THE CARIBBEAN ASSOCIATION OF

MEDICAL TECHNOLOGISTS

Newsletter: Volume 1, Issue 4

Anguilla

St. Vincent & Grenadines

Haiti

Grenada

Dominica

The Cayman Islands

Bermuda

Belize

The Bahamas

Barbados

Jamaica

Antigua & Barbuda

Trinidad & Tobago

St. Lucia

St. Kitts & Nevis

Suriname

Guyana

The Netherland Antilles

The British Virgin Islands

For Laboratory Professionals

CONTRIBUTORS FOR DECEMBER:

Chris Seay (USA)

The Pan American Health Organization (PAHO)

Victor Farrell (Barbados)

The Bahamas Branch

Greselda Evans (Barbados)

Earther Went (Barbados)

Distributed: September 2012

Word from the Liaison pg 2.

Congratulations & Looking Back pg 3.

The Development of Dengue Vaccines and their Potential use in the Americas pg 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.

A NEWSLETTER FOR THE CHRISTMAS SEASON!

Season’s 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 !!!

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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, let’s 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.

Word from the Liaison: Chis Seay (AMT)

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

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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 1960’s to mid 1970’s 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 1970’s the training of Medical Technologists was largely on the job, supplemented by

lectures and demonstrations.

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

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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

Dengue is a disease caused by an infection of four

serologically and genetically related but distinct flaviviruses,

denominated dengue viruses 1 to 4. Aedes mosquitoes,

principally of the species Aedes aegypti, that bite infected

persons infect themselves and then serve as the vector of the

infection between people. In humans, 50–90% of primary

infections remain asymptomatic.

When it clinically manifests, dengue has a spectrum of

clinical presentations ranging from a debilitating fever to

potentially lethal severe complications (severe plasma

leakage, severe bleeding, or severe organ involvement). A key

risk factor for severe dengue is a previous infection with a

dengue virus of a different serotype.

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

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.

Although the incidence remains historically high, dengue

incidence appears lower in 2011.

As of November 18, 2011 (epidemiological week 46),

997,974 cases had been reported, of which 17,055 were severe

dengue and 708 case-patients deaths.

At country level, severe dengue manifests itself in either

children or adolescent and adults. The distinct age group

pattern depends on the previous waves of dengue epidemics

and on the dengue virus serotype types that circulated

previously. El Salvador and Venezuela are examples of

countries where dengue occurs in children; in contrast,

Mexico, Colombia, and Paraguay are examples of countries

where all age groups, in particular adolescents and young

adults, are affected. Incidence does not vary between genders.

The integrated management strategy for dengue

prevention and control

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).

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IMMUNIZE AND PROTECT YOUR FAMILYIMMUNIZE AND PROTECT YOUR FAMILY

Through the integration of health information-education

communication, social mobilization and marketing, and

training and situation analysis research, this methodology

aims to motivate and encourage communities to adopt and

maintain key preventive actions for dengue.

Clearly, dengue prevention and control has a history in the

Americas stretching back several decades. At least since

2003, dengue prevention and control is anchored on a well-

defined strategy based in the integrated management of

different components. In a few years, vaccination and

transgenic Aedes aegypti mosquitoes incompetent for dengue

transmission (being developed and tested in Asia and the

Americas) might become an additional component and tool of

this strategy, and thus complement and strengthen ongoing

actions.

Dengue vaccine development

Dengue vaccine development has faced unique challenges due

to the peculiar nature of dengue virus infection. Although

significant

advances have been made since the mid- 1960s, the

pathogenesis of severe dengue is still not completely

explained, in part because of the absence of an animal model

for the clinical disease. In simplified terms, the leading

hypothesis has postulated that the

transient protection conferred by one dengue virus serotype

against infection by the three heterologous serotypes actually

creates the conditions for an enhanced immune response and

thus for severe dengue, should a subsequent secondary

infection by a heterologous serotype occur. This phenomenon,

commonly denominated antibody-dependent enhancement

(ADE), implies that any dengue vaccine must provide a

simultaneous and long-term protection against all four dengue

virus serotypes, i.e. it needs to be tetravalent. Although

neutralizing antibodies are thought to be the immunological

correlated for protection, the required antibody quantity is still

uncharacterized— a lack in knowledge that has also

contributed to the delays in vaccine development.

In spite of these challenges, the dengue vaccine pipeline is

considerable and includes candidate vaccines at both the pre-

clinical and clinical development stage. The Table (pg. 5)

summarizes five candidate vaccines in active clinical

development. Three of these vaccines are live-attenuated and

tetravalent, but vary in the employed virus and the actual

dengue virus antigen; the two additional candidate vaccines

are non-replicating.

The candidate vaccine that is more advanced in its clinical

development is a live-attenuated tetravalent vaccine called

ChimeriVax-DEN. This vaccine was obtained by replacing in

the yellow fever vaccine 17D strain the genes coding for the

membrane and envelope proteins for the corresponding genes

of each of the four dengue viruses. The vaccine was deemed

safe and efficacious in phase I–II clinical trials. Consequently,

phase III clinical trials started in October 2010 in Australia

(age groups included: 18–60 years) and in June 2011 in

South-east Asia (2–14 years). A phase III trial is also planned

at sites in five Latin American countries, namely Brazil,

Colombia, Honduras, Mexico and Puerto Rico.

Over 20,000 children and adolescents aged 9–16 years are

being enrolled in this trial, expected to last until August 2016.

In all these phase III trials, the vaccine is administrated

subcutaneously in a 3-dose schedule at 0, 6 and 12 months.

First efficacy and safety results from these phase III trials may

be available in 2013; if results were satisfactory, the vaccine

developer plans to seek licensure as early as 2014–2015.

During the first five years following licensure, the annual

production is projected at 100 million doses. Whilst

substantial, at least initially vaccine availability would clearly

be much smaller than the potential worldwide demand. No

information has been released on the possible price of this

vaccine.

In addition to clinical stage candidate vaccines, a large variety

of candidates are in preclinical development. Some of these

candidate vaccines potentially show superior product profiles

and might thus become a second generation of dengue

vaccines.

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References and further readings:

1. Beatty ME, Beutels P, Meltzer MI, et al. Health economics of dengue: A systematic literature review and expert panel’s assessment. American Journal of Tropical Medicine and Hygiene 2011, 84:473–88. PMID:21363989

2. Coller BA and Clements DE. Dengue vaccines: Progress and challenges. Current Opinion in Immunology 2011, 23:391–8. PMID:21514129

3. Guzman MG, Halstead SB, Artsob H, et al. Dengue: A continuing global threat. Nature Reviews Microbiology 2010, 8:S7–16. PMID:21079655

4. San Martín 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, 82:128–35. PMID:20065008

5. San Martín JL and Brathwaite-Dick O. Integrated strategy for dengue prevention and control in the Region of the Americas. Revista Panamericana de Salud Publica 2007, 21:55–63. 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, 29:7276–84. 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, 84:200–7. 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, 80:846–55. PMID:19407136

10. Whitehorn J and Simmons CP. The pathogenesis of dengue. Vaccine 2011, 29:7221–8. PMID:21781999

TABLE: Dengue candidate vaccines in active clinical development, October 2011*

Clinical trial phase

Developer

Approach (details) DEN

DEN V antigens

Valencies

Phase 3 Sanofi Pasteur Live attenuated YF17D/DENV chimeras)

prM/E Tetravalent

Phase 1 Inviragen Live attenuated (DENV2-PDK53 DENV chimeras)

Whole virus Tetravalent

Phase 1 US National Institute of Health; licensees: Biological E, Butantan, Panacea, Vabiotech

Live attenuated (targeted mutagenesis DENV chimeras)

Whole virus Tetravalent

Phase 1 Merck Recombinant subunit 80% of E Monovalent

Phase 1 NMRC/WRAIR DNA prM/E 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.

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. ■

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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.

.

The Safe Hospitals Initiative in the World

Posted in Issue 117 - April 2012 Perspective

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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. ■

The Safe Hospitals Initiative in the World cont’d:

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.

http://www.edlin.org/humour/xmas_jokes.html

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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.

NASSAU CITY TOUR

Learn about the history and culture of The Bahamas on this one of a kind Nassau sightseeing tour. You’ll 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.

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.

NATIONAL ART GALLERY

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

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.

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.

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.

SNORKELING

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

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.

SCUBA DIVING

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

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.

SUBMAMINE ADVENTURE

Take an underwater cruise in your own personal submarine.

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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 d. 1/100

b. 1/1000 e. 1/400

c. 1/4000

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 a-mulching.

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

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

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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

This Newsletter is a production of the

Education Committee of the Caribbean

Association of Medical Technologists

All rights reserved @ March 31St 2012