Maternal and Child Health
Section Newsletter
Fall 2004

From the Chair

This is the last newsletter before the Annual Meeting and therfore my last column. I hope to see many of you in Washington, D.C. As some of you may know, I am running for a seat on the APHA Executive Board and would very much appreciate your support and assistance in my campaign. Because of this,
Jan Weingrad Smith (MCH Section Chair-Elect) may be running some of the Section meetings as I will be needing to make the rounds of the other sections to meet with them. She and I are working closely and she will be focused on continuing the efforts to build an advocacy agenda for the MCH Section.

The MCH program for the meetings is very strong as we had a significant increase in the number of high quality abstract submissions. In addition, there will be an invited session for the Martha May Eliot Forum on childhood obesity that will include former Surgeon General Louis Sullivan. It should be an excellent presentation and session. I hope that many of you will be there.

As this will be my last meeting as Section Chair, I want to thank everyone for making this more fun than work and for the energy and passion all of you bring to the section and to the issues and agendas of the MCH network around the country. It has been my great pleasure to work with you as the Chair and look forward to the future activities of the section.

MCH Section Session Schedule

Saturday, Nov. 6

10:00 – 11:30 - Business Meetings

103 Governing Council

noon – 1:30 – Business Meetings

108 Governing Council

2:00 p.m. – 3:30 p.m. - Business Meetings

115 Genetics Committee

4:00 p.m. – 5:30 p.m. - Business Meetings

118 MCH Journal Editorial Board

6:00 p.m. – 7:30 p.m. - Business Meetings

120 Community and Family Violence Committee

Sunday, Nov. 7

10:00 a.m. – 11:30 - Business Meetings

216 Association of Teachers of Maternal and Child Health Executive Committee
Improving Pregnancy Outcome Committee


2:00 – 3:30 p.m. - Business Meetings

230 Adolescent Health Committee
231 Breastfeeding Committee
231.1 Association of Teachers of Maternal and Child Health

4:00 – 5:30 p.m. - Business Meetings

264 Infant Mortality and SIDS and Child Health Committees
265 Breastfeeding Committee
267.1 Association of Teachers of Maternal and Child Health
266 Membership Committee
267 Data and Epidemiology

6:00 – 9:00 p.m. - Business Meetings

290 MCH Section Business Meeting

Monday, Nov. 8

6:30 – 8:00 a.m. - Business Meetings

308 MCH Section Leadership Meeting

8:30 – 10:00 a.m. – Oral Sessions

3057 War as an Environmental Hazard for Women and Children
3058 Using Data to Evaluate Risk of Violence Toward Mothers and Children in Target Populations
3059 Adolescent Nutrition, Obesity and Physical Activity
3060 Women’s Health: Women and Their Environments – Work, Home and Community

10:30 – noon – Oral Sessions

3133 Child and Adolescent Epidemiology
3134 The Role of Families and Providers in Identifying and Managing Children With Asthma
3135 State and National Issues in Genetics
3136 Preterm Birth, SIDS and Infant Mortality: From Research to Action

12:30 – 2:00 p.m. – Poster Sessions

3204 Barriers to Care and Evidenced Based Research in Maternity Health Services
3205 Improving Pregnancy Outcomes Posters: Assessing Risk Factors, Enhancing Protective Factors
3206 Topics in Maternal and Child Health


2:30 – 4:00 p.m. – Oral Sessions

3277 Breastfeeding and Infant Nutrition: Evidence-based Clinical Care, Innovative Programs, Policy Implementation, and Research
3278 Systems of Care for Children with Special Health Care Needs: Ensuring Quality and Access
3279 Policy and Financing of Women’s and Children’s Health
3280 Delving into the Black Box: New Perspectives on Race/Ethnicity and Birth Outcomes

2:30 – 4:00 p.m. – Roundtable

3280.1 Systems to Improve Maternal and Child Health

4:30 – 6:00 p.m. – Oral Session

3346 Evidence Based Childbirth: Does Data Make a Difference in the Medical Delivery Business?

6:30 – 8:00 p.m. – Business Meetings

350 Innovations in Maternity Care Committee
351 International Committee

8:30 – 10:00 p.m. - Oral Session

3380 Data Analysis to Improve Maternal and Child Health

Tuesday, Nov. 9

6:30 – 8:00 a.m. – Business Meeting

403 Child Care Committee

8:30 – 10:00 a.m. – Oral Sessions

4051 International Maternal and Child Health: Reducing Environmental and Social Hazards
4052 Enhancing Interactions In A Home Visiting Environment: Lessons From Evidence-Based Practice
4053 Using Data for MCH Planning and Evaluation
4054 The Third Annual Outstanding Student Papers in Maternal and Child Health

8:30 – 10:00 a.m – Technology Theater

4020 Multi Media as a Tool to Educate Professionals and the Community about Maternal and Child Health Issues


12:30 – 2:00 p.m. – Social/Business Meeting

420 The Martha May Eliot Luncheon

2:30 – 4:00 p.m. - Oral Session

4220 The Martha May Eliot Invited Session: Obesity in the African American Community – the Problem, the Science, the Response and the Policy Needs

4:30 – 6:00 p.m. – Poster Sessions

4290 Infant and Child Health Poster Session
4291 Student Papers in Child and Family Health
4292 Student Papers on Birth Outcomes for Infants and Women
4293 Substance Abuse, Mental Health and Risky Behaviors
4294 Provider and Family Interaction to Improve Child Health
4295 Coordinated Care for Children with Special Health Care Needs: State and Local Efforts

Wednesday, Nov. 10

8:30 – 10:00 a.m. – Poster Sessions

5054 Family Violence and Injury Prevention
5055 Strategies for Encouraging Mothers of Diverse Backgrounds to Initiate and Continue Breastfeeding
5056 Adolescent Sexual Behavior, Teen Pregnancy and Motherhood
5057 Topics in MCH Data and Epidemiology

10:30 – noon – Oral Sessions

5058 Healthy Childcare America: Building Child Care Health Consultant Networks and Supporting Social-Emotional Development of Children in Child Care Settings
5059 Youth Violence and Aggressive Behaviors

12:30 – 2:00 p.m. – Oral Sessions

5121 Determinants of Maternal and Infant Health: Interventions to Improve Outcomes
5122 The Prognosis for Poor birth Outcomes: What Makes the Difference
5123 The Future Research Agenda for Maternal and Child Health

2:30 – 4:00 p.m. – Oral Sessions

5175 Understanding Adolescents and Their Health Needs
5176 Community Response to Improving Maternal and Child Health

MCH Section Sponsored Sessions at the Annual Meeting

MARK YOUR CALENDARS

The MCH Section is sponsoring two invited sessions in addition to the many contributed and poster sessions. A special thanks to Judy Lewis and Dorothy Browne who arranged these sessions.

War as an Environmental Hazard for Women and Children
Monday, Nov. 8, 2004: 8:30-10:00 a.m.


Civil conflicts and wars are both intermittent and chronic in various regions of the world, creating an environment with negative consequences for all affected people but especially women and children. In countries such as Sri Lanka and Sudan, where civil wars have lasted for 20-30 years, the impact on families and communities has been profound. World attention has primarily focused on immediate relief issues and the social and political aspects of war. The health needs of refugees and internally displaced people are beginning to attract concern, creating a focus on the long-term health effects on infrastructure, human development, human rights and long-term reconstruction. A number of studies have also confirmed the impact of war on maternal and child health including indirect mortality and morbidity from infectious diseases, trauma, and loss of sanitation and health care services. This session will look at current conflicts, with an emphasis on services and development principles. This invited session will address recent developments and experiences using data from UN and NGO sources, such as Physicians for Human Rights and the International Centre for Migration and Health. Program interventions addressing gender-based violence, provision of reproductive health services, and rehabilitation of children will be discussed.

Martha May Eliot Session: Obesity in the African American Community -- the Problem, the Science, the Response and the Policy Needs
Tuesday, Nov. 9, 2004: 2:30 p.m.-4:00 p.m.


The prevalence of overweight and obese individuals is at epidemic levels in the United States, and this epidemic is particularly high among African Americans. Obesity is of particular concern in the maternal and child health population since it has been linked to prenatal complications, infant mortality and morbidity, and serious pediatric physical and emotional problems. In addition, pediatric obesity has been directly linked with early onset of chronic illnesses such as hypertension and diabetes in adulthood. Environment, especially cultural and ethnic practices, plays an important role in the development of obesity. The purpose of this session will be to identify trends in obesity for the African American maternal and child health community. This forum will feature former Surgeon General David Satcher as well as other experts in the field who will present research and discuss policy options related to this important issue.

MCH helps create a new Caucus on Family Violence Prevention

Family violence is a public health issue, but professionals work separately. The MCH Violence Prevention Committee began a process that joins MCH with members of Injury Control and Emergency Health Services Section and other Sections, SPIGs and Caucuses. The goal is a new APHA Caucus addressing family violence prevention and intervention.

The MCH Section is a natural resource for issues addressing families with a unique role for topics including perinatal violence. The Section on Injury Control and Emergency Health Services is a major player addressing violence. Other Sections, SPIGs and Caucuses add their particular resources on domestic violence, child abuse and elder abuse. Several professionals said they will join or renew APHA membership to be part of this Caucus. Most will continue in home Sections adding resources as we work together.

APHA members who want to join should send an e-mail to Michael Durfee, MD, co-chair of the MCH Violence Prevention Committee, at <michaeld55@aol.com>. Identify yourself as an APHA member and state that you want to be part of this new Caucus on Family Violence Prevention. Include your name, title, address and phone. We will meet by e-mail and file papers to be an official Caucus.

Michael Durfee, MD
ICAN National Center for Child Fatality Review, Los Angeles
210 Starlight Crest, La Canada, California 91011
W (626) 455-4585 Cell (818) 388-2052
Michaeld55@aol.com

Martha May Eliot Award Winner Selected

Charles Samuel Mahan, MD, has been named winner of APHA's 2004 Martha May Eliot Award, which honors exceptional achievements in the field of maternal and child health.

Mahan, who is director of maternal and child health policy for the Florida-based Lawton and Rhea Chiles Center for Healthy Mothers and Babies, has been described by his colleagues as one of the most distinguished pioneers and current experts in the field of maternal and child health. He is a full professor in the University of South Florida College of Medicine's Department of Obstetrics and Gynecology, a member of the university's Graduate School faculty and a courtesy clinical professor for the University of Florida College of Medicine. He also served as dean of the University of South Florida's School of Public Health from 1995–2002.

Mahan's illustrious career spans four decades, beginning with a fellowship in endocrinology at Chicago's Cook County Hospital in 1964. While there, he developed his first interest in maternal and child health from a public health perspective, especially in pregnancy prevention.

Mahan was instrumental in developing Minnesota's first so-called "red door clinics," designed to reduce the stigma of venereal disease and offer services to populations that previously had no access to care.

He arrived in Gainesville, Fla., in 1974 to work at the University of Florida's Shands Hospital. Mahan took a year sabbatical in 1982 to write the Florida state infant mortality plan. The plan led to the development of Florida Healthy Start in 1991. He served as Florida's maternal and child health director from 1982­-1987 and state health director from 1988-­1995.

Mahan is involved in state and national policy development and currently is working with the American College of Nurse Midwives to make midwifery the standard of care for Medicaid and to make doulas, or trained labor support people, available for Medicaid births.

Congratulations to Dr. Mahan!

MCH Section Young Professional Awardee Selected

This year's Young Professional Awardee is Michael C. Lu, MD, MS, MPH -- an assistant professor of obstetrics and gynecology at the UCLA School of Medicine. He holds a joint faculty appointment in the Department of Community Health Sciences at the UCLA School of Public Health. Lu is the director of the OB/GYN residency training program at UCLA. He is also the associate director of the UCLA Child and Family Health Leadership Training Program, which provides training in maternal and child health for health professionals through a grant funded by the Maternal and Child Health Bureau. He also serves as the medical director of the UCLA OB/GYN Clinic and the UCLA Sexual and Reproductive Health Program, where he provides oversight of the clinical, teaching and research programs. Congratulations to Dr. Lu!

MCH Section 2004 Student Fellows

Congratulations to the 2004 MCH Section Student Fellows!

Cynthia Childs -- University of Rochester
Amy Beth Cornbleet -- University of Illinois, Chicago
Deborah Dee -- UNC Chapel Hill
Lud Abigail Duchatelier -- Boston University
Emily McDonald Evens -- UNC Chapel Hill
Beth Marshall -- Johns Hopkins University
Italia Rolle -- University of Illinois, Chicago
Patricia Grace Tee -- University of Texas, Houston
Corrine Williams -- Harvard University
Sarah Williamson -- Harvard University

Announcing: "After Birth: Policies for Healthy Women, Families and Workplaces"

What: An exciting one-day conference that will examine the critical issues of women's employment after childbirth, the role of family and medical leave policies and families' division of household labor. Nationally recognized speakers, including Susan Maushart, PhD, author of "The Mask of Motherhood:How Becoming a Mother Changes Everything and Why We Pretend It Doesn't," are included on the agenda.

Who: The conference is designed to bring together university faculty, staff and students, activists, policy makers, health care professionals, employers and community members.

When: Friday, Oct. 1, 2004; 8:00 a.m.-6:00 p.m.

Where: University of Minnesota's Hubert H. Humphrey Institute of Public Affairs, Cowles Auditorium, 301 19th Avenue S., Minneapolis, MN 55455.

Visit <www.hhh.umn.edu/afterbirth/> to learn more and to register online.

UIC MCH Leadership Conference: Translating Research into MCH Public Health Practice

SAVE THE DATE: The 18th annual UIC MCH Leadership Conference Translating Research into MCH Public Health Practice will take place at the Hyatt Lodge in Oak Brook, Ill., May 12-13, 2005. For more information, please visit our Web site at <www.uic.edu/sph/mch/ce/mch_leadership>. Be sure to check out archived Webcast sessions from the 2002-2004 conferences including keynote and plenary talks by Michael Q. Patton, Doug Kirby, David Olds, Bernard Guyer, Deborah Klein Walker, William Sappenfield, David Williams, Richard Cooper, Barbara Ferrer, Peter Van Dyck, Robert Blum, and Jose J. Gorrin-Peralta.

News from ATMCH Fall 2004 Meeting

You are invited to attend the Association of Teachers of Maternal and Child Health Fall 2004 Meeting to be held in conjunction with the APHA Annual Meeting in Washington, D.C. The meeting will be held on Nov. 7, 2004 from 2-5 p.m. in the Washington Convention Center. Please visit the ATMCH Web site at <www.atmch.org> for more information.

ATMCH CE Institute
ATMCH invites you to participate in their second continuing education institute: "Teaching the Maternal and Child Health Competencies" (session 2021.0). This half-day session will feature national leaders in MCH education providing state-of-the art information about how to teach in three key areas in MCH: Management and Communication (Donna Petersen), MCH Ethics (Kay Perrin) and Science Base of MCH (Donna Strobino). The program should be of great interest to graduate students who are interested in careers in teaching MCH as well as junior (and not so junior) faculty who wish to enhance their skills. The institute is part of the APHA 2004 Annual Meeting in Washington, D.C. and will be held from 2:30 - 6:00 p.m. on Sunday, Nov. 7. Please consult the APHA Web site at <http://www.apha.org/meetings/cei_2021.htm> for more information.

ATMCH Sponsored Panel on the Future of MCH Research
ATMCH will sponsor a panel on the Future of MCH Research at the APHA Annual Meeting on Nov. 10, 12:30 - 2:00 p.m. This panel will examine trends in maternal and child health research with a discussion of where such trends may lead in the future. Leading researchers in Women's Health (Stacey Geller & Trude Bennett), Perinatal Health (Michael Lu), Child Health (Bernie Guyer), Children with Special Health Care Needs (Debbie Allen) and Adolescent Health (Clair Brindis) will focus on three issues: (1) What are the major data sets and sources now and likely to be in the future in each of their respective areas? (2) What are the current key issues and challenges facing researchers in each area? (3) What are the future questions that will likely arise for researchers on each topic? A discussant (Milt Kotelchuck) will summarize their comments and consider potential linkages between topic areas. The session will conclude with an open discussion on the future of MCH research. For more information about the session. please visit <http://apha.confex.com/apha/132am/techprogram/session_12887.htm>.

ATMCH Faculty Mentorship Project
ATMCH launched a mentorship program in 2002 to provide an opportunity for new or developing MCH programs located in any institution of higher learning in the United States and its territories to receive assistance in shaping and/or strengthening their programs. This assistance would be received from a senior MCH faculty member who is a member of ATMCH. ATMCH has some funds to support the travel and consultation expenses of one mentor and expects the program receiving the mentoring support to contribute a portion as well. The University of Medicine and Dentistry of New Jersey School of Public Health and the Saint Louis University School of Public Health have received this service in 2002 and 2003. To apply for these funds, interested schools should contact Kalpana Ramiah at <kramiah@asph.org>. The ATMCH executive committee will review all applications to select the mentee institution. In addition, the ATMCH executive committee will then work to find the appropriate mentor for the recipient institution based on the institution's needs as expressed in their application.

March of Dimes Launches New Data Web Site

On August 17, 2004, the March of Dimes officially launched the new PeriStats Web site at <www.marchofdimes.com/peristats>. Developed by the March of Dimes Perinatal Data Center, PeriStats provides free access to maternal and infant health-related data at the national, state, county, and city level, and was developed to ensure that health professionals, researchers, medical librarians, policymakers, students, and the media have easy access to this information. Funding was provided by the National Library of Medicine, National Institutes of Health through a two-year grant collaboration with the New York Academy of Medicine.

Founded on research aimed to understand how different audiences use health-related data, the new PeriStats system was designed to compile vast amounts of maternal and infant health data and make it useful and accessible. Despite the large volume of information, all data is available within two clicks of any Web page. Data are updated throughout the year, and helpful for multiple tasks, including fact-finding, health assessments, grant writing, policy development, lectures and presentations. As part of the grant, the March of Dimes Perinatal Data Center and The New York Academy of Medicine will be incorporating relevant biomedical literature searches that link directly from PeriStats to the National Library of Medicine’s MEDLINE/PubMed biomedical literature database. They will also be providing perinatal data training for health professionals and medical librarians.

Aggregating data from 11 government agencies and organizations, PeriStats provides access to the most current maternal and infant health statistics on topics such as preterm birth, infant mortality, tobacco use, cesarean section rates, and health insurance coverage. Detailed information by race, ethnicity, and maternal age for many indicators is available. To communicate this information, PeriStats produces printer-ready graphs, maps, and tables that can be copied and pasted into reports and presentations. The site also provides functionality enabling you to make comparisons between states, counties, and cities and to the United States. Over 60,000 graphs, maps and tables are available on PeriStats, and data are always referenced to the relevant source and Healthy People 2010 objective.

Future Web site releases will include additional maternal and infant health data from U.S. government agencies and organizations. Updates will be communicated through the PeriStats e-mail newsletter, and sign-up is available on the homepage. To contact the March of Dimes Perinatal Data Center, send an e-mail to <peristats@marchofdimes.com>, or call Michael Davidoff at (914) 997-4549.

Director Appointed at UNC Center for Women's Health and Wellness

Paige Hall Smith has been appointed the new director of the
Center for Women's Health and Wellness at the University of
North Carolina at Greensboro. This relatively new women's health research center focuses on understanding and promoting the health and wellness of all women across the lifespan. The telephone number is (336) 334-4736, and the address is Center for Women's Health and Wellness, PO Box 26170, 430 HHP Building, UNC Greensboro, Greensboro NC 27402.

Adolescent Health Committee

Co-Chairs: Joyce Eatmon, MPA and Lynn Roberts, PhD

Are you concerned about the welfare of today’s youth? Do you have a burning desire to reach out and help those youth who are headed down the wrong path? The Adolescent Health Committee is just the place for you. We in adolescent health promote programs and research with the goal of improving the health status of adolescents. In keeping with the changing needs and concerns of the adolescent population, our current focus is on wellness, risk behaviors (including sexual behavior and substance use), interpersonal violence, intentional and unintentional injury, teen parenting, and school health.

Priorities for the Coming Year
1.Increase membership involvement through:
a.Regular contact with members via Adolescent Health listserv;
b.Posting info on committee to MCH Web Board;
c.Maintaining contact with State Adolescent Health Coordinators Network; and
2.Promoting adolescent health issues, i.e., wellness, risk behaviors, violence, unintentional & intentional injury, teen parenting, school health.

The Adolescent Health Committee is still looking for members and other interested parties to join our listserv. If you are interested in being a part of the listserv, please send an e-mail with your name, organization, address, phone, fax, and e-mail address to Joyce Eatmon at: <jeatmon@healthyarkansas.com>.

We also are looking for volunteers to help in drafting a resolution on the provision of comprehensive sex education for adolescents. If you are interested in helping us draft this resolution, please contact Lynn Roberts by e-mail at: <lroberts@hunter.cuny.edu>.

Annual Meeting Highlights
The Adolescent Health Committee is sponsoring three very informative oral sessions at this year’s Annual Meeting. The first oral session is scheduled for Monday, Nov. 8 from 8:30 a.m.-10:00 a.m., entitled “Adolescent Nutrition, Obesity and Physical Activity.” The presentations in this session will examine physical activity, nutrition and obesity and the factors related to these issues. On Wednesday, Nov. 10 from 8:30 a.m.-10:00 a.m., our second oral session entitled “Youth Violence and Aggressive Behaviors” is scheduled. Issues and factors involved in youth violence and aggressive behaviors will be under investigation. The last oral session is a compendium of issues related to adolescent health. These issues will be presented on Wednesday, Nov. 10 from 2:30 p.m.-4:00 p.m., “Understanding Adolescents and Their Health Needs.”

The Adolescent Health Committee is also sponsoring two poster sessions. The first is on Tuesday, Nov. 9 from 4:30 p.m.-6:00 p.m., entitled "Substance Use, Mental Health and Risky Behaviors." The second poster session is on Wednesday, Nov. 10 from 8:30 a.m.-10:00 a.m., entitled “Adolescent Sexual Behavior, Teen Pregnancy & Motherhood.”

The Adolescent Health Committee Business Meeting will be held Sunday, Nov. 7 from 2:00 p.m.-3:30 p.m. Please plan to join us as we make plans for the coming year, set goal and priorities and finalize plans for the resolution on comprehensive sex education for adolescents. We also will be making plans for the 2005 Annual Meeting in New Orleans.

Innovations in Maternity Health Services Committee

The Innovations in Maternity Health Services scientific session is entitled “Evidence based childbirth: Does data make a difference in the Medical Delivery Business?“ It will be moderated by Kitty Ernst, CNM, MPH, emeritus executive director of the National Association of Childbearing Centers, and the Mary Breckenridge professor at Frontier Nursing Services. The session will address issues such as vaginal birth after Cesarean (VBAC), maternal mortality, and medical delivery business. The session is # 3346.0 and is scheduled for Monday, Nov. 8, at 4:00p.m., at the 132nd Annual Meeting in Washington, D.C.

The Business meeting for the Innovations Committee will be held on Monday, Nov. 8, at 6:30-8:00 p.m. following this scientific session. The location for both the scientific session and business meeting will be announced in the final program.

As this Section newsletter is being prepared for the membership, each committee has just finished preparation for the Annual Meeting. With this momentary pause, there is time to reflect on the “bigger picture” –- what is Maternal and Child Health is really about these days (daze?). The recurrent need to consider the plight of the most vulnerable populations, such as pregnant women and their families in this time of so many conflicting priorities, is challenging for society in general and public health workers in specific.

The importance of well baby care and positive maternity health services can not be set aside. This is the future, and what happens during these formative nine months of maternity can mark an individual’s entire life. These issues, while global and philosophical, permeate the daily activities of public health workers in every community. How does a particular patient/client receive the care and assistance which she needs to provide adequately for her child?

The Innovations in Maternity Health Services Committee has chosen to focus on evidence based practice as an example of improving patient-centered health care. The group continues to address the issues of access to quality care for all pregnant women as the primary goal for all MCH programs. The growing impact of increased malpractice costs in the United States has further limited care to women across the nation.

The mission of the Innovations in Maternity Health Services Committee is to raise the “hard” questions in childbirth: Why are certain procedures done? Is it necessary? Is it mother and child friendly? Does it improve outcomes? At this time, with a continued growth of health care technology, the committee feels that the underlying structure of maternal health care delivery should be evaluated particularly as such development impacts the control which childbearing families have in these decisions.

This year our committee will continue to focus on data issues which affect the Business of Medical Childbirth. Learning how evidence based data can help health professionals improve their clinical decision making is key to this process. Determining what pregnant women want and need; how they make their decision; and where they get information about birth options is a first step in this process.

Yes, there must be answers, and there must be time for such discussions….online, in committee meetings, and at the annual meeting. The members of the MCH section must support each other through these trying times. Together there can be improved access to services and quality of care, which will enhance satisfaction with such services for both for patients and providers.

Carol Nelson
cpmcnel@usit.net

Barbara Levin
BarbL11@aol.com