Comparing the Seed Cotton and Wheat Marketing Chains in Sindh

This paper contrasts the operation of seed cotton and wheat marketing systems in Sindh. Analysis of marketing margins indicates that the private sector cotton marketing chain appears to be working efficiently, given the many adverse aspects of its socioeconomic environment. There is evidence that higher domestic prices resulting from alignment with world markets have been transmitted through the marketing chain to producers, and that production has increased. In contrast to cotton, the government continues to be heavily involved in wheat procurement and storage, with private traders usually acting as intermediaries between the Food Department and the grower. Despite expensive involvement of the same private traders as in cotton, the wheat market is characterised by bureaucratic failure and rent-seeking behaviour, leading to stagnation of incentives and production. For cotton, the primary recommendations are to sustain liberalisation of the market and to support the developing beneficial model of private competition through improvements in communications and transport infrastructure. The practical means to improve the grading of cotton lint and seed cotton should also be developed and promoted to provide incentives for higher quality output. For wheat, the main recommendations are to liberalise farmgate prices, reduce the state’s role in procurement, and privatise government godowns. Research is needed on how this might best be achieved, with attention to the conditions necessary for private financing of storage activities, and to ways of minimising price and supply fluctuations. The impact of higher flour prices on poor consumers also needs to be addressed.

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