State welfare reform policies and maternal and child health services: a national study.

OBJECTIVES: Welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) resulted in dramatic policy changes, including health-related requirements and the administrative separation of cash assistance from Medicaid. We were interested in determining if changes in welfare and health policies had had an impact on state MCH services and programs. METHODS: We conducted a survey in fall 1999 of state MCH Title V directors. Trained interviewers administered the telephone survey over a 3-month period. MCH directors from all 50 states, Washington, DC, and Puerto Rico participated (n = 52; response rate = 100%). RESULTS: Among the most noteworthy findings is that similar proportions of respondents reported that welfare policy changes had either helped (46%) or hindered (42%) the agency's work, with most of the positive impact attributed to increased funding. MCH data linkages with welfare and other social programs were low. Despite welfare reform's emphasis on work, limited services and exemptions were available for mothers with CSHCN. Almost no efforts have been undertaken to specifically address the needs of substance abusers in the context of new welfare policies. CONCLUSIONS: Few MCH agencies have developed programs to address the special needs of women receiving TANF who either have health problems themselves or have children with health problems. Recommendations including increased MCH and family planning funding and improved coordination between TANF and MCH to facilitate linkages and services are put forth in light of reauthorization of PRWORA.

Maternal and child health and health care reform.

Women and children, because of particular characteristics and vulnerabilities, should be afforded special attention in health care reform. Health care reform provides an opportunity to positively affect the maternal and child health (MCH) status. Universal coverage of a comprehensive benefit package must be combined with a strong public health system of population-based services if benefits are to be realized. There must be an accountable public locus of responsibility for promoting MCH, including clear authority and resources for four primary activities: (1) core public health, (2) systems development, (3) coordinated services for children with special health care needs, and (4) access to care.

Inhibition by somatostatin of the proliferation of T-lymphocytes and Molt-4 lymphoblasts.

The proliferation of Molt-4 lymphoblasts and phytohemagglutinin-stimulated human T lymphocytes in vitro was inhibited significantly by 10(-12) to 10(-10) M to 10(-13) to 10(-9) M somatostatin, as assessed by the uptake of [3H]thymidine and [3H]leucine, respectively. The inhibitory effect of somatostatin was not attributable to cytotoxicity and was associated with a mean degradation of 52 and over 95% of immunoreactive somatostatin, respectively, after 3 and 24 hr of incubation at 37 degrees C. The specific suppression of Molt-4 lymphoblasts and T lymphocytes by somatostatin represents a distinct mechanism for the specific regulation of immunological responses by neuropeptides of the peripheral nervous system and gastrointestinal tract.

Epidermal growth factor in the healing of second degree burns: a controlled animal study.

The effects of the topical application of epidermal growth factor (EGF) on the healing of partial-thickness scald burns in rats was evaluated. Time to complete healing, the rate of healing, daily percentage weight change, and cell growth were the measured parameters. We were able to demonstrate an insignificant healing advantage with the topical application of EGF, by itself or in combination with silver sulphadiazine. This insignificant healing advantage does not warrant clinical evaluation.