India’s ‘silent contestation’ of the EU’s perspective on local ownership

Local ownership has become a central theme in today’s discourse on peacebuilding, with the EU being very vocal in embracing the norm. On the surface, it thus seems that the EU is supported in its perspective on local ownership by the international community at large. Looking more closely at the discourse surrounding peacebuilding practices, it becomes however apparent, that local ownership remains contested, particularly among emerging countries such as India. The chapter, therefore, sets out to explore why and how India is contesting the EU on local ownership, and how far this impacts the legitimacy of the EU’s norm. Using document analysis on India and the EU’s speeches at the UN, as well as policy documents outlining their peacebuilding strategies, the chapter finds that while India is critical of the content of the norm and the degree of its institutionalization, it chooses more indirect modes of contestation, such as ‘silent contestation’. As a result, the European Union has not been receptive to India’s critique. This is amplified, as the EU has developed its perspective on local ownership among like-minded countries, within the OECD-DAC context and hence relies on internal legitimization of the norm

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients