Objective: Historically, patients have fasted before elective surgery to ensure an empty stomach to avoid aspiration. However, fasting-induced biological changes may adversely affect the speed of recovery after surgery. In our randomised control trial, we tested the effect of oral carbohydrate loading on the inflammatory markers in patients undergoing major surgery for advanced stage ovarian cancer. Methods: A double-blinded, single-centre randomised trial was designed to recruit 110 patients with advanced stage epithelial ovarian cancer undergoing either primary surgery, or neoadjuvant chemotherapy prior to debulking surgery (IDS) (reference number: 08/H1306/108). Following informed consent, the patients were randomised into two groups. Group 1 received the carbohydrate drink and group 2 received flavoured water. The volume of fluid in both groups was 800ml the night before the surgery and 400ml two hours before the induction of anaesthesia. We examined the white cell, neutrophil and lymphocyte counts as well as lymphocyte subsets using a flowcytometry approach. Results: Between March 2009 and December 2011, 85 patients were approached, 80 patients were randomised and 75 completed the study. A decision was made to close the trial early, as a change in routine clinical practice meant that patients were admitted on the day of surgery rather than a day before. Analysis of the data revealed that oral carbohydrate loading can positively modulate the white cell counts in patients undergoing primary surgery rather than IDS. Conclusion: In this single-centre study, that failed to recruit the planned number of patients, we found evidence to support that oral carbohydrate intake pre-operatively has some positive influence in enhancing white cell counts in patients with advanced stage ovarian cancer having interval debulking surgery.

In this paper I explore the relationship between Orientalism, empire-building and the development of the social sciences in the US during the long twentieth century. I focus on the construction of a series of academic infrastructures that the sponsors of the social sciences have underwritten to produce knowledge about the Others of empire. I am especially concerned with the role of these academic infrastructures in concealing imperial domination and in Orientalising imperial subjects. I trace the historical development of the infrastructures and explore the dilemmas they create for scholars who seek to critique processes in which they are unavoidably involved.

Objective Historically, patients have fasted before elective surgery to ensure an empty stomach to avoid aspiration. A fasting-induced catabolic state however may adversely influence recovery after surgery. Our study was designed to test the effect of oral carbohydrate loading on clinical parameters in patients undergoing major surgery for advanced-stage ovarian cancer. Methods A double-blinded single-centre randomised trial was designed to recruit 110 patients with advanced-stage epithelial ovarian cancer undergoing either primary surgery, or neoadjuvant chemotherapy prior to debulking surgery. Following written informed consent, the patients were randomised into two groups. Group 1 received the carbohydrate drink (intervention) and group 2 received flavoured water (placebo). The quantity of fluid in both groups was 800ml the night before the surgery and 400ml two hours before the induction of anaesthesia. The primary endpoint of the study was the Length of Hospital Stay (LoHS); the secondary parameters assessed were pain scores, nausea and vomiting scores, bowel function, and postoperative complication rate. Results Between March 2009 and December 2011, 80 patients were randomised and 75 completed the study. A decision was made to close the trial early as a change in routine clinical practice meant that patients were admitted on the day of surgery rather than a day before. Analysis of the data revealed that there were no significant differences between the study groups in terms of LoHS and other clinical parameters. Conclusion In this single-center study, which failed to recruit the planned number of patients, we were unable to demonstrate that oral carbohydrate intake pre-operatively has significant impact on the recovery process or the length of hospitalisation postoperatively. Future studies should examine all aspects of an Enhanced Recovery Program after Surgery as a package as compared to a single element to enhance patient outcome.

What is the state? How is it implicated in the reproduction of relations of domination? Theorists from Marx to Weber, from Durkheim to Gramsci, from Abrams to Foucault have pondered these questions. In The Encrypted State, anthropologist David Nugent sheds new light on these questions by focusing on disorder and delusion, rather than order and rationality. Nugent analyzes mid-century Peru, where the government experienced a crisis of rule. Officials believed that their efforts to govern were being systematically thwarted by an underground political party called APRA that remained largely invisible to the naked eye. APRA’s ability to disrupt official processes of rule produced deep paranoia among officials. They concluded that the party had established a vast subterranean polity of remarkable power and potency, to which virtually everyone secretly belonged. This episode of paranoia and delusion is especially puzzling because immediately prior everyday administration had been entirely normal and routine. In seeking to understand how irrationality and disorder could emerge out of rationality and order, Nugent finds that government projects had always been delusional. During periods of apparent order and rationality, however, officials had disguised their delusion—from themselves and others—by employing a series of bureaucratic and documentary mechanisms. The Encrypted State identifies these mechanisms and shows how they operated. The book also explores when these mechanisms succeeded in creating a facade of order and rationality and when they failed. In the process, the volume advances a radically new way of thinking about the state.

The Conclusion draws out the implications of the analysis for theories of sovereignty and state formation. The focus is on state ritual, bureaucratic and documentary practices that produce the illusion of ordinary, mundane rule, the mechanisms by which the delusional nature of state activity is rendered unremarkable, and the processes that undermine the effectiveness of these mechanisms. Central to the analysis is the notion of sacropolitics, a form of sovereignty that is based not on the management of life (biopolitics) or on the subjugation of life to death (necropolitics) but rather on the animation of life. Sacropolitics seeks to bring to life dead, dying or moribund social formations. It calls upon the entire population to engage in public performances of mass sacrifice, which are intended to help create new life worlds that can redeem poor countries from the profane state into which they have fallen.

This chapter offers an in-depth exploration of the crisis of rule that unfolded in the Chachapoyas region circa 1950. At this time officials came to believe that they were incapable of carrying out even the most basic of government functions. Furthermore, officials came to believe that their efforts to govern the region were being thwarted by APRA, the party they themselves had forced underground. In accounting for the failure of their own efforts to govern, officials attributed to APRA a subterranean party apparatus with all the powers of state that their own regime lacked. Indeed, the political authorities came to view their administration as a pale imitation of a sophisticated, complex state structure located somewhere deeply underground. They could not actually see the subterranean party state to which they attributed such power and influence. As a result, they were left to imagine the contours of their invisible enemy.

This chapter analyzes the efforts of the Pizarro-Rubio casta to implement the central government’s sacropolitically-motivated plans to modernize the Chachapoyas region during the 1920s. The period is an interesting one for scholars of state formation because the developments of the 1920s provide a direct challenge to institutional understandings of the state. According to these views, state formation depends on the ability of central powers to eliminate violence-wielding competitors, who interfere with the monopoly on force the state seeks to establish. The ability of the central government to impose its will in Chachapoyas, however, was contingent not upon the elimination of violence-wielding actors but on their preservation. The fact that the Pizarro-Rubio had succeeded in eliminating all competing elite factions meant that the clients of the ruling casta were able to work together to ensure that government projects proceeded un a timely and efficient manner.

This chapter explores official efforts to understand why state activities that had formerly been ordinary and routine (conscription) become increasingly difficult to carry out. It focuses on the police investigation of clandestine Aprista activities, and what this discovery suggests to the authorities about the existence of an extensive underground network of subversion. The chapter also traces the emergence in official circles of an explanation that resolves official anxieties, even as it displaces responsibility for problems that were of the government’s own making onto phantom forces that were regarded as hyper-real. The less the authorities were able to carry out everyday activities, the more extraordinary were the powers of subversion they attributed to these phantom forces. The most important of these forces was APRA.

This chapter traces the evolution of successive forms of political rule in the northern Peruvian Andes in the middle decades of the twentieth century. It explores the process by which state crisis emerges out of seemingly ordinary, unremarkable political conditions. My findings suggest that the state was in fact in continual crisis, even during periods that appeared normal, but that elaborate processes of masking and dissimulation generally succeeded in concealing this fact. In those rare moments when crisis became visible it therefore seemed inexplicable, exceptional, a deviation from the normal state of affairs. On this basis, I argue that scholars have yet to understand the full extent or significance of the modern state's commitment to producing the appearance of the ordinary—to the role of concealment and misrepresentation in creating a legitimating veneer of rule. I also suggest that viewing what appear to be normal conditions through a lens of crisis can raise new questions about the state and state formation.

In this paper, I draw on Peruvian government responses circa 1950 to the Alianza Popular Revolucionaria Americana, an underground political party, to identify the features of a distinctive, mid-twentieth-century corruption/anti-corruption complex. I also show how this earlier complex differs from its contemporary counterpart. In the neoliberal present, concerns with corruption emerge in a context in which the public domain finds itself at risk from an alarming expansion of private appropriating powers. National governments play a key role in reconfiguring the public/private divide, and thus they are directly implicated in corrupt activities. Around 1950, however, it was just the opposite: the private domain was regarded as being under dire threat from an emergent global public. Furthermore, national governments were at the forefront of efforts to prevent the spread of the corrupt globalizing forces that were said to be gathering at the nation's borders. To draw out the distinctiveness of the mid-century corruption/anti-corruption complex, I focus on the distinctive shadow worlds imagined into being around 1950 as government officials sought to protect the nation from corruption. I also explore the peculiar state optic that emerged at mid-century, which mediated government efforts to see the shadow worlds that officials regarded as such a profound danger.

A Segunda Guerra Mundial marca um importante, mas pouco reconhecido divisor de águas na história das ciências sociais nos Estados Unidos. Durante a guerra, oficiais do exército e professores universitários em todo o país envolveram-se numa série de relações sem precedentes que transformaram a maneira de conceber e gerenciar o mundo e que vigeu durante décadas. Essa colaboração resultou na primeira implementação abrangente do esquema para os estudos de área. Foram as exigências militares - o desejo de impor controle e estabilidade em extensos territórios que eram “liberados” pelo Eixo - que levaram os militares a procurar especialistas na academia. Juntos, os planificadores militares e os cientistas sociais, desenvolveram um esquema conceituai inteiramente novo que facilitou a administração direta dos povos que viviam em regiões dispersas e devastadas pela guerra. Ao final do conflito, esse novo esquema de estudos de área havia sido empregado pelas Forças Armadas em seu esforço de disciplinar e administrar as vidas de mais de 300 milhões de pessoas em todo o mundo, ou seja, mais de 10% da população mundial. Depois da guerra, os estudos de área tomaram-se o paradigma dominante nas ciências sociais estadunidenses.