Information Interventions to Reduce Maternal Mortality in Indonesia

<p>Indonesia consistently records higher levels of maternal mortality than other countries in Southeast Asia with its same level of socioeconomic development. I use a quasi-experimental, difference-in-differences approach to understand whether the role of information on the risk of death in childbirth can change women’s reproductive behaviors. In the first two chapters, I use the Maternal Mortality Module from the Demographic and Health Survey (DHS) in Indonesia to examine fertility and reproductive behavior responses to a sister’s death in childbirth. Fertility desires remain relatively unchanged but women take up behaviors in subsequent births that avert the risk of maternal death. In the last chapter, I combine population-representative data from the DHS with a village-level census (PODES) on service availability to understand how a village-level intervention to improve obstetric service use using a birth preparedness and complications readiness (BPCR) approach may improve obstetric service use. In this study, I find that the Desa Siaga intervention in Indonesia improved knowledge of the danger signs of complications among women but not among men relative to villages that did not get the program while controlling for endogenous program placement. More women got antenatal care due to the program but use of a skilled birth attendant and postpartum care did not change as a result of the intervention. Both genders report discussing a blood donor in preparation for delivery.</p>

You and I: The Effects of Intra- and Inter-Species Interactions on Microbial Biofilms, Growth, and Morphology

<p>Humanity is shaped by its relationships with microbes. From bacterial infections to the production of biofuels, industry and health often hinge on our control of microbial populations. Understanding the physiological and genetic basis of their behaviors is therefore of the highest importance. To this end I have investigated the genetic basis of plastic adhesion in Saccharomyces cerevisiae, the mechanistic and evolutionary dynamics of mixed species biofilms with Escherichia coli and S. cerevisiae, and the induction of filamentation in E. coli. Using a bulk segregant analysis on experimentally evolved populations, I detected 28 genes that are likely to mediate plastic adhesion in S. cerevisiae. With a variety of imaging and culture manipulation techniques, I found that particular strains of E. coli are capable of inducing flocculation and macroscopic biofilm formation via coaggregation with yeast. I also employed experimental evolution and microbial demography techniques to find that selection for mixed species biofilm association leads to lower fecundity in S. cerevisiae. Using culture manipulation and imaging techniques, I also found that E. coli are capable of inducing a filamentous phenotype with a secreted signal that has many of the qualities of a quorum sensing molecule.</p>

How did varying levels of intensity of the 2005 Pakistan earthquake differentially affect women’s fertility decisions and children’s health outcomes?

This paper uses a difference in difference model to investigate the impact of a large scale and high mortality 2005 earthquake in Pakistan on women’s fertility decisions and children’s health outcomes. Using a nationally representative, cross sectional DHS data from 2006 and geographical data from USGS, this paper investigates how variation in earthquake intensity levels can differentially impact total fertility for women and the likelihood of children suffering from diseases such as diarrhea, Acute Respiratory Infections (ARI) and fever. The post-earthquake results demonstrate a statistically significant increase in total fertility for areas closer to the epicenter of the earthquake, within a 100km radius of the rupture surface and at higher altitudes. Similarly, for children who were in-utero at the time of the earthquake, the probability of having early symptoms of ARI or fever was much smaller in lower earthquake intensity zones compared to the highest intensity zone.

Predicting Forest Responses to Changing Environmental Conditions

<p>Forests change with changes in their environment based on the physiological responses of individual trees. These short-term reactions have cumulative impacts on long-term demographic performance. For a tree in a forest community, success depends on biomass growth to capture above- and belowground resources and reproductive output to establish future generations. Here we examine aspects of how forests respond to changes in moisture and light availability and how these responses are related to tree demography and physiology.</p><p>First we address the long-term pattern of tree decline before death and its connection with drought. Increasing drought stress and chronic morbidity could have pervasive impacts on forest composition in many regions. We use long-term, whole-stand inventory data from southeastern U.S. forests to show that trees exposed to drought experience multiyear declines in growth prior to mortality. Following a severe, multiyear drought, 72% of trees that did not recover their pre-drought growth rates died within 10 years. This pattern was mediated by local moisture availability. As an index of morbidity prior to death, we calculated the difference in cumulative growth after drought relative to surviving conspecifics. The strength of drought-induced morbidity varied among species and was correlated with species drought tolerance. </p><p>Next, we investigate differences among tree species in reproductive output relative to biomass growth with changes in light availability. Previous studies reach conflicting conclusions about the constraints on reproductive allocation relative to growth and how they vary through time, across species, and between environments. We test the hypothesis that canopy exposure to light, a critical resource, limits reproductive allocation by comparing long-term relationships between reproduction and growth for trees from 21 species in forests throughout the southeastern U.S. We found that species had divergent responses to light availability, with shade-intolerant species experiencing an alleviation of trade-offs between growth and reproduction at high light. Shade-tolerant species showed no changes in reproductive output across light environments. </p><p>Given that the above patterns depend on the maintenance of transpiration, we next developed an approach for predicting whole-tree water use from sap flux observations. Accurately scaling these observations to tree- or stand-levels requires accounting for variation in sap flux between wood types and with depth into the tree. We compared different models with sap flux data to test the hypotheses that radial sap flux profiles differ by wood type and tree size. We show that radial variation in sap flux is dependent on wood type but independent of tree size for a range of temperate trees. The best-fitting model predicted out-of-sample sap flux observations and independent estimates of sapwood area with small errors, suggesting robustness in new settings. We outline a method for predicting whole-tree water use with this model and include computer code for simple implementation in other studies. </p><p>Finally, we estimated tree water balances during drought with a statistical time-series analysis. Moisture limitation in forest stands comes predominantly from water use by the trees themselves, a drought-stand feedback. We show that drought impacts on tree fitness and forest composition can be predicted by tracking the moisture reservoir available to each tree in a mass balance. We apply this model to multiple seasonal droughts in a temperate forest with measurements of tree water use to demonstrate how species and size differences modulate moisture availability across landscapes. As trees deplete their soil moisture reservoir during droughts, a transpiration deficit develops, leading to reduced biomass growth and reproductive output.</p><p>This dissertation draws connections between the physiological condition of individual trees and their behavior in crowded, diverse, and continually-changing forest stands. The analyses take advantage of growing data sets on both the physiology and demography of trees as well as novel statistical techniques that allow us to link these observations to realistic quantitative models. The results can be used to scale up tree measurements to entire stands and address questions about the future composition of forests and the land’s balance of water and carbon.</p>