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Biomedical subjects

D R Neuspiel

Publications and source records attributed to D R Neuspiel.

24 records · Page 2Linked to original sources

Pediatric health rationing. Recent trends and lessons from history.

Recent health care rationing proposals are related to shifting economic and political priorities. Pediatric implications of these proposals include restrictive policies toward premature and congenitally malformed newborns. Historical experience of similar developments suggests that early warning signals of such measures should be heeded to avoid major public health consequences. In the best interests of society-at-large, health care rationing should be rejected.

Abnormalities, Multiple↗

Maternal cocaine use and infant behavior.

We hypothesized that prenatal cocaine exposure results in less optimal infant behavior and more impaired maternal-infant interaction in healthy term infants. Infants were evaluated with the Neonatal Behavioral Assessment Scale (NBAS) at days 1-3 and 11-30 of age, and mother-infant pairs with the Nursing Child Assessment of Feeding Scale (NCAFS) at 7-16 weeks of age. Drug use was determined from confidential interviews, urine assays and medical records. Cocaine-exposed infants (N = 51) were no different than unexposed comparison infants (N = 60) on the first NBAS exam. On the second NBAS exam, 20 cocaine-exposed infants had slightly lower motor cluster scores compared with those of 32 unexposed infants (p = 0.01), but this difference was reduced after control for several confounding variables. The NCAFS detected no differences between groups in maternal or infant behavior. Infants in this population showed no clinically meaningful effects of cocaine exposure on behavior or maternal-infant interaction.

Behavior↗

Racism and perinatal addiction.

Recent publicity and policy have targeted drug use by non-white women, particularly during pregnancy and parenthood. This emphasis on women of color is discordant with the population demographics of substance use and addiction, although morbidity and mortality related to drugs is often greater among nonwhites. Women with addictive disorders that are exacerbated by their social environments are blamed for their behavior. Meanwhile, drug treatment and primary health care services for these women are woefully inadequate. Among newborns testing positive for cocaine, those with black mothers are more likely to be discharged to non-maternal care, which may perpetuate family disruption. There are multiple reasons for true and perceived ethnic differences in substance use, addiction, and related social and medical harm. Such harm may be worsened by the racism inherent in U.S. drug policy. The scapegoating of non-white drug-using women and the paucity of treatment for them may be related to political and economic imperatives of society in maintaining and pacifying exploited groups.

Black or African American↗