This article presents empirical evidence on changing rainfall patterns in Kurigram district in northern Bangladesh, on the local people's perception of these changes, and on their decision to migrate, or not, in order to cope with rainfall variability and food insecurity. Our study was conducted as one of eight case studies within the 'Where the Rain Falls' Project. Taking on a social vulnerability perspective, we show that migration from the region is not driven by climatic changes, but rather by the existing livelihood and labour migration systems. First, there is a distinct seasonality and thus rainfall dependency of rural livelihoods, which makes the rural population sensitive to changing rainfall patterns. Second, rainfall variability and food security are closely intertwined. Third, the distinct rhythm in the labour migration system is largely structured by seasonal hunger (Monga) in northern Bangladesh and by the demand for agricultural labourers and informal workers at the respective destinations. Fourth, persisting local patterns of social inequality shape both people's condition of food security and their decision to migrate for work or not. We conclude that, instead of climate change, social inequality and food insecurity as well as structural economic differences are the strongest drivers of migration inside Bangladesh.

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Background:Propofol is one of the widely used intravenous (i.v.) anaesthetics, although pain on injection still remains a considerable concern for the anaesthesiologists. A number of techniques has been tried to minimize propofol-induced pain with variable results. Recently, a 5-HT3 antagonist, ondansetron pre-treatment, has been shown to reduce propofol-induced pain. The aim of our randomized, placebo-controlled, double-blinded study was to determine whether pre-treatment with intravenous granisetron, which is routinely used in our practice for prophylaxis of post-operative nausea and vomiting, would reduce propofol-induced pain.Methods:Eighty-two women, aged 18–50 years, American society of Anaesthesiologist grading (ASA) I–II, scheduled for various surgeries under general anaesthesia were randomly assigned to one of the two groups. One group received 2 mL 0.9% sodium chloride while the other group received 2 mL granisetron (1 mg/mL), and were accompanied by manual venous occlusion for 1 min. Then, 2 mL propofol was injected through the same cannula. Patients were asked by a blinded investigator to score the pain on injection of propofol with a four-point scale: 0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain.Results:Twenty-four patients (60%) complained of pain in the group pre-treated with normal saline as compared with six (15%) in the group pre-treated with granisetron. Pain was reduced significantly in the granisetron group (P<0.05). Severity of pain was also lesser in the granisetron group compared with the placebo group (2.5% vs. 37.5%).Conclusion:We conclude that pre-treatment with granisetron along with venous occlusion for 1 min for prevention of propofol-induced pain was highly successful.

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