Effectiveness of a home-environmental intervention package and an early child development intervention on child health and development in high-altitude rural communities in the Peruvian Andes: a cluster-randomised controlled trial

Unsafe drinking water, poor sanitation and hygiene, exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low- and middle-income countries. We implemented an integrated home-environmental intervention package (IHIP), comprising a kitchen sink, hygiene education and a certified improved biomass cookstove, and an early child development (ECD) programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru

Socio-cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes - a qualitative study

BACKGROUND: In some areas of the world, breast milk is seen as a potential source of child diarrhoea. While this belief has been explored in African and Southeast Asian countries, it remains vastly understudied in Latin American contexts. We investigate socio-cultural factors contributing to breastfeeding cessation in rural high-altitude populations of the Peruvian Andes. The role of socio- cultural factors in the local explanatory model of child diarrhoea, and whether these perceptions were integrated in the local healthcare system were assessed. METHODS: Within the framework of a randomised controlled trial, we conducted semi-structured interviews with 40 mothers and 15 health personnel from local healthcare centres involved in the trial. RESULTS: Cultural beliefs on breastfeeding cessation included the perception that breast milk turned into "blood" after six months and that breastfeeding caused child diarrhoea. We identified eight local types of child diarrhoea, and women linked six of them with breastfeeding practices. "Infection" was the only diarrhoea mothers linked to hygiene and the germ disease concept and perceived as treatable through drug therapy. Women believed that other types of diarrhoea could not be treated within the formal healthcare sector. Interviews with health personnel revealed no protocol for, or consensus about, the integration of the local explanatory model of child diarrhoea in local healthcare and service provision. CONCLUSIONS: The local explanatory model in rural Andean Peru connected breastfeeding with child diarrhoeas. Cultural beliefs regarding diarrhoea management may increase home treatments, even in cases of severe diarrhoeal episodes. Future national breastfeeding support programmes should promote peer-counselling approaches to reduce negative attitudes towards breastfeeding and health practitioners. Local explanatory models should be incorporated into provincial and regional strategies for child diarrhoea management to promote equity in health and improve provider-patient relationships

Acceptance and uptake of improved biomass cookstoves in Peru: learning from system level approaches to transform large-scale cooking interventions

Improved biomass cookstoves (ICS) are cooking technologies that increase wellbeing and reduce household air pollution. With the goal of identifying factors influencing ICS acceptance and uptake at five system levels (intrapersonal, interpersonal, community, institutional, and policy), we carried out a qualitative study in three regions in Peru. We conducted 32 focus group discussions (243 ICS users) and 26 semi-structured interviews with key stakeholders, applying a combination of two system-level frameworks for analysis: the socio-ecological model and the ICS adoption domain. Enabling and impeding factors at each level were closely related to each other. Decisions made by policy makers - often centralised and not considering local/regional realities - strongly influenced acceptance and barriers at lower levels. ICS acceptance and uptake tended to be low when ICS users were not involved from the start. Most ICS programmes focused on stove distribution outputs, without considering community needs, such as training on ICS building, maintenance and repair, or issues related to spare part availability, which is a strong barrier to sustained uptake of ICS. Using a combination of models that allows one to examine facilitators and barriers at multiple levels, as well as the interactions of those levels, was useful in assessing potential improvements to intervention design, facilitating programme success, preventing unforeseen programme adaptations, and improving cost-effectiveness of interventions

Estimation of solar prominence magnetic fields based on the reconstructed 3D trajectories of prominence knots

We present an estimation of the lower limits of local magnetic fields in quiescent, activated, and active (surges) promineces, based on reconstructed 3-dimensional (3D) trajectories of individual prominence knots. The 3D trajectories, velocities, tangential and centripetal accelerations of the knots were reconstructed using observational data collected with a single ground-based telescope equipped with a Multi-channel Subtractive Double Pass imaging spectrograph. Lower limits of magnetic fields channeling observed plasma flows were estimated under assumption of the equipartition principle. Assuming approximate electron densities of the plasma n_e = 5*10^{11} cm^{-3} in surges and n_e = 5*10^{10} cm^{-3} in quiescent/activated prominences, we found that the magnetic fields channeling two observed surges range from 16 to 40 Gauss, while in quiescent and activated prominences they were less than 10 Gauss. Our results are consistent with previous detections of weak local magnetic fields in the solar prominences.Comment: 14 pages, 12 figures, 1 tabl

La ciudad del cuarto de hora, ¿una solución sostenible para la ciudad post-COVID-19?

Algunas de las grandes urbes de nuestro planeta han ido planteando su transformación en busca de una ciudad más humana y sostenible que permita afrontar, de manera inequívoca, los nuevos retos de la sociedad, superando el actual paradigma urbano donde el vehículo privado juega un papel esencial. A esta situación se sumará, inevitablemente, las consecuencias que el COVID-19 tendrá en la concepción de nuestra sociedad y con ello, en nuestras ciudades. Entre las apuestas más novedosas e interesantes que están presentes en el debate urbano de los últimos años se encuentra la idea del cronourbanismo y la ciudad del cuarto de hora que Anne Hidalgo, actual alcaldesa de París, incluía en el programa con el que ha sido reelegid

Incidencia de los informes sectoriales autonómicos en el planeamiento

El marco del planeamiento urbanístico de las diversas Comunidades Autónomas establece que en el procedimiento de tramitación de los Planes Generales se deberá solicitar una serie de informes a fin de coordinar los intereses de las diferentes materias que tienen influencia en este proceso. Además de los informes vinculantes y preceptivos que deben emitir determinados órganos de la Administración sectorial del Estado, y que ya se estudiaron en el artículo que apareció en el número anterior de la revista, existen un buen número de informes, de diverso carácter, que deberán ser evacuados por los órganos competentes de la Comunidad Autónoma. En dos artículos sucesivos se estudiarán estos últimos; en concreto, en esta primera parte el análisis se centrará en los informes previstos en la legislación urbanística de cada Comunidad, junto con los mecanismos establecidos para su coordinación, se examina también el modo en que se coordinan estos informes con los que se producen en la Evaluación Ambiental Estratégica. Un segundo artículo estudiará los informes sectoriales que se prevén en la legislación de cada Comunidad Autónoma