Start your new year with sweet, savory and healthy flavors

There are few better ways to ring in a new year than a decadent brunch with loved ones. These recipes are low in calories, fat and carbohydrates — AND packed full of flavor.

Here’s to a happy, healthy 2020!

Pilot project puts heroic stamp on student immunization numbers

By STACY HALL | LDH Immunization Program Director

Jefferson Parish students had the opportunity to see real heroes in action over four days in December.

Through the combined efforts of the Louisiana Department of Health, Health Heroes with the guidance from the Louisiana Academy of Pediatrics, Jefferson Parish School Board and — most importantly — school nurses and staff, more than 2,500 flu vaccines were administered to students at 79 schools December 9-12. Students received their vaccines in their schools, missing less than 5 minutes of class time.

This pilot program was voluntary, allowing parents and guardians the choice to have their child vaccinated against the flu. Since the vaccines were given at school, parents and guardians didn’t miss any time from work. Also, they didn’t have to worry about any co-pays, meaning no out-of-pocket expenses.

Students were given Flucelvax®, a flu vaccine for anyone ages 4 and older. It is made from inactivated (dead) flu viruses, protects against four strains of influenza and is free of antibiotics, latex, preservatives and eggs.

Thanks to the success of this pilot program in Jefferson Parish, it will be expanded to six more school districts beginning in January 2020.

The vaccination clinics were made possible through a public/private partnership between the Department of Health and Health Heroes, which brings flu immunization clinics to schools. These clinics provide flu vaccines to all consented school children regardless of their health insurance coverage and with no out-of-pocket expense.

Now, more children will be protected against the flu as they prepare to travel or gather with family and friends for the holidays. If your child wasn’t included in this effort to prevent flu, or if you haven’t received your flu shot, now is the time to get vaccinated. It’s your first and best way to reduce your chances of getting the flu and spreading it to others.

Flu shots are available at any parish health unit throughout flu season at no cost to the patient. Local pharmacies, clinics, doctors’ offices and federally qualified (community) health centers also will offer flu shots throughout the season. Check ldh.la.gov/fighttheflu for a flu shot provider near you.

Smart eating is a gift at Christmas and all year round

“It’s the most wonderful time of the year,” crooner Andy Williams famously sang of Christmas. As he further sang, “There’ll be parties for hosting, marshmallows for toasting …”

Was he ever right or what? The holiday season is overflowing with merry gatherings, usually full of delicious things to eat and drink. From cups of cocoa topped with marshmallows, to your mom’s famous pecan pie, to full-scale feasts, there’s something to make everyone’s belly happy.

But – is a happy belly a healthy belly? Shown below are the calories in an average portion of some classic dishes, drinks and desserts. However, instead of all the sweets and high-calorie foods, there are smarter choices you may want to consider at the next gathering you attend. These choices will let you enjoy your meal AND be better for your health!

Here are some tips to treat your taste buds and maintain your weight.

• Don’t skip meals or sleep before a feast, or you’ll be more likely to overeat.
• Choose a small plate of your favorite foods, including a healthy selection of fiber-rich foods like fruits, veggies and whole grains that will help you stay full longer.
• Choose fewer carbohydrates, like potatoes and bread.
• Fill one small plate, then leave the buffet table.
• Eat slowly, taking the time to savor your food. Your brain needs at least 20 minutes to realize your stomach is full.
• If you’re thinking about going back for a second plate, drink some water and wait 10 minutes. Then see if you’re still hungry before going back for more.
• Choose one dessert you really love and then savor a small serving.
• Have your alcoholic drink with food.
• Make time for physical activity such as a game of backyard football, a walk with family or a bicycle ride.

A little preparation and motivation will go a long way toward keeping you healthy and happy during “the most wonderful time of the year.” Happy holidays!

Lady Luck doesn't belong under the Christmas tree

When children rush to the tree or their stockings on Christmas morning, what shouldn't they find among the candies and toys? Lady Luck — in the form of a lottery ticket, scratch-off or other gambling game.

These games of chance are often seen as inexpensive, harmless gifts that give children a fleeting thrill. Most win nothing at all, a few win a little something and even fewer win big. No matter what, the odds of a win are very small potatoes when stacked against the odds of developing a gambling addiction.

“The Impact of Gambling in Louisiana: 2016 Study of Problem Gambling,” released by the LDH Office of Behavioral Health, details the most recent gambling statistics among students in grades 6, 8 10 and 12. In the study, students in 2014 reported playing bingo for money and betting on sports, cards, dice and games of skill.

Among the highest gambling incidences were 20.2% of sixth-graders playing bingo for money, 19.7% of eighth-graders betting on sports and 19.4% of eighth-graders playing bingo for money — or roughly 1 in 5 students participating in some form of gambling.

Studies of adults with gambling problems have shown that the earlier a person begins gambling, the more likely they are to develop a gambling problem, especially when scoring a big win at a young age. An article by Renee St-Pierre and Jeffrey Derevensky noted “disordered gambling among youths is frequently linked with … greater gambling expenditure, academic difficulties, poor or disrupted family relationships, both concurrent and later alcohol and substance abuse problems.”

“This holiday, if you are considering giving a lottery ticket or scratch-off to a child as a gift, be a Scrooge and DON'T give lottery tickets as a gift,” said Kenneth Saucier, program manager with the Office of Behavioral Health. “Scratch-off cards might seem like a cheap, fun and harmless gift, but that's not the case. Any games of chance can increase risk factors for an addiction problem further down the road.”

Louisiana provides problem gambling resources at no cost to residents. For more information on problem gambling or to set up an appointment to address a problem or concern, call the Louisiana Problem Gamblers Helpline at 1-877-770-STOP (7867). The helpline is available 24 hours a day, seven days a week. Help is also available at ldh.la.gov/index.cfm/page/1545 and helpforgambling.org.

Holiday stress, depression and blues

By DR. JAMES E. HUSSEY | Medical Director, LDH Office of Behavioral Health

Holidays are often seen as a time of celebration, family gatherings, gift-giving, joy and other happy moments. But, for some, it is a time of additional stress, anxiety, blues or depression. In one survey conducted by the American Psychological Association, 38% responded that their stress levels increased during holidays (including lack of time, money, commercialism, gift pressures) and 56% responded that they experience most stress at work (only 29% at home).

There may be several reasons why people become more anxious, sad or depressed during the holidays:

• SOCIAL ISOLATION: Those with small social circles or minimal family support due to few or no relatives living close by sometimes begin to feel lonely, unsupported, and left out and isolated. Winter/cold/bad weather also contributes to staying inside.
• GRIEVING: For those gathering with relatives, they may become more aware of those who are no longer part of the gatherings or celebrations due to severe illness or death during the prior year.
• INCREASED WORK DEMANDS: With holidays, vacations, end-of-year deadlines, reports, taxes and other demands, there can be real increases in work demands, leading to stress and anxiety.
• FINANCIAL STRESS: Money issues can become very obvious during holidays. Finding the money to provide gifts for everyone is stressful. Worries about debt or not providing enough for family, kids and others can lead to despair, sadness, depression and anxiety. Maybe as many as 53% of people report this as a source of stress, according to a Principal Financial Group survey.
• SEASONAL AFFECTIVE DISORDER/DEPRESSION (MAJOR DEPRESSION WITH SEASONAL PATTERN): It should be noted that there are depressive episodes that can go beyond the blues, become more sustained, and sometimes occur more frequently during the fall and develop during the winter. Most people stop having these symptoms during the spring and summer, but some may persist. This may have to do with the length of the days being shorter, decreased exposure to light or other factors. For more severe symptoms of depression, treatment should be sought, such as light therapy, talk therapy or medications.
• HEALTH AND WELLNESS: Overeating, weight gain and bloating can be problematic for some.

Dealing with holiday depression

• Talk to your doctor if dealing with depression or sadness for long periods of time, or if it begins to affect your functioning, activities of daily living, appetite or sleep, or if suicidal thoughts come into play.
• There are resource help lines such as the National Suicide Prevention Lifeline (1-800-273-8255), Veterans Crisis Line (1-800-273-8255) and the Crisis Text Line (www.crisistextline.org). For emergencies, call 911.
• Otherwise:
• Make sure you get enough sleep.
• Eat healthy.
• Exercise 30 minutes per day (if tolerated).
• Continue or begin new holiday traditions like family gatherings, outings or vacations instead of staying home.
• Be mindful of holiday pressures.
• Volunteer at soup kitchens, church activities, gift drives, helping elderly neighbors with yard tasks, etc.
• Get back to nature with walks in the woods, parks along a lakeshore, etc.

Contrary to popular belief, suicides do NOT spike during holidays. November, December and January are actually low months for suicide. Peak months may be more like April through August.

Vaping use among Louisiana students triples since 2015

E-cigarette and vaping devices come in an array of sizes and shapes.

By ANGELA VANVECKHOEVEN | Health Education Manager, Well-Ahead Louisiana

A recently released report compiled by Well-Ahead Louisiana and the Louisiana Campaign for Tobacco-Free Living shows that vaping among the state’s middle and high school students has doubled since 2017 and tripled since 2015. 2019 E-Cigarette Use Among Louisiana Youth reveals that 32% of high school students and 15% of middle school students vape, which follows the national trend of increased vaping among youth and youth adults.

These numbers are especially alarming in light of the current outbreak of lung injury (EVALI) associated with e-cigarette use, also known as vaping. The CDC launched an investigation into the outbreak on Aug. 1, and as of Dec. 4 has confirmed 2,291 cases in 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands, with 48 of the patients dying because of the illness. In Louisiana, 32 cases have been confirmed, with two deaths. The median age of victims is 24 nationally and 28 within the state.

As of Nov. 8, the CDC found vitamin E acetate in lung fluid samples from 29 patients from 10 states, the first detection of a potential chemical concern in biologic samples from EVALI patients. Vitamin E acetate usually does not cause harm when ingested as a vitamin supplement or applied to the skin. However, previous research suggests when vitamin E acetate is inhaled, it may interfere with normal lung functioning. Vitamin E acetate is used as an additive in the production of e-cigarettes because it resembles THC (tetrahydrocannabinol) oil, and it’s also used as a thickening ingredient in e-liquids. Click the links to learn more about the national outbreak and the Louisiana cases.

Action steps

Even without the threat of EVALI, vaping can harm a teenager's still-developing brain and negatively affect memory, learning and concentration. To effectively protect young people from all forms of tobacco — including e-cigarettes, cigarettes, cigars, little cigars and hookah — Well-Ahead Louisiana offers the following resources and encourages adults to take action.

• KNOW WHY TEENS VAPE: According to the new report, 45% of middle school students and nearly 37% of high school students said the reason they vape is because a friend or family member does. More than 14% of middle school students and nearly 21% of high school students like that vape products are available in flavors. Nearly 7% of the middle school students and almost 15% of the high school students believe that vaping is less harmful than other tobacco products.
• KNOW THE RISKS AND EDUCATE YOUTH: In addition to harming brain development, nicotine exposure in youth can increase the risk for future addiction to other drugs. Well-Ahead has compiled resources to educate parents, teachers, coaches, etc. about the harmful effects of these products, as well as how to talk to teens about vaping.
• HELP YOUTH QUIT: Youth who vape are four times more likely to go on to smoke cigarettes. Quitting nicotine isn't easy, but it can be done with the right support. Find access to youth cessation resources here.
• IMPLEMENT EFFECTIVE, 100% TOBACCO-FREE SCHOOL POLICIES: Every Louisiana school district is required to have a written 100% tobacco-free school policy that prohibits the use of any tobacco products, including e-cigarettes, on campus and at school-related events for students, staff and visitors. It is important to educate and promote compliance among school staff to support this policy. Visit wellaheadla.com to ensure your school’s policy complies with Louisiana law and to find resources for effective implementation.

The bottom line

Because nicotine and other chemicals in e-cigarettes can be damaging to the development of a teen's brain, yet youth do not see vaping as being harmful, it's important for adults to understand the products youth are using and be prepared to talk about their effects. For more information, visit wellaheadla.com or contact us at wellahead@la.gov.

Vaccines save lives. Period.

By DR. DAWN R. MARCELLE | Region 2 Medical Director, LDH Office of Public Health

Keeping our children safe and healthy rank among the highest of parents’ concerns — and where safety and health meet, the topic of vaccines will often arise. While parents have the right to make decisions about their children’s health, as a pediatrician and a mother of two, I can confidently say without hesitation that overall, vaccines are safe and effective.

Vaccines are the best way to protect your child against a number of illnesses, including measles, whooping cough (pertussis) and mumps, all of which have made a comeback in recent years due to a drop in vaccination rates. Other vaccine-preventable illnesses include tetanus, diphtheria, varicella (chickenpox), rubella, hepatitis B, polio, meningococcal meningitis and influenza, especially now with flu season in full swing across Louisiana.

How they work

A vaccine contains a version of the bacterium or virus responsible for a particular disease. Vaccines can be live (containing a weakened form of the bacterium or virus) or inactivated (containing a killed version of the bacterium or virus).

For example; if you receive a chickenpox vaccine, the presence of the chickenpox virus in the vaccine causes the body to think that it’s under attack. This activates the immune system, which treats the weakened/dead chickenpox virus (antigen) like a full-blown infection and makes antibodies to fight off the disease. These chickenpox antibodies remain in the person’s immune system, ready to provide active protection if you come into future contact with live chickenpox virus.

Immunization schedules

With so many vaccines out there, how is a parent to know which vaccine is needed and when? That’s where immunization schedules are helpful. Developed with your child’s safety in mind, immunization schedules show which vaccines are given at which stages of your child’s life. Following such schedules provides immunity early in life before most infants and children are exposed to life-threatening diseases.

Vaccination schedules are developed by the CDC’s Advisory Committee on Immunization Practices (ACIP). The committee includes physicians and public health practitioners who are dedicated to keeping children safe and healthy. All vaccines listed on immunization schedules have been exhaustively tested to be sure they are safe and effective. Sometimes multiple vaccines will be given at a single pediatric visit, and this is safe and normal. There’s not enough antigens in vaccines to overload a healthy baby’s immune system. In fact, during an average day a baby will encounter more antigens than they will receive in a vaccine.

Some parents, expressing concern about the number of vaccines their children receive from infancy to school age, may wish to follow an alternative schedule that spreads out vaccines or even skips some entirely. This practice is discouraged by the American Academy of Pediatrics, which recommends parents follow established immunization schedules. These schedules are for your child’s protection, and following them gives your child immunity early in life, before they can be exposed to potentially deadly diseases like measles.

Keep in mind that some children can’t be vaccinated, such as those with weakened immune systems due to an illness or medical treatment. The best protection for these children is for everyone around them to be vaccinated — that includes parents, grandparents, siblings, aunts, uncles and any caregivers.

Life savers

As a pediatrician, let me say once again that vaccines are overwhelmingly proven safe and effective. I encourage parents to follow the recommended immunization schedules to give their children the best possible protection against a number of serious diseases.

The American Academy of Pediatrics considers vaccines to be one of the the most significant medical innovations of our time. Considering the countless lives saved thanks to vaccines, I couldn’t agree more.

Helpful links

• View the Centers for Disease Control and Prevention (CDC) immunization schedule: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
• View the State of Louisiana’s 2019 immunization schedule: https://lalinks.org/linksweb/pdf/Immunization%20Schedule_January%202019.pdf
• Review and print your child’s official immunization records at any time, free of charge: https://la.myir.net/
• Free vaccines for qualified children younger than 19 years of age: http://www.ldh.la.gov/index.cfm/page/3015

Friends and family will be thankful for these healthy Thanksgiving dishes

Thanksgiving is famously known as a time for good eating. Your eyes are often bigger than your stomach, and you may be eating special foods that only come around once or twice a year. In anticipation of packing so many delicious dishes into your belly, you may even bring out your “fat pants” so you have extra room.

But, instead of letting temptations run free, why not make a healthy and delicious contribution to the Thanksgiving table? A little planning and preparation can go a long way toward giving you and your loved ones’ waistlines something to be thankful for, like one of these better-for-you side dishes from Well-Ahead Louisiana.

If you’re serving a larger group than what the recipe calls for, no worries — just double or even triple the recipe to meet your needs. Click on any recipe card to enlarge it.

When Thanksgiving is over, what can you do with leftover turkey besides sandwiches? Try a hot, comforting and healthy cup of soup. To make this soup lower in saturated fat, prepare it ahead of time to cool and skim off the fat that rises to the top.

For more healthy lifestyle advice, visit Well-Ahead Louisiana.

Happy Thanksgiving!

Time to travel, but do it safely

By DR. DAVID J. HOLCOMBE | Medical Director, LDH Region 6

With summer well behind us and school in session, it is a great time to travel. Seniors, with time and disposable income, can devote more of their life to exploring the U.S. and abroad. In fact, world travel for all ages has exploded in the last few decades, with more people traveling to more and more exotic locations, often remote and underdeveloped.

Travelers need to consider many precautions, however, prior to any long-distance, prolonged voyage in order to have a safe experience.

Precautions start in the airplane. Reduced cabin pressure, prolonged inactivity and close quarters predispose travelers to reduced oxygen, deep venous thromboses and increases in airborne or contact transmitted infections.

Once on site, exotic foods, wild animals and insect-borne illnesses all pose threats to travelers. Avoiding unfiltered water and raw or undercooked foods, especially from street vendors, can go a long way toward preventing food- and water-borne diseases. Never touch or approach any dogs, cats, or other domestic or wild animals, since rabies is common around the world.

Safe driving, safe sex and mosquito avoidance can prevent a whole host of serious health issues.

High altitude carries its own danger of altitude-related sickness, a significant risk for older travelers and those with chronic heart or lung diseases. Careful acclimatization or the use of medications such as Diamox may be required.

Remember to use caution when climbing the steps of that wonderful, ancient pyramid or magnificent cathedral.

Vaccinations

Vaccinations largely depend on the location of travel. All travelers need to consult www.cde.gov/travel for site-specific vaccination recommendations.

• Yellow fever vaccination is required for multiple areas of Africa and South America. Unfortunately, stocks of the vaccine are severely limited worldwide and there is only a single site in Louisiana — in Metairie — with consistent availability.
• Hepatitis A and B vaccines should be up to date since both diseases remain widespread in developing countries. Because both vaccines are administered in a series that takes from four to six months to complete, do not wait until the last minute. That being said, it is better to be partially vaccinated than not vaccinated at all.
• Meningitis vaccine remains necessary for most of Sub-Saharan Africa, especially in the dry winter season from December through June.
• Typhoid vaccine, as either an injection or four capsules taken over seven days, offers protection, especially for travelers in Southeast Asia.
• Japanese encephalitis vaccine is also recommended in some parts of Asia, especially rural areas.
• Cholera, transmitted by contaminated food and water, remains a danger and travelers to countries where it occurs should be vaccinated with a single oral dose of the vaccine.
• Influenza (flu) varies depending on the season, which differs in the Northern (winter) and Southern (summer) hemispheres. Annual vaccination against the flu protects in either hemisphere although variations occur in the organism due to genetic shifts in the virus.
• Measles, mumps and rubella remain worldwide threats and that particular vaccine (MMR) should be administered to those born from 1957 to 1989. Measles is highly contagious and rates are much higher outside the U.S., even in Europe.
• Poliomyelitis and TdaP (tetanus, diphtheria and pertussis or whooping cough) vaccines should be up to date prior to any travel.

Pregnant women and those with complex medical conditions should always consult a physician prior to travel. Both MMR and varicella are live vaccines and should not be given to pregnant women.

Medications and insurance

Everyone should carry enough medication for the entire trip as well as a complete list of his or her medications (with commercial and generic nomenclature) and the doses.

For older travelers, remember that Medicare does not work overseas. Some private insurances do cover clients out of the U.S. but this coverage varies significantly. Supplemental health insurance for travelers is available for a price, often hefty in senior citizens.

Travel should be a mind-expanding experience and not one ending in costly medical problems or death. See the world, have fun, but be sure to take all the necessary precautions for safe travel. Prevention is always the best medicine at any age and anywhere in the world.

Vulnerable adults can be easy targets for financial abuse

By SHARON JACKSON | Adult Protective Services Program Director, LDH Office of Behavioral Health

News headlines in recent months have brought us stories of elderly Louisianans who have been tricked into withdrawing money from the bank or taking money from a family member’s account without permission, among other stories of financial abuse. While cases such as these are handled by the Governor’s Office of Elderly Affairs, which serves people ages 60 and older, there is a resource within the Louisiana Department of Health that serves a similar purpose for those under 60.

Adult Protective Services (APS) operates under the umbrella of the Department’s Office of Aging and Adult Services, serving ages 18 to 59 and emancipated minors (those who are legally considered an adult). APS investigates reports of abuse and arranges for services to protect vulnerable members of these populations who are at risk of abuse, neglect, exploitation or extortion.

Financial abuse, including exploitation and extortion, is one of the allegations APS investigates, and the number of cases APS investigates has been on the rise over the past several years. Reports of vulnerable adult Louisianans falling victim to financial abuse climbed from 760 in 2017 to 828 in 2019. It’s the third most common kind of abuse investigated by APS in Louisiana, after caregiver neglect and emotional abuse. While being highly common, financial abuse is also highly underreported.

What is considered financial abuse?

Adult Protective Services handles issues of theft and fraud by a family member, caregiver or other parties known to the adult.

Theft involves assets taken without the adult’s knowledge, consent or authorization. It may also include the taking of their cash, valuables, medications or other personal property. Fraud involves acts of dishonestly by those entrusted to manage the adult’s assets but instead use them for unintended purposes. Fraud may include falsification of records, forgeries, unauthorized check-writing and Ponzi-type financial schemes.

According to the National Adult Protective Services Association (NAPSA), vulnerable adults who fall victim to financial exploitation may be subject to:

• Loss of trust in others
• Loss of security
• Depression
• Feelings of fear, shame, guilt, anger, self-doubt, remorse and/or worthlessness
• Financial destitution
• Inability to replace lost assets through employment
• Inability to hire an attorney to pursue legal protections and remedies
• Becoming reliant on government safety net programs
• Inability to provide long-term care needs
• Loss of primary residence

Sometimes, people who have been the victims of financial abuse may also be victims of physical and/or emotional abuse or neglect.

Reporting abuse

Louisiana’s Adult Protective Services Reporting Law requires all Louisianans to report abuse, neglect, exploitation and extortion of adults with disabilities. Any citizen who reports in good faith and who cooperates or participates in judicial proceedings to assistant in an investigation by APS is granted immunity from civil or criminal liability.

Under this law, anyone who knows of such an incident and fails to report it or knowingly makes a false report is subject to criminal penalties.

To report a case of a vulnerable adult (between ages 18 and 59) who may be at risk of abuse, call APS at 1-800-898-4910. This toll-free hotline takes reports 24 hours a day, seven days a week. If the situation threatens the life of an adult with disabilities, call 911 immediately.

You don’t have to give your own name when making a report, but doing so along with providing your contact information helps APS with its investigation if additional information or details are needed at a later date. If you choose to share your name, it will be kept confidential unless the case requires the involvement of law enforcement.

When reporting a case to APS, you’ll need to provide the alleged victim’s name, location and details of the alleged abuse. Share as much information as possible. APS will screen your report to make sure it’s appropriate for APS services. If deemed appropriate, an APS specialist is assigned to the case. This specialist will conduct an investigation and arrange protective services for the victim.

Investigating abuse

Depending on the victim’s risk of harm, an investigation will begin within 24 hours or before 10 business days of the report being filed, with investigations being completed within 30 days. Because APS is not a law enforcement agency, these probes are not criminal investigations. However, APS may refer a case to law enforcement or the District Attorney’s Office when a crime is suspected.

If during the course of the investigation the victim is determined to be at continued risk of harm or mistreatment has occurred, APS will use social service or civil legal options to protect the victim. Interventions to protect the victim or reduce their risk of harm go into action within 90 to 120 days, though competent adults have the legal right to refuse intervention.

APS investigations are confidential, so results can’t be shared or released except for certain information and only to the victim and/or their legal representative and with law enforcement, medical or social service agencies, as needed, to coordinate services to the victim.

Remember: If you suspect or have evidence that someone is being financially abused, report it. Help keep some of our most vulnerable Louisianans safe.

For more resources on Adult Protective Services, click here.

Center for Evidence to Practice working to improve behavioral health

The Louisiana Department of Health’s Office of Behavioral Health and the LSU Health New Orleans School of Public Health are proud to say the Center for Evidence to Practice is up and running.

Now, you’re probably wondering — what is the Center for Evidence to Practice? This initiative serves Louisiana as a hub for training and implementation of best practices for behavioral health services for children, youth and families.

Behavioral health evidence-based practices are therapies that have undergone the multiple, rigorous, randomized controls vital to determine whether a practice has proven to be effective. While many behavioral health therapies exist, only a handful are considered best practices. Evidence-based practices in behavioral health are a nationally-recognized strategy to seeing improved outcomes, and it’s something that’s been gaining steam in Louisiana.

Resources at your fingertips

One of the biggest achievements of the Center’s launch is its website, laevidencetopractice.com. If you’re a parent seeking help for your child, a behavioral health service provider or any other kind of stakeholder in behavioral health, you will want to check out this website.

There’s a statewide map that shows where to find specialized, trained providers certified in evidence-based practices and providers currently working toward certification. This map is continually being updated, so if you find inaccurate information, just use the “Contact Us” function on the website to report it so that it can be corrected.

Another feature is a calendar listing events and trainings for behavioral health providers, sponsored by the Center and by other partners such as state agencies and managed care organizations. Many of these trainings are free of cost to providers who serve Medicaid-eligible youth.

You also will have the option to sign up for the Center’s newsletter, Behavioral Health Buzz, which includes monthly updates on evidence-based practice trainings and implementation.

Coming soon is E2P Learn, an online e-learning platform for behavioral health provider agencies, practitioners and other stakeholders. This platform will use videos and webinars to provide comprehensive support for the implementation and sustainability of evidence-based practices in Louisiana.

Find behavioral health providers certified in evidence-based practices using a map available
on the Center for Evidence to Practice website, laevidencetopractice.com

Best practices

So, what are these evidence-based practices? The Center currently recognizes these 10 evidence-based practices in Louisiana:

• Homebuilders: A home-based intensive family preservation services treatment program that enlists families as partners in assessment, goal setting and treatment planning, with the aim of avoiding unnecessary placement of children and youth into foster care or other out-of-home placements.
• Functional Family Therapy (FFT): Home-based intensive therapeutic model for families with multiple risk factors, serving youth ages 10 to 18 in the context of their families. The goals are to reduce behavioral and emotional problems in youth through family therapy that engages and motivates the family to improve family functioning, and change behaviors such as truancy, aggression and substance use.
• Multisystemic Therapy (MST): An intensive home-, family- and community-based treatment serving youth ages 12 to 17, in the context of their families, who are exhibiting significant negative behaviors such as chronic or violent juvenile offenses.
• Assertive Community Treatment (ACT): An intensive home- and community-based intervention delivered by an interdisciplinary team, for individuals 18 and older with a severe and persistent mental illness, with the goal of promoting symptom stability, increasing the individual’s ability to cope and relate to others, and enhancing the highest level of functioning in the community.
• Functional Family Therapy – Child Welfare (FFT-CW): Home-based intensive therapeutic model for families of youth ages birth to 18, where there are issues of child safety/neglect/family violence. The goals are to address safety and risk factors, change referral behaviors, reduce child maltreatment risk and preserve home placement.
• Parent-Child Interaction Therapy (PCIT): Therapy that focuses on improving parent-child relationships, by coaching the parents of young children in specific skills to help establish a nurturing relationship with their child, foster positive behavior and discourage negative behavior.
• Child-Parent Psychotherapy (CPP): A parent-child therapy for children up to age 6, which addresses trauma with the caregiver and child, with the goal of supporting and strengthening the parent-child relationship as a vehicle for restoring and protecting the child’s mental health.
• Youth- and Preschool-PTSD Treatment (YPT and PPT): For children who have experienced trauma, a therapy that works with parent and child to acknowledge the trauma experienced, learn skills to cope with trauma reminders and reduce the severity of trauma-related symptoms.
• Triple P Positive Parenting Program (Triple P-Standard Level 4): Parenting skills program for parents seeking intensive training in positive parenting skills.
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): For youth ages 3 to 18 who have experienced trauma, this therapy provides skills for relaxation, emotion regulation and coping, and helps both the child and the caregiver to understand and process the trauma experience, to reduce trauma-related symptoms and enhance future safety.

By identifying these evidence-based practices, Louisiana behavioral health providers are able to apply the most appropriate therapy to youth and families, helping them to heal and live full, healthy lives.

To learn more about the Center for Evidence to Practice, visit laevidencetopractice.com.

Knowing your family history can help you catch cancer early

(Note: October is Breast Cancer Awareness Month. The following is a transcript of the video posted above, which was originally shared by Taking Aim at Cancer in Louisiana [TACL] on its Facebook page.)

Hello, I’m Gerrelda Davis, the executive director of the Louisiana Primary Care Association. In collaboration with TACL and its Knowing Your Family History campaign for Breast Cancer Awareness Month, I’d like to tell you about my story.

In 2010, I actually had a mammogram, and it was my second mammogram ever in my life. I was 40 years old and I, thank goodness, had decided when I was 39 and pressured my doctor to have a baseline mammogram. They thought I was too young, but I told them I needed it. I’d only at that point in my family history had one maternal aunt that had been diagnosed with breast cancer.

So, at 40, when I turned 40 and had the test done, unfortunately about a day later I got a call and they were telling me that I needed to come back in for further tests. So, it took me about, I think, five tests later for them to diagnose me with Stage 1 breast cancer. It really turned my life upside down, not knowing whether or not I would survive, what I would have to go through.

Gerrelda Davis, right, with Louisiana Department 

of Health Secretary Dr. Rebekah Gee

But I’d say — and this is not a plug for them, believe it or not — Ochsner Health System in New Orleans, they were so, so welcoming and kind to me, and the doctors that worked there were just a blessing. And, then when I found out that those same doctors had been on the same team that my aunt had been when she was diagnosed, I was just so comfortable, and by the grace of God I got through what I had to get through.

Because of my age, I had to go through a very long and extensive amount of chemo, a chemo regimen, and after that I had to do radiation. But I had the support that I needed from family, from friends, from work. I had the best bosses at that time who allowed me to take off when I needed to, to do my treatment and come back into the office whenever I could. And, it was just an experience I’d say that could have really shattered my life but didn’t because of the support that I had, the connectedness.

And then, though, at the very end, after the radiation, after the chemo, I will say that for anyone, you, that after you’re not going to the doctor every single day or every week it makes you feel lost. And, I did feel lost. Because I wasn’t sure. Every time I thought about it, I’m like, “OK, is it gonna come back?” Also, I had that survivor’s guilt — I thought about all those people that were diagnosed who didn’t survive. But thank goodness, by the grace of God I got through that because of, once again, the support system that I had.

And, I’ll tell you, there’s this quote by Eleanor Roosevelt that I actually decided to make a mantra for in my life and it says, “You must do the thing you think you cannot do,” and that’s to be a survivor. And, I determined after all of that, that no matter what I would be a survivor. No matter what, whether or not my hair grew back, my eyebrows grew back — you know, being a female and being very, I guess, vain about those types of things — no matter what, I determined that I would be a survivor.

And, here I am, nine years later, still surviving — going to my oncologist every six months, having a clean bill of health — and thankful and very grateful that I determined to survive. And, by the grace of God, I have. Thank you.

Flu season’s making an early appearance this fall

By DR. GINA LAGARDE | Medical Director, LDH Region 9

As the heat of a seemingly endless summer finally begins to wane and the crisp coolness of fall takes its place, it’s the perfect time to schedule flu vaccinations for you and your family. Why now? Because here in Louisiana, flu activity is off to an earlier start than usual.

The Louisiana Department of Health’s Infectious Disease Epidemiology Program has already seen statewide influenza-like activity, which is a fever greater than 100 degrees Fahrenheit plus a cough and/or sore throat, in the absence of another diagnosis. In Louisiana, 4.4% of patient visits were due to influenza-like illness, which is higher than the regional baseline of 3.8% and the highest level of influenza-like activity so far in the nation this flu season.

The flu is a highly contagious respiratory illness that kills thousands of people every year. Last year in Louisiana, there were 14,000 hospitalizations, 1,400 deaths and one confirmed pediatric death. If you are 6 months or older and you don’t have a medical reason, such as a prior allergic reaction to the flu shot, you should get vaccinated. It’s the best way to reduce your chance of getting and spreading the flu.

Cold or flu?

It’s often hard to distinguish the difference between a cold and flu since both illnesses share several of the same symptoms. While both are unwelcome, a cold settles in gradually and flu shows up abruptly. Here’s how to tell the difference between the two.

• It’s flu if you have …
• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headaches
• Chills
• Fatigue
• Diarrhea
• Vomiting
• It’s a cold if you have …
• Loss of appetite
• Sore throat
• Sneezing
• Cough
• Vomiting

With plenty of fluids, rest and treating symptoms with over-the-counter medications, most people will recover from the flu on their own. If you have had the flu, stay home for at least 24 hours after the symptoms subside, unless you’re very sick and in need of medical care.

Anyone suspected of having the flu is strongly recommended to take antiviral drugs. This treatment may make the illness milder, shorten the time a person is sick and prevent serious complications and/or even death. If you or a family member may have the flu, call your doctor immediately.

These healthy everyday habits help slow the spread of flu:

• Coughing/sneezing into your sleeve or tissue and throwing the tissue in the trash
• Washing your hands often with soap and water, or using an alcohol-based sanitizer
• Avoiding close contact with sick people

Why the flu shot matters

Flu can be especially dangerous to the very old, the very young, pregnant women and people who have certain chronic medical conditions. When everyone around people from these groups is vaccinated, the so-called “herd immunity” of a large population of vaccinated people helps to keep them from getting sick.

Pregnant women are especially at risk when it comes to flu, but don’t worry — it’s safe to get your flu shot, and it’s recommended by the CDC. Changes in the immune system, heart and lungs during pregnancy make pregnant women and up to two weeks after birth more prone to severe illness from flu, including illness resulting in hospitalization. Flu is also a danger to the developing baby, who may have neural tube defects or other complications due to flu symptoms in the mother. Fortunately, a mom who gets her flu vaccine during pregnancy will pass antibodies on to her baby, helping protect the baby from flu after birth.

Schoolchildren are another group particularly affected by flu. Every year, about 28% of school-age kids come down with the flu. For every 100 children with the flu, there’s an average of 63 missed school days a year. Not only that, but for every 100 kids with the flu, 25 family members will come down with the flu within three days, leading to lost work time and reduced productivity.

Don’t wait — vaccinate!

An annual vaccination is your best prevention against the flu. It’s available either as the traditional shot or a nasal spray. The spray is recommended for healthy people ages 2 to 49 who are not pregnant and don’t have chronic illnesses, but check with your doctor or other primary care provider before getting the spray.

We have had flu vaccines for more than 50 years now and they are very safe. The CDC and FDA closely monitor vaccine safety, and vaccines are given in a setting where healthcare staff can rapidly recognize and treat a potentially severe allergic reaction with equipment on site. Besides safety concerns, people cite lots of reasons why you shouldn’t get a flu shot. These reasons are all wrong. Learn more about these myths – and the facts –here.

This October and November, flu vaccine clinics where you can get a flu shot at no cost to you are being held around Louisiana. To find the location closest to you, click here. Make sure to bring your private insurance, Medicaid or Medicare card, and wear short or loose-fitting sleeves. If you’re unable to make it to one of these clinics, you can get a flu shot at any time during flu season from your parish health unit, local pharmacies, clinics, doctors’ offices and federally qualified (community) health centers. Find a provider near you by clicking here.

For more information, visit ldh.la.gov/FightTheFlu.

Traumatic Head & Spinal Cord Injury Trust Fund Program is here to help

Whether it’s from a motor vehicle accident, a fall, a near-drowning experience, physical assault or some other trauma, a traumatic head and/or spinal cord injury can be a life-changing event. This kind of event doesn’t just affect the individual — it also impacts the lives of their loved ones, who may eventually become the caregiver, assisting with daily living activities like bathing and dressing.

In Louisiana, the Traumatic Head & Spinal Cord Injury Trust Fund Program (THSCI) helps those with such injuries, who meet eligibility requirements, to return to a reasonable level of functioning and independent living in their communities. The Louisiana Legislature created the program in 1993 with Act 654. Through this act, the program is funded by imposing additional fees on motor vehicle violations in Louisiana for the offenses of driving under the influence, reckless operation and speeding.

The Louisiana Department of Health’s, Office of Aging and Adult Services administers the THSCI Program, which includes but is not limited to processing admissions to the program, paying service providers for services on behalf of eligible individuals and reviewing Plans of Care. In addition, the Brain Injury Association of Louisiana (BIALA) serves as the program’s designated resource center for people with traumatic head and/or spinal cord injuries.

Who may be eligible for assistance through the program?

Louisiana residents who have suffered a traumatic head and/or spinal cord injury may apply for program assistance.

A traumatic head injury is caused by an external physical force, such as falls, which affect the brain, producing diminished or altered state of consciousness. The injury can lead to impaired cognitive and/or physical functioning. Degenerative or congenital conditions do not meet the definition of traumatic head injury as it relates to the program. For example, a person with Alzheimer’s would not be eligible for the THSCI program.

Similar to traumatic head injury, a spinal cord injury is caused by an external force, such as a car accident. This kind of injury can lead to paraplegia (paralysis of the legs and lower body) or quadriplegia (paralysis of both the arms and legs). Degenerative and congenital conditions do not meet the definition of spinal cord injury as it relates to the program. For example, a person with spina bifida would not be eligible for the THSCI program.

To be determined eligible for services, a person must:

• Meet the definition of traumatic head/spinal cord injury (above), per their treating physician
• Be a resident of Louisiana and officially domiciled in Louisiana at the time of the injury and while receiving services
• Have a reasonable expectation to gain improvement in functional outcome with assistance, per their treating physician
• Have exhausted all other Medicare and Medicaid sources as attested to by the applicant
• Provide proof of denial from other sources, if requested
• Be willing to accept services from an approved facility or program
• Complete and submit the appropriate application for services
• Cooperate with program requirements

What services are available?

Participants work with their assigned case manager to develop a Participant Service Plan that offers flexible services aimed at improving how they function in their homes and communities as it relates to their injuries. Eligible participants may receive services including, but not limited to:

• Evaluations and therapies
• Post-acute medical care rehabilitation
• Home and vehicle accessibility modifications
• Medication and medical supplies
• Personal Care Attendant Services
• Equipment necessary for activities of daily living
• Transportation for non-emergency medical appointments
• Other goods and services deemed appropriate and necessary
• Post-acute medical care rehabilitation

Service providers must be THSCI Program approved, with in-state facilities and programs receiving priority. All services are on a first-come, first-served basis.

Is there a cap on what I can receive?

An individual’s expenditures are limited to $15,000 for any 12-month period or $50,000 total per person per lifetime

How do I apply?

Call (225) 219-2410 or (888) 891-9441 for questions, additional information or to have an application for services sent to you. You can also download and print the application at this link. Mail the completed forms with original signatures to the THSCI Trust Fund Program, P.O. Box 2031 – Bin #14, Baton Rouge, LA 70821-2031.

Additional resources are available through the Brain Injury Association of Louisiana Resource Center, 8325 Oak St., New Orleans, LA 70118. The association also staffs a 24-hour support line at (504) 982-0685.