Political economy of Caribbean drug trafficking: The case of the Dominican Republic

The purpose of this dissertation was to examine the relationship between narcotics trafficking and the processes of economic liberalization and democratization in the Caribbean. The salient social, political and economic processes were explored at each juncture of the drug trafficking chain to determine why certain groups and locales became integrated in the global narcotics economy. It also considered the national security implications of the global narcotics economy. ^ The Global Commodity Chain framework allowed the study to examine the social, political and economic processes that determine how a commodity is produced, transported, distributed and consumed in the global economy. A case study method was used to specify the commodity (cocaine) and locations (U.S. and Dominican Republic) where these processes were examined. ^ The important contributing factors in the study included: a liberalizing global economy, the social processes of migration, the formation of enclaves in the U.S., the opening of the political process and institutional weakness in the country of origin. All of these factors contributed to the Dominican Republic and Dominican migrants becoming key players in the cocaine commodity chain. It concluded that narcotics trafficking as a national security issue remains a fluid concept, contingent on specific cultural and historic antecedents. ^

The health and nutritional status of multiethnic perimenopausal women

An integrated, dual-phase study design assessed the health and nutritional status and practices of African-American (A-A), Caribbean (A-C), and white non-Hispanic (W-A) women during perimenopause (40–55 years). During Phase I, four focus groups (n = 37) of male and female participants discussed the health and social implications of perimenopause. A conceptual framework for the main study (Phase II) was developed from the focus groups' findings, in concert with the main study's specific aims and objectives. ^ The main study, a cross-sectional survey, quantitatively assessed the health and nutritional status of a convenience sample of 109 women (25 A-A, 31 A-C and 53 W-A), who met specific eligibility criteria. Using seven instruments, sociodemographic, dietary, medical, reproductive health, health practice and anthropometric data were collected. ^ The groups were of comparable age, education, and socioeconomic status (SES). Despite these similarities, statistically significant interethnic nutritional status differences were found. Significantly more total energy and energy from fat were consumed by A-A than W-A and A-C women. Also, significantly more A-A and A-C than W-A women were overweight or obese with android-type weight patterning. ^ Overall, iron and calcium Recommended Dietary Allowances (RDA's) were not met by 35% and 68% of participants, respectively. Iron deficiency anemia was reported by 29% of participants while 33% reported heavier menstrual bleeding. Coupled with suboptimal iron intakes, this is likely to present a serious public health problem. Similarly, increased bone demineralization characteristic of perimenopause, coupled with suboptimal calcium intakes could precipitate another public health problem, osteoporosis. ^ Participants had different expectations about the role of medical care during perimenopause. Significantly more white (57%) than black (38% [A-A and AC]) women sought medical attention for symptoms. Whereas Hormone Replacement Therapy (HRT) was prescribed for 25% of them, only 13% were compliant at enrollment. ^ The trends and statistically significant findings of this study have huge public health policy implications. It is imperative that appropriate policies are formulated to ensure that America's ethnically diverse perimenopausal women have ready access to culturally appropriate care. This would optimize their health outcomes, and enhance their quality of life and productive capacities at this critical juncture of their lives. ^