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Biomedical subjects

L Finnegan

Publications and source records attributed to L Finnegan.

15 recordsLinked to original sources

Prevention and treatment issues for pregnant cocaine-dependent women and their infants.

The increase in cocaine use among pregnant women has created significant challenges for treatment providers. Drug dependent women tend to neglect general health and prenatal care. Perinatal management is often difficult due to medical, obstetrical, and psychiatric complications. Research has demonstrated that comprehensive care, including high risk obstetrical care, psychosocial services, and addiction treatment can reduce complications associated with perinatal substance abuse. Research investigating the effectiveness of residential and outpatient treatment for pregnant cocaine-dependent women also suggests that many biopsychosocial characteristics and issues influence treatment outcomes. Homelessness and psychiatric illness require a more intensive level of care, and abstinence is difficult to maintain for many women in outpatient treatment as they continue to live in drug-using environments. To optimize the benefit of comprehensive services, services should be provided within a multilevel model of substance abuse treatment including long- and short-term residential, intensive outpatient, and outpatient settings.

Clinical Protocols↗

Opioid dependence during pregnancy. Effects and management.

This article describes the complex problems associated with opioid dependence during pregnancy. Medical, obstetric, and psychosocial problems are presented. Methadone maintenance for the treatment of opioid dependence is described in this article. Specific issues of appropriate methadone dose during pregnancy, medical withdrawal, and the relationship of methadone dose and the severity of neonatal abstinence also are discussed.

Delivery, Obstetric↗

An epidemiological approach to community assessment.

An epidemiological approach to community assessment is useful for students and practicing nurses. Shamansky and Pesznecker's definition of community is applied to the community assessment process in order to provide an organized framework for data collection, data analysis, and community diagnosis. We applied the framework to an actual community in a case study format.

Community Health Nursing↗

Small-area census data services by microcomputer: applications of REDATAM system in Latin America.

The authors describe a data retrieval system called REDATAM, Retrieval of Data for Small Area by Microcomputer. "The interactive REDATAM system, in English and Spanish versions, was created to solve the problem of providing small-area population and housing information by using an IBM or fully compatible microcomputer to store the microdata of an entire census on a hard disk (or laser disks for larger countries) and to permit any tabulation to be produced rapidly for any area down to city blocks or smaller....REDATAM may play an important role in the 1990 censuses in the Latin American and Caribbean countries since the system will permit the provision of timely small-area services (and at the national level in the Caribbean countries) before, as well as after, the regular data processing and publication of results are ready."

Americas↗

Pregnancy in a drug-abusing population.

Substance abuse in pregnancy places both mother and infant at extremely high risk. There is little information, however, about the impact of changing patterns of drug use and improvements in medical technology on pregnancy outcome. The Family Center Program utilizes a team approach to provide counseling, support, and education as well as complete medical care for substance-abusing pregnant women. We reviewed the records of women seen in the Family Center Program from 1981 to 1983 to evaluate the effect of intervention on pregnancy outcome. Complications, including prematurity, growth retardation, intrauterine fetal demise, and neonatal abstinence, were common, although early prenatal care and frequent visits appear to reduce the risk of low birth weight infants. Uncorrected perinatal mortality was 11/163 (67/1,000). Compared to earlier experience in this program, few women delivered with no prenatal care. Thus a program designed specifically for the needs of these women is successful in increasing the number seeking prenatal care and appears to improve pregnancy outcome. Despite this, serious problems are common and further improvement seems unlikely unless such women can be maintained in a stable, drug-free environment during their pregnancies.

Adult↗

Developmental interventions in infancy during lengthy hospitalizations.

A review of concepts related to infant development, care, and stimulation is presented. A description is provided of the development of an infant with small bowel syndrome during her hospitalization from birth until age 19 months. Interventions which facilitated feeding, sitting, walking, fine motor and language development are described. In addition, interventions are reviewed which focus on enhancing the infant's attachment to her cartakers, object permanence, and object constancy, and helping the normal unfolding of the individuation process. Efforts to "normalize" the hospital environment for the infant are stressed. The implications of the infant's hospitalizations and her future psychological development are discussed.

Anxiety↗

Acute pneumonia in the newborn: changing picture.

Pneumonia is one of the most serious infections in the neonate and is responsible for a large percentage of neonatal mortality. Pneumonia in a premature or term infant who is debilitated by an underlying problem such as hyaline membrane disease carries an extremely high morbidity and mortality. Since most of the bacterial pneumonias are treatable, early recognition and diagnosis and vigorous treatment are essential. X-ray findings, though helpful, serve only as a guideline. Prognosis is adversely affected if pneumonia results in generalized sepsis, leading to meningitis, disseminated intravascular coagulation, and osteomyelitis. Prompt antibiotic treatment should be begun before the etiologic agent or drug susceptibility is known.

Acute Disease↗

Cocaine abuse in pregnancy: effects on the fetus and newborn.

The outcome of infants born to cocaine-using drug dependent women was compared to that of infants of non-cocaine using drug dependent and non-drug dependent women. The study population included 150 pregnant women: 50 women used heroin and methadone plus cocaine, 50 used heroin and methadone minus cocaine, and 50 were non-drug dependent women. Significant differences were found between the cocaine and drug-free groups in infant birth weight, length, head circumference and Apgar scores, with the cocaine group having lower values for each variable. Average gestational age did not vary between the 3 groups. The cocaine group included 1 spontaneous abortion and 4 fetal deaths; non-cocaine drug dependent women had 2 fetal deaths, with none in the control group. Mean abstinence scores for 19 of the physiological and behavioral parameters were lower in the cocaine group than in the non-cocaine drug dependent women with the exception of vomiting and convulsions. These data suggest that: (1) infants born to drug dependent women have a poorer general outcome than those born to non-drug dependent women; (2) maternal cocaine use does not appear to increase the incidence of severe neonatal abstinence symptomatology; (3) pregnancies complicated by cocaine abuse have a greater chance for fetal loss resulting from both spontaneous abortions and fetal death; (4) infants born to cocaine abusing women had infants with decreased birth weight, head circumference, length and Apgar scores.

Cocaine↗