Global Expenditure Research Articles

Analysis of energy and macronutrient balance in the postoperative infant

The purpose of this study was to better define the energy and macronutrient balance of infants after major surgery. Forty studies were conducted in 29 full-term surgical infants (mean weight, 3.27 +/- 0.19 kg; mean days postsurgery, 8 +/- 1). Nineteen infants were receiving total parenteral nutrition, 13 were orally fed, and eight received a combination of intravenous and oral nutrition (mean caloric intake, 84 +/- 4 kcal/kg/d). Each study was comprised of a three-day nutritional balance measuring energy intake and energy losses in excreta. Metabolizable energy intake (MEI) was determined by subtracting losses from gross intake. Energy expenditure and macronutrient oxidation were determined on the second day of the balance using continuous open-circuit indirect calorimetry in combination with timed urinary nitrogen excretion. Energy and macronutrient storage were calculated by subtracting oxidation and losses from measured intake. The mean global energy expenditure was 57 +/- 1 kcal/kg/d. Linear regression analysis of the nutritional balance data allowed estimates of energy, fat, and protein storage at various MEI. The data suggest that in the surgical infant, protein balance is maintained, even during hypocaloric nutritional regimens. In infants receiving adequate calories to maintain energy balance, maintenance metabolism is supported by the oxidation of endogenous fat. Net fat deposition will predictably only occur at metabolizable intakes of greater than 71 kcal/kg/d.

The Campaign for Nuclear Disarmament Is Alive and Well and Gaining Members

DESPITE REGULAR REPORTS of its demise, the Campaign for Nuclear Disarmament has entered the eighties alive and well, with a renewed sense of purpose and a growing membership. The time has gone for nostalgia and has come for facing the challenges of today's militarists. With a global annual arms expenditure of more than 420 billion dollars, with nuclear weapon proliferation proceeding apace, with first-strike possibilities on the way, military accidents occurring with increasing regularity, those with positive ideas about ending the arms race are getting a more attentive hearing. Unilateralism, which once produced such convulsive spasms the thinking of eND opposition, now makes simple common sense, especially as two new British contributions to the arms race, the Polaris replacement and American Cruise missiles, seem to be Government policy. The Polaris decision underlines the solid irrationalitv of what passes for serious defence thinking. Those who press for this£S,OOO million enterprise no longer try to explain what the next nuclear generation, let alone the present one, is actually for. Clearly the independently unusable can hardly present a credible independent threat, and certainly it cannot be squared with our obligation in good faith under Article VI of the Non-Proliferation Treaty to reduce our nuclear arsenal. There has been a significant public response to these British escalations, especially to the Cruise missile proposal. Constructive

Forgetfulness and Interest

1. In earlier publications,3 I have tried to show how the quantity theory of money can be formulated operationally by considering two new concepts, the rate of forgetfulness and psychological time. The rate of forgetfulness bears the same relation to the past as the rate of interest does to the future. Psychological time defolnes a transformation of the time reference scale such that the rate of forgetfulness per unit of time is constant. For fifteen different cases studied, confrontation of this theory with available data on the money supply and global expenditure shows that the results are what one would expect if the theory were correct.3 4 The purpose of this study is to show that it is possible to derive the new formulation from simpler and more attractive postulates than those used earlier, following systematic application of the fundamental analogy between interest and forgetfulness,5 6 and that it results from the confrontation of the new theory, in its new