Violence against Women Living with HIV: A Cross Sectional Study in Nepal

Background: Violence against Women (VAW) and Human Immunodeficiency Virus (HIV) both constitute major public health issues and there is an increasing evidence of their intersection. Data are sparse on the intersection of VAW and HIV in South Asia region. We aimed to identify different forms and magnitude of violence incurred by women living with HIV, and analyse causes and consequences. Methods: A cross-sectional study was conducted among 43 HIV positive women in three districts of Nepal, in the period of March-May 2008. Data was collected through semi-structured interview questionnaire. Results: The vast majority of the participants (93.02%) had suffered from at least one form of the violence. The prevalence of violence rose up sharply after being diagnosed with HIV positive than before (93.02% vs.53.5%). Forty-five percent of the participants reported their husbands being main perpetrator of violence. Self-humiliation and health and treatment problem were the major consequences of violence as reported by 90% and 77.5% of the participants respectively. Conclusion: Violence was observed to be highly prevalent among women living with HIV in Nepal. Further larger and nationally representative researches are imperative to better understand the cross-section between VAW and HIV. Our finding recommends to prioritizing programs on social aspects of HIV such as violence

The prevalence of metabolic syndrome in South Asia: A systematic review

© Research Society for Study of Diabetes in India 2015. The objective of this study was to estimate the prevalence of metabolic syndrome and its individual components in South Asia region. A search was conducted on PubMed, Scopus and OvidSP (MedLine and EMBASE) using the term ‘metabolic syndrome’, ‘prevalence’ and the name of each South Asian country for studies published on or after the year 2000. Reference lists and citation references of the included papers were also checked. Eligibility criteria were mainly population-based studies on both gender and healthy participants aged ≥18 years. Four definitions of metabolic syndrome were considered: the World Health Organisation (1999), Third Adult Treatment Panel (2001) and its modified version (2005) and International Diabetes Federation (2005). A total of 558 papers were retrieved from all sources, of which 16 relevant studies were identified comprising 14,515 males (44.1 %) and 18,390 females (55.9 %). The weighted mean prevalence of metabolic syndrome was 14.0 % (WHO), 26.1 % (ATPIII), 29.8 % (IDF) and 32.5 % (modified ATPIII). Low levels of HDL cholesterol and hypertension were prevalent in half of the study population. Overall, females had a higher prevalence of MS under all definitions except WHO. Females were more likely to have low levels of HDL cholesterol (68.8 vs 37.9 %) and central obesity (47.9 vs 37.9 %), whereas males were comparatively more hypertensive (42.3 vs 38.1 %). Despite the high rates of metabolic risk factors, research is extremely sparse in South Asia preventing knowledge of actual burden. Along with the increased access to clinical intervention, prevention strategies should be intensified with special attention to females

Climate change and indigenous people: perceptions of transhumant herders and implications to the transhumance system in the Himalayas

Climate change poses differential vulnerability for different communities, sectors and regions. People, whose subsistence livelihood is based on the direct utilisation of natural resources are most affected by climate change and have different but accurate perceptions of climate change than those people following modern lifestyles. The herders of the higher Himalayas follow vertical transhumance and combine it with subsistence agriculture for their livelihood. Although, climate models have predicted pronounced warming in high altitude areas of the Himalayas and there are many indications that climate change impacts different aspects of transhumance, there is no information on how transhumant herders have perceived change in climate and how these changes might impact transhumance system. One hundred and forty five transhumant herders were interviewed from three Village Development Committees (VDCs) namely Khumjung in Solukhumbu, Kalinchok in Dolakhaand Majhigaun in Bajhang; representing Eastern, Central and far-Western mountainous areas of Nepal respectively to explore their perceptions about climate change and other observed changes in biophysical indicators. About 80% of the herders perceived increasing summer temperature, 92% decreasing winter rainfall and more than 93% noticed decreasing snowfall. Majority of the herders agreed that there was fast melting of snow in the rangelands, rainfall events were becoming more and more unpredictable, drought events increased, there was early induce in greenery and maturity of grasses in the rangelands and appearance of new livestock diseases. These observations suggest that transhumant herders in the Himalayas have experienced change in climatic variables and have noticed change in bio-physical indicators that have implications to the transhumance system. The findings help to devise adaptation strategies for indigenous communities and incorporate them in the climate change policies in the Himalayas

Identifying the gaps in Nepalese migrant workers' health and well-being: a review of the literature.

Background: The health and well-being of migrant workers from low-income countries is often neglected in travel medicine. This article uses Nepal as a case study to highlight key issues affecting this particular group of international travellers. Methods: This narrative review used a comprehensive systematic literature search to identify relevant studies on Nepal. The included articles were thematically analysed leading to four key themes or risk factors. Results: The search found 18 articles from which we identified 3 key themes related directly to migrant workers: (1) sexual risk taking; (2) occupational health and (3) lifestyles, and a fourth theme related to partners and family of migrant workers who are left behind in Nepal. Of the 18 included articles, 11 articles discussed sexual risk taking and HIV, whilst considerably fewer focused on work-related risk factors and lifestyle factors in migrant workers. Conclusions: Migrant workers who are generally healthy appear to be similar to tourist travellers in regarding sexual health as a key issue related to being abroad. Risky sexual behaviour increases in individuals separated from their usual sexual partners, away from their own communities and families, leading to the so-called 'situational disinhibition'. Considering the recent media coverage of deaths and injuries among migrant workers in the Middle East, it is interesting to see that their sexual health is more prevalent in the research literature. This article argues that travel medicine should provide more emphasis to the health and well-being of migrant workers as a highly vulnerable group of travellers with additional impact on the health of those left behind

Thorny Spheres and Black Holes with Strings

We consider thorny spheres, that is 2-dimensional compact surfaces which are everywhere locally isometric to a round sphere $S^2$ except for a finite number of isolated points where they have conical singularities. We use thorny spheres to generate, from a spherically symmetric solution of the Einstein equations, new solutions which describe spacetimes pierced by an arbitrary number of infinitely thin cosmic strings radially directed. Each string produces an angle deficit proportional to its tension, while the metric outside the strings is a locally spherically symmetric solution. We prove that there can be arbitrary configurations of strings provided that the directions of the strings obey a certain equilibrium condition. In general this equilibrium condition can be written as a force-balance equation for string forces defined in a flat 3-space in which the thorny sphere is isometrically embedded, or as a constraint on the product of holonomies around strings in an alternative 3-space that is flat except for the strings. In the case of small string tensions, the constraint equation has the form of a linear relation between unit vectors directed along the string axes.Comment: 37 pages, 11 figure