Programs In Louisiana Research Articles

High prevalence of dysfunctional uterine bleeding in candidates for metabolic/bariatric surgery: increased endometrial cancer risk?

BackgroundEndometrial cancer (EC) is the strongest obesity-associated malignancy and the fastest-growing cancer in young women. Early identification of EC and other endometrial pathology (malignant and nonmalignant) in women with severe obesity may improve treatment options and uterine preservation. Screening for endometrial pathology using abnormal or postmenopausal uterine bleeding (APUB) as a surrogate in women pursuing metabolic/bariatric surgery may be clinically beneficial, but data supporting this effort are limited. ObjectiveTo develop and institute a screening program for APUB as a surrogate for endometrial pathology in bariatric surgery candidates. SettingTwo, academic metabolic/bariatric surgery programs in Louisiana, United States. MethodsThe Modified SAMANTA is a 10-item questionnaire that was implemented to identify patients with APUB, specifically combining tools designed to identify anovulatory/postmenopausal and heavy menstrual bleeding. Demographic (age, race), body mass index, and questionnaire data were analyzed with respect to positive screening using data from March 2021 through May 2023. ResultsOf 1371 eligible women presenting for surgical evaluation, 664 (48.4%) positive screens were identified and referred for gynecologic evaluation to rule out endometrial hyperplasia/cancer or other endometrial pathology. The likelihood of positive screening for APUB was associated with increasing BMI (P = .001) and Black/African American race (P = .003), as well as increasing SAMANTA score (P < .001). In contrast, risk of positive screening was negatively associated with increasing age (P < .001). ConclusionsWomen presenting for metabolic/bariatric surgery have a high prevalence of APUB and, given this dysfunctional bleeding and concurrent obesity, are at greater risk for underlying EC. Potential risk factors for APUB, given their associations with screening positive, include increased body mass index, younger age, and Black/African American race. Standardized screening with appropriate gynecologic referral should be a routine part of the overall evaluation for women with severe obesity.

Fire on the Bayou: The Status of School Orchestra and String Programs in Louisiana

This study examined the status of school orchestra and string programs in Louisiana. A manual web search for string programs in parish school districts, student school affiliations from honor orchestra lists, Louisiana members of the American String Teachers Association (ASTA), and members of the Louisiana Music Educators Association was conducted to determine the approximate number of programs in the state. These data were cross-referenced with available data from the Louisiana Department of Education, which listed course offerings by school. A total of 44 teachers serving 97 schools were identified. Semi-structured interviews were then conducted with five-string teachers and two district arts coordinators from around the state to determine the strengths of current string programs and opportunities for growth. Findings from participant interviews revealed the legacy of school segregation, inadequate funding for public education, competition from non-public schools, and the challenges of maintaining program infrastructure due to limited funding and perennial natural disasters. The results of this study were compared with other statewide string program surveys to situate Louisiana string programs in a national context with implications for string teachers, music teacher education, and professional development offered.

Hepatitis C Virus Elimination Programs in Louisiana and Washington: Importance of Screening and Surveillance Systems.

The US government has established a national goal of hepatitis C virus (HCV) elimination by 2030. To date, most HCV elimination planning and activity have been at the state level. Fifteen states presently have publicly available HCV elimination plans. In 2019, Louisiana and Washington were the first states to initiate 5-year funded HCV elimination programs. These states differ on motivation for pursuing HCV elimination and ranking on several indicators. Simultaneously, however, they have emphasized several similar elimination components including HCV screening promotion through public awareness, screening expansion, surveillance enhancement (including electronic reporting and task force development), and harm reduction. The 13 other states with published elimination plans have proposed the majority of the elements identified by Louisiana and Washington, but several have notable gaps. Louisiana's and Washington's comprehensive plans, funding approaches, and programs provide a useful framework that can move states and the nation toward HCV elimination.

Teacher Turnover in Early Childhood Education: Longitudinal Evidence From the Universe of Publicly Funded Programs in Louisiana

This study uses longitudinal data to follow a cohort ( N = 4,465) of all early childhood education teachers working in publicly funded, center-based settings in Louisiana over a 3-year period. We present the proportion of teachers still at their sites across six time points between 2016 and 2019, providing the first statewide, longitudinal estimates of within-year and multiyear retention. We find that less than 40% teachers in the fall of 2016 are still at their site by the fall of 2019. Turnover is particularly high among childcare teachers (compared to teachers at Head Start or school-based pre-kindergarten), teachers of toddlers, and teachers new to their sites. Policy implications are discussed.

Breastfeeding-supportive hospital practices and breastfeeding maintenance: results from the Louisiana pregnancy risk assessment monitoring system.

Identify practices associated with breastfeeding maintenance, examine breastfeeding-related hospital practices by hospital designation level (Baby Friendly vs. Gift vs. none), and assess racial disparities in hospital practices and breastfeeding maintenance. The Pregnancy Risk Assessment Monitoring System is a population-based survey of mothers who have recently given birth. Non-Hispanic Black (NHB) and non-Hispanic White (NHW) participants who gave birth from 2016-2019 and initiated breastfeeding were included (n = 2200). Associations between twelve breastfeeding-related hospital and breastfeeding at 2-6 months postpartum were assessed. Baby Friendly hospital designation is based on a set of criteria related to hospital practices that promote breastfeeding. The Gift is a Louisiana program that offers a lower level designation and quality improvement support designed to help hospitals transition to and achieve Baby Friendly designation. Breastfeeding in the hospital, infant only receiving breast milk, and breastfeeding within one hour after birth were positively associated and receiving a gift pack with formula was negatively associated with breastfeeding maintenance in both NHW and NHB women. Associations were stronger in NHW compared to NHB mothers. We identified several practices significantly associated with breastfeeding maintenance. However, racial disparities indicate a need for population-specific supportive practices.

58.2 Perinatal and Early Childhood Consultation in Louisiana: Collaborating to Bridge Care Gaps

The objectives of this presentation are to describe 2 consultation programs in Louisiana—the Louisiana Mental Health Perinatal Partnership (LAMHPP), a statewide, telephone-based perinatal psychiatry access program, and the Tulane Early Childhood Collaborative (TECC), a regionally focused early childhood mental health consultation program—and to discuss opportunities and strategies for collaboration and integration across programs.

African American Satisfaction With the SNAP-Ed Program: A Qualitative Exploration

ObjectivesNutrition educators and public health professionals are increasingly focused on structural racism and its contribution to racial disparities in rates of food insecurity and obesity. In the context of these barriers to healthful eating affecting marginalized populations, nutrition education programs must be carefully evaluated to determine whether they meet the needs of those populations. This study aimed to assess African Americans perceptions of and satisfaction with the SNAP-Ed program in Louisiana.MethodsThree trained African American facilitators conducted five focus group discussions (FGD) with 25 African American participants in SNAP-Ed. The discussion guide for FGD was based on issues identified by SNAP-Ed leadership in Louisiana and revised by African American implementers of SNAP-Ed. FGD were recorded and transcribed verbatim. Transcripts were coded independently using inductive and in-vivo coding by two members of the research team using Dedoose software.ResultsParticipants were generally satisfied with the program and thought information was important for African Americans in the context of medical issues faced by their community. However, participants viewed lessons as race neutral and thought they should include more information about African American history and culture. Participants also noted a lack of engagement with the African American stressed the need for African American staff to better engage with the African American community.ConclusionsThe SNAP-Ed program in Louisiana may need to be modified to specifically address African American food history and culture. The implementation of the program should be modified to include more African American SNAP-Ed staff and better engage with the African American community.Funding SourcesSNAP-Ed.

Patient-specific factors associated with use of diabetes self-management education and support programs in Louisiana

IntroductionThe prevalence of diabetes self-management education and support (DSME/S) use among patients with newly diagnosed type 2 diabetes mellitus (T2DM) and patients with insulin prescription has not been evaluated. It...

Teacher Education and the Quality of Teacher-Child Interactions: New Evidence from the Universe of Publicly-Funded Early Childhood Programs in Louisiana

ABSTRACT Research Findings: Many policy efforts designed to improve the quality of early care and education (ECE) settings in the United States have focused on increasing teachers’ education levels, despite the weak evidence linking education to quality. Much of this evidence comes from studies with single-sector samples (e.g., only child care, Head Start, or state pre-k) and typically does not include programs serving toddlers. This paper addresses these limitations using statewide data from Louisiana to estimate whether teacher education and the quality of teacher-child interactions differ by sector and age, and whether differences in education level may explain differences in quality. We find that both education level and the quality of teacher-child interactions is greater in more highly regulated sectors, and that differences in education explain part of the by-sector differences in interaction quality across age groups. Policy or Practice: Findings support recent calls to increase ECE teacher education at all ends of the education spectrum (e.g., including AA and CDA), and suggest future research on the causal link between education and quality is warranted. Researchers should continue to find ways to leverage data from Quality Rating and Improvement Systems to ask key first-order questions about quality in ECE.

New Evidence on Teacher Turnover in Early Childhood

This brief provides a systemwide look at early childhood teacher turnover using data from all publicly funded, center-based early childhood programs in Louisiana, including subsidized child care, Head Start, and pre-kindergarten. It provides new evidence on the prevalence of turnover and explores whether teachers who leave differ from those who stay on a widely used measure of teacher–child interaction quality. Results show that more than one third of teachers leave their program from one year to the next, and the vast majority of teachers who leave are not teaching in another program the following year. Turnover rates are higher among teachers working in child care and with younger children. Compared with teachers who stay, those who leave are rated lower on interaction quality.

P45 Identifying Barriers and Facilitators to Implementing Policy, Systems, and Environmental Change Work in Cooperative Extension Using the Consolidated Framework for Implementation Research

<h3>Background</h3> Following guidance provided in the 2014 National Framework for Health and Wellness, Cooperative Extension (CE) nutrition education programs in Louisiana shifted towards making policy, systems, and environmental (<i>P</i>SE) changes to promote healthy eating and increased physical activity according to the social-ecological model of behavior change. The transition to PSE work from an exclusive focus on direct nutrition education posed challenges for CE staff in Louisiana. In order to better understand barriers and facilitators to implementing PSE change work, we conducted qualitative semi-structured interviews with CE staff using constructs from the Consolidated Framework for Implementation Research (CFIR). <h3>Objective</h3> To identify CE staff's perceived barriers and facilitators to implementing PSE change interventions according to CFIR constructs. <h3>Study Design, Setting, Participants</h3> Qualitative semi-structured interviews were conducted with 5 Cooperative Extension staff using an interview guide with questions based on constructs from the Consolidated Framework for Implementation Research (CFIR). <h3>Measurable Outcome/Analysis</h3> Interviews were transcribed verbatim. Transcripts were independently coded by 2 researchers using codes defined a prori according to CFIR constructs. Coding differences were resolved through consensus. <h3>Results</h3> Though all 39 CFIR constructs were relevant, 16 emerged through interviews with CE agents as either barriers or facilitators to the implementation of PSE change work. The adaptability of PSE work and its relative advantage over traditional direct education emerged as major facilitators to its implementation. Major barriers to the implementation of PSE change work included the relative priority of PSE change work within CE agents' organizations, the complexity of PSE change work, and a lack of resources to support implementation. <h3>Conclusions</h3> Implementing PSE change work poses a challenge for CE staff who have traditionally conducted only direct nutrition education programs. Cooperative Extension programs should ensure PSE change work is presented as a priority to all staff within the organization. Training materials for PSE change work should prepare CE staff for the complexity of these interventions and emphasize their advantages over direct education.

Comparison of Male and Female Patients in Louisiana Medical Marijuana Dispensaries.

Relatively little is known in terms of patient demographics, indications, previous cannabis use, or the forms and dosages of medical marijuana (MM) dispensed for patients at MM dispensaries. Even less is known in terms of how male and female patients may differ in each of these aspects. The goal of the current study was to examine each of these variables using a retrospective analysis of deidentified patient data from MM dispensaries in Louisiana. Deidentified data were analyzed from web-based pharmacist–patient consultations at MM dispensaries throughout Louisiana. Data were collected during the first 6 months following the initiation of the MM dispensing program in Louisiana. A total of 1195 MM patients (598 male/597 female) were included in the analyses. The average age of the sample was 51.9 years (±14.8) and it was composed primarily of white patients (86.7%). Males and females were nearly identical in terms of average age, race, previous cannabis use, indication profile, and MM recommendations. Differences between males and females were observed in terms of opioid use, history of psychosis, presence of more than one indication, and the duration of previous cannabis use. Our data indicate that, in MM dispensaries of the Deep South state, there are numerous similarities—and some potentially important differences—between male and female MM patients. The importance of these differences, and the importance of continued data collection/analysis, for improving MM dispensing are discussed.

Genome-wide association mapping identifies markers associated with cane yield components and sucrose traits in the Louisiana sugarcane core collection

Sugarcane is an economically important crop for both food and biofuel industries. Marker-assisted breeding in sugarcane is becoming a reality with the recent development and deployment of markers linked with disease resistance genes. Large linkage disequilibrium in sugarcane makes genome-wide association studies (GWAS) a better alternative to biparental mapping to identify markers associated with agronomic traits. GWAS was conducted on a Louisiana core collection to identify marker-trait associations (MTA) for 11 cane yield and sucrose traits using single nucleotide polymorphism (SNP) and insertion-deletion (Indel) markers. Significant (P < .05) MTAs were identified for all traits where the top ranked markers explained up to 15% of the total phenotypic variation. High correlations (0.732 to 0.999) were observed between sucrose traits and 56 markers were found consistent across multiple traits. These markers following validation in more diverse populations could be used in marker-assisted selection of clones in sugarcane breeding program in Louisiana and elsewhere.

Development of a Structural Capacity Prediction Model Based on Traffic Speed Deflectometer Measurements

The importance of incorporating pavement structural conditions in the selection of maintenance and rehabilitation strategies along with functional indices has been recognized by state agencies. To measure in-service pavement structural capacity, surface deflection under a defined load has been typically used. The traffic speed deflectometer (TSD) has emerged as a continuous deflection-measuring device as it operates at traffic speed and reduces lane closure and user delays. The present study developed a nonlinear regression model to predict pavement structural number (SN) based on surface deflections measured by the TSD along with the total pavement layer thickness and traffic volume. The proposed model was successfully developed and validated with SN calculated based on TSD and falling weight deflectometer deflection data obtained from two testing programs in Louisiana and Idaho. The model was further validated with respect to its prediction of in-service structural capacity loss and deficiency. Based on statistical measures and the model’s ability in identifying structurally deficient sections, results showed satisfactory accuracy of the model and supports its use for network-level decision-making processes in the pavement management system.

Randomized Trials of the Teen Outreach Program in Louisiana and Rochester, New York.

To evaluate the Teen Outreach Program, a pregnancy prevention program, in 2 community-based settings. We evaluated the Teen Outreach Program, a 9-month positive youth development program, in 3 cohorts of youths from 2012 to 2015 in 2 states. In Louisiana, 7 agencies participated in an individualized randomized controlled trial, with youths randomly assigned to a treatment or control condition. Fourteen agencies in Rochester, New York, participated in a cluster randomized controlled trial. We found no differences between the intervention and control youths on delay of sexual onset in Louisiana (adjusted odds ratio [AOR] = 0.80; 95% confidence interval [CI] = 0.62, 1.03) or in Rochester, New York (AOR = 0.89; 95% CI = 0.45, 1.77), or for sex with no effective means of birth control (Louisiana, AOR = 1.18; 95% CI = 0.78, 1.78; Rochester, AOR = 0.41; 95% CI = 0.13, 1.27) after controlling for relevant covariates. We found no short-term effects for the offer of the intervention. Research might be needed for the long-term and intermediate impacts of youth development programs on these and other adolescent risk behaviors.

Achieving successful evidence-based practice implementation in juvenile justice: The importance of diagnostic and evaluative capacity

Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation.

Financing of a 1.6 Billion Sanitary Sewer Overflow (SSO) Program in Louisiana

Financing of a 1.6 Billion Sanitary Sewer Overflow (SSO) Program in Louisiana

Conversation with Charles P. O'Brien

Conversation with <scp>C</scp>harles <scp>P</scp>. <scp>O</scp>'<scp>B</scp>rien

Reinforcing Inequalities: The Impact of the CDBG Program on Post-Katrina Rebuilding

Over the last two decades, the Community Development Block Grant (CDBG) program has repeatedly been adapted as a vehicle to respond to federal disasters, such as floods, hurricanes, and terrorist strikes. In this article, I describe the use of the CDBG program for disaster recovery, identify changes in rules governing the use of special disaster-related allocations, and explain the advantages and limitations of using the CDBG program to distribute funds to disaster-devastated areas. In particular, I analyze the operation of CDBG disaster-recovery assistance programs in Louisiana and Mississippi following Hurricane Katrina in 2005. I examine how the U.S. Department of Housing and Urban Development–approved CDBG disaster-recovery programs in these states were designed and implemented in a class and racially discriminatory manner that violated the Fair Housing Act and the low-and-moderate-income rules of the Housing and Community Development Act. In conclusion, I critique the practice of granting waivers of CDBG rules and requirements and suggest policy recommendations to better address the needs of disaster-impacted communities in the future.

Ghost fishing activity in derelict blue crab traps in Louisiana

Derelict crab traps impact the coastal ecosystem through continued catch of target species and species of conservation, economic, or recreational importance. During volunteer-supported crab trap cleanups in 2012 and 2013, we quantified ghost fishing activity in derelict crab traps in coastal Louisiana through a citizen scientist program. Volunteers removed 3607 derelict traps during these events, and over 65% of traps analyzed by citizen scientists were actively ghost fishing. Additionally, volunteers identified 19 species enmeshed in derelict traps, including a combination of fresh and saltwater species. We also detected a significant difference in the number of blue crab in actively ghost fishing derelict traps across removal locations with estimated catches varying between 2.4 and 3.5 crabs/trap. Our instantaneous estimates of ghost fishing activity are greater than those previously thought in Louisiana, further justifying current derelict crab trap prevention and removal extension and outreach programs in Louisiana and throughout the Gulf of Mexico.