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John,
Congratulations on having the insight and drive to develop an affordable and studied product to assist the next generations through our country’s opiate epidemic.

As a Family Physician with an interest in rural issues, I would like to impress upon you the additional value that Prapela’s SVS system may provide in rural communities.

As you likely are aware, the opiate crisis has a geographical component to it. Good documentation of this can be seen in the 2016 JAMA Pediatrics article by Villapiano et al. In their article, the authors reviewed national data and found that pre-natal maternal opiate use in rural counties (recorded at time of delivery) occurred at a much greater rate, 8 cases per 1,000 as opposed to 4.8 per 1,000 childbirth hospitalizations in urban counties. So while rural infants accounted for “only” 21 percent of all infants with NAS, the burden of treating these infants in rural communities is disproportionately higher than in urban settings (2012 data).

While great progress has been made in making Neonatal Intensive Care Unit (NICU) treatment available across the United States, the logistics and costs of delivering this high level of care make it unobtainable in many rural communities, due in part to the generally lower economic status of rural areas.

Prapela’s “Next-Gen Baby Box” has the opportunity to provide a cost effective, non-pharmaceutical, widely available, research supported method of helping not only the newborn’s physiology but the family’s stability and success by helping to promote good quality sleep.

Some of our youngest patients & their families are sure to benefit from your efforts.

Best of luck with continued development!

Respectfully, Karl Kuzis MD PhD

Journal Reference:
Nicole L. G. Villapiano, Tyler N. A. Winkelman, Katy B. Kozhimannil, Matthew M. Davis, Stephen W. Patrick. Rural and Urban Differences in Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004 to 2013. JAMA Pediatrics, 2016; DOI: 10.1001/jamapediatrics.2016.3750