Functional data analysis (FDA) offers a robust statistical framework for handling complex data arising from a variety of fields. The presented dissertation focuses on the development and application of innovative FDA methods to analyze scientific data. We introduce three novel approaches tailored to distinct health-related topics: the mechanisms of neural activation during skilled movement and the role of the menstrual cycle in clinical studies performed on women. In the realm of neuroscience, we propose a functional clustering method designed to analyze high-dimensional, temporal data collected across multiple trials of varying conditions. Leveraging two datasets involving motor neuron behavior in mice, our method identifies latent neuron subgroups and conducts group-specific dimensionality reduction. Through simulations and real-data analyses, we demonstrate the method's efficacy in capturing subtle differences between groups, offering insights into the underlying mechanisms of voluntary movement. Turning to women's health, we address the often-overlooked effects of the menstrual cycle in clinical research. We develop a method to estimate menstrual cycle day using hormone values derived from a single spot urine sample. We leverage patterns of hormonal variation obtained from two sources of data, which follow a collection of women across a full cycle. Through simulations and real data applications, we demonstrate our ability to obtain accurate estimations of cycle day within three days of the truth in optimal settings. This work paves the way for improved model accuracy and statistical power in clinical studies performed on women. Furthermore, we propose an innovative analysis strategy to model menstrual cycle day as an effect modifier on the relationship between hormone levels and breast cancer risk, providing insights into the cyclic variations of hormone levels and their implications on breast cancer etiology. This dissertation aims to advance our understanding of complex health-related processes and empower clinicians and researchers to develop more personalized interventions. The dissertation structure comprises detailed chapters discussing the development, application, and results of each method, highlighting the pivotal role of functional data analysis in advancing scientific research and discovery.

This study utilized a self-reported survey design to obtain information from 47 Latinas to determine their breast cancer knowledge levels and compliance with early detection methods.

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Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

This thesis examines Irish and Jewish mothers' experience of maternity provision and infant care services in East London in the years 1870-1939. As newcomers these immigrants not only had to cope with poverty but also the barriers of language and different cultural customs. Leaving their family and kinship networks behind them, Irish and Jewish mothers had to find new sources of support when incapacitated through pregnancy or childbirth. Living in one of the poorest areas of London and unfamiliar with the local medical and welfare services, these immigrants might be expected to have suffered very poor health. On closer examination, however, Irish and Jewish immigrants appear to have had remarkably low rates of infant and maternal mortality. Despite the difficulties they faced as newcomers, Irish and Jewish mothers had certain advantages over the local population in East London. They were not only able to rely on the prolific and diverse services already present in East London, but could also call upon their own communal organisations. This provision offered a wide range of care and was a vital support to the newcomers. After examining the social and economic background to Irish and Jewish emigration and settlement the thesis examines what impact this had on their health patterns, particularly infant and maternal mortality. The following chapters explore what forms of support were available to married Irish and Jewish mothers through their own family and local neighbourhood and communal agencies. Chapter five concerns the unmarried mother and what provision was made specifically for her. The care offered by the host society to immigrant mothers and their infants is explored in chapters 6 to 8. Institutions covered by these chapters include voluntary hospitals, Poor Law infirmaries, and charitable organisations such as district nursing associations and medical missions. The thesis examines not only the services available to Irish and Jewish mothers, but also the attitudes of health professionals and philanthropists towards immigrants and how these affected the accessibility and acceptability of maternity and infant welfare services to Irish and East European Jewish mothers.

Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.

BACKGROUND: Women represent more than one quarter of all new HIV/AIDS diagnoses; in particular, women of color are disproportionately affected. Early detection and knowledge of HIV status are essential in the management and prevention of the disease. Further research is needed to extensively investigate predictors of HIV/AIDS screening among minority women. OBJECTIVES: 1) To estimate the rate of HIV screening among U.S. adult women, ages 18-64; and 2) to identify determinants of HIV screening among this population. METHODS: The 2006 National Behavioral Risk Factor Surveillance System (BRFSS) was utilized. Female respondents aged 18-64 (N=160,388) were included in the analyses. Multivariate logistic regression was conducted to examine predictors of HIV screening. RESULTS: Nearly 39% of the women reported that they were screened for HIV in their lifetime. Being Black, 25-34 years old, having a lower income, unemployed, unmarried, having fair or poor health and lack of healthcare coverage were significant predictors of having HIV screening. CONCLUSION: Findings of this study suggest that Black, young, unmarried and women with a lower socioeconomic status were more likely to receive HIV screening. However, efforts need to be made to target other populations such as the elderly.

Submitted in partial compliance with the requirements for the Master's Degree in Technology : Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Introduction: Symptoms associated with large breasts result from bra strap chafing, poor body posture, headaches, neck, shoulder, thoracic and lower back pain. There is a paucity of literature quantifying objective data regarding the effect of breast size on posture. Therefore correct bra sizing may improve posture, however this is undetermined. This study aimed to investigate the effect of bra correction on selected postural parameters in order to determine its relevance in a clinical setting. Methodology: Sixty five females who met the inclusion criteria had the following parameters recorded: age, height, weight, body mass index, occupation, and underbust and overbust bra size. An anterior-posterior, right and left lateral digital photographs were taken before and after bra correction. These were then processed using the Posture Pro software. The data was analysed using the latest version of SPSS. The results were presented by means of standard deviations and ranges and differences between pre and post measures were performed with an ANOVA. Results: It was found that there was no correlation between changes in any of the four parameters from pre to post correction, which changed significantly with postural correction (4/43 post correction significant readings) and the demographic variables. Most participants changed to a larger cup sizes after correction which is in line with Greenbaum, (2003) who found that participants tend to buy a smaller bra size. In this study 3% of the study population changed to a bigger cup size and 97% wore bras that were too tight. Similar to the findings of Wood eta/., (2008) who found that 70% of the study population wore bras that are too small and 10% wore bras that were too big. Conclusion: In the study on effect of incorrect bra size on selected postural parameters it was found the there were four parameters that changed significantly with p<O, 05 [ANOVA]. Further investigation needs to be done on a larger sample size, age group range, BMI and different demographic. / PDF copy unavailable. please refer to hard copy for full text information / M

Apesar do treinamento dos músculos do assoalho pélvico ser considerado tratamento de primeira linha nos casos de IU de esforço em mulheres, a literatura ainda é escassa e controversa em relação a sua efetividade no período gestacional. Este estudo avaliou os efeitos de um programa de treinamento dos músculos do assoalho pélvico na melhora de sua função e na diminuição de relatos de perda urinária. Quarenta e duas primigestas de baixo risco foram randomicamente distribuídas para fazerem parte de um grupo controle ou de um grupo de treinamento dos MAP. O grupo de intervenção realizou 16 sessões de treinamento individual e supervisionado. Todas as gestantes foram avaliadas com 20 semanas de gestação, 24 semanas, 36 semanas de gestação e com 6 semanas após o parto quanto a força dos MAP utilizando-se a escala de Oxford modificada e o perineômetro Peritron?. Foram consideradas incontinentes as mulheres que relataram um ou mais episódios de perda urinária no último mês. O pico e média da perineometria na avaliação com 20 semanas de IG para o grupo controle foram respectivamente 51,89cmH 2O e 33,71cmH2 O e para o grupo de treinamento 43,01cmH 2 O e 28,21cmH 2 O. No grupo controle 52% relataram perder urina e 33% do grupo de treinamento na primeira avaliação. Não houve diferença significativa entre os grupos em relação a média (p=0,18) e o pico (p=0,47) da perineometria e relato de perda urinária (p=0,34) na primeira avaliação. Na avaliação com 36 semanas o pico e a média da perineometria para o grupo controle foram respectivamente 50,81cmH 2 O e 33,06cmH 2O e para o grupo de treinamento 42,49cmH2O e 28,21cmH2 O. Não houve diferença estatística significante entre os grupos para a perineometria, mas houve diferença entre as avaliações para a média da perineometria para o grupo de treinamento (p=0,03 de 20 sem para 36 sem de gestação e <0,01 de 20 sem de gestação para 6 semanas após o parto). O número de mulheres que não perdiam urina aumentou de 48% para 52% no grupo controle, e de 67% para 87% no grupo exercício (p=0,04). O treinamento dos MAP proporcionou aumento da perineometria (média) imediatamente após o treinamento, manteve a função dos MAP após o parto e foi eficaz na diminuição dos relatos de perda urinária / Although pelvic floor muscle training (PFMT) is considered a treatment of first line in the cases of UI in women, the literature still is scarce and controversy in relation its effectiveness in the gestacional period. This study it evaluated the effect of a program of PFMT in the improvement of its function and the reduction of self related urinary loss. Forty and two primiparous women of low risk pregnancy had been distributed to be part of a group have controlled or a group of training of the PFM. The group of intervention carried through 16 sessions of individual and supervised training. All the pregnant women had been evaluated with twenty, twenty four and thirty six of gestacional age and six weeks post partum using the perineometer Peritron TM and digital palparions (modified Oxford scale). The women had been considered not continents who told at least one episode of urinary loss in the last month. The peak and mean of the perineometry in the first evaluation with 20 weeks of IG for the control group had respectively 51,89cmH 2O and 33,71cmH2O and the training group had 43,01cmH 2 O and 28,21cmH 2 O. The control group 52% told to lose piss and 33% of the training group in the first evaluation. It did not have significant difference enters the groups in relation the average (p=0,18) and the peak (p=0,47) of the perineometry and self related urinary loss (p=0,34) in the first evaluation. In the evaluation with 36 weeks the perineometry (peak and mean) for the control group had respectively 50,81cmH 2 O and 33,06cmH 2O and for the training group 42,49cmH2O and 28,21cmH2 O. The perineometry did not have difference significant statistics between the groups, but e had difference between the evaluations for the perineometry (mean) in the training group (p=0,03 between 20 weeks and 36 without of gestation and p<0,01 between 20 weeks of gestation and 6 weeks post partum).

Background: A global cervical cancer health disparity persists despite the demonstrated success of primary and secondary preventive strategies, such as cervical visual inspection (VI). Cervical cancer is the leading cause of cancer incidence and death for women in many low resource areas. The greatest risk is for those who are unable or unwilling to access screening. Barriers include healthcare personnel shortages, cost, transportation, and mistrust of healthcare providers and systems. Using community health workers (CHWs) may overcome these barriers, increase facilitators, and improve participation in screening for women in remote areas with limited access to clinical resources. Aim: To determine whether the accuracy of VI performed by CHWs was comparable to VI by physicians or nurses and to consider the affect components of provider training had on VI accuracy. Methods: A systematic review and quantitative meta-analysis of published literature reporting on VI accuracy, provider type, and training was conducted. Strict inclusion/exclusion criteria, study quality, and publication bias assessments improved rigor and bivariate linear mixed modeling (BLMM) was used to determine the affect of predictors on accuracy. Unconditional and conditional BLMMs, controlling for VI technique, provider type, community, clinical setting, HIV status, and gynecological symptoms were considered. Results: Provider type was a significant predictor of sensitivity (p=.048) in the unconditional VI model. VI performed by CHWs was 15% more sensitive than physicians (p=.014). Provider type was not a significant predictor of accuracy in any other models. Didactic and mentored hours predicted sensitivity in both BLMMs. Quality assurance and use of a training manual predicted specificity in unconditional BLMMs, but was not significant in conditional models. Number of training days, with ≤5 being optimal, predicted sensitivity in both BLMMs and specificity in the unconditional model. Conclusion: Study results suggest that community based cervical cancer screening with VI conducted by CHWs can be as, if not more, accurate than VI performed by licensed providers. Locally based screening programs could increase access to screening for women in remote areas. Collaborative partnerships in “pragmatic solidarity” between healthcare systems, CHWs, and the community could promote participation in screening resulting in decreased cervical cancer incidence and mortality. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection