THE CARIBBEAN ASSOCIATION OF MEDICAL TECHNOLOGISTS

For Laboratory Professionals

Newsletter: Volume 1, Issue 4

A NEWSLETTER FOR THE CHRISTMAS SEASON!

Anguilla St. Vincent & Grenadines

Seasons Greetings and Happy Holidays to all from the Education Committee! May your Xmas be all that you wish it to be, with lots of Xmas cheer and love for everyone! Have a blessed Christmas and a happy and prosperous 2013 !!!

Haiti

Grenada

Dominica

The Cayman Islands

Bermuda

Belize

The Bahamas

Barbados

Jamaica

Antigua & Barbuda

CONTRIBUTORS FOR DECEMBER: Chris Seay (USA) The Pan American Health Organization (PAHO) Victor Farrell (Barbados) The Bahamas Branch Greselda Evans (Barbados) Earther Went (Barbados)
Word from the Liaison pg 2.

Trinidad & Tobago

St. Lucia

Congratulations & Looking Back pg 3. The Development of Dengue Vaccines and their Potential use in the Americas pg Distributed: September 2012 4. The Safe Hospitals Initiative in the World pg 7. BGM 2013 pg 9. Laboratory Mathematics Answers pg 12. Press Release: Christmas Downsizing pg 13. My New Year Resolutions pg 14.

St. Kitts & Nevis

Suriname

Guyana

The Netherland Antilles

The British Virgin Islands

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Word from the Liaison: Chis Seay (AMT)

As 2012 draws to a close, I would to express my appreciation to CASMET for doing such a great work.
As the official liaison, I have attended two Regional Council Meetings (RCM) and they both were tremendous successes. The work to coordinate meeting places, work areas and transportation arrangement took fantastic individual as well as team effort. I give, my personal thanks, to those individuals and teams.

As 2013 begins, please be supportive of all the activities of CASMET and AMT:
In July, AMT will hold the national meeting in Pittsburg, Pennsylvania. In October, CASMET will have the Biennial General Meeting (BGM) in the Bahamas.

All Members of both organizations should be supportive for two reasons. First these meetings allow important
business to be accomplished, which affords Members the opportunity to have their input about the affairs of the organization. The second reason is to learn, as valuable educational opportunities are presented. This enables us all to stay abreast of new information and technologies related to the healthcare field. Therefore, lets work to make 2013 an even greater year than 2012. May the Christmas, New Year and holidays be a blessing to you all.

Be blessed with safe travels.

A QUOTE OF NOTE:

You're either part of the solution or part of the

problem.

(Leroy) Eldridge Cleaver (1935-1998) An excerpt from a speech given in San Francisco in 1968

MEMBER OF THE ORDER OF THE BRITISH EMPIRE (MBE) Mr. Victor DaCosta Farrell of Barbados has been made a Member of the Order of the British Empire (MBE) in the New Year Honors. For services in the field of medical laboratory technology in Barbados and other Caribbean counties

LOOKING BACK : By Victor Farrell

DID YOU KNOW THAT ??
The first meeting to introduce the formation of the Society of Medical Technologists (W.I) was held at the

Department of Pathology, University of the West Indies, Jamaica on May 29, 1953. At that time the name agreed on was the Association of Medical Technicians.
The inauguration of the Association took place at a General Meeting held on December 9, 1953 at which

Professor Hill was elected President.

At a meeting held on September 28, 1954, it was decided that the word Association should be replaced by

Society and that the full name should be The Society of Medical Technologists (West Indies).
Professor G. Bras succeeded Professor Hill as President in November 1956. The decade of the mid 1960s to mid 1970s saw an increase in the number of Medical Technology students

from other Caribbean islands undergoing training at the Department of Pathology, U.W.I, Mona. This was made possible largely through the financial assistance from the World Health Organization.
Up until the mid 1970s the training of Medical Technologists was largely on the job, supplemented by

lectures and demonstrations.

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Immunization Newsletter: Pan American Health Organization, October 2011 The Development of Dengue Vaccines and Their Potential Use in the Americas: Volume XXXIII Number 5 Although the incidence remains historically high, dengue Dengue is a disease caused by an infection of four incidence appears lower in 2011. serologically and genetically related but distinct flaviviruses, As of November 18, 2011 (epidemiological week 46), denominated dengue viruses 1 to 4. Aedes mosquitoes, 997,974 cases had been reported, of which 17,055 were severe principally of the species Aedes aegypti, that bite infected dengue and 708 case-patients deaths. persons infect themselves and then serve as the vector of the infection between people. In humans, 5090% of primary At country level, severe dengue manifests itself in either infections remain asymptomatic. children or adolescent and adults. The distinct age group pattern depends on the previous waves of dengue epidemics When it clinically manifests, dengue has a spectrum of and on the dengue virus serotype types that circulated clinical presentations ranging from a debilitating fever to previously. El Salvador and Venezuela are examples of potentially lethal severe complications (severe plasma countries where dengue occurs in children; in contrast, leakage, severe bleeding, or severe organ involvement). A key Mexico, Colombia, and Paraguay are examples of countries risk factor for severe dengue is a previous infection with a where all age groups, in particular adolescents and young dengue virus of a different serotype. adults, are affected. Incidence does not vary between genders. Starting in the 1960s, dengue has gradually become a leading
cause of hospitalization and death among children and adults in many countries of South-east Asia, the Western Pacific, and Latin America and the Caribbean. Because Aedes aegypti is the main vector, dengue flourishes in tropical and subtropical countries mainly among residents of urban and peri-urban poor areas but does not spare more affluent neighbourhoods.
Dengue burden globally and in the Americas The integrated management strategy for dengue prevention and control

One third (2.5 billion people) of the world population live at risk of a dengue infection. Worldwide, dengue is now reported in over 110 countries; it is estimated that up to 50 million infections, 500,000 cases of severe dengue and 20,000 deaths occur each year. In Latin America and the Caribbean, dengue virus transmission now occurs in all countries and territories except for Uruguay and continental Chile. In 2010, 1,663,276 dengue cases were reported throughout the Americas the highest number ever recorded (Graph). This number of cases corresponds to an annual rate of 3.2 cases per 1,000 people. Of the total dengue cases, 48,954 cases were classified as severe dengue and 1,194 case-patients deaths.

Countries have made important efforts to contain and curb dengue burden. Since 2003, PAHO has supported Member States with the implementation of an integrated strategy for dengue prevention and control. Its core element is a management model designed to strengthen national programs interprogrammatically through stronger partnerships among public entities at all levels, communities, and the private sector. Activities are organized into five components: patient care; social communication; epidemiological surveillance; vector control; and laboratory capacity. Until October 2011, the strategy had been adopted by 21 countries and systematically evaluated in 16. In recent years, recognizing the key role of communities involvement in dengue prevention and control, PAHO reinforced the communication component of the integrated strategy with a methodology called COMBI (Communication for Behavioral Impact).

Through the integration of health information-education In spite of these challenges, the dengue vaccine pipeline is communication, social mobilization and marketing, and considerable and includes candidate vaccines at both the pretraining and situation analysis research, this YOUR FAMILYIMMUNIZE and clinical development stage. The Table (pg. 5) IMMUNIZE AND PROTECT methodology clinical AND PROTECT YOUR FAMILY aims to motivate and encourage communities to adopt and summarizes five candidate vaccines in active clinical maintain key preventive actions for dengue. development. Three of these vaccines are live-attenuated and tetravalent, but vary in the employed virus and the actual Clearly, dengue prevention and control has a history in the dengue virus antigen; the two additional candidate vaccines Americas stretching back several decades. At least since are non-replicating. 2003, dengue prevention and control is anchored on a welldefined strategy based in the integrated management of The candidate vaccine that is more advanced in its clinical different components. In a few years, vaccination and development is a live-attenuated tetravalent vaccine called transgenic Aedes aegypti mosquitoes incompetent for dengue ChimeriVax-DEN. This vaccine was obtained by replacing in transmission (being developed and tested in Asia and the the yellow fever vaccine 17D strain the genes coding for the Americas) might become an additional component and tool of membrane and envelope proteins for the corresponding genes this strategy, and thus complement and strengthen ongoing of each of the four dengue viruses. The vaccine was deemed actions. safe and efficacious in phase III clinical trials. Consequently, phase III clinical trials started in October 2010 in Australia Dengue vaccine development (age groups included: 1860 years) and in June 2011 in Dengue vaccine development has faced unique challenges due South-east Asia (214 years). A phase III trial is also planned to the peculiar nature of dengue virus infection. Although at sites in five Latin American countries, namely Brazil, significant Colombia, Honduras, Mexico and Puerto Rico. advances have been made since the mid- 1960s, the Over 20,000 children and adolescents aged 916 years are pathogenesis of severe dengue is still not completely being enrolled in this trial, expected to last until August 2016. explained, in part because of the absence of an animal model In all these phase III trials, the vaccine is administrated for the clinical disease. In simplified terms, the leading subcutaneously in a 3-dose schedule at 0, 6 and 12 months. hypothesis has postulated that the First efficacy and safety results from these phase III trials may transient protection conferred by one dengue virus serotype be available in 2013; if results were satisfactory, the vaccine against infection by the three heterologous serotypes actually developer plans to seek licensure as early as 20142015. creates the conditions for an enhanced immune response and During the first five years following licensure, the annual thus for severe dengue, should a subsequent secondary production is projected at 100 million doses. Whilst infection by a heterologous serotype occur. This phenomenon, substantial, at least initially vaccine availability would clearly commonly denominated antibody-dependent enhancement be much smaller than the potential worldwide demand. No (ADE), implies that any dengue vaccine must provide a information has been released on the possible price of this simultaneous and long-term protection against all four dengue vaccine. virus serotypes, i.e. it needs to be tetravalent. Although In addition to clinical stage candidate vaccines, a large variety neutralizing antibodies are thought to be the immunological of candidates are in preclinical development. Some of these correlated for protection, the required antibody quantity is still candidate vaccines potentially show superior product profiles uncharacterized a lack in knowledge that has also and might thus become a second generation of dengue contributed to the delays in vaccine development. vaccines.
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TABLE: Dengue candidate vaccines in active clinical development, October 2011*

Clinical trial phase Developer
Sanofi Pasteur Inviragen US National Institute of Health; licensees: Biological E, Butantan, Panacea, Vabiotech Merck NMRC/WRAIR

Approach (details) DEN

Live attenuated YF17D/DENV chimeras) Live attenuated (DENV2PDK53 DENV chimeras) Live attenuated (targeted mutagenesis DENV chimeras) Recombinant subunit DNA

DEN V antigens
prM/E Whole virus Whole virus

Valencies
Tetravalent Tetravalent Tetravalent

Phase 3 Phase 1 Phase 1 Phase 1 Phase 1

80% of E prM/E

Monovalent Monovalent

Adapted from Julia Schmitz and Joachim Hombach World Health Organization / Initiative for Vaccine Research (WHO/IVR).

Overall, the considerable dengue vaccine pipeline promises that several and diverse dengue vaccines might become available within a decade or so after a first vaccine is licensed.
Conclusions

As in other continents, dengue burden has notably increased in Latin America and the Caribbean over the past decades. Although an integrated management strategy for dengue prevention and control was implemented in several countries throughout the Region, anticipation exists for vaccination to complement current actions. For the first time in the history of the Americas expanded immunization programs (EPI), discussion on the potential use of a vaccine has started even before the vaccine has been licensed.
References and further readings:

In the next few years, clinical trials are being continued and partially concluded, thus generating needed additional safety and efficacy data. Given the peculiar nature of dengue, experts are actively discussing long-term evaluations of the interaction of mass vaccination and natural infection occurrence. Whilst some level of uncertainty persists, a window of opportunity is nonetheless present for national dengue and immunization programs to similarly to what has been done for other new vaccines collaborate towards supporting national level decision-making on a possible dengue vaccine introduction through the use of economic evaluations grounded in local data and towards ensuring surveillance systems able to inform vaccination policies and monitor vaccination effectiveness and impact.

1. Beatty ME, Beutels P, Meltzer MI, et al. Health economics of dengue: A systematic literature review and expert panels assessment. American Journal of Tropical Medicine and Hygiene 2011, 84:47388. PMID:21363989 2. Coller BA and Clements DE. Dengue vaccines: Progress and challenges. Current Opinion in Immunology 2011, 23:3918. PMID:21514129 3. Guzman MG, Halstead SB, Artsob H, et al. Dengue: A continuing global threat. Nature Reviews Microbiology 2010, 8:S716. PMID:21079655 4. San Martn JL, Brathwaite O, Zambrano B, et al. The epidemiology of dengue in the Americas over the last three decades: A worrisome reality. American Journal of Tropical Medicine and Hygiene 2010, 82:12835. PMID:20065008 5. San Martn JL and Brathwaite-Dick O. Integrated strategy for dengue prevention and control in the Region of the Americas. Revista Panamericana de Salud Publica 2007, 21:5563. PMID:17439693 6. Sanofi-Aventis. Study of a novel tetravalent dengue vaccine in healthy children and adolescents aged 9 to 16 years in Latin America (ClinicalTrials.gov identifier: NCT01374516). Available online at: http://clinicaltrials.gov/ct2/show/NCT01374516 (accessed on 11/22/2011). 7. Schmitz J, Roehrig J, Barrett A, and Hombach J. Next generation dengue vaccines: a review of candidates in preclinical development. Vaccine 2011, 29:727684. PMID:21781998 8. Shepard DS, Coudeville L, Halasa YA, et al. Economic impact of dengue illness in the Americas. American Journal of Tropical Medicine and Hygiene 2011, 84:2007. PMID:21292885 9. Suaya JA, Shepard DS, Siqueira JB, et al. Cost of dengue cases in eight countries in the Americas and Asia: a prospective study. American Journal of Tropical Medicine and Hygiene 2009, 80:84655. PMID:19407136 10. Whitehorn J and Simmons CP. The pathogenesis of dengue. Vaccine 2011, 29:72218. PMID:21781999 6

The Safe Hospitals Initiative in the World

Posted in Issue 117 - April 2012 Perspective

Prevention is better than treatment is more than a wise proverb. It is also at the center of the efforts of every health system that values the protection of the life and well-being of its population. It is also the challenge faced by disaster management systems, which aim at reducing risk to acceptable levels and thus contributing to sustainable development. The Safe Hospitals Initiative, started in the Americas in 2004, has influenced the thinking of the 168 United Nations Member States, leading to the commitment as a goal for 2015 that all new hospitals should be built in such a way that continued operation in disasters is ensured and that existing hospitals should progressively improve their safety levels in this respect. The development of instruments for safety evaluations, in order to understand and analyze the situation of hospitals, compare results, and prioritize interventions, proved to be the best strategy to move from theory to practice, giving priority to interventions in those critical services for which continuous operation can represent the difference between life and death. Presently, the Hospital Safety Index (HSI) is the most widely used instrument of this kind in the world. In March 2012, 31 countries and territories in the Americas reported its use in setting priorities. It is also one of the central elements in the implementation of national and subnational policies and programs for safe hospitals. More than 1,400 hospitals have been evaluated with the HSI. The results showed that 51% are in category A, that is, they have high probability of continuing to function in disasters; 37% in category B, meaning that they can resist a disaster but that equipment and critical services are at risk; and 12% in category C, which indicates that they will very probably stop functioning in disasters and be unable to guarantee the lives of their patients and personnel.

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The Safe Hospitals Initiative in the World contd:

WHO representatives from around the world met in Turkey to study the hospital safety evaluation instruments used in the different continents and agreed to take the HSI as a basis for a global instrument that can be adapted to different realities. Some regions of the world adopted the HSI as such, while others adapted it to their own context. Countries in Europe that implemented actions for safe hospitals translated the HSI into their respective languages and have applied it without variations. In the countries of the Eastern Mediterranean, where there are high levels of social and political violence that require temporary and variable health services to be set up, the structural component is much less important than the availability and capacity of the health workers who operate these services. In the countries of South East Asia, with highly diverse realities, the main focus is in having a series of tools based on the HSI, making it possible for the countries to apply the instruments and adapt the components to their levels of development and implementation of the Safe Hospitals Initiative. The countries of the Western Pacific, in turn, developed a series of goals (benchmarks) aimed at steadily increasing the response capacity of hospitals in the region. Although they did not try to assign numerical values in ranking hospital safety levels, they have established mechanisms for prioritization based on hospital complexity. In Africa, the application of the HSI has begun in Uganda, and the region is currently generating common policy papers to delimit the framework of action for disaster risk management in the health sector and the implementation of the program of safe hospitals, with the participation of experts from PAHO. The evaluation of the safety of medium and small hospitals and health facilities of lower complexity is another important step that many countries of the Americas have initiated. The results to date show that it is necessary to check the instruments and the criteria for relative assessment in greater detail, so that they can provide useful results, especially for those communities that only have lower-complexity health facilities and, accordingly, should ensure their operation with no interruptions.

A Politically Correct Holiday Greeting -------------------------------------Best wishes for an environmentally conscious, socially responsible, low stress, non-addictive, gender-neutral, winter solstice holiday, practiced within the most joyous traditions of the religious persuasion of your choice, but with respect for the religious persuasion of others who choose to practice their own religion as well as those who choose not to practice a religion at all; plus... A fiscally successful, personally fulfilling, and medically uncomplicated recognition of the generally accepted calendar year 2013, but not without due respect for the calendars of choice of other cultures whose contributions have helped make our society great, without regard to the race, creed color, religious, or sexual preferences of the wishes.
Disclaimer: This greeting is subject to clarification or withdrawal. It implies no promise by the wisher to actually implement any of the wishes for her/himself or others and no responsibility for any unintended emotional stress these greetings may bring to those not caught up in the holiday spirit .
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BGM 2013
The city of Nassau has a variety of historic buildings as well as many sightseeing opportunities. Engage the service of our many knowledgeable tour guides to keep you busy.

ARDASTRA GARDENS AND ZOO

This exotic tropical garden houses more than 300 birds, mammals, and reptiles from the Bahamas and around the world. Come enjoy the world famous flamingo marching band.

NASSAU CITY TOUR

Learn about the history and culture of The Bahamas on this one of a kind Nassau sightseeing tour. Youll have the opportunity to visit the old romantic sector of Nassau, ancient Forts, historic sites, churches, and commercial sectors.

HORSE AND CARRIAGE

Absolutely the most authentic way to tour the center of Nassau is by riding in a horse drawn carriage. Its fun, informative and you get the benefit of a breeze to beat the heat.

BOTANICAL GARDENS
Garden enthusiasts will love this display of more than 600 flowering trees and shrubs. Visit these 18 acres of tropical beauty.

PIRATES OF NASSAU
An interactive pirate attraction in the heart of Down Town Nassau, come face to face with pirates like Black Beard and his rogue of fellow pirates.

NATIONAL ART GALLERY

Bahamian artists exhibit numerous works here, ceramics, paintings, sculptures and photography.

BEACHES
If you like the idea of soaking up some sun and lazing around the beach at your leisure you will definitely find our beaches irresistible.

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ARAWAK CAY FISH FRY

Here you can mingle with the locals and enjoy native food and beverages. You must try the conch salad and conch fritters.

SNORKELING
Swim with schools of tropical colourful fish in shallow waters off Nassaus famous reefs.

DOLPHIN ENCOUNTERS
On a luxuriant coconut palm paradise, relax and have fun as you meet our beloved marine mammals face to face. Be entertained by world famous dolphin and sea lions.

SCUBA DIVING
If you ever wanted to try scuba diving Nassau is the perfect place for it.

HARBOUR ISLAND DAY AWAY

Visit the famous pink beach of Harbour Island tour the island in a golf cart or take a horse back ride on the beach.

SUBMAMINE ADVENTURE
Take an underwater cruise in your own personal submarine.

ROSE ISLAND DAY AWAY

Enjoy a scenic boat ride on a triple deck catamaran travel Nassau picturesque water to Rose Island where you can take part in various beach and water activities, relax on a sun drenched beach or strech out in a hammock under a palm tree.

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Answers to Laboratory Mathematics Questions

Please note that there was an error to question # 2 It should have read: You need 200ml of a 1:300 solution of Glucose /L. You have a 1:100 solution. How
would you prepare the desired quantity of 1:300 solution? ANS: 66.66 ml of stock iodine made up to 200 ml with diluent. 1.

A stock potassium solution has a concentration of 500 mg%. A 1/5 dilution of this standard is made. What would be the concentration of the final solution? ANS: 100mg%

2.

You need 200ml of a 1:300 solution of Glucose /L. What dilution is necessary to prepare a working standard containing 5mg / 100 ml.

3.

Give the ratio of 3ml of serum diluted with 17ml of water. Give the dilution of the solution. ANS: 1/ 6.666 OR 1/6.67

4.

A glucose standard contains 5 mg of glucose/ml. A 1/10 dilution of this standard would contain how much glucose? ANS: 0.5 mg/ml

5.

You have a stock standard with a stated concentration of 1000 mg/dl. How would you prepare 50 ml of a 5.0 mg/dl working standard? ANS: 0.25 ml of stock made up to 50ml with diluent.

6.

You need 50 ml of HCL solution which is 0.02N. You have on hand 0.5N solution. How would you prepare this solution to give the desired volume and concentration? ANS: 2.0 ml of 0.5N HCL made up to 50 ml with diluent.

7.

If 1 ml of a 1:4 dilution is further diluted by adding to it 1.5 ml of distilled water, the final dilution is: ANS: 1/10 a. 1:5 b. 1:6 c. 1:10 d. 1:25

8.

A stock standard solution contains 200 g of glucose /l. What dilution is necessary to prepare a working standard containing 5mg /100 ml. ANS: 1/400 a. 1/500 b. 1/1000 c. 1/4000 d. 1/100 e. 1/400

9.

The following quantities are placed in a test tube: 0.1 sample, 2.9ml of diluent, 0.5 ml of reagent #1, 0.5 ml of reagent #2. What is the final dilution of the sample? ANS: 1/40
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Press Release: Christmas Downsizing

Today's global challenges require the North Pole to continue to look for better, more competitive steps. Effective immediately, the following economy measures are to take place in the "Twelve Days of Christmas" subsidiary: 1. The partridge will be retained, but the pear tree never turned out to be the cash crop forecasted. It will be replaced by a plastic hanging plant, providing considerable savings in maintenance. 2. The two turtle doves represent a redundancy that is simply not cost effective. In addition, their romance during working hours could not be condoned. The positions are therefore eliminated. 3. The three French hens will remain intact. After all, everyone loves the French. 4. The four calling birds were replaced by an automated voice mail system, with a call waiting option. An analysis is underway to determine who the birds have been calling, how often and how long they talked. 5. The five golden rings have been put on hold by the Board of Directors. Maintaining a portfolio based on one commodity could have negative implications for institutional investors. Diversification into other precious metals as well as a mix of T-Bills and high technology stocks appear to be in order. 6. The six geese-a-laying constitutes a luxury which can no longer be afforded. It has long been felt that the production rate of one egg per goose per day is an example of the decline in productivity. Three geese will be let go, and an upgrading in the selection procedure by personnel will assure management that from now on every goose it gets will be a good one. 7. The seven swans-a-swimming is obviously a number chosen in better times. Their function is primarily decorative. Mechanical swans are on order. The current swans will be retrained to learn some new strokes and therefore enhance their outplacement. 8. As you know, the eight maids-a-milking concept has been under heavy scrutiny by the EEOC. A male/female balance in the workforce is being sought. The more militant maids consider this a dead-end job with no upward mobility. Automation of the process may permit the maids to try a-mending, a-mentoring or amulching. 9. Nine ladies dancing has always been an odd number. This function will be phased out as these individuals grow older and can no longer do the steps. 10. Ten Lords-a-leaping is overkill. The high cost of Lords plus the expense of international air travel prompted the Compensation Committee to suggest replacing this group with ten out-of-work congressmen. While leaping ability may be somewhat sacrificed, the savings are significant because we expect an oversupply of unemployed congressmen this year. 11. Eleven pipers piping and twelve drummers drumming is a simple case of the band getting too big. A substitution with a string quartet, a cut back on new music and no uniforms will produce savings which will drop right down to the bottom line. 12. We can expect a substantial reduction in assorted people, fowl, animals and other expenses. Though incomplete, studies indicate that stretching deliveries over twelve days is inefficient. If we can drop ship in one day, service levels will be improved. Regarding the lawsuit filed by the attorneys association seeking expansion to include the legal profession ("thirteen lawyers-a-suing"), action is pending. Lastly, it is not beyond consideration that deeper cuts may be necessary in the future to stay competitive. Should that happen, the Board will request management to scrutinize the Snow White Division to see if seven dwarfs is the right number.
Adapted from: http://www.dancentury.com/xmas.html#.UOBwSXen3IV
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I will not throw the cat out the window Or put a frog in my sister's bed I will not tie my brother's shoelaces together Nor jump from the roof of Dad's shed I shall remember my aunt's next birthday And tidy my room once a week I'll not moan at Mum's cooking (Ugh! fish fingers again!) Nor give her any more of my cheek. I will not pick my nose if I can help it I shall fold up my clothes, comb my hair, I will say please and thank you (even when I don't mean it) And never spit or shout or even swear. I shall write each day in my diary Try my hardest to be helpful at school I shall help old ladies cross roads (even if they don't want to) And when others are rude I'll stay cool. I'll go to bed with the owls and be up with the larks And close every door behind me I shall squeeze from the bottom of every toothpaste tube And stay where trouble can't find me. I shall start again, turn over a new leaf, leave my bad old ways forever shall I start them this year, or next year shall I sometime, or .....?
By Robert Fisher

Adapted from: http://www.123newyear.com/newyear-poems/my-new-years-resolution-by.html

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This Newsletter is a production of the Education Committee of the Caribbean Association of Medical Technologists

All rights reserved @ March 31St 2012

Education Committee Contact Information:

Earther Went (Chairperson): ewent@bcc.edu.bb Sashoy Duncan: sashoyforbes@hotmail.com Marcia Robinson- Walters: brian_0299@hotmail.com Delphia Theophane: djphia41@hotmail.com Tamara Chambers: tamara.chambers@ncu.edu.jm Janice Wissart: jwissart@yahoo.co.uk

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