ABSTRACT The role of the school counselor encompasses providing comprehensive and proactive programming to support student success and growth. Small group counseling allows for integration of a strengths-based approach to school counseling services and aligns with the ASCA National Model. The following article provides considerations and recommendations for the implementation of small groups through lunch bunch sessions. Facilitating small groups during lunch provides an optimal opportunity for school counselors to deliver direct services.

To describe the burden and sources of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel (HCP), such as occupational role, work setting, vaccination status, and patient contact between March 2020 through May 2022. Active prospective surveillance. Large tertiary-care teaching institution with inpatient and ambulatory care services. We identified 4,430 cases among HCPs between March 1, 2020, through May 31, 2022. The median age of this cohort was 37 years (range, 18-89); 2,840 (64.1%) were female; and 2,907 (65.6%) were white. Most of the infected HCP were in the general medicine department, followed by ancillary departments and support staff. Less than 10% of HCP SARS-CoV-2-positive cases worked on a COVID-19 unit. Of the reported SARS-CoV-2 exposures, 2,571 (58.0%) were from an unknown source, 1,185 (26.8%) were from a household source, 458 (10.3%) were from a community source, and 211 (4.8%) were healthcare exposures. A higher proportion of cases with reported healthcare exposures was vaccinated with only 1 or 2 doses, whereas a higher proportion of cases with reported household exposure was vaccinated and boosted, and a higher proportion of community cases with reported and unknown exposures were unvaccinated (P < .0001). HCP exposure to SARS-CoV-2 correlated with community-level transmission regardless of type of reported exposure. The healthcare setting was not an important source of perceived COVID-19 exposure among our HCPs. Most HCPs were not able to definitively identify the source of their COVID-19, followed by suspected household and community exposures. HCP with community or unknown exposure were more likely to be unvaccinated.

Abstract Background Introduction: Health care personnel (HCP) are at increased risk for SARS-CoV-2 exposure. However, the exposure sources among HCP are poorly understood. Methods Design: We conducted active surveillance for all employed HCP newly diagnosed with COVID-19 between March 2020 and February 2022. We inquired about their sources of exposure using a standardized health department checklist and CDC guidance for managing healthcare personnel with SARS-CoV-2 infection or exposure. Results Among all 8,766 HCP, 2,220 (25.3%) tested positive. Among positive cases, 749 (33.7%), 651 (29.3%), and 221 (10%) were among ancillary services HCP, RNs, and allied HCP, respectively (Table 1). The majority of the sources of exposures were unknown (57.8%), followed by household (26.2%), community (10.5%), and health care (5.5%), respectively. The incidence of COVID-19 increased with level of patient contact regardless of source of exposure. The majority of the cases, N=1054 (47.5%), occurred among HCP who were not up-to-date on COVID-19 vaccines and had unknown exposure, and vaccination status varied by source of exposure (Table 2). HCP COVID-19 cases mirrored transmission in the community (Figure). Table 1.Incidence of COVID-19 Among Employed HCP Overall and by Exposure Type (N=8766)Table 2.Vaccine status among Employed HCP Covid-19 Cases by Source of Exposure (N=2220)Figure.HCP COVID-19 cases by exposure type (Left Axis) in the Central New York region (Right Axis) between March 2020 and February 2022. Conclusion The majority of HCP cases had no known exposure to SARS-CoV-2 and were not up-to-date on COVID-19 vaccines highlighting the importance of vaccination as the single most effective mean to COVID-19 prevention among HCP. Disclosures Jana Shaw, MD,MS,MPH, Pfizer: Advisor/Consultant Stephen J. Thomas, MD, Clover: case adjudication committee (compensated for time)|EdJen: Advisor/Consultant|Icosavax: data monitoring (compensated for time)|Island Pharma: Ownership Interest|Merck: Advisor/Consultant|Moderna: chair, safety monitoring committee (compensated for time)|New Day Diagnostics: Honoraria|Pfizer: Advisor/Consultant|PrimeVax: Ownership Interest|Sanofi Pasteur: Advisor/Consultant|Takeda: Advisor/Consultant|Takeda: case adjudication committee (compensated for time)|Vaxxinity: data monitoring committee (compensated for time).

We observed ASASSN-19ax during the long outburst in 2021 September-October. The object has been confirmed to be an SU UMa-type dwarf nova with a superhump period of 0.1000-0.1001 d. This object showed two post-superoutburst rebrightenings both in the 2019 and 2021 superoutbursts. These observations have established that ASASSN-19ax belongs to a group of long-period SU UMa-type dwarf novae which show multiple rebrightenings. This phenomenon probably arises from premature quenching of the superoutburst due to the weak 3:1 resonance near the stability border of the resonance, resulting in a considerable amount of disk mass after the superoutburst. We noted that ASASSN-19ax is very similar to QZ Ser, an SU UMa-type dwarf nova with an orbital period of 0.08316 d and an anomalously hot, bright secondary star, in that both objects showed multiple post-superoutburst rebrightenings at least once and that they are bright in quiescence. We expect that the core of the secondary in ASASSN-19ax may be evolved as in QZ Ser.

A STEAM-based approach to education is presented that encompasses science, technology, engineering, and math (STEM), with the addition of “the Arts” as a means of reversing continuing declines in science, math, and reading scores in U.S. secondary schools and to better prepare future STEAM scholars and professionals. This is despite the significant emphasis U.S. schools have placed on STEM curricula for nearly the past 20 years. The 2014 New York State Department of Labor report states, the President's Council of Advisors on Science and Technology (PCAST) has indicated that the United States needs at least one million more STEM workers than is currently available. The report also cites that 75 percent of students who graduate with a STEM-related degree do not take STEM jobs; however, the need for STEM careers is 2.5 times higher than other fields within New York State. A case study of Project Fibonacci® is presented whose approach is one of immersive learning that emphasizes math within a STEAM context, holding focused STEAM educational forums, and establishing centers of excellence in STEAM education. This may offer additional benefits beyond traditional STEM-only approaches. There is an upward trend towards STEAM-focused curricula driven by the decline in academic scores, which provides more challenges for our youth to compete in the global workforce; and recognizing that STEAM builds upon math as the interconnection between the science and art disciplines, thus expanding career opportunities and experience that ensure a well-rounded citizenry. We are rediscovering the need for balancing the cognitive and logical sides of the brain with the creative force to engender an agile, growth-driven nationwide community.

Two antidepressants, venlafaxine and fluoxetine, were evaluated in vivo for their effect on cytochrome P450 2D6 (CYP2D6) activity, measured by the ratio of dextromethorphan, a sensitive CYP2D6 marker, to its metabolite dextrorphan (i.e., DM:DT) excreted in urine after DM coadministration. Twenty-eight healthy extensive metabolizers of CYP2D6 received either venlafaxine (37.5 mg bid for 7 days, then 75 mg bid until Day 28) or fluoxetine (20 mg daily for 28 days); 26 completed the study. Plasma concentrations of both drugs and their active metabolites were determined. DM:DTs were evaluated at baseline (Day 0), on Days 7 and 28 of dosing, and 2 weeks after drug discontinuation (Day 42). Steady-state drug and metabolite levels were achieved in both groups by Day 28. Mean DM:DTs for venlafaxine and fluoxetine differed statistically significantly (p < 0.001) on Days 7, 28, and 42. Comparisons of DM:DT as a percentage of baseline values showed that DM:DT increased 1.2-fold for venlafaxine and 9.1-fold for fluoxetine on Day 7 (p < 0.001) and increased 2.1-fold for venlafaxine and 17.1-fold for fluoxetine on Day 28 (p < 0.001). Inhibition of CYP2D6 metabolism persisted for 2 weeks after discontinuation of fluoxetine, unlike the case with venlafaxine. These in vivo results confirm in vitro data demonstrating significantly weaker inhibition of CYP2D6 with venlafaxine than with fluoxetine. This suggests that clinically significant interactions involving CYP2D6 inhibition could occur between fluoxetine and drugs metabolized by CYP2D6 but may be less likely to occur with venlafaxine.

First Page

1. The malarial course and therapeutic results in 123 patients (88 females and 35 males) inoculated with a sexual strain were identical with those noted in over 350 patients inoculated with an “asexual” strain of malaria. 2. After seven months the sexual strain of malaria began to lose its capacity to produce gametocytes. During the succeeding nine months this was found to be much more striking in female than in male patients. Approximately one-third of all the female patients having malarial parasites failed to reveal the presence of any sexual forms of the plasmodium. 3. The sexual strain of malaria becomes biologically adapted to its host upon repeated human passage, as evidenced by its increasing failure to produce gametocytes.