text:
This is what the recently retired canon of St Paul's Cathedral, the Rev Giles Fraser, had to say in an interview in Friday's Guardian:
"I used to be a socialist and for a long time I did have the view that there was something intrinsically immoral about capitalism. I changed my mind quite fundamentally about that quite a few years ago. I had a conversion sitting in Notting Hill market, reading the chief rabbi on the subject – an essay called 'the moral case for market economy'."
Perhaps not quite a road to Damascus moment but then Notting Hill is a lot safer especially these days.
I do however wonder whether the Chief would ever dare tell the world of a conversion of his by a leader of another faith. He got himself into trouble in the past when suggesting that Judaism may have something to learn from others, which he then hastily retracted. Ever since he has steered clear of sensitive issues for fear of getting tangled in the knotty beards or the crocheted yarmulkes.
It is a shame he lacks his predecessor's forthrightness on anything from Israel to charedim. For while the world benefits greatly from his writing and speeches Judaism sorely lacks someone of his stature and capabilities to give us some straight talking.
Well, a rabbi resigning on point of principle. When was the last time you heard that one?


text:
For International Donors
RB88热博官网 www.cfwlf.com SUA has been supported by generous individuals all over the world, such as Asia, Oceania, Europe, North & South America, and Africa. In 2008 over 90% of Soka's students, both domestic and international, received financial aid totaling over 8 million dollars; which included nearly 5 million dollars in need-based grants and 3 million dollars in merit-based scholarships.
The mission of Soka University is to "foster a steady stream of global citizens committed to living a contributive life." Nearly 50% of current students are from 30+ other countries, and all students will participate in a Study Abroad/International Internship during their junior year.
Your generous support enables students from all over the world to receive an opportunity for humanistic education for global citizens.
The ways to give
- Giving online is an easy process that is safe and secure. This allows you to give immediately with your credit card (VISA, MasterCard, American Express or JCB) in a short and simple process.
- Wire Transfer
- A local bank or other financial institution can transfer the fund. Please contact us by email: firstname.lastname@example.com for the bank information.
- Mail Check
- A cashier's check or money order can be sent directly to the office of International Development. The denomination should be in US$.
- Please make it payable to "Soka University of America" and mail to the following address.

subset: commoncrawl


text:
CHESTER, Pa. — A 10-man Colorado Rapids took the lead and refused to let go despite heavy pressure from the Philadelphia Union to walk out of a sold-out PPL Park on Sunday afternoon with a hard-fought 2-1 win.
Colombian import Jaime Castrillón scored his first goal in MLS to give the Rapids a 1-0 advantage in the second half and rookie Tony Cascio doubled the lead just minutes later.
The Union were unable to capitalize on their chances more than just once, when Lionard Pajoy got on the scoresheet, despite playing most of the second half up a body after Jeff Larentowicz was sent off.
It was nearly a dream start for manager Peter Nowak & Co., who were opening their home in 2012. Less than 30 seconds into the match, Danny Mwanga got behind the Colorado defense only to be taken down by Drew Moor from behind. Referee Mark Geiger did not whistle for a foul on the challenge, however, and play rolled on.
Making his first start of the season, Mwanga was a focal point of the Union attack early on, combining well with strike partner Pajoy. In the 30th minute, the former Oregon State standout nearly opened the scoring, but was unable to get his foot on the end of a Sheanon Williams chip over the Colorado defense.
In the 41st minute, Keon Daniel – making his first appearance at PPL Park since last August – set Mwanga up with a lofted ball over the top. The subsequent left-footed shot to the far post was stopped by Matt Pickens, with the rebound pushed tantalizingly across the face of goal. Pajoy lunged forward to finish the opportunity, but Moor swept away the danger.
The teams went into the locker rooms at halftime tied 0-0, and though the Union continued to control the run of play after the break, it was Colorado who struck first.
In the 56th minute, Omar Cummings got to the endline and played in a cross that slipped through the hands of Philly 'keeper Zac MacMath but didn't escape Castrillón, who tapped in the loose ball at the back post.
The complexion of the match changed drastically for the visitors just moments later, though, as Larentowicz was sent off for his second yellow card.
Despite the subsequent Union onslaught and the man disadvantage, the Rapids managed to double their lead in the 62nd minute, when Cascio got in behind Chris Albright on the wing, moved in on goal, and fired under the leg of MacMath and into the net.
Looking to cut into the lead, Nowak brought on Roger Torres, and the move paid immediate dividends. In the 67th minute, Torres gathered a cleared corner kick and whipped a curling cross into the penalty area. Pajoy met the service just outside the six-yard box and powered a diving header under the arms of Rapids netminder Matt Pickens to halve the deficit.
The Union came within inches of tying the score in the 71st minute. With a few quick cuts, Pajoy eluded a couple of challenges inside the box before putting a pass across the box. Michael Farfan redirected the close-range delivery, but his looping attempt on goal bounced off the crossbar before being cleared away.
Philadelphia continued to push for an equalizer, with Josué Martinez entering the match in the 79th minute. An aggressive aerial challenge from the former Saprissa striker set up Pajoy at the top of the box, but the Colombian's open look went high and wide.
Despite their best efforts, the Union ultimately could not find a second goal, with Colorado hanging on for the 2-1 victory.
The loss was the Union's first in a home opener, giving the team an 0-2-0 record for the first time to start a season. The club will look to rebound next Saturday when they travel to take on the Chicago Fire at Toyota Park.
For the Rapids, the win moves them to a perfect 2-0-0 to start the season. They will head to New York next to face the Red Bulls next Sunday in a match that will be broadcast on ESPN (2 pm MT)
Scoring Summary:
COL: Jaime Castrillon 1 (unassisted) 56'
COL: Tony Cascio 1 (unassisted) 62'
PHI: Lionard Pajoy (Roger Torres) 67'
Disciplinary Summary:
PHI: Gabriel Gómez (yellow) 31
COL: Jeff Larentowicz (yellow) 44
PHI: Michael Farfan (yellow) 52
COL: Jeff Larentowicz (2nd yellow, ejection) 58
COL: Jaime Castrillon (yellow) 74
PHI: Roger Torres (yellow) 91
Colorado lineup: Matt PIckens, Kosuke Kimura, Marvell Wynne, Drew Moor, Luis Zapata, Jeff Larentowicz, Pablo Mastroeni (Ross LaBauex 76'), Jaime Castrillon, Brian Mullan, Tony Cascio (Wells Thompson 68'), Omar Cummings (Quincy Amarikwa 83')
Subs not used: Stew Ceus, Scott Palguta, Tyrone Marshall, Andre Akpan.
Philadelphia lineup: Zac MacMath, Chris Albright (Roger Torres 63'), Carlos Valdez, Porfirio Lopez, Keon Daniels (Christian Hernandez 72), Gabrial Gomez, Brian Carroll (Josué Martinez 79), Michael Farfan, Danny Mwanga, Lionard Pajoy


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WASHINGTON, DC, December 9, 2008 – The three major financial planning organizations in the United States – Certified Financial Planner Board of Standards, Inc., Financial Planning Association®, and National Association of Personal Financial Advisors – announced today that they are holding a series of exploratory meetings to discuss a unified response to widely expected reform of the financial services industry in the 111th Congress.
The leadership of the three organizations met on Dec. 3, 2008, at CFP Board's Washington, D.C. offices. The purpose of the meeting was a general review of regulatory gaps in the delivery of retail advice and other financial services to consumers, and the opportunities and threats with respect to establishing appropriate standards of conduct for the financial planning profession. Financial planning is currently regulated indirectly through licenses held by investment advisers, securities brokers and insurance producers or consultants, but not as a separate, stand-alone profession.
"We are very pleased to have opened positive lines of communications within the financial planning community to discuss an issue that is so critical to consumer protection," the group said in a joint statement. "As a component of regulatory reform, we anticipate that, at some point in the near future, Congress will consider enhanced protections for consumers of financial services."
"The global financial crisis will require comprehensive review of the regulatory structure by Congress. The three organizations, over the coming weeks and months, will actively solicit feedback from stakeholders on future regulation of the financial planning profession. They will also reach out to other organizations that share the same belief that high ethical standards and qualifications for advisory services are needed more than ever to benefit the public."
About CFP Board: The mission of Certified Financial Planner Board of Standards, Inc. is to benefit the public by granting the CFP® certification and upholding it as the recognized standard of excellence for personal financial planning. The Board of Directors, in furthering CFP Board's mission, acts on behalf of the public, CFP® certificants and other stakeholders. CFP Board owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNER™ and federally registered CFP (with flame design) in the U.S., which it awards to individuals who successfully complete CFP Board's initial and ongoing certification requirements. CFP Board currently authorizes more than 58,000 individuals to use these marks in the United States. For more about CFP Board, visit www.CFP.net.
About FPA: The Financial Planning Association® (FPA®) is the leadership and advocacy organization connecting those who provide, support and benefit from professional financial planning. FPA demonstrates and supports a professional commitment to education and a client-centered financial planning process. Based in Denver, Colo., FPA has close to 100 chapters throughout the country representing more than 29,500 members involved in all facets of providing financial planning services. Working in alliance with academic leaders, legislative and regulatory bodies, financial services firms and consumer interest organizations, FPA is the community that fosters the value of financial planning and advances the financial planning profession. For more information about FPA, visit www.FPAnet.org or call 800.322.4237.
About NAPFA: Since 1983, The National Association of Personal Financial Advisors (NAPFA) has provided Fee-Only financial planners across the country with some of the strictest guidelines possible for professional competency, comprehensive financial planning, and Fee-Only compensation. With more than 2,000 members across the country, NAPFA has become the leading professional association in the United States dedicated to the advancement of Fee-Only financial planning. For more information on NAPFA, please visit www.napfa.org.
# # #
More Events
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Complications resulting from
sinusitis are relatively rare. But when
complications do occur, they may be life-threatening and often require extensive
medical or surgical treatment.
The complications of sinusitis usually involve the spread of the
infection beyond the sinuses.
Sinusitis may also increase symptoms of
asthma and other lifelong (chronic) lung diseases.
Sinus infections are a common problem for people who have asthma. Treating
sinusitis may also help control the symptoms of asthma.
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I have updated this page because of recent posts by "Davis" who appears to have something to do with Local Grassroots - http://www.local-grassroots.com/, as website that encourages greater involvement in the affairs of the TWU.
I think these top two still work. Check out this new site, above, it seems pretty level.
Local 8 - http://www3.telus.net/twulocal8/index.html
Local 16 - http://www.twu16.shawbiz.ca/
Deleted due to dead liinks, if you know where they are now, send us a note:
Local 32 - http://www.twu-local32.ca/index-new.html (just links back to TWU home page now)
Local 60 - http://www.twulocal60.ca/
Local 213 - http://twu213.pfak.org/
Local 503 - http://twulocal503.com/
Hey everyone. I got some time to do the latest update to the board software, but it meant that all the old modifications and styles wouldn't work anymore. So, here you have the newest iteration of LabourTalk. Please let me know by Private Message if you run into any issues with the new styling. Some new features on the board are:
We hope you like the changes!
- Latest HTML5 Responsive Styling - You can now see a new, more modern styling on the board. Along with this, you can resize the browser to see the board change with it. The board is now functional on all sizes of screens, including your cell phone, table and desktop/laptop.
- Post Sharing - Although you could previously, the new layout means the sharing icons are more visible on the lower right hand corner of each post. Click your favourite social media outlet to share the desired post with them.
- Multiple Themes - Previously there was only one theme in an attempt to lower the workload when modifications were put in place. Fortunately, the new modification system is much simpler to implement and we now have multiple colour options for you to enjoy. You can change these from your User Control Panel under the Board Settings heading.
- Announcements - Announcements can now be posted here (where you're seeing this one) and, in most cases, can be dismissed. To dismiss them, please click the "X" in the top right corner of this box.
- Collapsing Categories - Categories, such as News & Announcements or Welcome (below), can be collapsed to clear up some of the clutter. This state should be maintained as long as you're logged in.
We hope you like the changes!
TWU Websites
Add your links here. Could be caselaw or links to other orginizations.
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Now that many advisory firms have mostly recovered from the down markets of 2008 and 2009, it may be time to address what I've come to believe is a rather serious flaw in the independent advisory business model. This idea was brought home to me the other day as I was catching up with an old friend who runs a small, but successful, fee-only independent firm. She was lamenting the fact that her firm's revenues had begun to recover when the market took its downturn this past spring; as a result, her cash flow was once again below a comfortable level.
Most financial advisors who base their services on financial planning also recommend that their clients buy and hold carefully constructed portfolios, with their holdings allocated between low-correlating asset classes to reduce risk and smooth out market downturns. The idea is that much like the homes that clients own, investment portfolios don't really experience losses until the holdings are actually sold. If they don't sell out when asset values are down, and have the fortitude and a long enough time horizon to wait until the markets and their asset values recover, they will continue to grow their portfolios at acceptable rates. This makes financial sense because the powerful U.S. economy always manages to recover, and grow larger.
This is all well and good for the clients. Although some advisors today are beginning to question this long-term, buy-and-hold strategy, the markets have indeed always recovered and this strategy has well served at least two generations of financial planning clients: there are also many advisors today who see no reason to try something else.
Does Buy and Hold Help Advisors?
Here's my question: Has the long-term buy-and-hold investment strategy served the independent advisors who recommend it as well as it has served the clients who use it? The problem is that advisory firms don't have nearly the long-term time horizons as most of their clients. What's more, most of their clients have jobs that generate a separate cash flow, some of which, of course, goes into their portfolios. But most advisory firms don't have another source of revenues: because they charge fees based on a percentage of their client assets under management, their only source of revenues is the assets themselves. So when those assets go down, so do firm revenues—sometimes quite significantly, as they did in 2008-2009.
This is what the business school guys would call a weak business model: It is locked into delivering a set of services that virtually guarantees a wildly cyclical revenue stream. In the investment advisory business, periods of substantially lower revenues aren't unfortunate occurrences; they are regular, entirely predictable events: we may not know exactly when they are going to happen, but we know for sure they will happen, with some regularity. Since I've been covering financial advisors, I've witnessed four such periods: 1987, 1991, 2001, and 2008.
Back in 2002, after the dust of the dot.com crash and 9/11 had started to settle, veteran financial advisor and industry leader Harold Evensky wrote an article questioning the advisory business model, suggesting that advisory firms switch their compensation structure to flat, rather than asset-based, fees. I have to admit that I didn't think very much of Harold's idea, and wrote as much at the time. My objection was that from a PR perspective, advisors would look like jerks converting to flat fees at a time when portfolio values had fallen, and asset-based revenues were down.
But bad timing aside, Harold's model may very well have been the right one: Or at least some combination of fixed and asset-based compensation. Because it's very hard to grow an advisory business when every seven to 10 years cash flow falls into the red. Only this time, let's make sure that portfolio assets are back up before we start talking to clients about changing their fee structures.


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You've probably seen that Macy's commercial that takes that song from that musical about poor kids dying of AIDS in 1989 and juxtaposes it with images of delicate silver jewelry. And, if you're like me, you've thought: What the fuck?
I don't think I'm exaggerating at all here when I say that this is one of the most uncomfortably bad song choices to be featured in a commercial in awhile, and, forgive me for sounding like Seth Meyers here, but REALLY?!, Macy's? REALLY?! And, to whoever sold the rights to that song: REALLY?!
I get that Macy's is trying to somehow harness the hopeful optimism of the words of the song, that they're trying to communicate to viewers that buying shit for those you love is appropriate for all seasons (seasons of LOVE!), but, in case every single one of the people who green lit this have forgotten: Rent is a musical about being poor and having AIDS. And it's 1989. And many of the characters are dying of AIDS. Do you really want to associate dying of AIDS with your line of your products? And how about the fact that the commercial ends with a shot of a bride haughtily flashing her big sparkly ring at the camera? You know who can't get married, bride? Gay people, some of whom have been disproportionately affected by AIDS. And people who died of AIDS in 1989.


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ATLANTA, Jan. 23 (UPI) -- Online retail giant Amazon.com could be gearing up for a legal battle over a sales tax law a law professor said is open to legal debate.
"My inference is that they feel comfortable challenging the legislation, probably with good reason," said University of Connecticut School of Law Professor Richard Pomp, referring to Georgia's new tax law requiring online companies to charge a sales tax for customers from Georgia.
The U.S. Supreme Court has ruled states can charge taxes only from businesses that have a presence in that state -- a ruling that first came up in reference to catalog sales companies.
Amazon has fought legal battles across the country and has made deals with several states to allow them temporary stays from sales tax in exchange for the company providing jobs in that state, The Atlanta Journal-Constitution reported Wednesday.
Georgia and other states have responded by writing laws that extend the concept of having a presence in a state so that it also includes firm or other agents that collect a fee from Amazon for directing Internet visitors to the retail giant.
Georgia's new law began at the start of the year, but the website does not appear to be collecting sales tax from Georgia residents. Nor did it return phone calls looking for comment on the subject, the newspaper said.
"Our expectation is that the law would be abided by," said attorney Ryan Teague, executive counsel to Georgia Gov. Nathan Deal.
By not collecting the tax, Amazon could be setting itself up for an audit by the Georgia Department of Revenue and that could end up with a court battle, said University of Arizona Rogers College of Law Professor Jud Seymour.


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911 caller among four dead in Longmont murder-suicide
The Associated Press
LONGMONT – Dispatchers listened as a Colorado woman who called 911 to report a shooting was apparently killed as she begged for her life in the pre-dawn hours Tuesday.
She was among four people found dead at a home near Longmont, about 35 miles north of Denver, in what police are characterizing as a murder-suicide.
Emergency phone line operators heard the woman scream "no, no, no," cries that were followed by what sounded like a gunshot, Weld County sheriff's spokesman Tim Schwartz said. A man then picked up the phone and said he was going to kill himself before dispatchers heard what they believe was another shot fired, Schwartz said.
Authorities have not identified the victims or the man they suspect as the shooter. The dead included two men and two women. Police said they are convinced the gunman was among those killed.
There were no apparent survivors, Schwartz said.
It was unclear whether all four lived in the home, Schwartz said.
Investigators think they have uncovered a motive for the shootings, Schwartz said. He refused to release such details, however.
A handgun believed to be murder weapon was recovered.
As investigators searched the home, a woman slipped under the crime tape and ran toward the house. The unidentified woman was restrained by police, fell to the ground on her knees and began crying before being led away.
A pickup truck with Texas license plates, meanwhile, sat idling in the driveway while police waited for permission to enter the vehicle. A neighbor said it had been running since morning.
Several neighbors described what happened around 4 a.m. Tuesday.
Joyce Vibbert said she heard three gunshots and a woman's voice.
"It was just screaming. I couldn't hear what she was saying. It was just screaming," she said.
Vibbert said she couldn't see what was happening from her bedroom window.
Kathy Tubb said she heard the shots at about the same time and had no idea what was happening.
She said when her husband went outside to warm up the car to go to work, she saw a policeman wearing a helmet and armed with a rifle standing in the street. Tubb said her husband was worried there might be a gunman still on the loose and feared for his life.
Desirae Swazoe said she awoke shortly after 4 a.m. and heard repeated shouting, "Weld County Sheriff's Department! Open the back door! Do it now!"
Associated Press writer Steven K. Paulson reported from Denver.
Start a dialogue, stay on topic and be civil.
If you don't follow the rules, your comment may be deleted.


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Students in the San Francisco Bay area were invited to create artwork inspired by a word or phrase from Martin Luther King's "I Have a Dream" speech. A jury of distinguished judges from SFMOMA, the Oakland Museum, Museum of the African Diaspora/MOAD, and others selected a winner and two runner-ups in the Elementary, Middle, and High School categories, as well as an over-all Grand Prize winner. Come see beautiful examples of the young artists' works on display at the Main Library Children's Center from February 5 to March 31st, 2013.
Produced by Karz Productions, the San Francisco/Bay Area The Dream @ 50 art contest is sponsored by Target, along with co-presenters including the San Francisco Unified School District, the Alameda County Office of Education, CBS Outdoor, the Children's Creativity Museum, Oakland Public Library, the Museum of the African Diaspora/MOAD, the San Francisco Arts Commission, and the San Francisco Museum and Historical Society.


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Starting MSRP from $15,295
- Vehicle user interface is a product of Apple and its terms and privacy statements apply. Requires compatible iPhone and data plan rates apply. Apple CarPlay is a trademark of Apple Inc. iPhone is a trademark of Apple Inc., registered in the U.S. and other countries.
- Vehicle user interface is a product of Google and its terms and privacy statements apply. Requires the Android Auto app on Google Play and an Android compatible smartphone running Android 5.0 Lollipop or higher and data plan rates apply. Android, Android Auto, Google, Google Play and other marks are trademarks of Google Inc.
- Always use safety belts and child restraints. Children are safer when properly secured in a rear seat in the appropriate child restraint. See the Owner's Manual for more information.
- Visit onstar.com for vehicle availability, details and system limitations. OnStar acts as a link to existing emergency service providers. Not all vehicles may transmit all crash data.
- EPA estimate for Sonic with available 1.4L turbocharged engine and 6-speed manual transmission.
New 2018 Chevrolet Sonic at our dealership in Darlington
Discover the new Chevrolet Sonic, available to buy or lease today at Patriot Chevrolet of Darlington. On this page, you will find the 2018 Sonic vehicles that are currently available to buy or lease at our Darlington dealership, be able to see the exterior color options, view photos, and more. If you have a question about this new Sonic or any other new or used vehicle at Patriot Chevrolet of Darlington, please give us a call at (877) 476-8157, and our friendly staff will be happy to assist you.


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One of Vizag's breathtaking locations, a 16th Century Buddhist Complex discovered during an Indian Navy aerial survey. For further information refer the following links-
Visakhapatnam, also known as Vizag, is the second largest city in Andhra Pradesh, after the state capital Hyderabad. It is the industrial capital of the state with major industries such as Steel Plant, HPCL, Hindustan Shipyard, NTPC, etc. It is blessed with a natural harbour and houses the Headquarters of Eastern Naval Command of the Indian Navy. Popularly known as the City of Destiny is a jewel on the east coast of India. It has some breathtaking beaches, thronged by the Eastern Ghats. Naturally formed red sand dunes(reminiscents of rivers), Buddhist monuments, etc., add to the beauty of the city.For more information refer to the Wikipedia page.


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Kentucky has completed a two-year, statewide initiative to move 173 school districts onto a cloud-based enterprise resource planning system, currently making the state's education system one of the largest in the country to deploy a financial management system in the cloud.
The state moved the school districts from traditional on-premise deployments of Tyler Technologies' Munis ERP system to a hosted Munis solution, according to a release. The Kentucky Department of Education (KDE) has been a Munis client for 18 years. KDE recommended its school districts migrate to a hosted Munis solution for numerous benefits, state officials said.
"Kentucky is a national P-12 leader in cloud computing and has already successfully transitioned many services to the cloud, including statewide e-mail, and we believe that migrating to a hosted Munis solution is the best investment of state dollars for the long term," David Couch, associate commissioner for the Office of Knowledge, Information and Data Services, said in a statement.
The on-premise infrastructure had gotten old, requiring significant investment to keep it up and running. Moving to Munis' cloud-based model will increase reliability and capabilities for Kentucky's school districts, while taking a lot of work off the IT staff, Couch said.
"Cost reductions are a benefit of cloud-computing, but for Kentucky schools, our primary driver was increasing the reliability of services beyond what our aging on-premise infrastructure could provide," he said.
A hosted solution also gives the school districts more efficient disaster-recovery services than an on-premise solution. And a cloud-based solution ensures the districts will have the most current version of Munis without disruption of business or relicensing costs, officials said.
Kentucky and Tyler officials transitioned approximately 10 districts per month in less than two years, and completed the project on time and on budget, said Richard Peterson, president of Tyler's ERP & School Division.
Tyler provides cloud-based ERP services to several municipalities and on-premise ERP to dozens of cities. The town of Mount Desert, Maine, recently signed a 10-year agreement to access Munis via Tyler's software as a service platform. The company has offered cloud-based ERP services to Boulder City, Nev. since September 2012.
Two years ago, former federal CIO Vivek Kundra predicted that financial management systems would be the next step in the cloud for government agencies. The difficulty of wrestling with large internal financial systems would prompt agencies to move those systems to the cloud, he said at the time.
About the Author
Rutrell Yasin is is a freelance technology writer for GCN.
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Archival Pigment Print, 2015
Palimpsest #10 (Archival Print)
from 36.00
Archival Pigment Print, 2015
Printed on 100% Acid-Free Cotton Rag Paper
With Archival Inks
Signed & Numbered by Artist
Ready-to-Frame Sizes
Limited Editions of 25
The idea for this series came from an interest in creating something new out of repurposed and altered materials. These works are layered in such a way that traces of their earlier form are still visible.
* View original art for sale from this series.
Size/Framing Options:


text:
The Potomac State College of WVU Athletic Department is proud to offer its athletes two full-time Certified Athletic Trainers(ATC) and a renovated athletic training facility. The Athletic Training Department consists of two well-equipped athletic training room.
The main Athletic Training Room is located in the basement of Lough Gymnasium. It is conveniently located near the home and visitor locker rooms and down stairs from the main gym. It houses the Certified Athletic Trainer's office and is fully equipped with electrical stimulation, ultrasound, and hot and cold modalities for daily athlete treatments and rehabilitation.
The fieldhouse Athletic Training Room is located directly adjacent to the baseball field, the football/soccer field, and the softball field. Its location makes it convenient for athletes that require pre-practice and pre-game treatments.
Having two full-time certified athletic trainers means that all in-season team practices and games have athletic training/medical coverage. The Certified Athletic Trainer and the staff of student athletic trainers are available throughout the day to aid athletes in any way possible. The PSC Athletic Training Department also has a team physician that is readily available, as well as, several other local physicians that are more than willing to see athletes when a referral is necessary.


text:
We couldn't be more pleased with your professionalism and customer care, read more…
I have met John several times and he is one of the nicest guys I know.
Although my husband dealt with John – All turned out as discussed. Thanks.
25 Fox Meadow Dr
Abbottstown, PA 17301
Phone: 717-577-7329
Email firstname.lastname@example.com
John Parichuk Paving
25 Fox Meadow Dr
Abbottstown, PA 17301
Call 717-577-7329
Website SEO By Fuhrman Creative, LLC


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Welcome to Sirio Antenna Store - USA!
Locate in the Silicon Valley, the SirioAntenna.COM is dedicated to delivering top quality Ham radio equipments to the enthusiasts around the world, a tradition that has kept many of our customer happy since 2000.
At SirioAntenna.COM, we specialize import to the maximum the best radio products from around the world and sell them at the lowest possible prices. Everything we sell comes with a manufactuer warranty. Our customer not only get a good price on a quality item but also Fast Shipping and Great Customer Service.
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1. Definitions
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6. Processing of Personal Data
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From time to time FLE Learning may pass personal data (including sensitive personal data where appropriate) to third parties, including local authorities, other public bodies (eg, UK Border Agency, HM Revenue and Customs, British Consulate in different countries), health care professionals, social activities providers, university/college/hotels providing conference venue, who will process the data:
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FLE Learning will endeavour to ensure that all personal data held in relation to students is accurate and up to date. Delegates must notify FLE Learning of any changes to information held about them. A delegate has the right to request that inaccurate information about them is to be corrected.
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It sounds like it's getting close to the end of league season but is it to late for a new guy to get in. I usually play at Wyandotte so it's not to far and I have been wanting to get up there and play. I've only been playing four months so I'm not very good. Maybe you guys can straighten me out.
Tomorrow is the last USM Tuesday of the season (unless we go glow a few times). 4:45pm sharp tee time. If we get more than five we may split into two cards.


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LANDOVER, Md.—Senior Chris Snyder (McConnellsburg, Pa./McConnellsburg) won the 1,000-meter run to lead the UMBC men's track and field team to a first place finish out of 31 schools at the Terrapin Indoor Invitational Saturday. The men finished with 105 points, while the women finished seventh with 29 points.
UMBC went 1-2-3 in the 1,000-meter run, with Snyder winning gold in a UMBC season-best time of 2:30.49. Senior Michael Christmas (Invercargill, New Zealand/James Hargest College) and freshman Jake Albino (Hampton, N.Y./Minisink Valley) earned silver and bronze, finishing in 2:31.39 and 2:31.77, respectively.
Senior Martin Nevarez (Casa Grande, Ariz./Central Arizona College) earned bronze in the pole vault, hitting a mark of 4.70m, while junior Sam Wilson (Davidsonville, Md./South River) and sophomore Sean Kshimetski (Pasadena, Md./Chesapeake) finished 10th and 11th with vaults of 4.25m and 4.10m, respectively.
Junior Aaron Brooks (Upper Marlboro, Md./Dematha) just missed the school record in the shot put, finishing third with a throw of 15.39m, while sophomore Cameron McDearmon(Owings Mills, Md./Franklin) was ninth with a mark of 13.89m. McDearmon finished third in the weight throw with a heave of 15.90m and Brooks placed sixth with a mark of 15.03m.
In the 800-meter run, freshman Andrew Smith (Chadds Ford, Pa./Garnet Valley) finished fourth in a time of 1:58.61, while junior Roy Jones (New Market, Md./Linganore) crossed just after in fifth in 1:58.86 and fellow junior Patrick Hairfield (Abington, Md./Archbishop Curley) was eighth in 2:00.03.
Senior Chris Bowie (Bethesda, Md./Bethesda-Chevy Chase) finished sixth in the 3,000-meter run in a time of 8:59.94, while junior Tim Jones (New Market, Md./Linganore) placed 10th in the 1-mile run in a time of 4:25.80.
Sophomore Shioma Obembata (New Rochelle, N.Y./Iona Preparatory/St. Francis College) placed sixth in the triple jump with a leap of 13.84m.
Freshman Brandan McGee (Hiram, Ohio/Crestwood) crossed the line seventh in the 5,000-meter run in 15:11.34, while sophomore TJ Cowing (Severna Park, Md./Severna Park) was next in 15:12.39.
Sophomore Trae Proctor (Brandywine, Md./Thomas Stone) placed seventh in the 60-meter hurdles in a time of 8.27. Freshman Dosu Teyibo (Silver Spring, Md./Barrie) placed 10th in the long jump with a leap of 6.26m.
On the women's side, junior Laura Walker (Eldersburg, Md./Liberty) broke the school record in the pole vault and earned bronze, reaching a height of 3.20m.
In the shot put, sophomore Amanda Deller (Aberdeen, Md./Aberdeen) earned bronze with a throw of 13.39m, while junior Chrissy Robinson (Lusby, Md./Patuxent) hit a mark of 12.57m, good enough for seventh. Deller also took home bronze in the weight throw with a heave of 15.86m.
Junior Kiki Malomo-Paris (Northern Ireland/Glenlola Collegiate School) finished sixth in the long jump with a leap of 5.41m, while fellow junior Imani Colbert (Upper Marlboro, Md./C.H. Flowers) placed seventh in the 60-meter hurdles in an ECAC-qualifying and UMBC season-best time of 8.73.
Freshman Deborah Adelola (Lanham, Md./Bladensburg) finished 10th in the 400-meter dash in a time of 1:00.01.
The Retrievers return to action next Saturday, with most of the team competing at George Mason, while a few will travel to Penn State.


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Daniel Ramos is alleging assault, battery, negligence and violation of his civil rights in the lawsuit. He claims he suffered a terrifying attack by Kanye West at Los Angeles International Airport.
The alleged attack could give a green light to further celebrity-paparazzi scuffles. Our list of celeb-pap standoffs would suggest it's not really needed...Picture: Splash News


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NEW YORK, NY - August 1, 2012 - Nationally-syndicated morning talk show "LIVE! with Kelly" announces the lineup of guest co-hosts who will join Kelly Ripa during the week of August 13-17, 2012.
August 13, 2012 - "Dancing with the Stars" judge CARRIE ANN INABA co-hosts with Kelly this morning. Kelly and Carrie Ann speak with Lisa Kudrow about the series "Web Therapy," and "Dallas" star Larry Hagman stops by.
August 14, 2012 - "Bachelor Pad" host CHRIS HARRISON joins Kelly as co-host today, and they sit down with Jordin Sparks from the new film "Sparkle." Plus, Dr. Greg Yapalater gives tips on getting kids ready for the new school year.
August 15, 2012 - Broadcaster BRYANT GUMBEL returns as Kelly's co-host, and they revisit recent chats with actress Jenny McCarthy, "So You Think You Can Dance" judge Cat Deeley, and Miss USA Olivia Culpo.
August 16, 2012 - BRYANT GUMBEL is back as Kelly's co-host today. Kelly and Bryant look back at their recent interview with First Lady Michelle Obama, plus White House Garden cooking with Chef Marc Forgione.
August 17, 2012 - NFL broadcaster MICHAEL STRAHAN finishes the week as Kelly's co-host. Kelly and Michael show an encore presentation of their chats with leading men John Travolta, Channing Tatum and Andrew Garfield.
Emmy Award-winning talk show "LIVE! with Kelly" is distributed in national syndication by Disney-ABC Domestic Television. Produced by WABC-TV in New York and executive produced by Michael Gelman, "LIVE! with Kelly" airs in more than 200 markets across the U.S. Visit "LIVE" on the web at www.livewithkelly.tv, on Facebook, or follow "LIVE" on Twitter, @LiveKelly.


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Clinging to the twists and turns of my family tree
I came to your blog to look at your Sepia Saturday for this week and saw your cars - had to look at all of them. I love this photogaph. The little girl is adorable! It's interesting that she's wearing a swimsuit and her mom is wearing a coat.


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Posts Tagged 'texting'
Society - Written Friday, June 18, 2010 by Naumi Haque - 5 Comments
The Net Gen: Too plugged-in for parenting?
Actually, the title of this post should really be, "The Net Gen: Too connected to wireless devices, social media, and 'always-on' technologies for parenting," but "plugged-in" just sounded better. In fact, fewer of us are actually physically plugged-in these days, with smart phones replacing computers as the device of choice for digital accessibility as well as 'interrupt-ability.' We've researched the effect this has on the Net Generation as both customers and employees, but as this generation gets older (the oldest Net Geners are now 32), it's also worth discussing how it will affects them as parents. We know that many Net Geners are waiting longer to have kids, but for those that have taken the plunge, how does the experience of 'growing up digital' translate into parenting behaviours and attitudes towards technology in the home?


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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
This complementary and alternative medicine (CAM) information summary provides an overview of the use of Cannabis and its components as a treatment for people with cancer -related symptoms caused by the disease itself or its treatment.
This summary contains the following key information:
Many of the medical and scientific terms used in this summary are hypertext linked (at first use in each section) to the NCI Dictionary of Cancer Terms, which is oriented toward nonexperts. When a linked term is clicked, a definition will appear in a separate window.
Reference citations in some PDQ CAM information summaries may include links to external Web sites that are operated by individuals or organizations for the purpose of marketing or advocating the use of specific treatments or products. These reference citations are included for informational purposes only. Their inclusion should not be viewed as an endorsement of the content of the Web sites, or of any treatment or product, by the PDQ Cancer CAM Editorial Board or the National Cancer Institute.
Cannabis, also known as marijuana, originated in Central Asia but is grown worldwide today. In the United States, it is a controlled substance and is classified as a Schedule I agent (a drug with increased potential for abuse and no known medical use). The Cannabis plant produces a resin containing psychoactive compounds called cannabinoids. The highest concentration of cannabinoids is found in the female flowers of the plant.[1]Clinical trials conducted on medicinal Cannabis are limited. The U.S. Food and Drug Administration (FDA) has not approved the use of Cannabis as a treatment for any medical condition. To conduct clinical drug research in the United States, researchers must file an Investigational New Drug (IND) application with the FDA.
The potential benefits of medicinal Cannabis for people living with cancer include antiemetic effects, appetite stimulation, pain relief, and improved sleep. Although few relevant surveys of practice patterns exist, it appears that physicians caring for cancer patients in the United States who recommend medicinal Cannabis predominantly do so for symptom management.[2]
Cannabinoids are a group of terpenophenolic compounds found in Cannabis species (Cannabis sativa L. and Cannabis indica Lam.). This summary will review the role of Cannabis and the cannabinoids in the treatment of people with cancer and disease-related or treatment-related side effects.
Cannabis use for medicinal purposes dates back at least 3,000 years.[1,2,3,4,5] It was introduced into Western medicine in the 1840s by W.B. O'Shaughnessy, a surgeon who learned of its medicinal properties while working in India for the British East Indies Company. Its use was promoted for reported analgesic, sedative, anti-inflammatory, antispasmodic, and anticonvulsant effects.
In 1937, the U.S. Treasury Department introduced the Marihuana Tax Act. This Act imposed a levy of one dollar an ounce for medicinal use of Cannabis and one hundred dollars an ounce for recreational use. Physicians in the United States were the principal opponents of the Act. The American Medical Association (AMA) opposed the Act because physicians were required to pay a special tax for prescribing Cannabis, use special order forms to procure it, and keep special records concerning its professional use. In addition, the AMA believed that objective evidence that Cannabis was harmful was lacking and that passage of the Act would impede further research into its medicinal worth.[6] In 1942, Cannabis was removed from the U.S. Pharmacopoeia because of persistent concerns about its potential to cause harm.[2,3]
In 1951, Congress passed the Boggs Act, which for the first time, included Cannabis with narcotic drugs. In 1970, with the passage of the Controlled Substances Act, marijuana was classified as a Schedule I drug. Drugs in this category are distinguished as having no accepted medicinal use. Other Schedule I substances include heroin, LSD, mescaline, methaqualone, and gamma-hydroxybutyrate.
Despite its designation as having no medicinal use, Cannabis was distributed to patients by the U.S. government on a case-by-case basis under the Compassionate Use Investigational New Drug program established in 1978. Distribution of Cannabis through this program was discontinued in 1992.[1,2,3,4] Although federal law prohibits the use of Cannabis, the table below lists the localities that permit its use for certain medical conditions.
The main psychoactive constituent of Cannabis was identified as delta-9-tetrahydrocannabinol (THC). In 1986, synthetic delta-9-THC in sesame oil was licensed and approved for the treatment of chemotherapy -associated nausea and vomiting under the generic name dronabinol. Clinical trials determined that dronabinol was as effective as or better than other antiemetic agents available at the time.[7] Dronabinol was also studied for its ability to stimulate weight gain in patients with AIDS in the late 1980s. Thus, the indications were expanded to include treatment of anorexia associated with human immunodeficiency virus infection in 1992. Clinical trial results showed no statistically significant weight gain, although patients reported an improvement in appetite.[8,9]
Within the past 20 years, the neurobiology of cannabinoids has been analyzed.[10,11,12,13] The first cannabinoid receptor, CB1, was identified in the brain in 1988. A second cannabinoid receptor, CB2, was identified in 1993. The highest concentration of CB2 receptors is located on B lymphocytes and natural killer cells, suggesting a possible role in immunity. Endogenous cannabinoids (endocannabinoids) have been identified and appear to have a role in pain modulation, control of movement, feeding behavior, and memory.[11]
Cannabinoids are a group of 21-carbon–containing terpenophenolic compounds produced uniquely by Cannabis sativa and Cannabis indica species.[1,2] These plant-derived compounds may be referred to as phytocannabinoids. Although delta-9-tetrahydrocannabinol (THC) is the primary psychoactive ingredient, other known compounds with biologic activity are cannabinol, cannabidiol (CBD), cannabichromene, cannabigerol, tetrahydrocannabivarin, and delta-8-THC. CBD, in particular, is thought to have significant analgesic and anti-inflammatory activity without the psychoactive effect (high) of delta-9-THC.
Antitumor Effects
One study in mice and rats suggested that cannabinoids may have a protective effect against the development of certain types of tumors.[3] During this 2-year study, groups of mice and rats were given various doses of THC by gavage. A dose-related decrease in the incidence of hepatic adenoma tumors and hepatocellular carcinoma was observed in the mice. Decreased incidences of benign tumors (polyps and adenomas) in other organs (mammary gland, uterus, pituitary, testis, and pancreas) were also noted in the rats. In another study, delta-9-THC, delta-8-THC, and cannabinol were found to inhibit the growth of Lewis lung adenocarcinoma cells in vitro and in vivo.[4] In addition, other tumors have been shown to be sensitive to cannabinoid-induced growth inhibition.[5,6,7,8]
Cannabinoids may cause antitumor effects by various mechanisms, including induction of cell death, inhibition of cell growth, and inhibition of tumor angiogenesis invasion and metastasis.[9,10,11,12] One review summarizes the molecular mechanisms of action of cannabinoids as antitumor agents.[13] Cannabinoids appear to kill tumor cells but do not affect their nontransformed counterparts and may even protect them from cell death. These compounds have been shown to induce apoptosis in glioma cells in culture and induce regression of glioma tumors in mice and rats. Cannabinoids protect normal glial cells of astroglial and oligodendroglial lineages from apoptosis mediated by the CB1 receptor.[14]
The effects of delta-9-THC and a synthetic agonist of the CB2 receptor were investigated in hepatocellular carcinoma (HCC).[15] Both agents reduced the viability of hepatocellular carcinoma cells in vitro and demonstrated antitumor effects in hepatocellular carcinoma subcutaneous xenografts in nude mice. The investigations documented that the anti-HCC effects are mediated by way of the CB2 receptor. Similar to findings in glioma cells, the cannabinoids were shown to trigger cell death through stimulation of an endoplasmic reticulum stress pathway that activates autophagy and promotes apoptosis. Other investigations have confirmed that CB1 and CB2 receptors may be potential targets in non-small cell lung carcinoma [16] and breast cancer.[17]
An in vitro study of the effect of CBD on programmed cell death in breast cancer cell lines found that CBD induced programmed cell death, independent of the CB1, CB2, or vanilloid receptors. CBD inhibited the survival of both estrogen receptor–positive and estrogen receptor–negative breast cancer cell lines, inducing apoptosis in a concentration-dependent manner while having little effect on nontumorigenic, mammary cells.[18]
CBD has also been demonstrated to exert a chemopreventive effect in a mouse model of colon cancer.[19] In the experimental system, azoxymethane increased premalignant and malignant lesions in the mouse colon. Animals treated with azoxymethane and CBD concurrently were protected from developing premalignant and malignant lesions. In in vitro experiments involving colorectal cancer cell lines, the investigators found that CBD protected DNA from oxidative damage, increased endocannabinoid levels, and reduced cell proliferation.
Another investigation into the antitumor effects of CBD examined the role of intercellular adhesion molecule-1 (ICAM-1).[12] ICAM-1 expression has been reported to be negatively correlated with cancer metastasis. In lung cancer cell lines, CBD upregulated ICAM-1, leading to decreased cancer cell invasiveness.
In an in vivo model using severe combined immunodeficient mice, subcutaneous tumors were generated by inoculating the animals with cells from human non-small cell lung carcinoma cell lines.[20] Tumor growth was inhibited by 60% in THC-treated mice compared with vehicle-treated control mice. Tumor specimens revealed that THC had antiangiogenic and antiproliferative effects. However, research with immunocompetent murine tumor models has demonstrated immunosuppression and enhanced tumor growth in mice treated with THC.[21,22]
In addition, both plant-derived and endogenous cannabinoids have been studied for anti-inflammatory effects. A mouse study demonstrated that endogenous cannabinoid system signaling is likely to provide intrinsic protection against colonic inflammation.[23] As a result, a hypothesis that phytocannabinoids and endocannabinoids may be useful in the risk reduction and treatment of colorectal cancer has been developed.[24,25,26,27]
Appetite Stimulation
Many animal studies have previously demonstrated that delta-9-THC and other cannabinoids have a stimulatory effect on appetite and increase food intake. It is believed that the endogenous cannabinoid system may serve as a regulator of feeding behavior. The endogenous cannabinoid anandamide potently enhances appetite in mice.[28] Moreover, CB1 receptors in the hypothalamus may be involved in the motivational or reward aspects of eating.[29]
Understanding the mechanism of cannabinoid-induced analgesia has been increased through the study of cannabinoid receptors, endocannabinoids, and synthetic agonists and antagonists. The CB1 receptor is found in both the central nervous system (CNS) and in peripheral nerve terminals. Similar to opioid receptors, increased levels of the CB1 receptor are found in regions of the brain that regulate nociceptive processing.[30] CB2 receptors, located predominantly in peripheral tissue, exist at very low levels in the CNS. With the development of receptor-specific antagonists, additional information about the roles of the receptors and endogenous cannabinoids in the modulation of pain has been obtained.[31,32]
Cannabinoids may also contribute to pain modulation through an anti-inflammatory mechanism; a CB2 effect with cannabinoids acting on mast cell receptors to attenuate the release of inflammatory agents, such as histamine and serotonin, and on keratinocytes to enhance the release of analgesic opioids has been described.[33,34,35] One study reported that the efficacy of synthetic CB1- and CB2-receptor agonists were comparable with the efficacy of morphine in a murine model of tumor pain.[36]
When Cannabis is ingested by mouth, there is a low (6%–20%) and variable oral bioavailability.[1,2] Peak plasma concentrations of delta-9-tetrahydrocannabinol (THC) occur after 1 to 6 hours and remain elevated with a terminal half-life of 20 to 30 hours. Taken by mouth, delta-9-THC is initially metabolized in the liver to 11-OH-THC, a potent psychoactive metabolite. When inhaled, cannabinoids are rapidly absorbed into the bloodstream with a peak concentration in 2 to 10 minutes, declining rapidly for a period of 30 minutes and with less generation of the psychoactive 11-OH metabolite.
Cannabinoids are known to interact with the hepatic cytochrome P450 enzyme system.[3,4] In one study, 24 cancer patients were treated with intravenous irinotecan (600 mg, n = 12) or docetaxel (180 mg, n = 12), followed 3 weeks later by the same drugs concomitant with medicinal Cannabis taken in the form of an herbal tea for 15 consecutive days, starting 12 days before the second treatment.[4] The administration of Cannabis did not significantly influence exposure to and clearance of irinotecan or docetaxel, although the herbal tea route of administration may not reproduce the effects of inhalation or oral ingestion of fat-soluble cannabinoids.
Cancer Risk
A number of studies have yielded conflicting evidence regarding the risks of various cancers associated with Cannabis use.
A pooled analysis of three case-cohort studies of men in northwestern Africa (430 cases and 778 controls) showed a significantly increased risk of lung cancer among tobacco smokers who also inhaled Cannabis.[5]
A large retrospective cohort study of 64,855 men aged 15 to 49 years from the United States found that Cannabis use was not associated with tobacco-related cancers and a number of other common malignancies. However, the study did find that, among nonsmokers of tobacco, ever having used Cannabis was associated with an increased risk of prostate cancer.[6]
A population-based case-control study of 611 lung cancer patients revealed that chronic low Cannabis exposure was not associated with an increased risk of lung cancer or other upper aerodigestive tract cancers and found no positive associations with any cancer type (oral, pharyngeal, laryngeal, lung, or esophagus) when adjusting for several confounders, including cigarette smoking.[7]
A systematic review assessing 19 studies that evaluated premalignant or malignant lung lesions in persons 18 years or older who inhaled marijuana concluded that observational studies failed to demonstrate statistically significant associations between marijuana inhalation and lung cancer after adjusting for tobacco use.[8]
With a hypothesis that chronic marijuana use produces adverse effects on the human endocrine and reproductive systems, the association between marijuana use and incidence of testicular germ cell tumors (TGCTs) has been examined.[9,10,11] Three population-based case-control studies report an association between marijuana use and elevated risk of TGCTs, especially nonseminoma or mixed-histology tumors.[9,10,11] However, the sample sizes in these studies were inadequate to address marijuana dose by addressing associations with respect to recency, frequency, and duration of use. These early reports of marijuana use and TGCTs establish the need for larger, well-powered, prospective studies, especially studies evaluating the role of endocannabinoid signaling and cannabinoid receptors in TGCTs.
A comprehensive Health Canada monograph on marijuana concluded that while there are many cellular and molecular studies that provide strong evidence that inhaled marijuana is carcinogenic, the epidemiologic evidence of a link between marijuana use and cancer is still inconclusive.[12]
Cancer Treatment
No clinical trials of Cannabis as a treatment for cancer in humans were identified in a PubMed search; however, a single small study of intratumoral injection of delta-9-THC in patients with recurrent glioblastoma multiforme reported potential antitumoral activity.[13,14]
Antiemetic Effect
Despite advances in pharmacologic and nonpharmacologic management, nausea and vomiting (N/V) remain distressing side effects for cancer patients and their families. Dronabinol, a synthetic derivative of delta-9-THC, was approved in the United States in 1986 as an antiemetic to be used in cancer chemotherapy. Nabilone, another synthetic derivative of delta-9-THC, was first approved in Canada in 1982 and is now also available in the United States.[15] Both dronabinol and nabilone have been approved by the U.S. Food and Drug Administration for the treatment of N/V associated with cancer chemotherapy in patients who have failed to respond to conventional antiemetic therapy. Numerous clinical trials and meta-analyses have shown that dronabinol and nabilone are effective in the treatment of N/V induced by chemotherapy.[16,17,18,19] The National Comprehensive Cancer Network Guidelines recommend cannabinoids as breakthrough treatment for chemotherapy-related N/V.
One systematic review studied 30 randomized comparisons of delta-9-THC preparations with placebo or other antiemetics from which data on efficacy and harm were available.[20] Oral nabilone, oral dronabinol, and intramuscular levonantradol (a synthetic analog of dronabinol) were tested. Inhaled Cannabis trials were not included. Among all 1,366 patients included in the review, cannabinoids were found to be more effective than the conventional antiemetics prochlorperazine, metoclopramide, chlorpromazine, thiethylperazine, haloperidol, domperidone, and alizapride. Cannabinoids, however, were not more effective for patients receiving very low or very high emetogenic chemotherapy. Side effects included a feeling of being high, euphoria, sedation or drowsiness, dizziness, dysphoria or depression, hallucinations, paranoia, and hypotension.[20] Newer antiemetics (e.g., 5-HT3 receptor antagonists) have not been directly compared with Cannabis or cannabinoids in cancer patients.
Another analysis of 15 controlled studies compared nabilone with placebo or available antiemetic drugs.[21] Among 600 cancer patients, nabilone was found to be superior to prochlorperazine, domperidone, and alizapride, with nabilone favored for continuous use.
(Refer to the Cannabis section in the PDQ summary on Nausea and Vomiting for more information.)
Three trials have evaluated the efficacy of inhaled marijuana in chemotherapy-induced N/V.[22,23,24] In two of the studies, inhaled Cannabis was made available only after dronabinol failure. In the first trial, no antiemetic effect was achieved with marijuana in patients receiving cyclophosphamide or doxorubicin,[22] but in the second trial, a statistically significant superior antiemetic effect of inhaled Cannabis versus placebo was found among patients receiving high-dose methotrexate.[23] The third trial was a randomized, double-blind, placebo-controlled cross-over trial involving 20 adults in which both inhaled marijuana and oral THC were evaluated. One-quarter of the patients reported a favorable antiemetic response to the cannabinoid therapies. This latter study was reported in abstract form in 1984. A full report, detailing the methods and outcomes apparently has not been published, which limits a thorough interpretation of the significance of these findings.[24]
Anorexia, early satiety, weight loss, and cachexia are problems experienced by cancer patients. Such patients are faced not only with the disfigurement associated with wasting but also with an inability to engage in the social interaction of meals.
Three controlled trials demonstrated that oral THC has variable effects on appetite stimulation and weight loss in patients with advanced malignancies and human immunodeficiency virus (HIV) infection.[21] One study evaluated whether dronabinol alone or with megestrol acetate was greater, less, or equal in efficacy to megestrol acetate alone for managing cancer-associated anorexia.[25] In this randomized double-blind study of 469 adults with advanced cancer and weight loss, patients received 2.5 mg of oral THC twice daily, 800 mg of oral megestrol daily, or both. Appetite increased by 75% in the megestrol group and weight increased by 11%, compared with a 49% increase in appetite and a 3% increase in weight in the oral THC group after 8 to 11 weeks of treatment. These two differences were statistically significant. Furthermore, the combined therapy did not offer additional benefits beyond those provided by megestrol acetate alone. The authors concluded that dronabinol did little to promote appetite or weight gain in advanced cancer patients compared with megestrol acetate. However, a smaller placebo-controlled trial of dronabinol in cancer patients demonstrated improved and enhanced chemosensory perception in the cannabinoid group—food tasted better, appetite increased, and the proportion of calories consumed as protein was greater than in the placebo recipients.[26]
In a randomized clinical trial, researchers compared the safety and effectiveness of orally administered Cannabis extract (2.5 mg THC and 1 mg cannabidinol), THC (2.5 mg), or placebo for the treatment of cancer-related anorexia-cachexia in 243 patients with advanced cancer who received treatment twice daily for 6 weeks. Results demonstrated that although these agents were well tolerated by these patients, no differences were observed in patient appetite or quality of life among the three groups at this dose level and duration of intervention.[27]
Another clinical trial that involved 139 patients with HIV or AIDS and weight loss found that, compared with placebo, oral dronabinol was associated with a statistically significant increase in appetite after 4 to 6 weeks of treatment. Patients receiving dronabinol tended to have weight stabilization, whereas patients receiving placebo continued to lose weight.[28]
In trials conducted in the 1980s that involved healthy control subjects, inhaling Cannabis led to an increase in caloric intake, mainly in the form of between-meal snacks, with increased intakes of fatty and sweet foods.[29,30] No published studies have explored the effect of inhaled Cannabis on appetite in cancer patients.
Pain management improves a patient's quality of life throughout all stages of cancer. Through the study of cannabinoid receptors, endocannabinoids, and synthetic agonists and antagonists, the mechanisms of cannabinoid-induced analgesia have been analyzed. The CB1 receptor is found in the central nervous system (CNS) and in peripheral nerve terminals.[31] CB2 receptors are located mainly in peripheral tissue and are expressed in only low amounts in the CNS. Whereas only CB1 agonists exert analgesic activity in the CNS, both CB1 and CB2 agonists have analgesic activity in peripheral tissue.[32,33]
Cancer pain results from inflammation, invasion of bone or other pain-sensitive structures, or nerve injury. When cancer pain is severe and persistent, it is often resistant to treatment with opioids.
Two studies examined the effects of oral delta-9-THC on cancer pain. The first, a double-blind placebo-controlled study involving ten patients, measured both pain intensity and pain relief.[34] It was reported that 15 mg and 20 mg doses of the cannabinoid delta-9-THC were associated with substantial analgesic effects, with antiemetic effects and appetite stimulation.
In a follow-up single-dose study involving 36 patients, it was reported that 10 mg doses of delta-9-THC produced analgesic effects during a 7-hour observation period that were comparable to 60 mg doses of codeine, and 20 mg doses of delta-9-THC induced effects equivalent to 120 mg doses of codeine.[35] Higher doses of THC were found to be more sedative than codeine.
Another study examined the effects of a whole-plant extract with controlled cannabinoid content in an oromucosal spray. In a multicenter, double-blind, placebo-controlled study, the THC:cannabidiol nabiximols (THC:CBD) extract and THC extract alone were compared in the analgesic management of patients with advanced cancer and with moderate-to-severe cancer-related pain. Patients were assigned to one of three treatment groups: THC:CBD extract, THC extract, or placebo. The researchers concluded that the THC:CBD extract was efficacious for pain relief in advanced cancer patients whose pain was not fully relieved by strong opioids.[36] In a randomized, placebo-controlled, graded-dose trial, opioid-treated cancer patients with poorly controlled chronic pain demonstrated significantly better control of pain and sleep disruption with THC:CBD oromucosal spray at lower doses (1–4 and 6–10 sprays/day), compared with placebo. Adverse events were dose related, with only the high-dose group (11–16 sprays/day) comparing unfavorably with the placebo arm. These studies provide promising evidence of an "adjuvant analgesic" effect of THC:CBD in this opioid-refractory patient population and may provide an opportunity to address this significant clinical challenge.[37]
An observational study assessed the effectiveness of nabilone in advanced cancer patients who were experiencing pain and other symptoms (anorexia, depression, and anxiety). The researchers reported that patients who used nabilone experienced improved management of pain, nausea, anxiety, and distress when compared with untreated patients. Nabilone was also associated with a decreased use of opioids, nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, gabapentin, dexamethasone, metoclopramide, and ondansetron.[38]
Animal studies have suggested a synergistic analgesic effect when cannabinoids are combined with opioids. The results from one pharmacokinetic interaction study have been reported. In this study, 21 patients with chronic pain were administered vaporized Cannabis along with sustained-release morphine or oxycodone for 5 days.[39] The patients who received vaporized Cannabis and sustained-release morphine had a statistically significant decrease in their mean pain score over the 5-day period; those who received vaporized Cannabis and oxycodone did not. These findings should be verified by further studies before recommendations favoring such an approach are warranted in general clinical practice.
Neuropathic pain is a symptom cancer patients may experience, especially if treated with platinum-based chemotherapy or taxanes. A randomized controlled trial of inhaled Cannabis compared with placebo in 50 patients with HIV-related peripheral neuropathy found that pain was reduced by more than 30% in 52% of patients in the Cannabis group and in 24% of patients in the placebo group. This difference was statistically significant.[40] To date, no clinical trial has examined the effectiveness of cannabinoid preparations in the treatment of chemotherapy-induced neuropathic pain.
Anxiety and Sleep
Patients often experience mood elevation after exposure to Cannabis, depending on their prior experience. In a five-patient case series of inhaled marijuana that examined the analgesic effects of THC, it was reported that patients administered THC had improved mood, improved sense of well-being, and less anxiety.[41]
Another common effect of Cannabis is sleepiness. In a trial of a sublingual spray, a Cannabis-based mixture was able to improve sleep quality.[42] A small placebo-controlled study of dronabinol in cancer patients with altered chemosensory perception also noted increased quality of sleep and relaxation in THC-treated patients.[26]
Current Clinical Trials
Check NCI's list of cancer clinical trials for cancer CAM clinical trials on dronabinol, marijuana, nabiximols and nabilone that are actively enrolling patients.
General information about clinical trials is also available from the NCI Web site.
Cannabisand Cannabinoids
Because cannabinoid receptors, unlike opioid receptors, are not located in the brainstem areas controlling respiration, lethal overdoses from Cannabis and cannabinoids do not occur.[1,2,3,4] However, cannabinoid receptors are present in other tissues throughout the body, not just in the central nervous system, and adverse effects include tachycardia, hypotension, conjunctival injection, bronchodilation, muscle relaxation, and decreased gastrointestinal motility.
Although cannabinoids are considered by some to be addictive drugs, their addictive potential is considerably lower than that of other prescribed agents or substances of abuse.[4] The brain develops a tolerance to cannabinoids.
Withdrawal symptoms such as irritability, insomnia with sleep electroencephalogram disturbance, restlessness, hot flashes, and, rarely, nausea and cramping have been observed. However, these symptoms appear to be mild compared with withdrawal symptoms associated with opiates or benzodiazepines, and the symptoms usually dissipate after a few days.
Unlike other commonly used drugs, cannabinoids are stored in adipose tissue and excreted at a low rate (half-life 1–3 days), so even abrupt cessation of cannabinoid intake is not associated with rapid declines in plasma concentrations that would precipitate severe or abrupt withdrawal symptoms or drug cravings.
Since Cannabis smoke contains many of the same components as tobacco smoke, there are valid concerns about the adverse pulmonary effects of smoked Cannabis. A longitudinal study in a noncancer population evaluated repeated measurements of pulmonary function over 20 years in 5,115 men and women whose smoking histories were known.[5] While tobacco exposure was associated with decreased pulmonary function, the investigators concluded that occasional and low-cumulative Cannabis use was not associated with adverse effects on pulmonary function (forced expiratory volume in the first second of expiration [FEV1] and forced vital capacity [FVC]).
To assist readers in evaluating the results of human studies of complementary and alternative medicine (CAM) treatments for people with cancer, the strength of the evidence (i.e., the levels of evidence) associated with each type of treatment is provided whenever possible. To qualify for a level of evidence analysis, a study must:
Separate levels of evidence scores are assigned to qualifying human studies on the basis of statistical strength of the study design and scientific strength of the treatment outcomes (i.e., endpoints) measured. The resulting two scores are then combined to produce an overall score. An overall level of evidence score cannot be assigned to cannabinoids because there has been insufficient clinical research to date. For an explanation of possible scores and additional information about levels of evidence analysis of CAM treatments for people with cancer, refer to Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
In writing Cancer Information Summaries, PDQ Editorial Boards review current evidence. They do not make recommendations or develop guidelines. Their work is editorially independent of the National Cancer Institute (NCI). This summary on Cannabis and cannabinoids does not represent a policy statement of NCI or NIH. The summary statement represents an independent review of the literature; that review is not influenced by NCI or any other federal agency.
Revised text to state that although federal law prohibits the use of Cannabis, the table below lists the localities that permit its use for certain medical conditions.
Added a table listing localities that permit the use of Cannabis for certain medical conditions.
Human/Clinical Studies
Added text about three population-based case-control studies that report an association between marijuana use and elevated risk of testicular germ cell tumors, especially nonseminoma or mixed-histology tumors; however, the sample sizes in these studies were inadequate to address marijuana dose by addressing associations with respect to recency, frequency, and duration of use (cited Daling et al., Trabert et al., and Lacson et al. as references 9, 10, and 11, respectively).
Revised text to state that three controlled trials demonstrated that oral delta-9-tetrahydrocannabinol (THC) has variable effects on appetite stimulation and weight loss in patients with advanced malignancies and human immunodeficiency virus.
Added text about a randomized clinical trial that compared the safety and effectiveness of orally administered Cannabis extract with THC for the treatment of cancer-related anorexia-cachexia in patients with advanced cancer (cited Strasser et al. as reference 27).
Added text about a randomized, placebo-controlled, graded-dose trial of nabiximols for opioid-treated cancer patients with poorly controlled chronic pain that demonstrated significantly better control of pain and sleep disruption with THC:cannabidiol nabiximols oromucosal spray at lower doses compared with placebo (cited Portenoy et al. as reference 37).
This summary is written and maintained by the PDQ Cancer Complementary and Alternative Medicine Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of Cannabis and cannabinoids in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Cancer Complementary and Alternative Medicine Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Cannabis and Cannabinoids are:
Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Cancer Complementary and Alternative Medicine Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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The preferred citation for this PDQ summary is:
National Cancer Institute: PDQ® Cannabis and Cannabinoids. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/cancertopics/pdq/cam/cannabis/healthprofessional. Accessed <MM/DD/YYYY>.
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Last Revised: 2013-01-17
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