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BACKGROUND: Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide. OBJECTIVE: Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru. METHODS: We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25-64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and regular behavioral messaging, whereas controls continued their biomass cooking practices. During the second year, control participants received a free LPG stove, regular behavioral messaging, and vouchers to obtain LPG tanks from a nearby distributor, whereas fuel distribution stopped for intervention participants. We collected 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM) with aerodynamic diameter formula presented (formula presented ), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization. RESULTS: Baseline formula presented (kitchen area concentrations formula presented vs. formula presented ; personal exposure formula presented vs. formula presented ), CO (kitchen formula presented vs. formula presented ; personal formula presented vs. formula presented ), and BC (kitchen formula presented vs. formula presented ; personal formula presented vs. formula presented ) were similar between control and intervention participants. Intervention participants had consistently lower formula presented concentrations at the 12-month visit for kitchen (formula presented , and formula presented ) and personal exposures (formula presented , and formula presented ) to formula presented , BC, and CO when compared to controls during the first year. In the second year, we observed comparable HAP reductions among controls after the voucher-based intervention for LPG fuel was implemented (24-month visit formula presented , BC, and CO kitchen mean concentrations of formula presented , and formula presented and personal exposures of formula presented , and formula presented , respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit formula presented , BC, and CO kitchen mean concentrations of formula presented , and formula presented and personal exposures of formula presented , and formula presented , respectively). DISCUSSION: Both home delivery and voucher-based provision of free LPG over a 1-y period, in combination with provision of a free LPG stove and longitudinal behavioral messaging, reduced HAP to levels below 24-h World Health Organization air quality guidelines. Moreover, the effects of the intervention on HAP persisted for a year after fuel delivery stopped. Such strategies could be applied in LPG programs to reduce HAP and potentially improve health.

Despite widespread support for the principles of democracy, democratic norms have been eroding globally for over a decade. We ask whether and how political ideology factors into people’s reactions to democratic decline. We offer hypotheses derived from two theoretical lenses, one considering ideologically-relevant dispositions, and another considering ideologically-relevant situations. Pre-registered laboratory experiments combined with analyses of World Values Survey data indicate that there is a dispositional trend: Overall, liberals are more distressed than conservatives by low democracy. At the same time, situational factors also matter: This pattern emerges most strongly when the ruling party is conservative, and disappears (though it does not flip into its mirror image) when the ruling party is liberal. Our results contribute to ongoing debates over ideological symmetry and asymmetry; they also suggest that, if democracy is worth protecting, not everyone, everywhere will feel the urgency.

Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM(2.5) monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual’s time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM(2.5) exposures for women and children during two 24-hour periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM(2.5) monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM(2.5) concentration range: 5–528 μg/m(3)). Indirect exposure had better agreement with direct exposure measurements (bias: −17 μg/m(3)) than did kitchen area measurements (bias: −89 μg/m(3)). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.