American social science and the psychology of development in India, 1940s-1960s

With the arrival of independence in 1947, India’s first generation of post-colonial leaders embraced the concept of ‘development’ as a central objective of nation-building and a raison d'être of the post-colonial state. The opportunity of freedom, it was argued, would pave the way for a dramatic process of economic, social and political transformation that would turn India from an impoverished, colonial society into a ‘modern’, prosperous and democratic one. Set against this backdrop, this thesis explores intersections and entanglements between the post-independence pursuit of development and the forms of knowledge produced by post-war American social science. Foregrounding the concept of ‘psychologized development’, the thesis focuses in particular on the ways in which Indian elites – including government officials, intellectuals, industrialists and more – drew on American psychological expertise in the hope of realizing development dreams. With its claims to understand the complex processes that shaped human action (and interaction), I argue, American psychological knowledge promised solutions to the most pressing contemporary problems, from the treatment of ‘communal’ tension to the engagement of rural communities in uplift programmes. Psychology revealed the foundations of effective economic entrepreneurship and the basis of sound industrial leadership. It even explained how new ideas and practices could be ‘diffused’ throughout society. For Indians, psychologized theories of human nature offered knowledge of great utility in the context of plans for rapid societal change. For Americans, they offered tools that would turn India into a model of democratic development in the context of a global Cold War. Using a case study approach, this thesis explores the diverse settings in which Indians and Americans came together to psychologize development. In doing so, it examines both the common themes and the recurring challenges that came with attempts to realize development through social science expertise. The resulting history offers new perspectives not just on the character and complexion of developmentalism in post-colonial India, but also on the forms of cross-border connection that shaped India’s post-1947 transition. The thesis makes novel contributions to a number of historiographical fields, including the history of American social science, the history of Indo-US relations, the history of development and global history.Cambridge Commonwealth, European and International Trus

Evaluating the Influence of Room Illumination on Camera-Based Physiological Measurements for the Assessment of Screen-Based Media

Camera-based solutions can be a convenient means of collecting physiological measurements indicative of psychological responses to stimuli. However, the low illumination playback conditions commonly associated with viewing screen-based media oppose the bright conditions recommended for accurately recording physiological data with a camera. A study was designed to determine the feasibility of obtaining physiological data, for psychological insight, in illumination conditions representative of real world viewing experiences. In this study, a novel method was applied for testing a first-of-its-kind system for measuring both heart rate and facial actions from video footage recorded with a single discretely-placed camera. Results suggest that conditions representative of a bright domestic setting should be maintained when using this technology, despite this being considered a sub-optimal playback condition. Further analyses highlight that even within this bright condition, both the camera-measured facial action and heart rate data contained characteristic errors. In future research, the influence of these performance issues on psychological insights may be mitigated by reducing the temporal resolution of the heart rate measurements and ignoring fast and low-intensity facial movements

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society