O Allow reimbursement for screening for depression, such as for the Edinburgh Postnatal Depression Scale during the prenatal and postpartum period high priority ; o Provide information and training to providers on how to use the depression screening tool medium priority ; o Identify a mechanism to provide mental health screening and treatment to women beyond the current 60 days postpartum eligibility period and work with other agencies, e.g., Illinois Department of Human Services, Division of Mental Health ; to provide mental health services to these women requires further study ; Estimated Cost: The Illinois Department of Human Services, Division of Mental Health, estimates that the first year of the Perinatal Mental Health Consultation Service would cost approximately 2, 000. There would be no additional costs for the Edinburgh Postnatal Depression Scale to be allowed as an acceptable risk assessment during pregnancy as risk assessments during pregnancy are already covered. However, there would be an additional cost to allow reimbursement for the Edinburgh Postnatal Depression Scale during the postpartum period. Based on CY 2002 enrollment of pregnant women, assuming that one-half of the pregnant women receive a postpartum visit, and of those, 20 percent will be screened for depression, the estimated cost is 4, 000. Although it is recognized by IDPA that mental health screening should be universal for these women, it is unlikely that universal screening would initially occur. IDPA will collaborate with the other state agencies, provider groups, the Medicaid Advisory Committee, and other advocate and advisory groups to develop and implement a strategy for provider education in this area. Additionally, IDPA will work with the Illinois Department of Human Services, Division of Mental Health to explore available resources for providing mental health screening to women who are no longer eligible for Medicaid coverage. An appropriation of million was included in the Governor's FY 05 Budget to expand FamilyCare from 90 percent to 133 percent of the federal poverty level. FamilyCare offers health insurance to parents living with their children 18 years old or younger. FamilyCare also covers relatives who are caring for children in place of their parents. This expansion will assist more mothers in having access to health care, including mental health services, beyond the 60 days postpartum period. IDPA will explore the possibility of extending depression screening for up to six months post partum for those women enrolled in FamilyCare. K. S. Zafar, S. H. Inayat-Hussain and D. Ross. School of Pharmacy, University of Colorado Health Science Center, Denver, CO. Dopamine DA ; and its metabolites have been implicated in the pathogenesis of Parkinson's disease. DA has the potential to produce reactive oxygen species and we have previously shown that DA-derived quinones can induce proteasomal inhibition. We therefore examined the ability of dopamine to induce apoptosis and proteasomal inhibition in N27 rat dopaminergic mesencephalic cells. DA-induced toxicity in N27 cells was examined at concentrations from 0-500uM and at times up to 24h. DA-induced apoptosis as assessed by phosphatidylserine exposure and loss of mitochondrial membrane potential MMP ; in N27 cells was detected using flow cytometry employing Annexin V propidium iodide and tetramethylrhodamine ethyl ester respectively. DA treated N27 cells resulted in time and concentration dependent apoptosis. To better define the DA-induced apoptosis, the activation of initiator caspases-2 and caspase-9 and the executioner caspase-3 was investigated. Our results demonstrate that activation of caspase-2, caspase-9 and caspase-3 occurred early after DA treatment and prior to cell death. In addition, pretreatment with the antioxidant N-acetylcysteine NAC ; blocked DA-induced apoptosis and MMP loss. NAC can react with both reactive oxygen and quinoid metabolites and its inhibitory activity suggests a role for reactive species in dopamine induced apoptosis. Proteasomal inhibition could be detected after treatment of N27 cells with dopamine but this was difficult to dissociate from cell death. Increased levels of ubiquitination could be observed in N27 cells after dopamine treatment even at non-toxic concentrations where proteasomal inhibition was not apparent and ubiquitination could be blocked by NAC. Increased levels of ubiquitination might reflect increases in damaged proteins as a result of an increased flux of reactive species. Our results implicate DA-derived reactive species in DA-induced caspase-dependent apoptosis in N27 rat dopaminergic mesencephalic cells. Supported by NIH grant RO1 NS44613.

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The first and second SAH. During this procedure spontaneous respiration was maintained, and both PaCO2 and blood pressure were monitored. The PaCO2 was 35 to 45 Hg, and the mean arterial blood pressure before the induced SAH was 85 to 105 mm Hg in all animals. After the subarachnoid injection, a dramatic increase in systemic blood pressure occurred. Within 5 minutes, however, the blood pressure gradually returned to the preinjection level.

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C. White access to treatment might outweigh the possible drawbacks. and involve entire families in working toward the health maintenance or treatment of its members [30]. If the family is working together on health issues and if PSF representatives are understood as promoters of general health by the community, the potential for stigma associated with house visits is greatly reduced or eliminated.

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