Interview with Dr. Belton Fleisher (Executive Editor, China Economic Review)

Belton Fleisher serves as the Executive Editor for China Economic Review. His research has focused on China’s economy since 1990, and he has authored and co-authored over 40 articles in professional journals. One of his books, “Labor Economics: Theory and Evidence” (1970) is considered by many to be the first modern labor economics textbook. He is currently a professor of economics at the Ohio State University (OSU), where he has been working on faculty since 1965. Dr. Fleisher received his PhD in economics from Stanford University (1961), and has worked at the University of Chicago, the London School of Economics, and Renmin University of China in Beijing, as well as OSU. He is also a Senior Fellow and Special Term Professor of the China Center for Human Capital and Labor Market Research at the Central University of Finance and Economics in Beijing. Belton Fleisher 担任《中国经济评论》的执行主编。自1990年以来，他的研究主要集中在中国经济领域，并且撰写和合作撰写了40余篇专业期刊文章。他编著的《劳动经济学：理论与实证》（1970）一书是公认的第一部现代劳动经济学教程。他从1965年起在俄亥俄州立大学（Ohio State University）担任教职，目前是该大学的经济学教授。 Fleisher教授1961年在斯坦福大学获得经济学博士，并且曾经在芝加哥大学、伦敦经济学院、中国人民大学（北京）以及俄亥俄州立大学任职。此外，他还是中央财经大学中国人力资本与劳力经济研究中心（北京）的资深研究员和特聘教授

UNDERSTANDING INFANT AND YOUNG CHILD FEEDING CHALLENGES IN CHINA

This paper reviews infant feeding challenges China faces in the current economic and social climate. Infant and young childhood is a critical period of growth and development and losses due to under-nutrition are often irreversible. In urban areas, there has been a rapid increase in childhood obesity since the market reform policies of the early 1980’s, with interventions focusing on school-aged children or young adults. Under-nutrition continues to be widespread in many rural areas of China, and while improvements have taken place, most efforts are focused on school-aged children. In both under- and over-nutrition, little attention has been paid to the role infant feeding plays. Through observations and interviews with healthcare workers, mother’s groups and rural-urban migrant women in Shanghai and Yunnan, we attempt to deconstruct social and economic determinants of infant and young child feeding practices in order to illuminate specific barriers and possible solutions. Infant feeding decisions, particularly those regarding breastfeeding, are closely linked to cultural, economic and social values. Education, a crucial component of improving nutritional outcomes, does not alone change infant feeding behavior. Rural-to-urban migration, re-negotiation of family roles, and media as the main source of nutrition information for households each pose unique barriers to providing infant and young children with proper nutrition. Infant feeding and nutrition programs should take a multi-pronged approach that includes education, awareness, and policy. 摘要： 本文讨论在当前经济和社会环境下，中国所面临的婴儿喂养问题。婴儿和幼儿期是生长发育的关键期，在此阶段由于营养不足而造成的不利影响常常是无法弥补的。在中国很多农村地区，营养不足仍然相当普遍，虽然相应的改进措施已经实施，但是大多数只关注于学龄期儿童。在城市中，自80年代市场改革开放以来，儿童肥胖迅速增长，而相应的干预措施也只关注于学龄期儿童及青少年。无论是营养不足还是营养过剩，都没有注意到婴儿喂养在其中所起的作用。教育，虽然是改善营养状况的关键因素，但是单靠教育难以改变婴儿喂养习惯。从农村到城市的移居，家庭成员角色的重新定位，以及家庭营养信息主要来自于媒体等，各自从不同方面对婴幼儿获得适宜营养发挥着独特的作用。因此，婴儿喂养和营养计划应该多管齐下，包括教育、宣传、政策制定等

Three-Year Follow-Up of Participants from a Self-Weighing Randomized Controlled Trial

Frequent self-weighing is associated with weight loss maintenance. Several years ago, we investigated frequent self-weighing’s effect on weight loss and found the participants lost a significant amount of weight. Three years after this trial's end, participants were contacted for an update on their weight and self-weighing frequency. Weight change and self-weighing frequency since the end of the study were assessed. We hypothesized that participants who maintained frequent self-weighing behavior would have maintained their weight loss. Out of 98 participants enrolled in the RCT, 37% (n = 36) participated in this follow-up study. Total weight loss during the trial for the follow-up participants was 12.7 ± 19.4 lbs (p<0.001). Three years after intervention, participants regained 0.9 ± 4.34 lbs, a value that was not statistically different from zero (p=0.75). This did not differ by gender (p=0.655). Over 75% of these participants continued to weigh themselves at least once a week. Frequent self-weighing may be an effective, low-cost strategy for weight loss maintenance. Future research should further investigate the role of self-weighing in long-term weight gain prevention

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

Background Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. Methods This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. Results Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. Conclusions After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies

Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.

AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. RESULTS: This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients. CONCLUSIONS: In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P &lt; 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P &lt; 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease