and the Fury and As I Lay Dying.

Jamaica, the third largest island in the Caribbean, has been affected significantly by flooding and flood-related damage. Hence assessing the probability of flooding and susceptibility of a place to flood hazard has become a vital part of planning and development. In addition to heavy rainfall from tropical storms and Atlantic hurricanes, several terrestrial factors play significant roles in flooding, including local geology, geomorphology, hydrology and land-use. In this study, a GIS-based multi-criteria statistical methodology was developed to quantify hazard potential and to map flood characteristics. Fourteen factors potentially responsible for flooding were identified and used as initial input in a hybrid model that combined principal component analysis with logistic regression and frequency distribution analysis. Of these factors, seven explained 65 % of the variation in the data: elevation, slope angle, slope aspect, flow accumulation, a topographic wetness index, proximity to a stream network, and hydro-stratigraphic units. These were used to prepare the island’s first map of flood hazard potential. Hazard potential was classified from very low to very high, nearly one-fifth (19.4 %) of the island was included within high or very high flood hazard zones. Further analysis revealed that areas prone to flooding are often low-lying and flat, or have shallow north- or northwest-facing slopes, are in close proximity to the stream network, and are situated on underlying impermeable lithology. The multi-criteria hybrid approach developed could classify 86.8 % of flood events correctly and produced a satisfactory validation result based on the receiver operating characteristic curve. The statistical method can be easily repeated and refined upon the availability of additional or higher quality data such as a high resolution digital elevation model. Additionally, the approach used in this study can be adopted to evaluate flood hazard in countries with similar characteristics, landscapes and climatic conditions, such as other Caribbean or Pacific Small Island Developing States.

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