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Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13–19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.
The Alcohol Use Disorders Identification Test (AUDIT) is a ten-item standardised questionnaire to assess an individual's vulnerability to alcohol use disorders. Three of these ten questions are related to alcohol consumption. Nepal has a distinct alcohol culture, where alcohol use is socially and religiously acceptable in some caste/ethnic groups and is prohibited in others, thereby influencing the scores of AUDIT questions related to all three conceptual domains. Identifying and endorsing subsets of AUDIT questions relevant to different ethnic groups could be the way forward for effective screening of alcohol use disorders in Nepal.
Identifying the impact of remittances on household members remaining behind is difficult due to selection into migration. In this paper, we exploit an unexpected embargo on Qatar, the second major destination among Nepali migrants. Using longitudinal data on about 1,500 Nepali households with migrants prior to the embargo, we assess how this shock translates into changes in remittances and development outcomes. We find a 56% reduction in remittances for households with a migrant in Qatar. At least in the months immediately after the shock, such a fall in remittances does not seem to translate into recipient household's welfare. However, we cannot exclude that such effect might materialize in the medium run. That is particularly true for poor and credit-constrained households, especially vulnerable to the remittance windfall and lacking the ability to move their migrants or other household members to other destinations.
Drug addiction is rife in Nepal, with a high relapse rate following treatment. Apart from basic psychosocial support, there are no evidence-based aftercare services for individuals in recovery. Recently, mindfulness-based interventions have shown promising results in preventing relapse. We discuss the context, challenges and opportunities of organising a 2-day intensive face-to-face mindfulness-based training for Nepalese mental health professionals to facilitate 8-week mindfulness-based relapse prevention (MBRP). Altogether, 24 participants completed the feedback questionnaire. Most were rehabilitation staff, along with a few psychologists and psychiatrists. Feedback suggested a high degree of satisfaction and provided comments to improve the programme. It has prompted us to design online MBRP training and set up a feasibility study for an MBRP programme in Nepal. If successful, this may help a huge number of individuals in recovery.
Chapter 9 looks comparatively within monarchies to assess whether the theory contributes to understanding why some monarchies survived and others were overthrown in the past two centuries. It begins by analyzing two datasets of ruling monarchies from the 1800s to the 1900s, showing that monarchies that shared more power with parliaments were less likely to fall to revolutions. It then uses case studies of the Iranian and Nepali monarchies to illustrate how centralizing monarchs made themselves vulnerable to blame and attracted mass opposition, ultimately leading to their downfalls. The chapter suggests that the theory has implications for understanding historical transitions from monarchy, and it underscores that kings who forego their delegation advantage and monopolize power are also vulnerable to being blamed and facing mass opposition when they govern poorly.
Recent critical scholarship on terrorism has centred on matters of race, class, and gender regarding how counterterrorism policies are connected to multiple systems of hierarchical power relations. This article builds upon this scholarship and looks towards the future. It engages with understandings of emancipatory futures in critical scholarship on terrorism while drawing upon abolitionist and anarchist political thought to expand understandings of such futures. Anarchist and abolitionist thinking are useful for considering futures beyond the ‘global war on terror’ (GWOT) because of their anti-state and anti-domination orientations and focus on building alternatives to prevent and manage violence apart from contemporary ‘counterterrorism’. After providing an outline of anarchist and abolitionist thought, the article connects these to contemporary examples drawn from the United States and Nepal. In doing so, it theorises and imagines futures for preventing violence and building public security that are linkedto anarchist and abolitionist understandings of violence and the state. In contrast to ‘power politics’ which centres on the state, an anarchist abolitionist approach explores how safety and security can be reimagined and remadein the absence of a state.
An examination of the Anatolian sources of Greek theogonic traditions, syncretistic myths that took shape in admixed Ur-Aeolian–Luvian communities in the Late Bronze Age, and descendent Aeolian assemblages of mythic and cult elements that persist into the Iron Age. Essential to many of these traditions is the presence of honey, especially honey having psychotropic properties of a sort that occurs naturally along the southern and eastern shores of the Black Sea.
Hunter–gatherer populations underwent a mass extinction in the Neolithic, and in present times face challenges such as explicit sedentarisation policies. An exception is in Nepal, where the nomadic Raute people receive monthly governmental individual payments. One consequence of the money transfers has been a significant increase in alcohol consumption, with nearly all individuals drinking industrially produced alcohol. Here we investigate the Raute demography based on a full census of 144 individuals. We show that the Raute exhibit the short life expectancies typical of other hunter–gatherer populations from Africa, Asia and America. Bayesian survival trajectory analysis demonstrated that heavy drinking by either parent substantially reduces offspring survival to age 15. Bayesian regressions revealed a significant effect of heavy drinking on maternal fertility by decreasing the number of living children and reducing the proportion of live children at the end of maternal reproductive life. Although the absence of data prior to monetary support precludes a direct assessment of long-term demographic trends, relatively stable population sizes over the last decades and a fertility rate close to the replacement rate rule out an imminent population crash. Further studies are required to elucidate the Rautes’ origins and relationship with other nomadic people in the region.
A growing number of institutions that hold cultural heritage artifacts are now considering voluntary repatriations in which they choose to return an artifact despite unfilled gaps in their knowledge of its ownership history. But how are institutions to judge whether it is more probable that such gaps conceal theft and illicit export or are innocuous? Attempting to answer this question for Nepal, we examine published and archival records to trace the history of the growth in collecting of Nepali cultural heritage in the United States, with special attention to a 1964 exhibition at New York’s Asia Society Gallery, “The Art of Nepal,” and the activity of the New York dealers Nasli and Alice Heeramaneck. We conclude that the majority of Nepali heritage items in America entered after Nepal prohibited their export.
Khata Corridor forest, which serves as a border crossing for wildlife between Nepal and India, is one of the areas in Nepal with the highest incidence of human–wildlife conflict. In recent years both the tiger Panthera tigris tigris and human populations in this region have increased, leading to more frequent conflict. We aimed to determine whether increased conflict risk was primarily from tigers entering human settlements or whether there are additional drivers associated with human use of forested areas. We conducted the study in four settlements that varied in socio-economic status and distance from Bardiya National Park, through field visits and household surveys. Tiger records (sightings, pug marks and attacks) were most frequent far from Bardiya National Park, in settlements without benefits from tiger-based tourism and nearer the periphery of forest, and were rarely associated with the interior of settlements. Human visitation into forests was also highest in the most remote settlement. Our findings suggest that conflict risk is driven by the extent of human activity in forested areas, reflecting an unequal distribution of the conservation benefits of tourism amongst settlements. In the long-term, continued coexistence between people and tigers will depend on minimizing conflict risk across settlements through establishing an equitable distribution of conservation benefits. In the short term, we recommend raising public awareness of tiger behaviour to emphasize that tigers are highly unlikely to enter and occupy the interior of human settlements, mitigating negative perceptions of conflict risk.
The Chinese pangolin Manis pentadactyla is categorized as Critically Endangered on the IUCN Red List but little is known about its status in Nepal. Although indirect sign surveys have reported its presence in several community forests in Kavrepalanchok district, no photographic or video evidence has previously been documented. We used camera traps to investigate the occurrence of pangolins in 20 community forests in Panauti Municipality in Kavrepalanchok. A total of 75 0.01 km2 plots were surveyed using camera traps during September 2022–February 2023, with a total survey effort of 803 trap-days. The cameras recorded a total of 16 individual video footage events of Chinese pangolins in six of the community forests. This is the first camera-trap evidence of the species' presence in these forest patches, and in Kavrepalanchok district. The pangolins displayed behaviours such as sniffing, gathering plant material and digging, between 18.00 and 1.00. The camera-trap records provide more accurate species identification and reliable information than indirect sign surveys, indicating camera traps are a useful surveying tool for rare, nocturnal and elusive pangolins.
In the current IUCN Red List assessment, the south-western distribution range of the brown bear Ursus arctos in Nepal ends in Upper Mustang, in the central Himalaya, and extends northwards into the Tibetan Autonomous Region of China. Although brown bears have been recorded further west of Upper Mustang, details of these findings have not been published previously. Using camera traps, we present new evidence of brown bears in Limi Valley, Upper Humla, north-western Nepal. Covering a study area of 336 km2, we deployed 61 camera traps for 3,145 trap-nights during July–October 2021 and 10,748 trap-nights during June 2022–October 2023. In 2021 we recorded a single independent image of a brown bear, followed by 23 independent images during 2022–2023. The images were captured during spring and autumn but not in summer and winter. These new records increase the distribution range of the brown bear in Nepal, extending its global range south-westwards. Our results indicate the significance of Limi Valley as a stronghold for brown bears in Nepal and underscore the importance of formally protecting the currently unprotected wildlife habitats in Limi Valley. Our study emphasizes the need for further research into the ecology and population status of brown bears in Nepal.
Major depressive disorder (MDD) is the leading cause of disability globally, with moderate heritability and well-established socio-environmental risk factors. Genetic studies have been mostly restricted to European settings, with polygenic scores (PGS) demonstrating low portability across diverse global populations.
Methods
This study examines genetic architecture, polygenic prediction, and socio-environmental correlates of MDD in a family-based sample of 10 032 individuals from Nepal with array genotyping data. We used genome-based restricted maximum likelihood to estimate heritability, applied S-LDXR to estimate the cross-ancestry genetic correlation between Nepalese and European samples, and modeled PGS trained on a GWAS meta-analysis of European and East Asian ancestry samples.
Results
We estimated the narrow-sense heritability of lifetime MDD in Nepal to be 0.26 (95% CI 0.18–0.34, p = 8.5 × 10−6). Our analysis was underpowered to estimate the cross-ancestry genetic correlation (rg = 0.26, 95% CI −0.29 to 0.81). MDD risk was associated with higher age (beta = 0.071, 95% CI 0.06–0.08), female sex (beta = 0.160, 95% CI 0.15–0.17), and childhood exposure to potentially traumatic events (beta = 0.050, 95% CI 0.03–0.07), while neither the depression PGS (beta = 0.004, 95% CI −0.004 to 0.01) or its interaction with childhood trauma (beta = 0.007, 95% CI −0.01 to 0.03) were strongly associated with MDD.
Conclusions
Estimates of lifetime MDD heritability in this Nepalese sample were similar to previous European ancestry samples, but PGS trained on European data did not predict MDD in this sample. This may be due to differences in ancestry-linked causal variants, differences in depression phenotyping between the training and target data, or setting-specific environmental factors that modulate genetic effects. Additional research among under-represented global populations will ensure equitable translation of genomic findings.
The identification and implementation of conflict reduction measures are necessary to reduce predator attacks on people and livestock and to minimize human encroachment into predator habitats. We identified potential human–tiger conflict reduction measures and prioritized these measures for Chitwan National Park, Nepal. We identified these measures through a literature review, key informant interviews and a local stakeholder workshop. We prioritized the identified measures using a questionnaire survey of victims of tiger attacks (farmers, forest users and fishers), beneficiaries of tiger conservation (tourist guides, Jeep and elephant safari operators, tour and hotel operators and business operators) and National Park managers. We identified 22 measures (12 preventative, five reactive and five mitigative) as having potential for reducing negative interactions between people and tigers. Amongst these, we identified compensation payments, tiger-proof fences and habitat and prey management as high-priority measures. Conflict reduction priorities also varied amongst stakeholder groups. The victims assigned the highest priority to the construction of tiger-proof fences, whereas beneficiaries identified the management of habitat and prey as their highest priority. Compensation payments were the first preference of National Park managers and were amongst the top two priorities of all stakeholder groups. We recommend the adoption of the identified stakeholder priorities for reducing human–tiger conflict around Chitwan National Park and encourage consideration of the variations in priorities between stakeholder groups during policy development and decision-making.
The gharial Gavialis gangeticus is a Critically Endangered crocodilian currently known from only 14 disjunct locations in Nepal and India. The protected stretch of the Babai River in Bardia National Park, Nepal, is home to one of the six subpopulations of gharials that have exhibited recent evidence of reproduction. However, there is limited information available on the gharial population in this region. We conducted surveys during the breeding, nesting and hatching seasons of gharials during 2020–2022 to study the gharial population in the Babai River in Bardia National Park. We located one breeding group of gharials in Soth Khola (2–3 individuals) and one in Dhanuse (5–6 individuals), and we observed pre-mating or mating behaviours in all 3 years. We identified potential nesting areas on sand banks of 19–175 m in length. During nesting seasons we found abundant signs of nesting only in Dhanuse, including entry and exit trails of female gharials to and from the water and trial nests. In 2020 and 2021 we did not find any signs of hatching, probably because of flooding. In 2022 we recorded two gharial nests, producing c. 60 hatchlings, in Dhanuse. Our findings indicate that the gharial population in the Babai River is probably nesting annually. We recommend various conservation actions for this gharial population.
Assessing gender disparity in mental health is crucial for targeted interventions. This study aims to quantify gender disparities in mental health burdens, specifically anxiety and depression, and related care-seeking behaviors across various sociodemographic factors in Nepal, highlighting the importance of gender-specific mental health interventions.
Methods
Data from the 2022 Nepal Demographic and Health Survey was utilized, employing the Generalized Anxiety Disorder 7 scale (GAD-7) and Patient Health Questionnaire (PHQ-9) scales for anxiety and depression symptoms, respectively. Multiple logistic regression models assessed gender associations with these conditions and care-seeking behaviors.
Results
Women had a higher point prevalence of anxiety (21.9% vs. 11.3%) and depression (5.4% vs. 1.7%) than men. Large variations were noted in gender disparities in the prevalence of anxiety and depression, influenced by age, geographical areas, level of education and household wealth. After adjustment for sociodemographic factors, women were more likely to experience anxiety (adjusted odds ratio (aOR) = 2.18, 95% confidence interval [CI]: 1.96–2.43) and depression (aOR = 3.21, 95% CI: 2.53–4.07). However, no difference was observed in the rates of seeking care for anxiety or depression (aOR = 1.13, 95% CI: 0.91–1.40).
Conclusions
Our findings show a higher point prevalence of mental health issues among women than men, influenced by sociodemographic factors, underscoring the need for gender-focused mental health interventions in Nepal and globally.
We show that the exposure to war-related violence increases the quantity of children temporarily, with permanent negative consequences for the quality of the current and previous cohorts. Our empirical evidence is based on Nepal, which experienced a 10 year long civil conflict of varying intensity. We exploit that villages affected by the conflict had the same trend in fertility as non-affected villages prior to the onset of conflict and employ a difference-in-differences estimator. We find that women in affected villages increased their fertility during the conflict by 19%, while child height-for-age declined by 10%. Supporting evidence suggests that the temporary fertility increase was the main pathway leading to reduced child height, as opposed to direct impacts of the conflict.
National policies can be used to reveal structural stigma and discrimination in relation to mental health. This review assesses how structural stigma and discrimination are manifested in the policies and legislations of Government of Nepal.
Methods
Scoping review methodology was followed to review policy documents (acts of parliament, legislation, policies, strategies, guidelines and official directives) drafted or amended after 2010.
Results
Eighty-nine policies were identified related to health, social welfare, development and regulations which were relevant to people with psychosocial and mental disabilities or have addressed the mental health agendas. Several critical policy failings and gaps are revealed, such as the use of stigmatizing language (e.g., ‘insane’ or ‘lunatic’), inconsistencies within and between policies, deviation from international protocols defining legal capacity and consent, lack of inclusion of the mental health agenda in larger development policies and lack of cost-effective interventions and identification of financing mechanisms. Provisions for people living with mental health conditions included adequate standard of living; attaining standard mental health; the right to exercise legal capacity, liberty and security; freedom from torture or discrimination; and right to live independently. However, other policies contradicted these rights, such as prohibiting marriage, candidacy for and retention of positions of authority and vulnerability to imprisonment.
Conclusion
Mental health–related structural stigma and discrimination in Nepal can be identified through the use of discriminator language and provisions in the policies. The structural stigma and discrimination may be addressed through revision of the discriminating policies, integrating the mental health agenda into larger national and provincial policies, and streamlining policies to comply with national and international protocols.
This paper describes the development process of a mobile app-based version of the World Health Organization mental health Gap Action Programme Intervention Guide, testing of the app prototypes, and its functionality in the assessment and management of people with mental health conditions in Nepal. Health workers’ perception of feasibility and acceptability of using mobile technology in mental health care was assessed during the inspiration phase (N = 43); the ideation phase involved the creation of prototypes; and prototype testing was conducted over multiple rounds with 15 healthcare providers. The app provides provisional diagnoses and treatment options based on reported symptoms. Participants found the app prototype useful in reminding them of the process of assessment and management of mental disorders. Some challenges were noted, these included a slow app prototype with multiple technical problems, including difficulty in navigating ‘yes’/‘no’ options, and there were challenges reviewing detailed symptoms of a particular disorder using a “more information” icon. The initial feasibility work suggests that if the technical issues are addressed, the e-mhGAP warrants further research to understand if it is a useful method in improving the detection of people with mental health conditions and initiation of evidence-based treatment in primary healthcare facilities.
Jalthal Forest (62.6 km2) is a remnant forest patch of a once continuous, lush and dense area of sal Shorea robusta and mixed deciduous vegetation in eastern lowland Nepal that is now surrounded by a dense human population. The forest is one of the last remnants of suitable habitat for the Critically Endangered yellow-headed tortoise Indotestudo elongata. This study explored the distribution of and conservation threats facing the yellow-headed tortoise in Jalthal Forest through field surveys in 20 community forests and structured interviews with 80 members of 22 community forest user groups and local people during September–November 2021. We surveyed 11.3 km2 of the forest and observed only four individuals of I. elongata, indicating a population density of 0.35/km2. Local people perceived that the species is decreasing mainly because of hunting (42%) and habitat deterioration from incursion of invasive species (30%). Based on the interviews with local people involved in hunting, an annual mean of 6.8 tortoises were killed during 2017–2021. The purposes of hunting were consumption (70%) and ethnomedicinal uses (30%) by the Meche and Sathar communities. Awareness campaigns and networks of communication amongst all stakeholders are required to conserve this species in Jalthal Forest.