A virada ideacional: quando e como ideias importam

O ensaio bibliográfico analisa a literatura que ficou conhecida como virada ideacional. Seu objetivo é, primeiro, resumir as críticas dessa literatura às perspectivas institucionalistas com as quais ela dialoga; segundo, sistematizar suas vantagens teóricas e, por fim, identificar o ferramental metodológico utilizado pelos autores que se filiam a ela. O ensaio baseia-se na análise de uma ampla gama de livros e artigos publicados sobre o assunto nos últimos 20 anos. Por meio dessa revisão bibliográfica, fomos capazes de mostrar como a literatura da virada ideacional permite incluir as ideias nas explicações dos fenômenos políticos. A inclusão das ideias, por sua vez, exige uma postura metodológica pluralista que pode significar avanços importantes para a ciência política

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

Background: 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\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 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\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients