The Development of Public Opinion in Bengal 1818-1835.

This thesis is a study of the ideas which constituted public opinion in Bengal, the influences which shaped them and the effect of those ideas on Government policy. There were three distinct types of reaction to the Western impact: (i) The conservative Hindus who were anxious for practical reasons to promote English education, but were afraid of Western ideas. Their tendency was to resist Western ideas by adopting Western techniques, (ii) The reformist Hindus had imbibed the liberal ideas of the age and sought to reinterpret but not reject Hinduism, (iii) The radicals rejected Hinduism in the light of rationalist criticism. The growth of the Press helped the development of public opinion. The English Press influenced the growth of the vernacular Press. By 1835 the Bengal Press reflected the opinion of the different sections of the people. The Government policy towards the Press was not consistent. The Government's attitude of avoiding serious conflict with Indian public opinion was apparent in its social policy. It modified its policy of resuming rent-free lands with defective titles, a policy which had produced serious discontent among the zamindars. It was only when a fairly strong opinion against sati was created in Bengal, that the Government decided to act. But it needed a man of Bentinck's stature to effect the abolition of this custom. As a result of strong Indian protest, the Government also abolished the discriminatory clauses of the Indian Jury Act of 1826. The growing though predominantly Hindu demand for English education and the influence of the 'Anglicists' led the Government to change its education policy which had been to promote, traditional Indian learning. But 'Anglicism' could not go very far, Muslim fears and protest influenced the Government decision. The sources on which this thesis is based consist of unpublished and published materials - official documents and private papers, books and tracts, newspapers and periodical journals, in both English and Bengali. In using these materials emphasis has been placed on contemporary or near-contemporary sources

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status