MEDICAL NOTES Valerie J. Shereck, MSN, ANP-C

SLEEP DISORDERS Sleep disorders are common among the elderly and occur in up to 50% of individuals over the age of 65. Sleep disorders are defined as the inability to fall asleep, stay asleep, sleeping too much, or having abnormal, sleep-related behaviors. The American Academy of Sleep Medicine categorizes them into the following major groups: insomnia, hypersomnia (excessive sleepiness), sleep-related breathing disorders, circadian rhythm sleep-wake disorders, parasomnias (sleep disorders that include unwanted events or experiences that occur while people are falling asleep, sleeping, or waking up), and sleep movement disorders. In this article, discussion will be limited to insomnia, obstructive sleep apnea, and restless leg syndrome. As people age, the timing and amount of sleep changes. Older individuals tend to fall asleep earlier and awaken earlier and are less tolerant of changes in the sleep-wake cycle (i.e., jet lag and daylight saving time). Daytime napping in older adults may compensate for poor nighttime sleep, but napping can also contribute to poor nighttime sleep. Sleep efficiency also decreases from 95% during adolescence to less than 80%.

TWO TYPES OF SLEEP The two main types of sleep are non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. * NREM Sleep is divided into four stages based upon the amount and frequency of different types of brain waves (electrical activity of the brain). Stage I occurs as people become drowsy and fall into a light sleep. Stage II, where most sleep time is spent, is a continuation of light sleep. Stages III and IV are the deepest levels of sleep and are necessary for feeling rested. * REM Sleep is a very deep but active stage of sleep in which people dream. In this stage, the heart rate and breathing speed up and then slow down, and the individual’s eyes move rapidly. Older individuals reach the deepest stage of sleep (Stage IV) more slowly and spend less time in REM sleep.

INSOMNIA is defined as the inability to fall or remain asleep. It can lead to restlessness and anxiety which can make obtaining sleep even more difficult. It can also interfere with the ability to function during the day. It is the most common sleep disorder in older adults; up to 40% report insomnia and approximately 20% report severe insomnia. It is more prevalent as age increases and is more common in women than men. Insomnia can be acute or short term or chronic and long term.

Risk Factors for the Development of Insomnia: - Stress (may be acute or chronic) - Acute or chronic illness – Pain - Environmental changes  Consumption of or withdrawal from caffeine, nicotine, or alcohol - Medications that have stimulant properties - Withdrawal from certain medications especially antianxiety medication or antidepressants - Inadequate sleep hygiene (habits and practices that are conducive to sleeping well) - Psychiatric disorders such as depression, anxiety, and post-traumatic stress disorder - Other sleep disorders.

Treatment of insomnia depends on the cause. One of the most important things to alleviate insomnia is to educate individuals about good sleep hygiene habits.

Ways to Improve Sleep: -Having a regular sleep schedule; going to bed at the same time and rising at the same time each day -Regular bedtime routine -Use of the bedroom primarily for sleep -Avoidance of substances that interfere with sleep such as caffeine, chocolate, and alcohol prior to bedtime -meditation, listening to calming music, deep breathing, and progressive relaxation. ST PATRICK’S DAY Pegi Schlis, CTRS, ACC, AC-BC March 17, 2020 HISTORY

St. Patrick, the patron saint of Ireland, was not Irish. He was born in Scotland or Wales (depending on the source) as Maewyn Succat between 373 and 385 A.D. (depending on the source). (He later took the Latin name Patricus - Patrick is the English version - when he became a priest.) At the age of 16, he was captured by Irish raiders and brought to Ireland as a slave. During this time, he became deeply religious and began to have visions. Six years later, he escaped and settled in France. After having visions of bringing Christianity to the Irish people, he returned to Ireland in 432 A.D. and stayed there until his death on March 17 in 461 A.D. Legend has it that Patrick pounded a drum and banished all the snakes from Ireland. There are no snakes in Ireland today. The first St. Patrick’s Day celebration in America was in 1737 in Boston. The first St. Patrick’s Day parade was in 1779 in New York City. More than 100 U.S. cities hold St. Patrick’s Day parades now.

IRISH FOOD & DRINK TRIVIA • The potato is not native to Ireland. It was originally brought to Ireland from the Americas by Sir Walter Raleigh in 1585. • A potato is sometimes called a Smiling Murphy. • Colcannon, a mashed potato dish (a Halloween specialty), is made with kale, scallions, butter, and hot cream. • Beef, not beer, is Ireland’s largest edible export. • Corned beef is not a traditional dish in Ireland, but it was popular with the Irish immigrants who settled in New York City because it was 5¢ a portion, making it affordable. • Boiled bacon and cabbage is considered Ireland’s most popular traditional dish. • Four million pints of Guinness® beer are produced daily. • All the grain used by Guinness® is grown in Ireland. • Ireland’s longest bar is the Grandstand Bar at Galway Race Course. It is 210 feet long. • Approximately 50% of a bottle of Bailey’s® Irish Cream is fresh Irish dairy cream. • Worldwide consumption of Bailey’s® Irish Cream is 1,000 glasses a minute.

IRISH AMERICANS • The first census of the U.S., taken in 1790, recorded 44,000 Irish-born residents. More than half of them lived south of Pennsylvania. Now, it is estimated that more than 38 million Americans claim Irish ancestry. • As many as 25% of Americans claim pure Irish ancestry. • More than 40% of U.S. Presidents have claimed Irish ancestry. • Billy the Kid, the old West outlaw and gunfighter, was born Henry McCarty and was the son of Irish immigrants. • Daniel Boone descended from Donegal immigrants. • James Cagney was born in 1899 and raised on New York City’s Lower East Side by an Irish father and Norwegian mother. • Davy Crockett, a pioneer born in 1786, was an Irish American. • Richard Daley, born in 1902, served six terms as mayor of Chicago. Both of his parents’ families emigrated from Ireland in the 1840s. • Colorado-born Jack Dempsey, a heavyweight champion, was a descendent of Irish immigrants from County Kildare. • John Ford, the father of Henry Ford, immigrated to America after being evicted from Cork in 1847. • James Hoban, an Irishman from County Kilkenny, designed the White House in 1792.

IRISH WORDS: • Small fragments SMITHEREENS (smithiríní) • Area where turf can be cut from BOG • Type of execution (last name of mayor and magistrate of Galway who convicted his own son to hang) LYNCH • Decrepit dwelling SHANTY (sean tigh pronounced shan tig) • Beverage traditionally associated with Ireland means “water of life” WHISKEY (uisce beatha pronounced ish-kuh ba-ha) • Word that describes the Irish way of speaking BROGUE (bróg. It entered the English language directly from the Irish word for shoe.) • St. Patrick use this to teach about the Trinity SHAMROCK (seamróg) • Word that comes from the name of the woods in County Wicklow from which oak clubs were believed to come SHILLELAGH.

WOMEN’S HISTORY MONTH Shelley Evans, MT-BC, ACC, CDP, AC-BC HISTORY

The month of March recognizes women’s contributions to society, culture, and history. The first observance of National Women’s Day was in New York City on February 28, 1909. It became known as International Women’s Day in 1911. In 1975, the United Nations adopted International Women’s Day. The Education Task Force of the Sonoma County (California) Commission on the Status of Women celebrated Women’s History Week in 1978. The organizers selected the week with March 8 to correspond with International Women’s Day. The movement spread across the country as other communities initiated their own Women’s History Week celebrations the following year. Women’s groups and historians led by the National Women’s History Project (now the National Women’s History Alliance) lobbied for national recognition. In February 1980, President Jimmy Carter issued a Presidential Proclamation declaring the week that includes March 8 as National Women’s History Week. By 1986, 14 states were celebrating March as Women’s History Month. Members of Congress were lobbied to declare the month of March as Women’s History Month. In 1987, there was a Congressional resolution to declare March as Women’s History Month. Programming for this year’s Women’s History Month can show honor and respect to the women of our past, recognize those of our present, and encourage and inspire the women of our future. The following women had the distinction of being welcomed into the National Women’s Hall of Fame in Seneca Falls, NY in 2019: attorney , educator , educator , actress , Air Force Nicole Malachowski, suffrage artist Rose O’Neill, congresswoman , associate justice , composer Laurie Speigel, molecular biologist Flossie Eong-Staal, and fashion designer Diane von Furstenberg. Learn more about the National Women’s Hall of Fame at www.womenofthe hall.org.

WOMEN WHO HAVE CHANGED THE WORLD TRIVIA QUIZ Whether as activists, musicians, or scientists, women have changed the world. Host a discussion about these notable women. • Cleopatra was a ruler of which country? EGYPT • How old was Joan of Arc when she led a successful revolt for the French - 15, 17, or 19? 17 • Catherine the Great improved the welfare of the serfs in which country? RUSSIA • T/F: Mary Wollstonecraft was a pioneer in women suffrage and wrote a pamphlet titled, “A Vindication of the Rights of Women.” TRUE • Jane Austen defied the odds and became a popular author penning Emma and Pride and _____? PREJUDICE • T/F: campaigned for women’s rights and had a famous speech titled, “Ain’t I Fantastic?”. FALSE (She wrote a speech titled, “Ain’t I a Woman?”) • campaigned against slavery and wrote which book? UNCLE TOM’S CABIN • T/F: was a leading figure in the women’s rights movement. TRUE • T/F: Florence Nightingale was a British doctor who improved wounded soldiers’ treatment. FALSE (She was a nurse.) • The first woman to receive an American medical degree was Elizabeth _____. BLACKWELL • Clara _____ was an American Civil War nurse. BARTON • T/F: Mother Teresa, an Albanian nun, devoted her life to the poor. TRUE • was an American civil rights activist who refused to give up her ______in Alabama. BUS SEAT.

PURIM March 10, 2020 Jill Cueni-Cohen, BSJ

The festival of Purim honors the life of a Jewish heroine named Esther who saved her people from certain death in the 4th century B.C. Every year on the 14th of the Hebrew month of Adar (sundown on March 9 in 2020), this joyous holiday is kicked off with the reading of the Book of Esther and then the fun begins. Jewish children love Purim because it’s the one holiday where they can dress up in costume at the synagogue and make a lot of noise. Girls can dress up like Queen Esther. On the other hand, the boys can portray three main characters: Esther’s cousin Mordechai, King Ahasuerus, or the evil Haman. Commonly known as the Megillah, which means scroll, the Book of Esther is always read during religious services. The kids love it because Purim involves the entire congregation, regardless of age. ESTHER’S STORY Esther’s story took place in ancient Persia. The Jewish people were living under the rule of King Ahasuerus at the time. He killed his wife, Queen Vashti, because she refused his request to appear before him. After her death, King Ahasuerus searched for a new wife and ended up choosing young Esther, unaware that she was a Jew. Esther’s cousin, Mordechai, was the leader of the Persian Jews. He advised her to keep quiet about her true identity and marry the king. Mordechai’s advice was sound because he knew that Persia’s new prime minister - a man named Haman - was a rabid anti-Semite. Mordechai then called attention to himself by refusing to bow down to Haman. Outraged at Mordechai’s subordination, Haman ran to King Ahasuerus to tell him, “There is a certain people scattered abroad and dispersed among the peoples in all the provinces of your realm. Their laws are different from those of every other people’s, and they do not observe the king’s laws; therefore, it is not befitting the king to tolerate them.” (Esther 3:8) King Ahasuerus took his prime minister’s warning seriously and decided to make a decree ordering the extermination of all Persian Jews. As the story is told, everyone in the synagogue reacts to the name “Haman” with “groggers” or noisemakers. Grogger is the Yiddish word for rattle. Most groggers are constructed out of wood or tin. A cog is attached to a handle with a freely rotating slat fitted into the teeth. By swinging the rattle around, the slat is forced to move around the cog which vibrates every time it passes a tooth. This makes a loud, grinding sound. People can also boo, hiss, or make noise with maracas and bells. As the story continues, Haman chose the 13th of Adar as the date when the Jews’ death decree would be carried out. He did so by “drawing lots,” and this is where we get the word “Purim” from. Literally translated, Purim means “lots,” and this is in reference to Haman’s deadly lottery. In anticipation of this date, Mordechai told the Persian Jews to fast starting three days prior to the 13th of Adar. Even Queen Esther, who had been living in the palace and subsisting on seeds in order to avoid eating non-kosher foods, began fasting. Then, on the 13th of Adar, Mordechai told Esther to go to the king and ask him to join her for a feast. This was a dangerous move because anyone who tried to face the king without being summoned could be put to death; however, the king was kind to Esther, and she confessed to him that she was a Jew. The king had grown to love Esther, and he proved it by repealing the death decree before it could be carried out against her people. The king also realized that Haman had been acting as his enemy. For this treason, he was hanged along with his 10 sons in the same gallows that he had previously constructed for Mordechai. Ironically, King Ahasuerus then appointed Mordechai as his prime minister. He also issued a new decree throughout the kingdom granting Persian Jews the right to defend themselves against their enemies. Coronavirus

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans. Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing. https://www.who.int/health-topics/coronavirus

Famous Women Quotes

infecciones son más comunes en otoño e invierno.

¿Cuáles son los síntomas de las infecciones por coronavirus?  Secreción nasal  Dolor de cabeza  Tos  Dolor de garganta Coronavirus  Fiebre  Malestar general La mayoría de las personas se infectan con estos virus en algún momento de su Como prevenir las infecciones por vida. Generalmente causan infecciones coronavirus? leves a moderadas en las vías  Lavarse las manos con respiratorias superiores, como el frecuencia con agua y jabón resfriado común. Pero también pueden durante al menos 20 segundos causar enfermedades más graves,  Evitar tocarse la cara, la nariz o como bronquitis y neumonía. la boca con las manos sin lavar Existen varios tipos de coronavirus humanos, incluyendo el síndrome  Evitar el contacto cercano con respiratorio de Oriente Medio y el personas enfermas síndrome respiratorio agudo grave.  Limpiar y desinfectar las superficies que toca con ¿Cómo se transmiten las infecciones frecuencia por coronavirus?  Cubrirse la tos y los estornudos En general, los coronavirus humanos se con un pañuelo de papel. Luego transmiten de una persona infectada a deseche el pañuelo y lávese las otras a través de: manos  Quedarse en casa cuando está  El aire al toser y estornudar enfermo  Contacto personal cercano, como tocar o estrechar la mano  Tocar un objeto o superficie con el virus para luego tocarse la boca, la nariz o los ojos antes de lavarse las manos ¿Quién está en riesgo de contraer infecciones por coronavirus? Cualquier persona puede contraer una infección por coronavirus, pero los niños pequeños tienen más probabilidades de infectarse. En los Estados Unidos, las

Como arreglar el mundo. Profesor: HÉCTOR J. ROBERT

Cuento corto de Gabriel García Márquez*

Muy propicio para estos momentos que vivimos_ Un cientí fico, que viví a preocupado con los problemas del mundo, estaba resuelto a encontrar los medios para aminorarlos. Pasaba dí as en su laboratorio en busca de respuestas para sus dudas. Cierto dí a, su hijo de 7 años invadió su santuario decidido a ayudarlo a trabajar. El cientí fico, nervioso por la interrupción, le pidió al niño que fuese a jugar a otro lado. Viendo que era imposible sacarlo, el padre pensó en algo que pudiese darle con el objetivo de distraer su atención.

De repente se encontró con una revista, en donde habí a un mapa con el mundo, justo lo que precisaba. Con unas tijeras recortó el mapa en varios pedazos y junto con un rollo de cinta se lo entregó a su hijo diciendo: " como te gustan los rompecabezas, te voy a dar el mundo todo roto para que lo repares sin ayuda de nadie".

Entonces calculó que al pequeño le llevarí a 10 dí as componer el mapa, pero no fue así . Pasadas algunas horas, escuchó la voz del niño que lo llamaba calmadamente. "Papá, papá, ya hice todo, conseguí terminarlo".

Al principio el padre no creyó en el niño!

Pensó que serí a imposible que, a su edad hubiera conseguido recomponer un mapa que jamás habí a visto antes. Desconfiado, el cientí fico levantó la vista de sus anotaciones con la certeza de que verí a el trabajo digno de un niño.

Para su sorpresa, el mapa estaba completo. Todos los pedazos habí an sido colocados en sus debidos lugares. ¿Cómo era posible? ¿Cómo el niño habí a sido capaz?

De esta manera, el padre preguntó con asombro a su hijo: Hijito, tú no sabí as cómo era el mundo, ¿cómo lo lograste?

Papá, respondió el niño; yo no sabí a como era el mundo, pero cuando sacaste el mapa de la revista para recortarlo, vi que del otro lado estaba la figura de un hombre.

Así que di vuelta los recortes y comencé a recomponer al hombre, que sí sabí a como era.

*"Cuando conseguí arreglar al hombre, di vuelta a la hoja y vi que habí a arreglado al mundo" GABRIEL GARCÍ A MÁRQUEZ

*MORALEJA* *PARA ARREGLAR EL MUNDO*  HAY QUE EMPEZAR POR ARREGLAR AL HOMBRE!! EMPEZANDO POR NOSOTROS MISMOS!  Espero les guste . Su profe

DELIRIUM …. AUTORA ISABEL HERBELLO

AMOR, que se alejó como una despedida, ya no te digo adios; Agradezco a la vida ese retorno breve de plena primavera que me hechizó dejándome feliz y bendecida.

¿Dónde quedó el temor ante la expectativa; ¿dónde el pretexto fácil de la huí da. Estás tan lejos, que tu imagen no empaña mi desvelo y el silencio ya devoró mi sueños.

¿Como clamar a una ilusión perdida ; A un lapidado corazón sin llamas; A la inviolada melodí a; Que no estrenó mi alma?

Estoy de pronto como adormecida en unos brazos que agotaron sus alas. En un delirio cósmico, exquisito Que se alojó en mi almohada.

No sé cómo llamarte ahora AMOR que casi se lleva mi vida alegrí a de mis ojos desterrada implacable temblor que se desliza sobre las aguas – ya aquietadas- de mis ansias donde no quiero indagar más Lo que queda de tu vida en la nada CONSEJOS DE BELLEZA NATURALES

Una manera de mantenerse joven es beber el elixir de la naturaleza, beber mucha agua, evitará la piel seca, las arrugas y mantendrá su cabello, uñas y piel suave y flexible, además de hacer que sus órganos y su sistema digestivo funcionen de manera eficiente. Aquellos que beben agua o infusiones con frecuencia limpian su cuerpo de toxinas que provocan estrés.

Una dieta rica en frutas y verduras frescas lo mantendrá joven y saludable. quienes siguen una dieta rica en verduras y frutas frescas sufren menos daño oxidativo,las verduras contienen antioxidantes, que revierten los signos del envejecimiento.

Use crema hidratante en todo el cuerpo justo después de una ducha , Esto regularmente hará maravillas con la suavidad y la elasticidad de su piel, ya que la dejará protegida contra las arrugas y la mantendrá suave y tersa.

Hay grasas buenas y grasas malas. Resulta que las grasas que recibe del aguacate, del aceite de oliva, de las nueces, del coco y de los pescados grasos (es decir, el salmón y el atún) son muy buenas para usted y para su piel. Los beneficios de los ácidos grasos omega 3 y omega-6 mantendrán su piel, su cabello y sus uñas con las vitaminas y nutrientes necesarios para que se vean brillantes.

Hay algo que se dice acerca de aquellos que adoptan la perspectiva de “ver el vaso medio lleno” en la vida — son felices. Y mientras más sonría y se concentre en lo positivo, más evitará el estrés, alejará el drama y seguirá sintiéndose y viéndose más joven de lo que es.

Magy

El Día de San Patricio se celebra todos los años el 17 de marzo. El Día de San Patricio es el día del santo patrón de Irlanda en el que se puede disfrutar de un día lleno de espectáculos celtas.

Origen El Día de San Patricio se celebra anualmente para conmemorar el fallecimiento de San Patricio, Santo Patrón de Irlanda. Hoy en día se ha convertido en una fiesta celebrada por cada vez por más gente aunque no tengan ascendencia irlandesa.

San Patricio nació en el año 387 en Kilpatrick, Escocia. A los 16 años fue tomado prisionero durante 6 años en Irlanda. Cuando quedó en libertad se marchó a prepararse la vida monástica en Francia. Años más tarde volvió a Irlanda para evangelizar a sus habitantes llegando a convertir a los irlandeses paganos al cristianismo.

Trébol de tres hojas

El shamrock o trébol de tres hojas es el símbolo oficial de Irlanda y de Boston y se ha convertido en un elemento importante en la celebración del Día de San Patricio. La tradición cristiana atribuye a San Patricio la utilización de un trébol de tres hojas para explicar el misterio de la Santísima Trinidad: El Padre, el Hijo y el Espíritu Santo. Los seguidores de esta costumbre llevan un trébol en la celebración de la festividad.

¿Cómo se celebra?

La temática de este día está relacionado con todo aquello que es verde por el color de la bandera de Irlanda por lo que es muy típico vestir e verde.

El tema del Día Internacional de la Mujer (8 de marzo) de 2020 es, Soy de la Generación Igualdad: Por los derechos de las mujeres. El tema es conforme con la nueva campaña multigeneracional de ONU Mujeres, Generación Igualdad, que conmemora el 25º aniversario de la Declaración y Plataforma de Acción de Beijing, que fue aprobada en 1995 en la Cuarta Conferencia Mundial sobre la Mujer, que tuvo lugar en Beijing, China, y es reconocida como la hoja de ruta más progresista para el empoderamiento de las mujeres y las niñas en todo el mundo. El año 2020 es un año decisivo para la promoción de la igualdad de género el 20º aniversario de la resolución de las Naciones Unidas sobre las Mujeres, la Paz y la Seguridad; y el 10º aniversario de la creación de ONU Mujeres.

En lodos los siglos e idiomas los grandes poetas no pudieron sustraer su pluma a la mujer, desde su diivina acepción como madre, hasta su imagen de maldad que lleva a la muerte.

En el siglo XVI un poema la describe...... de Lopez de Vega

Es la mujer del hombre lo más bueno, y locura decir que lo más malo, su vida suele ser y su regalo, su muerte suele ser y su veneno. Cielo a los ojos, cándido y sereno, que muchas veces al infierno igualo, por raro al mundo su valor señalo, por falso al hombre su rigor condeno. Ella nos da su sangre, ella nos cría, no ha hecho el cielo cosa más ingrata: es un ángel, y a veces una arpía. Quiere, aborrece, trata bien, maltrata, y es la mujer al fin como sangría, que a veces da salud, y a veces mata.