psi’s New Free Health Webinar Series!

All of us at psi are very excited to announce our free School Health Webinar Series! Join us this school year as psi’s Medical Director, Dr. Carly Wilbur, UH Pediatrician, takes on the ‘hot topic’ issues pertaining to school health in today’s classrooms. Log in, take part, ask questions, and Raise the Power of Education all for free! Mark your calendars now for:

September 18: Vaccinations- Are Your Students at Risk?
November 20: Functional Abdominal Pain
January 29: The Vaping Epidemic
March 18: Increasing Rates of Suicide Among Teens
May 6: Sleep Hygiene

We look forward to seeing you there!

Can’t wait? We understand! Visit psi’s free Webinar Library for past presentations from industry leaders and experts.

Lyme (and other tick-borne) Diseases


Written by Dr. Carly Wilbur, psi Medical Director

Welcome to a very special edition of psi’s Paradigm! Are you up to date on your Lyme disease symptoms, treatments, and preventions? With the beginning of the new school year as well as a nationwide increase in tick-illnesses, know the facts!

By all accounts, the number and extent of tick-borne illnesses are increasing annually in the United States. While Lyme disease is the most recognized of these illnesses, the Centers for Disease Control (CDC) reports that seven new tick-borne germs have been identified in the US in the last two decades.  And while not all cases get reported, the number of logged cases of Lyme disease has tripled since the early 2000’s. Several factors are to blame: new tick species have been identified, reforestation projects bring humans and wildlife in closer proximity, and climate change has altered the ecological nature and seasonal cycles that affect ticks and their hosts.

Nationwide, this has historically been an issue for the Northeast and Midwest regions of the United States, but the geographic area of concern is growing, and the number of counties that qualify for a “high risk” label for Lyme disease has increased 300% in 20 years.

In Ohio specifically, the incidence of Lyme has skyrocketed: Only 44 cases (in 28 counties) were reported in 2010, but that number was up to 270 cases (in 44 counties) by 2017 (the most recent published data for our state).


While not every tick encounter results in a diagnosis of Lyme disease, it’s important to recognize the symptoms that would increase one’s index of suspicion.

Erythema Migrans (EM) rash (pictured) and generalized malaise (fever, headaches, muscle pains, joint pains) within 1-2 weeks of a tick bite. If these complaints are not identified, the disease can progress within 2-4 weeks to a more disseminated form that carries the risk of central nervous system involvement (meningitis, cranial nerve palsies, eye conditions) and heart problems. Late disease, often recognized months after a tick bite, carries an even greater risk of nerve damage and prolonged arthritis.

Knowing what to look for is helpful. The Ixodes scapularis (AKA Blacklegged Tick) is tiny, and the nyph (baby) phase of the life cycle can be <3mm in size.

Certain precautions can help prevent Lyme disease:

  • When hiking, walk in the middle of the path, not the tall grass.
  • Use EPA-approved insect repellant spray with DEET.
  • Wear long sleeves and long pants. Tuck pant legs into socks.
  • Clothing and gear can be pre-treated with permethrin. After exposure, clothing can be placed in the dryer on a high heat setting.
  • Wearing light colored clothing makes ticks easier to see.
  • Shower off and check yourself (and your pet) thoroughly after being in tick-infested areas. Promptly remove any ticks discovered.
  • Continue to check for ticks 2-3 days after outdoor activities in areas known for ticks.
  • Be sure to protect your pet(s) with regular anti-tick treatments.

If a tick is discovered, immediate removal is advised.

Because NE Ohio is not currently considered an area of high endemicity for Lyme disease, the standard of care is to not start antibiotics unless certain criteria are met:

  • Tick is engorged
  • Tick has been in place >36 hrs
  • Patient has classic EM rash at tick site.

Blood tests to confirm diagnosis are not necessary if the history and  presentation are classic. EM with known exposure warrants a course of empiric antibiotic treatment.

Atypical symptoms should prompt a laboratory work-up that includes quantitative screening for serum antibodies to Lyme disease. If these are negative, no further testing is needed. Positive tests will need follow-up with Lyme immunoblot or Western blot for presence of IgM and IgG antibodies. Only with a strong response to both antibody types, can a definitive diagnosis be made.

If antibiotics are warranted, first-line agents include oral Doxycycline twice daily for 10 days or Amoxicillin three times a day for two weeks. Most clinicians will administer a single prophylactic dose of Doxycylcine if an engorged tick has been discovered.


For more info on Lyme disease symptoms, treatment, and prevention:

Center for Disease Control – Lyme Disease

More info on Dr. Carly Wilbur, psi Medical Director

psi’s School Health Clinic Services Program


Fun Summer Tips That Will Keep Your Child Learning!

Summer is almost here… and that means your students and children will be ready for fun and excitement! Try these great tips for keeping kids focused and avoid the dreaded.. Summer Brain Drain!

1. Get involved

Kids of all ages love to know that they’re making a difference, and community service opportunities abound. Read to nursing home residents. Stock food pantries. Clean up a local park. Getting involved helps our community build a Climate of Caring.

2. A day in the park

Ohio has 83 state parks, 2 National Historic Parks, and 3 National Wildlife Refuges. There’s camping, swimming, hiking, boating, breathtaking views — even theaters and historical landmarks. Many parks offer handicapped-accessible facilities and educational programs that will foster your learners’ love of nature!

3. Get creative

Engaging the mind with reading and other creative ventures is just as vital as engaging the body. Summer is the time to read books, make videos, write stories, stage shows, make music and create works of art without the pressure of assignments, deadlines and grades.

4. Backyard adventures

You don’t need to get in the car to discover new wonders. Send kids on a backyard bug hunt, or challenge them to create art with sticks, pinecones and leaves. Hold a backyard camping trip, complete with stargazing. Plant vegetables, and make healthy meals celebrating the bounty of your garden.

5. Kitchen curiosity

Bake a cake. Make a casserole. Build a banana split. Create a new drink recipe. Kitchen adventures teach kids the basics of cooking while giving them the pride of sharing their culinary successes with family and friends.

6. Start a business

Host a lemonade stand or mow lawns. Baby-sit. Sew and sell shopping bags. Kids who earn money learn to appreciate the value of a dollar and to manage their money.

Vaping: What You Need to Know

by Dr. Carly Wilbur
University Hospitals Rainbow Babies and Children’s Hospital

Vaping refers to the inhalation of aerosolized particles of a drug (nicotine or marijuana)  mixed with flavoring. Most vaping  devices  contain a battery for power, a heating  element, a place to insert the drug-containing liquid that will be heated  until it vaporizes, and a mouthpiece.

On the  Rise

Vaping  was initially  developed to help adults quit smoking but has quickly become popular among  teenagers. From 2011 to 2019, the CDC reported a 900% increase in vaping  for high schoolers.  And while current reports estimate about 27% of high schoolers have vaped  or currently vape, 5% of middle schoolers admit  to the same. Vaping  is a $22.6 billion  industry worldwide.

Impact on the  Brain

On a chemical  level, the nicotine salt delivered from  a vape pen is far more powerful than the nicotine free base that cigarette smokers inhale. This makes vaping  nicotine extremely addicting. Studies show that teens who vape are seven times more likely to smoke as adults. And more than half the high schoolers polled  admitted to having had their first vaping  experience at age 11 or younger.

The immature frontal cortex of a teenager’s developing brain is uniquely susceptible to the harmful  effects of nicotine. Regular use can cause long-term irreversible deficits in memory, attention, and concentration, and also mood  disorders and permanent lowering of impulse  control. Tobacco use in adolescence can also prime the brain for addiction to other stimulants of abuse, like cocaine  and methamphetamines.

What’s Next

The Surgeon General accurately labeled  teen vaping  an epidemic. And it’s a gravely dangerous one: Nicotine-related deaths  kill more adult Americans every  year than alcohol,  AIDS, car accidents, illegal drug abuse, murders, and suicides COMBINED.  Make sure you talk openly every  day with your  kids. Preventative education on vaping  is a must in every school, whether it is in health class or part of a science project. Vaping  does not discriminate. Let’s work  together to keep our kids from  vaping.  It might  even save their lives.

Click Here for more on Dr. Carly Wilbur.

Click Here for more on psi and University Hospital’s Rainbow Babies  and Children’s Hospital.

After a Suicide: Answering Student Questions and Providing Support

by Dr. Scott Poland
Co-Director of the  Suicide and Violence Prevention Office, Nova Southeastern University, Fort Lauderdale, Florida, and Richard Lieberman, Loyola Marymount University, Los Angeles, California

The aftermath of a youth suicide is a sad and challenging time for a school.  Postvention has become synonymous with the challenging aftermath of suicide and few events  are scarier for a school and a community than the suicide of a young person.

The major  tasks for suicide postvention are to help your  students and fellow  faculty to manage the understandable feelings of shock, grief and confusion. The major  focus at this time should be grief resolution and prevention of further suicides.

The research  literature estimates that once a suicide happens,  the chances of another death  by suicide increases dramatically. The following suggestions are intended to guide  schools during  this difficult time.

  • It is important to be honest with students about the scope of the problem of youth suicide and the key role that everyone (including the students) plays in prevention.
  • It is important to balance being truthful and honest without violating the privacy of the suicide victim  and his/her family  and to take great  care not to glorify the victim’s actions.
  • It is important to have the facts of the incident, be alert to speculation and erroneous information that may be circulating, and assertively yet kindly redirect students toward productive, healthy conversation.
  • It is important that students not feel that the suicide victim has been erased and that students be provided an opportunity to talk about the deceased.
  • Numerous professional associations caution that memorials not be dramatic or permanent, and instead encourage activities that focus on living memorials such as funding suicide prevention.
  • National research has found  that talking  with youth about  suicide does not cause them to think of it, and in fact provides the opportunity for them to relieve  anxiety and unburden themselves. The Jason Flatt Act, which focus- es on mandated training annually  for school staff on suicide prevention, has been passed in 30% of all states. More information about  the Jason Foundation is available  at
  • Major protective factors identified by the World Health Organization are the following: stable families, positive connections at school, good  connections with other  youth, religious  involvement, lack of access to lethal  weap-ons, access to mental  health  care, and awareness of crisis hotline  resources.

Click Here for more on Dr. Scott Poland.

Click Here for more on psi and Suicide  Prevention.

The Ohio Association of Student Councils: Teaching Valuable Leadership Skills in Grades 6 – 12

OASC representative Anthony Paletta (third from right) and the psi team help raise money for OASC’s Northeast Ohio Chapter.

Since 1953, the Ohio Association of Student Councils (soon to be the Ohio Association of Student Leaders in January 2020) has been dedicated to the teaching of leadership skills, organizational skills, and people  skills valuable  to the members  and officers of all student organizations in Ohio. The organization provides high-impact programming and events  for students in grades  6 – 12. All school districts in Ohio can become members  of OASC and send students to OASC events.

OASC Member Benefits Include:

  • Statewide recognition and awards
  • Diverse student networking
  • Opportunities for statewide leadership positions
  • Discounted event pricing for students
  • Student empowerment and school unity
  • Organization and advisor resources and support
  • Community involvement and growth of servant leadership

Upcoming OASC events during  the 2019-2020 school year include several events this fall: Leadership at the Point/Island (alternates each year), COSI Leadership Day, Middle Level Madness (an all-day  Saturday event)  and the Fall Retreat (a weekend in November), as well as the OASC State Conference in March and a week-long Summer Workshop Camp next summer.


  • 91% of OASC students go on to college and career education.
  • Last year, 1,300 students attended OASC’s Summer Workshop.
  • 97% of Americans believe our students need “real world” skills to be successful beyond middle and high school . – “Leadership Conference Education Fund, National  Survey on Common Core(2015)”

Click Here for more information about OASC.


Staff and Student Trainings for SY 2019-2020

Schedule now for your 2019-2020 staff and student trainings!

Safety and Violence Prevention Training (now includes the  required 2-hour mental health component)

CPR/AED/First Aid Training

Anti-Bullying Programs

Suicide Awareness and Prevention Training

Bloodborne Pathogen Training Diabetes

Education – HB 264

PBIS / RTI LifeAct


Communicable Disease

Epinephrine Auto Injector Training

Crisis Intervention Team Training

and many others!

Our expert partners and professional trainers  are up to date on the latest changes in education. psi will keep your school in compliance and add value to your team!

psi Sponsors: LifeAct’s 2019 Into the Light Walk!

The 14th annual LifeAct Into the Light Walk took  place recently on May 5, 2019.  This year’s event  brought in roughly

900 registered walkers,  students, volunteers, sponsors  and choir members. psi was part of a record-breaking number

of sponsors  this year!  University Hospitals  and 91.3 The Summit were two  of the 20 partner sponsors  that we had the opportunity to connect with this year at the event.   Keynote speaker  Loree Vick gave a heartfelt and endearing speech that left a lasting impression on all in attendance.

President of the Youth Advisory Board for LifeAct, Cami Kaye, also spoke at the event  and did not cease to amaze attendants with her poise, strength and conviction beyond her years.  We are excited to see what  the future holds for Cami.  Positive  outcomes for this event  are still having lasting effects weeks after  the event  is over, with donations still pouring in for the LifeAct organization and positive feedback from  all in attendance.

psi is the educational arm of LifeAct’s mission to deliver  lifesaving suicide prevention educational programs to North- east Ohio middle  schools and high schools.  Trained, caring instructors teach teens to recognize the warning signs of depression and suicide, empowering them to come forward to seek professional help for themselves or others.

The Into the Light Walk is a great  way for students, families, communities and survivors to connect with and support one another, and psi is very proud to be a part of this effort. We are thankful to have been a part of the 2019 experience and look forward to next year’s event!

Click Here  for more on LifeAct.

Click Here  for more on psi and LifeAct.