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Background: The scope of postpartum pelvic dysfunction and perineal trauma is under-researched. Instrumental vaginal delivery or 3rd/4th degree tears were recognised risk factors for pelvic/perineal dysfunction; caesarean delivery was not implicated. Aims: • To analyse obstetrical/biological factors associated with pelvic dysfunction after caesarean or non-instrumental vaginal delivery • To compare these associations between groups after determining frequencies • To evaluate severity of pelvic/perineal dysfunction, including quantifying maternal perception of the psychosocial impact Participants and Methods: 284 primiparae (184 caesarean, 100 vaginally delivered) had domiciliary, in-depth medical interviews using structured and open questioning. Results: Caesarean (elective, emergency) vs. vaginally delivered were compared: Stress incontinence manifested in 60/184 (33%, 33%) vs. 54/100 (54%), anal incontinence in 94/184 (53%, 50%) vs. 44/100 (44%), dyspareunia in 50/184 (28%, 27%) vs. 46/100 (46%), haemorrhoids in 3/184 (2%) vs. 5/100 (5%) and double incontinence with dyspareunia in 33/284 (14%, 10% vs. 12%). Sixty sustained perineal trauma. Delivery mode and non-labour factors were predictors. Severity was evaluated by devising a psychosocial measure tailored to maternal functioning. New faecal incontinence necessitated continuous perineal protection in two pre-labour caesarean and one vaginally delivered mother. Severe dysphoria was associated with incontinence (p=0.038, OR 2.334, CI 1.049, 5.192), dyspareunia (p=0.005, OR 2.231, CI 1.272, 3.914) and post-caesarean wound problems (p=0.022, OR 3.620, CI 1.203, 10.896). Incontinence impaired leisure activities (p=0.036, OR 2.165, CI 1.051, 4.463) and employment (p=0.023, OR 1.912, CI 1.093, 3.345); caesarean mode affected social-networking (p=0.018, OR 2.438, CI 1.166, 5.099) and employment (p=0.031, OR 1.967, CI 1.064, 3.636). Conclusions: Pelvic/perineal dysfunction was: ▪ Predicted by caesarean or non-instrumental vaginal delivery, with anal incontinence being more prevalent post-caesarean ▪ Comparable following elective or emergency caesarean ▪ Associated with severe and quantifiable biopsychosocial maternal morbidity.

With the vast array of genetically altered (knockout) mice becoming available there is a need for quantitative, repeatable, and efficient methodologies to characterize the phenotypic consequences of knocking out specific genes. Since knockout animals often have the ability to compensate for a single missing gene, it is important to examine the structural, material and morphological properties to obtain a thorough understanding of the changes occurring. For this project, femurs of knockout mice were first scanned using microcomputed tomography (micro-CT) to obtain high-resolution images of the trabecular bone in the distal femur, as well as cortical bone in the mid-diaphysis. After scanning, the femurs were tested to destruction in four-point bending at the mid-diaphysis about the medial lateral axis of the femur. These methodologies allowed quantification of (1) morphologic properties such as bone volume fraction, trabecular properties and 2nd moment of the area (2) structural properties such as stiffness, maximum load at failure, and post yield deformation and (3) material properties such as bone mineral density, elastic modulus and yield strength. As part of two independent studies, two different knockout mice, cyclooxygenase-2 (COX-2 -/-) and Apolipoprotein E (APOE -/-), were examined for structure-function relationships using these methodologies. COX-2 knockout mice were found to have decreased mineral content in their femurs, and increased post yield deformation. APOE knockout mice at 10 weeks of age had decreased bone mass and structural properties. However, by 40 weeks of age APOE deficient mice caught up to and exceeded the structural properties and bone mass of their wild type counterparts.

ABSTRACT ROBUST CONTROL CHARTS &Ccedil / etiny&uuml / rek, Aysun M. Sc., Department of Statistics Supervisor: Dr. BariS S&uuml / r&uuml / c&uuml / Co-Supervisor: Assoc. Prof. Dr. Birdal Senoglu December 2006, 82 pages Control charts are one of the most commonly used tools in statistical process control. A prominent feature of the statistical process control is the Shewhart control chart that depends on the assumption of normality. However, violations of underlying normality assumption are common in practice. For this reason, control charts for symmetric distributions for both long- and short-tailed distributions are constructed by using least squares estimators and the robust estimators -modified maximum likelihood, trim, MAD and wave. In order to evaluate the performance of the charts under the assumed distribution and investigate robustness properties, the probability of plotting outside the control limits is calculated via Monte Carlo simulation technique.

Classification approaches are used in many areas in order to identify or estimate classes, which different observations belong to. The classification approach, Mahalanobis Taguchi System (MTS) is analyzed and further improved for multi-class classification problems under the scope of this thesis study. MTS tries to explore significant variables and classify a new observation based on its Mahalanobis distance (MD). In this study, first, sample size problems, which are encountered mostly in small data sets, and multicollinearity problems, which constitute some limitations of MTS, are analyzed and a re-sampling approach is explored as a solution. Our re-sampling approach, which only works for data sets with two classes, is a combination of over-sampling and under-sampling. Over-sampling is based on SMOTE, which generates the synthetic observations between the nearest neighbors of observations in the minority class. In addition, MTS models are used to test the performance of several re-sampling parameters, for which the most appropriate values are sought specific to each case. In the second part, multi-class classification methods with MTS are developed. An algorithm, namely Feature Weighted Multi-class MTS-I (FWMMTS-I), is inspired by the descent feature weighted MD. It relaxes adding up of the MDs for variables equally. This provides representations of noisy variables with weights close to zero so that they do not mask the other variables. As a second multi-class classification algorithm, the original MTS method is extended to multi-class problems, which is called Multi-class MTS (MMTS). In addition, a comparable approach to that of Su and Hsiao (2009), which also considers weights of variables, is studied with a modification in MD calculation. It is named as Feature Weighted Multi-class MTS-II (FWMMTS-II). The methods are compared on eight different multi-class data sets using a 5-fold stratified cross validation approach. Results show that FWMMTS-I is as accurate as MMTS, and they are better than FWMMTS-II. Interestingly, the Mahalanobis Distance Classifier (MDC) using all the variables directly in the classification model has performed equally well on the studied data sets.

The longitudinal feature of measurements and counting process of responses motivate the regression models for longitudinal count data (LCD) to take into account the phenomenons such as within-subject association and overdispersion. One common problem in longitudinal studies is the missing data problem, which adds additional difficulties into the analysis. The missingness can be handled with missing data techniques. However, the amount of missingness in the data and the missingness mechanism that the data have affect the performance of missing data techniques. In this thesis, among the regression models for LCD, the Log-Log-Gamma marginalized multilevel model (Log-Log-Gamma MMM) and the random-intercept model are focused on. The performance of the models is compared via a simulation study under three missing data mechanisms (missing completely at random, missing at random conditional on observed data, and missing not random), two types of missingness percentage (10% and 20%), and four missing data techniques (complete case analysis, subject, occasion and conditional mean imputation). The simulation study shows that while the mean absolute error and mean square error values of Log-Log-Gamma MMM are larger in amount compared to the random-intercept model, both regression models yield parallel results. The simulation study results justify that the amount of missingness in the data and that the missingness mechanism that the data have, strictly influence the performance of missing data techniques under both regression models. Furthermore, while generally occasion mean imputation displays the worst performance, conditional mean imputation shows a superior performance over occasion and subject mean imputation and gives parallel results with complete case analysis.

Conditional Cash Transfer (CCT) is a social assistance program which aims for investing in human capital by enabling families under risk of poverty to send their children to school and to benefit from health services regularly. CCT aims for decreasing poverty by means of cash transfers in the short run and aims for investing in children&rsquo / s human capital by providing basic preventative health care, regular school attendance and nutrition in the long run. Under the state of these aims, beginning from 1990s, more than 20 countries in the world started their own CCT program by the mediation or leadership of World Bank. CCT program in Turkey started so as to decrease the adverse effects of economic crisis in 2001 within the Social Risk Mitigation Project which was financially supported by the World Bank loan and constituted under the Social Assistance and Solidarity Foundation. CCT program in Turkey has been adopted by poor families in recent years, and demands and overall payments within the program have been increased significantly in a consideration of years. The need for examining and predicting the increase in these demands scientifically / and considering the fact that CCT is being applied over 20 countries, and such a study being never done before made this study necessary. In this thesis study, the change of CCT applications and number of beneficiary household over time were modeled using multivariate time series models according to geographical regions. Using the vector autoregressive models with exogenous variables (VARX), the forecasts were obtained for the number of CCT applications and beneficiary households in the future.

Health problems of the human beings in a society are one of the main components of the social security systems due to the dimension of the financial burden it might bring on individuals, employers, insurance companies and governments. Morbidity measures, such as incidence and prevalence of a specific disease in a certain population enable researchers to estimate for individuals the probability of being diagnosed or being prone to the diseases. This information is usually not tractable because of the non-availability of the convenient data or recordings for many countries as well as Turkey. Even if it is available, it is commonly limited with largely varying characteristics about the type and coverage of the diseases. In this regard, the pattern that a population follows for an acute disease may not be the same for chronic diseases. Having those indicators determined for a group of insureds will enable underwriters to have more profitable and economical premium calculation and precision on required reserve estimation. v Based on their characteristics such as acute or chronic behaviour, the gender, and the location of residency of people, the diseases show different behaviour on their occurrences. From the insurer

This thesis illustrates a general sense of national identity within the Taiwanese people brought on by the Kuomintang (KMT) and existing throughout the KMT's reign over the island, and contrasts this with the new identity that came to exist in the post-KMT period. Comparisons are centered around two works of literature: Sayonara, Zaijian!, written in 1979 by Chunming Huang, and My Diary of Japanomania, written in 1999 by Hari Xingzi. Louis Althusser's view of history-based on structural materialism, complexity and overdetermination---will be employed to discuss and explain the contrast between Sayonara, Zaijian! and My Diary of Japanomania in order to discover how national subject is formed and how it interacts within ideology.

Thesis (Ph.D.)--Indiana University, Dept. of Anthropology, 2005. / Adviser: Joelle Bahloul. UMI # 3199412 Includes bibliographical references. Bibliography: p. 201-219.