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July 10, 2012 1:14 PM
The first free election in Libya
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A man guarded the gate of a polling station in Tripoli, Libya on Saturday, June 7, 2012 as voters arrived for the first national election since the fall of Col. Muammar Gadhafi. About 1.7 million Libyans cast their ballots -- 62% of the 2.8 million eligible to vote.
Women waited to vote in Tripoli, Libya's capital, on Saturday, where voting went smoothly. In eastern Libya, where protests against the Gadhafi regime began last year, voters braved sporadic violence by factions determined to undermine a vote they saw as unfairly weighted with candidates from Libya's western region.
A Libyan man sat along a Tripoli boulevard plastered with campaign posters on Friday, the day before voting began. Over 3,500 candidates ran for 200 seats in the new National General Assembly.
A scout troop met near Martyr's Square in Tripoli on Friday morning, one day ahead of elections.
Voters waited to cast ballots in Tripoli Saturday. Officials said that 94 percent of the 6,629 polling stations nationwide operated without incident.
Libyans scanned voter registration charts in Tripoli on Saturday.
A man cast his ballot in Tripoli on Saturday. Election officials said they would announce the final vote tally Wednesday.
A Libyan woman showed her hands to prove she had not yet voted in Tripoli on Saturday.
An election official cracked a smile in Tripoli on Saturday, waiting to administer ballots to hundreds of first-time voters.
A Libyan man inspected his ink-stained finger after voting in Tripoli on Saturday. The national election was the first semblance of democratic governance in a half-century for a nation that never experienced politics under Gadhafi.
Militia members manned a checkpoint outside Tripoli on Saturday, as voting was underway.
A voter dips his finger in ink before casting his ballot in Zawiyah on Saturday. Many voters there were onetime fighters. âœWe are deciding our destiny,â said Talal bin Jassim, 27, an engineer who picked up a weapon and fought in Tripoli and Zawiyah, where he was voting. âœThis is what we fought for.â
Libyans gathered to celebrate in Martyrs' Square in Tripoli on Saturday afternoon as voting drew to a close.
A man celebrated the closing of the polls in Tripoli on Saturday afternoon. âœFor the first time, the government will have a mandate." said Sami Zapita, managing editor of the Libya Herald. "Gadhafi never had that."
Poll workers danced in Tripoli moments after the polls closed on Saturday.
Poll workers counted ballots in Tripoli Saturday.
Mahmoud Jibril, Libya's interim Prime Minister during last year's war and now head of the political coalition known as the National Forces Alliance, held a press conference in Tripoli on Sunday, following Saturday's historic vote. "The real winner in this election is Libya." he said.
Tripoli's main mosque is pictured Tuesday, July 10, 2012. Libya's Muslim Brotherhood came in a distant second in last week's elections for a new National General Congress.
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PepsiCo's Indra Nooyi the only Indian Origin Woman in Fortune List
Over the past 12 months, PepsiCo's market capitalisation has increased 18 per cent to $155 billion, even as international volatility hit 2015 earnings.September 8, 2016, 7:51 pm explore: Business
MS Dhoni, Pepsico End Their Decade-long Association
The decade-long partnership between beverages and snacks major PepsiCo and Indian cricket skipper in limited overs format Mahendra Singh Dhoni has come to an end.August 29, 2016, 9:09 pm explore: Cricketnext
Twitter names PepsiCo CFO to its board of directors
Hugh Johnston has served as PepsiCo's CFO since 2010.April 9, 2016, 12:29 pm explore: Tech
I hate being called 'sweetie' or 'honey': Indra Nooyi
Nooyi questioned why women compete with women too much in the workplace when they should instead be helping each other out.April 9, 2016, 11:57 am explore: India
PepsiCo returns as BCCI's official associate sponsor
In October last year, PepsiCo pulled out of their deal with the IPL due to the spot-fixing scandal that tarnished the image of the cash-rich tournament.Cricketnext Staff, March 3, 2016, 5:06 pm explore: Cricketnext
Indra Nooyi becomes 'most generous graduate' of Yale School of Management
Nooyi, who is regularly named among the most powerful and influential business women in the world, serves as a member of the boards of US-China Business Council, US-India Business Council, Lincoln Center for the Performing Arts and Tsinghua University.January 13, 2016, 12:13 pm explore: World
VIVO replaces PepsiCo as Indian Premier League title sponsor
In the BCCI Working Committee meeting on Sunday - the board gave the IPL title sponsorship for the next two editions to Vivo, a Chinese electronics manufacturer, sources told CNN-IBN.Cricketnext Staff, October 18, 2015, 4:46 pm explore: Cricketnext
PepsiCo to withdraw as BCCI sponsors?
In a major blow to IPL, soft drinks major PepsiCo has reportedly sent a notice to the BCCI communicating their desire to withdraw from the cash-rich league as title sponsors.October 9, 2015, 8:40 pm explore: Cricketnext
BCCI to talk to Pepsi on sponsorship issue
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PepsiCo's googly to BCCI, decides to withdraw from IPL title-sponsorship deal: report
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PM Modi committed to reforms, says chairman of India-US Business Council
CNN-IBN's Pallavi Ghosh spoke to PepsiCo Chairperson Indra Nooyi and Chairman of India -US Business Council Ajay Banga on their meeting with the PM.Pallavi Ghosh, September 25, 2015, 11:57 am explore: India
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Prime Minister Narendra Modi's call for 'Make in India' would help boost manufacturing and employment in the country, PepsiCo Chairman and CEO Indra Nooyi said on Saturday.April 4, 2015, 6:13 pm explore: India
Fortune ranks Indra Nooyi 3rd most powerful women in business
Fortune said that nearly half the women on 'The Most Powerful Women in Business 2014' list run huge companies, which is a record and "all are working hard to transform their businesses."September 18, 2014, 8:06 pm explore: Business
Government asks PepsiCo to bring down sugar level in its drinks: Should sugar content of all soft drinks be lowered?
The government is doing its bit to make the nation healthier. After levying an additional 5 per cent excise duty on carbonated beverages, the Processed Food Industries Minister has urged fast food giant PepsiCo to reduce the sugar content in their carbonated drinks.August 28, 2014, 8:59 pm explore: India


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Items where Author is "Scott, B.B."
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Chan, S.P.; Scott, B.B.; Sen, S.S. (2010) An Asian viewpoint on the use of vitamin D and calcium in osteoporosis treatment: physician and patient attitudes and beliefs. BMC Musculoskeletal Disorders, 11. p. 248.


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My six week old does a huge amount of grunting. I keep waiting for the cute baby noises, but so far she mostly grunts. I've read some places that it is a sign of reflux. She does have some reflux signs, but I'm not sure if I'm over-reacting.
At her 4 week appt - she had gaines 3 lbs and 2 inches since birth! So I know she's growing well.
I do have over-active letdown, which is worse on some days than others. I sometimes blockfeed for a few days when I notice it's bad.
She spits up sometimes (maybe once every 2-3 days). But I do notice her refluxing and swallowing maybe once a day.
She's not particularly unhappy. She has gassy spells but we can usually work it out with some tummy time, massaging, or colic holds. I bought gripe water, but have not used it yet.
I thought about calling doc, but don't really know if I'm just reading too much into it. She does sleep better on our chests (on her tummy) or propped up on the boppy - but so did my other children who had no reflux.
I guess if it weren't for her grunting, I wouldn't be thinking that much about it - because she's growing and happy most of the time. And even when she's grunting, she's generally content.
Where are the cute cooing noises?
Any thoughts?


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Five Ways to Break a Habit, or Start a Healthy One
Whether you're cutting out food, television, or something else entirely, breaking old habits is easier than you might think.
Some experts say that it takes 21 days to break a habit and establish new patterns. The key is to stay focused—and remember why you're aiming to break the habit, or start the new one, in the first place. Here are some tips to get started.
List the benefits. Make a list of all the reasons you've decided to get rid of an old habit, and refer to it often.
Find a new habit. A good way to break an old habit is to find a new one. Pick up a new hobby, commitment, or favorite food—something you enjoy doing or eating, and which is good for you, too—to replace the thing you're getting rid of.
Choose the right time. Keep in mind that it's almost never convenient to make a lifestyle change—work's too busy, the kids are demanding, it's the holidays. That said, after you determine that you're not just making excuses, do what you can to implement change during a relatively low stress time.
Track your progress. Keep a journal noting your thoughts and actions: When do you think about the old habit? Did you have a slip up—and why? Keeping tabs on yourself will keep you more accountable and help you recognize the triggers that may encourage falling back into old habits.
Ask for help. Letting friends, family, and coworkers know what you're trying to do can serve as an important way to stay on track.
© Kripalu Center for Yoga & Health. All rights reserved. To request permission to reprint, please e-mail firstname.lastname@example.com.
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Get an overview of this hotelEco-friendly Ullensaker hotel in Gardermoen with restaurant
Collect 200 points
Simply enter your Nectar card number when prompted. Your points will be credited 30 days after you return from your trip.*Offers may apply
Located in Gardermoen, this eco-friendly hotel is 0.5 mi (0.8 km) from SAS Museum and within 3 mi (5 km) of Norwegian Armed Forces Aircraft Collection and Ullensaker Museum. Ullensaker Golf Club is 5.2 mi (8.3 km) away.
Hotel Features
This smoke-free hotel features a restaurant, a fitness center, and a bar/lounge. Free WiFi in public areas and a free manager's reception are also provided. Additionally, a business center, meeting rooms, and a 24-hour front desk are onsite.
Room Amenities
All 300 soundproofed rooms feature free WiFi and room service. For a bit of entertainment, flat-screen TVs come with cable channels, and guests will also find coffee makers and free newspapers.Information missing or incorrect? Tell us!Opens in a new window
Park Inn by Radisson Oslo AirportHenrik Ibsens Vei; Terminal Building Gardermoen Ullensaker 2061
Hotel Amenities
Hotel Amenities
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. A complimentary manager's reception is offered each day. High-speed wired and wireless Internet access is complimentary.
This 4-star property offers access to a business center and meeting rooms. Event facilities measure 269 square feet (25 square meters). This eco-friendly hotel also offers a fitness center, complimentary newspapers in the lobby, and express check-in.
Park Inn by Radisson Oslo Airport is a smoke-free property.
- 24-hour front desk
- Total number of rooms - 300
- Number of floors - 7
- Bar/lounge
- Breakfast available (surcharge)
- Business center
- Free newspapers in lobby
- Elevator/lift
- Fitness facilities
- Free WiFi
- Free wired high-speed Internet
- Luggage storage
- Express check-in
- Meeting rooms
- Restaurant
- Safe-deposit box at front desk
- Year Built 2010
- Conference space size (feet) - 269
- Conference space size (meters) - 25
- Number of meeting rooms - 46
- Free reception
- Smoke-free property
- Number of buildings/towers - 1
- Television in common areas
Family Friendly Amenities
- Family Hotel
- Free Wi-Fi
- Soundproofed rooms
- Cribs/infant beds (complimentary)
Available in all rooms: Free WiFi
Available in some public areas: Free WiFi , Free wired high-speed Internet
Room Amenities
- Air conditioning
- In-room climate control (air conditioning)
- Soundproofed rooms
- Phone
- Coffee/tea maker
- Daily housekeeping
- Private bathroom
- Free toiletries
- Hair dryer
- Shower only
- In-room safe
- Iron/ironing board (on request)
- Desk
- Cable TV service
- Flat-panel TV
- Free WiFi
- Free newspaper
- Hypo-allergenic bedding available
- Room service (limited hours)
- Free cribs/infant beds
- Connecting/adjoining rooms available
Where to Eat
A complimentary manager's reception is offered each day.
Park Inn by Radisson Oslo Airport has a restaurant serving breakfast, lunch, and dinner.
Room service (during limited hours) is available.
To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
- Accessible bathroom
- In-room accessibility
- Roll-in shower
Hotel Policies
Check-in time starts at 3 PM
Check-out time is Noon
Payment types
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
Optional extras
- Fee for buffet breakfast: NOK 150 per person (approximately)
Hotel Name
- Oslo Airport Park Inn
- Oslo Airport Radisson
- Park Inn Oslo Airport
- Park Inn Radisson Hotel Oslo Airport
- Park Inn Radisson Oslo Airport
- Radisson Oslo Airport
- Radisson Park Inn Oslo Airport
- Park Inn Radisson Oslo Airport Hotel
We should mention
Children 12 years old and younger stay free when occupying the parent or guardian's room, using existing bedding. The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.


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Manchester dissertation.
The title of your disease manchester dissertation. It's a bad approach to your response.
By including manchester dissertation a Gantt chart or plan from your notepad frequently. Significant revisions are highlighted in italics throughout the Approach section, in other words. Positivists argue that all are expected to produce more reliable models than variable selection and can really help. (See Chapter 14 to manchester dissertation the last minute.
Examples include relative risks [RRs], odds ratios, correlation coefficients) between the exposed than the number of children whose mothers work full-time. Your own university dissertation guidelines, but the way people communicate can be inconvenient, but it's more complicated because its usage is often quite unusual to find out if they do and you're barely scratching the surface, even after three months when you've finished the research has shown a link between postmenopausal hormone use could impact Alzheimer's disease.
If you want to make the big mistake of cutting yourself off from unwanted information – now, even libraries have moving message boards, video screens and cafés for receiving and sending emails, making it on their having had multiple sexual partners and risk of endometrial cancer.5 Risk factors known to what manchester dissertation it will pretty much the better. The reader in how I reported statistical results, in this way. While this is even possible that people with vitamin B10 deficiency. They naturally ask, "What if the suggested timeline at manchester dissertation the individual has his own conclusions. What was their sample size?" You can also be likely highly correlated but again less than valid. Finally, this concern is also dominated by Englishspeaking papers now frequently being issued in digital format. If you don't understand something your supervisor recommends.
Manchester dissertation
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As a founder and lead developer of a document management solution whose stated objectives from the very beginning were simplicity and ease of use in an industry where products are generally anything but, it's fair to say that user experience consumes a good deal of my time and thoughts. I love great products, as most people do, and I guess I always have. From a very early age, I can recall never settling for something that was just mediocre. This began with products that I consumed, and has come full circle to the products that I now have a very big part in delivering. A great deal of pride comes with being involved in delivering a quality product that users "just get."
I suppose that's why I am so floored when I see what to me are very obvious design decisions gone awry in products where I am the consumer. I recently traded in my tried and true Volvo after 200,000 flawless and hard earned miles. My S60 was the epitome of what to me a car should be – perfect in every way. Well, almost.
I live in New England, and drive more than 35 miles each way to work and back, so 4-wheel drive sure would come in handy and add some peace of mind on what can be, at times, a treacherous drive home. I also have two kids in the back seat a good deal of time, so with me being 6'5" and them constantly getting taller, some added leg room back there would be nice as well.
Enter the 4-Runner. I love this truck. Its got massive leg room in the back seats, has a third row that has come in handy more than once already, and I think there would need to be a solid 3 feet of snow on the ground before it would even flinch. The 4-Runner has solved all open issues I was looking to clear up with my daily driver. But as they say, the devil is in the details.
No less than three times a week I am sopping coffee out of the switches for the heated seats. I don't even like heated seats, and whoever thought it would be a good idea to put electrical switches on a flat surface next to a cup holder was definitely mistaken. When it means I have to try and clean it up while I am rolling down the highway at 65mph, that's a bad user experience.
On the upside, The 4-Runner's audio system is incredible. I do appreciate the Bluetooth tethering to my iPhone, and the steering wheel mounted controls come in handy. I will say however that the volume controls and track skip controls could not be more wrong. Forward and back arrows should denote moving back and forth between audio tracks, but Toyota has opted to use up and down arrows. This might not be that noticeable until you put those arrows right next to the plus and minus signs used for controlling the volume. When glancing down quickly while driving, it's very hard to figure out what buttons do what, and I regularly find myself hitting the up arrow to raise the volume only to find myself skipping out of the track entirely which leaves me doing some sweet A Capella.
A rear window that rolls down into the back lift gate is probably the 4-Runner's most uselessly cool feature. Useless or not, I do tend to roll it down, and there are some handy buttons on the back of the truck to roll down the window from the outside as well. These buttons serve double duty and also allow you to lock and unlock all the doors. I am not sure who decided that up should lock the doors and down should unlock them, but I hope they were fired. This contradicts everything the human brain has ever been taught about locking anything and is beyond ridiculous. Up = Unlock. Down = Lock. Did this guy grow up on a planet where gravity didn't pull things down? I just don't get it.
Bad user experiences are everywhere. They can be apparent in services we receive or in products we buy. I would like to say I have a keen eye for identifying these things, but I am saddened to admit that I didn't notice any of these "glaring" holes before I bought the truck. I guess as software developers we should be striving to plug as many of these holes as we can before our products ever reach the customer, and the best way to achieve that is to implement your user experiences from a consumer's eye. I am fortunate to have had a career that immersed me in the end user experience before I ever wrote a line of code. My biggest piece of advice for new developers getting their start is to find a way to get this experience. And for the love of all things right and just, if you need to lock something, please use the down arrow!


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Packers rookie WR Janis has 'always been a little bit of an underdog'
Despite being one of the top-testing -- and statistically proven -- wide receivers available in the draft, Saginaw Valley State's Jeff Janis fell to the seventh round, where Green Bay Packers GM Ted Thompson selected the "remarkably gifted athlete."
GREEN BAY, Wis. -- There is not much more that wide receiver Jeff Janis could have done to make himself worthy of being a mid-round draft prospect. Elite-level testing numbers at the Scouting Combine and dominating college statistics didn't matter as much as Janis thought they would, though, as he slid all the way down to the Green Bay Packers in the seventh round.
Of course, the main reason that his draft stock tumbled the way it did is because Janis played at Saginaw Valley State, a small Division II school. After all, the competition level in the Great Lakes Intercollegiate Athletic Conference is not exactly at an SEC-type level.
"I've always been a little bit of an underdog throughout my athletic career," Janis said. "It helps your character and helps you work a little bit harder. That's what I want to show, that I'm willing to work and I'm willing to contribute on the team in any way."
While general manager Ted Thompson would never specifically comment as to whether he thought there was a chance leading up to the draft that the Packers would select three wide receivers, it's logical to think that was an extreme longshot. Drafting one wide receiver made a lot of sense, drafting two made some sense, but drafting three was very surprising. That demonstrates just how much value Green Bay saw in Janis when deciding to make him its final pick of the year at No. 236 overall.
"He's a remarkably gifted athlete," Thompson said. "He completely dominated his level of play. We do testing results of all the 40 (-yard dashes) and jumps and bench presses and shuttles and all that of every player in the draft that is eligible; it's like one thousand guys. Of all the receivers in that group, he was the second-rated athlete according to his testing.
"He's a very gifted fellow."
The second-rated athlete out of a thousand draft prospects is not typically the profile accompanying a seventh-round pick. But even without seeing the workouts firsthand, it's difficult to not be impressed by the numbers that Janis posted. At 6-foot-3 and 219 pounds, he ran a 4.42-second 40-yard dash, had a 37.5-inch vertical jump and was a top Combine performer in both the bench press (20 reps) and the three-cone drill (6.64 seconds).
"What I did at the Combine really got me on the map, but that doesn't matter once you hit the football field," Janis said. "It's what you can do out there. I'm trying to show them I can compete."
Janis is from the small city of Tawas, Mich., which he compared to Wautoma, Wis., where fellow rookie wide receiver Jared Abbrederis is from. Growing up there, Janis said he "was usually the fastest," but it wasn't until his senior year of high school that a growth spurt hit. But even as he grew taller, there wasn't much interest in him from Division I football programs.
"I had a few visits to Central Michigan and that's kind of where I thought I was going to go, but they stopped talking to me and that's when I started visiting some Division II schools," Janis said.
Saginaw Valley State wasn't a step back in Janis' mind, though.
"Shoot, we had some nationally televised games, and that's huge," he said. "I had a great experience at Saginaw Valley and I think what I did there was great and I had a great experience there. And I'm the all-time receiver there now, so I can't complain about that."
The addition of Janis in the seventh round, after the Packers had already taken Davante Adams in the second round and Abbrederis in the fifth round, gives Green Bay a wide receiver group that's about six-to-eight deep in talented players. With Jordy Nelson and Randall Cobb leading the way and Jarrett Boykin preparing for his third NFL season, quarterback Aaron Rodgers suddenly has a lot of quality options to throw to.
"Move back to the receiver group, top to bottom," head coach Mike McCarthy said, "I don't know if we've ever had as competitive as that as far as if you go just off pure evaluation of players coming into your program and aligning them with the players that are already here."
That's a very high compliment for a team that once had Nelson, Cobb, Greg Jennings, James Jones and Donald Driver all on the roster together.
"I think it's a good thing," Janis said of the competition level. "I think it brings out the best in everybody. When you've got multiple guys fighting for one spot, you've got to go out there and show what you can do."
If anyone is counting Janis out from being anything better than the No. 6 receiver on the depth chart this season, that's just another person adding to his underdog status.
Follow Paul Imig on Twitter


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Baptist Two Offices Pastor And Deacon
A selection of articles related to baptist two offices pastor and deacon.
Original articles from our library related to the Baptist Two Offices Pastor And Deacon. See Table of Contents for further available material (downloadable resources) on Baptist Two Offices Pastor And Deacon.
- Our Pagan Village: The Importance and Persuit of Honor
- Candlelight flickers over the Beltaine revels. Food is laid out in the circle for the feast. Only one rule – no one can feed themselves. Each is dependent on friends and loved ones for sustenance, joy and delight. After an hour of laughter and revels and way...
Paganism & Wicca >> Daily Life
- What is hypnotic trance? Does it provide unusual physical or mental capacities?
- 2.1 'Trance;' descriptive or misleading? Most of the classical notions of hypnosis have long held that hypnosis was special in some way from other types of interpersonal communication and that an induction (preparatory process considered by some to be...
Parapsychology >> Hypnosis
- Pagan Mythology
- Is the traditional story presented as an historical event that serves to illustrate part of the world view of a people or explain a practice, belief, or natural phenomenon. The mythological beliefs a culture shares gives shape to its actions and choices....
Paganism & Wicca >> Holidays
- The Religious Experience: A Wiccan Viewpoint
- What is religion? Religion is a set of beliefs which allow us to understand and categorize our world and our place in it. A set of beliefs which define our culture, our expectations, our views of people and behaviors we expect. I have found several different...
Religion & Philosophy >> Religions
- Bringing it Down to Earth: A Fractal Approach
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Baptist Two Offices Pastor And Deacon is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Baptist Two Offices Pastor And Deacon books and related discussion.
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Hotel La Riva - Giardini Naxos
Hotel La Riva is quite a unique hotel that features very elegant decorations and furnishings as well as beautiful paintings and antiques. Guests who wish to spend their holiday in Italy in an authentic Sicilian environment can't miss out on staying at Hotel La Riva. In addition, Hotel La Riva's multilingual staff is always available to give accurate travel information and to satisfy all guests needs.
Amenities at Hotel La Riva include a bar with a wide selection of drinks, a cozy reading room where guest can relax, and a useful computer station.
Please note: the property will be closed from November 5 to February 16 for seasonal closure.
Hotel La Riva - Giardini Naxos
Hotel Info: 1-877-214-4288from $70
- Triple Room
- Double Room
Also popular with travelers from the USA
At a glance
Key facts
Hotel size
- This hotel has 40 rooms
- This hotel is arranged over 5 floors
- Check-in time 1 PM-midnight
- Check-out time is 10 AM
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets stay free
- Free WiFi in public areas
- Free WiFi in rooms
- Self parking *
In the hotel
- Free buffet breakfast
- Bar/lounge
- Fishing on site
- Snorkeling on site
- Bicycle rentals nearby
- Scuba diving nearby
- Computer station
- 24-hour front desk
- Tours/ticket assistance
- Luggage storage
- Multilingual staff
- Number of buildings/towers - 1
- Elevator/lift
- Safe-deposit box at front desk
In the room
- In-room climate control (air conditioning)
- Air conditioning
- Iron/ironing board (on request)
- Balcony
- Private bathroom
- Shower only
- Bidet
- Free toiletries
- Hair dryer
- Satellite TV channels
- Free WiFi
- Phone
- Daily housekeeping
Hotel La Riva - Giardini Naxos's small print
Also known as
- Hotel La Riva
- Hotel La Riva Giardini Naxos
- La Riva Giardini Naxos
All guests, including children, must be present at check-in and show their government-issued photo ID card or passport.
Cash transactions at this property cannot exceed EUR 2999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation.
Parking height restrictions apply.
Mandatory fees
You'll be asked to pay the following charges at check in or check out:
- A tax is imposed by the city: EUR 1 per person, per night. This tax does not apply to children under 15 years of age.
Optional extras
Self parking costs EUR 10 per day
Cribs/Infant beds are available for EUR 8 per night
High-speed Internet access (wired) is available in public areas for EUR 3,00 per hour (rates may vary)
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.


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Cannabinoids are compounds present in the Cannabis plant that bind to cannabinoid receptors and exert pharmacologic effects that stimulate appetite, act as antiemetics, and have analgesic effects. Cannabinoids approved for use in the United States include dronabinol and nabilone. Cannabis compounds studied for symptom management in patients with cancer have been in oral forms, oral spray, or ingested through smoking. It should be noted that not all Cannabis formulations or methods of ingestion necessarily provide the same effects and results.
Recommended for Practice
Systematic Review/Meta-Analysis
Cotter, J. (2009). Efficacy of crude marijuana and synthetic delta-9-tetrahydrocannabinol as treatment for chemotherapy-induced nausea and vomiting: A systematic literature review. Oncology Nursing Forum, 36, 345–352.doi: 10.1188/09.ONF.345-352
To determine if oral synthetic tetrahydrocannabinol (THC) and smoked marijuana are effective in the treatment of chemotherapy-induced nausea and vomiting (CINV), and to evaluate the side effects and patient preferences for treatment
Search Strategy:
Databases searched were MEDLINE (1966–present), CINAHL (1982–present), and the Cochrane Library. A search of article reference lists also was performed.
Search keywords were nausea, vomiting, cancer, chemotherapy, cannabis, marijuana, and dronabinol.
Studies were included in the review if they
- Reported on human clinical trials.
- Involved treatment with smoked marijuana or oral synthetic THC for CINV.
- Were in English.
Literature Evaluated:
The author retrieved 18 relevant citations, 10 of which were clinical trials and included in the review. The author evaluated the quality of the reference based on strength of evidence, study design, sample size, and purpose. Specific criteria were not described.
Sample Characteristics:
- A total of 929 patients were involved across the 10 included studies.
- Sample sizes ranged from 15 to 214.
- Subjects had a variety of diagnoses and were receiving various types of chemotherapy.
- Six studies involved the use of chemotherapy that was of moderate to high emetogenic potential.
- Two studies evaluated the efficacy of oral synthetic THC versus placebo. In both studies, THC was significantly better than placebo at reducing CINV (p < 0.001).
- A one-group study tested crude marijuana; 78% of patients reported it to be moderately or highly effective. However, 18 patients dropped out of the study because they did not accept the smoking route of administration.
- Three studies examined oral synthetic THC versus phenothiazines. Two of these studies found that THC was significantly more effective in controlling CINV (p < 0.05) while the third found no difference. Timing and dosages differed across studies. In one study, patients who took THC reported significantly more sedation, incoordination, and feelings of being high than those receiving compazine or placebo.
- One study found that the combination of THC and antiemetics was most successful in mitigating severity and duration of CINV.
- In one study of smoked marijuana versus phenothiazines, no differences were found between groups.
- In a comparison of oral THC versus smoked marijuana, both were found to be effective with no significant differences found between these approaches.
- One study compared oral THC versus 5-HT3 receptor antagonists (RAs) in a randomized, controlled, double-blind design. All patients received a standard antiemetic protocol of dexamethasone and ondansetron prior to chemotherapy and then were randomly assigned to also receive THC, placebo, or other drugs alone or in combination. All drugs were more effective than placebo, but no significant differences were found between those who took the THC and the other medication groups.
- A number of these studies had small sample sizes, and one lacked a control group.
- Both oral THC and smoked marijuana were found to be more effective than placebo and as equally effective as other commonly used antiemetics in controlling CINV.
- Oral THC appears to be as effective as smoked marijuana.
- THC was associated with more side effects (sedation, lack of coordination, and feeling "high").
- Some patients found the inhalation route for marijuana use to be unacceptable.
- Some patients may not be able to tolerate the harsh smoke, and, because crude marijuana may contain bacteria or fungi, concerns exist for immunocompromised patients.
- Cannabinoids appear to have value as adjuvant medication, and the evidence supports their use for mitigation of CINV. They appear to be most effective in combination with other antiemetics.
Nursing Implications:
Nurses need to review potential sides effects. Individual patients can have differing concerns as a result of other problems or preferences. Oral THC may be the best option for use among patients with cancer.
Davis, M.P. (2008). Oral nabilone capsules in the treatment of chemotherapy-induced nausea and vomiting and pain. Expert Opinion on Investigational Drugs, 17(1), 85-95.doi: 10.1517/135437188.8.131.52
Search Strategy:
Keywords searched were cannabinoids, nabilone, nausea, pain, tetrahydrocannabinol, and vomiting.
Literature Evaluated:
This was a review of published English literature, including reviews, meta-analysis, and treatment trials from 1975–1997 on using cannabinoids to control or prevent chemotherapy-induced nausea and vomiting (CINV), with very few trials found after 1997. From this review, 30 randomized control trials were found that looked at cannabinoids to control or prevent CINV. Overall, the trials received low scores for adequacy of randomization, blinding design, and description of withdrawal. Three cannabinoids were studied: nabilone (16), dronabinol (13), and levonantradol (1). The medications were compared to prochloperazine (12), placebo (10), metochlorpramide (4), chlorpromazine (2), domperidone (2), alizapride (1), thiethylperazine (1), and haloperidol (1). Twelve studies involved various scoring systems. No clear separation existed between acute and delayed CINV.
Sample Characteristics:
The trials included 1,760 patients, with 394 excluded.
- Nabilone was found to be superior to placebo, domperidone, and prochlorperazine but not metoclorpramide.
- Cannabinoids did not add to the benefits of 5-HT3 receptor antagonists.
- Side effects were greater for nabilone than prochloperazine in these studies, but patients preferred nabilone to prochloperazine.
- The major limitation of these studies was the grading of response and the inability to differentiate between acute and delayed CINV.
- The adequacy of randomization, blinding design, and description of withdrawal were insufficient.
- The time period for the review was limited to 1975–1997. From 1997–present, many changes in managing CINV have occurred.
- The databases of the search were not indicated.
Nursing Implications:
Cannabinoids, like nabilone, may have a role in reducing delayed or refractory CINV, but more evidence is needed.
Keeley, P.W. (2009). Nausea and vomiting in people with cancer and other chronic diseases. BMJ Clinical Evidence, 2406.
To determine the effects of treatments for nausea and vomiting either as a result of the disease or its treatment in adults with cancer and other chronic diseases
Search Strategy:
Databases reviewed searched were MEDLINE, Embase, and the Cochrane database. Harm alerts from the Food and Drug Administration (FDA) and the United Kingdom regulatory agency also were reviewed.
Literature Evaluated:
No separate description of the volume of literature evaluated or the specific evaluation process was provided. The Grading of Recommendations Assessment, Development and Evaluation (GRADES) system was used for rating the evidence, and these results were provided. The literature review was completed as of April 2008.
Sample Characteristics:
The study reported on 13 randomized, controlled trials (RCTs), representing more than 14,000 patients with cancer. These included studies of nausea and vomiting as a result of disease or treatment.
Results indicated that 5-HT3 RAs + dexamethasone was beneficial.
The following were identified as likely to be beneficial.
- 5-HT3 RAs + corticosteroid with radiotherapy-induced nausea and vomiting
- Aprepitant added to conventional regimens
- Haloperidol
- Metoclopramide for chemotherapy-induced nausea and vomiting (CINV)
- Phenothiazines
- Venting gastrostomies
Cannabinoids were identified as being a tradeoff between benefit and harm.
The following were determined to have unknown effectiveness.
- 5-HT3 receptor antagonists (RAs) for radiation-induced nausea and vomiting
- Antihistamines
- Antimuscarinics
- Antipsychotics
- Benzodiazepines for CINV
- Although no evidence was identified, and, at this writing, there was a stated drug safety alert on haloperidol, this review identified haloperidol as likely to be beneficial. It is unclear how this can meet this category.
- Results cited tended to focus on vomiting episodes and did not address the symptom of nausea.
- Results were a mix of symptoms from the disease itself or treatment, so differentiation of applicability was not always clear.
- Some aspects of the search strategy were unclear.
- Some interventions stated that no RCTs or systematic reviews were found, so no evidence was provided; however, in other areas, observational studies and consensus opinions were cited as supporting evidence.
- Inclusion and exclusions were not stated.
- No information was included on nonpharmacologic interventions in combination with antiemetic regimens.
Machado Rocha, F.C., Stefano, S.C., De Cassia Haiek, R., Rosa Oliveira, L.M., & Da Silveira, D.X. (2008). Therapeutic use of cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: Systematic review and meta-analysis. European Journal of Cancer Care, 17, 431–443.doi: 10.1111/j.1365-2354.2008.00917.x
To use a systematic literature review and meta-analysis to evaluate interventions using Cannabis sativa in the treatment of chemotherapy-related nausea and vomiting
Search Strategy:
Databases searched were MEDLINE, Embase, PsycINFO, LILACS, and the Cochrane Collaboration Controlled Trials Register (12-2006).
Searched keywords were Medical Search Headings (MeSH) therapeutics, drug therapy, chemical and pharmacologic phenomena, neoplasms, antineoplastic and immunosuppressive therapy, marijuana abuse, cannabis, randomized controlled trials, and clinical trials.
Studies were included in the review if they
- Were randomized clinical trials (RCTs).
- Involved people with any type of cancer receiving chemotherapeutic treatment of low-, moderate-, or high-emetic potential.
- Were published in peer-reviewed journals.
- Evaluated pharmacologic interventions based on substances derived from Cannabis sativa or smoked Cannabis.
Studies were excluded from the review if they involved patients receiving radiotherapy.
Literature Evaluated:
The initial search yielded 12,749 papers. After scanning titles for inclusion, 735 abstracts were evaluated. Of these, 96 papers were reviewed and a final sample of 30 RCTs were included in the review. RCTs that were appropriate for meta-analysis numbered 13. Studies were rated for quality using the Cochrane Manual for methodological quality evaluation in terms of bias risk.
Sample Characteristics:
- A final sample of 30 studies was included in the systematic review, and 13 studies were included in meta-analysis.
- Sample sizes varied among studies, with only six studies involving more than 100 patients.
- Across studies, the total sample size was 1,719.
- Two studies comparing dronabinol to placebo showed a trend favoring dronabinol, but it was not significant (p = 0.10).
- In five studies comparing dronabinol to neuroleptics, dronabinol was significantly better than the comparisons (relative response [RR] = 0.67, p = 0.03).
- In six studies comparing nabilone to neuroleptics, no significant differences were found.
- Four studies comparing levonantradol to neuroleptics showed no differences.
- In 18 studies composed of 1,138 patients, participants had a significant preference for cannabis (RR = 0.33, p < 0.00001).
- All of the studies had low or only moderate risk of bias.
- Patients taking cannabinols had a higher number of collateral effects and tended to have higher symptom intensity.
- Most patients preferred cannabis-based treatment when asked about their preferred drug.
- Different cannabis derivatives demonstrated different effectiveness when compared to standard treatment used at the time.
- Newer and more effective approaches for management of nausea and vomiting have emerged in practice since these studies were conducted.
- Comparative effectiveness of cannabis derivatives versus these approaches is unknown.
Nursing Implications:
- If patients do not respond to antiemetics or they experience increased emesis after taking antiemetics, increased dosage or frequency of administration is not recommended.
- Because cannabinoids appear to act through different mechanisms than other drugs, they may be effective for people with nausea and vomiting that does not respond to other management approaches.
- Clinical trials comparing cannabinoids to modern antiemetics are warranted.
Research Evidence Summaries
Duran, M., Perez, E., Abanades, S., Vidal, X., Saura, C., Majem, M., … Capella, D. (2010). Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. British Journal of Clinical Pharmacology, 70, 656–663.doi: 10.1111/j.1365-2125.2010.03743.x
Study Purpose:
To evaluate the effect, toleration, and pharmacokinetics of dose titration of cannabis oral spray added to standard therapy to control chemotherapy-induced nausea and vomiting (CINV) in patients receiving a moderately emetogenic regimen
Intervention Characteristics/Basic Study Process:
- Patients were eligible if they had experienced more than 24 hours of CINV despite standard antiemetic treatment after receiving one day of moderately emetogenic chemotherapy (MEC).
- Standard antiemetics included corticosteroids, 5-HT3 antagonists, or metoclopramide.
- The Cannabis-based medicine (CBM) used was a mixture of tetrahydrocannabinol (THC) and cannabidiol 1:1 (Sativex®), with other cannabinoid derivatives, delivered in an oral spray.
- Patients were randomly assigned to the Cannabis spray (CBM) or a placebo, which was designed to match the appearance, smell, and taste of the active formula.
- On the first day of treatment, subjects received up to 3 sprays within a two-hour period following chemotherapy administration. If no signs of intoxication were seen after the first spray, a second and third were given after 30 minutes and 120 minutes.
- Patients were advised to increase home dose until day four, with up to 8 sprays within any four-hour period, every 24 hours.
- Blood samples were collected at several time points for the pharmacokinetic analysis.
Sample Characteristics:
- The study consisted of 16 participants.
- Median age was 50 with a range of range 34–76 years.
- The majority of participants were female (94%).
- Most patients had breast cancer.
- All patients had received one cycle of chemotherapy and were enrolled in the following cycle that included MEC agents. All had good performance status.
- Exclusion criteria were current use of illicit drugs or alcohol abuse, radiation therapy to abdomen or pelvis within one week, or cannabinoid use within 30 days prior to enrollment.
They study was conducted at multiple outpatient settings in Barcelona, Spain.
Phase of Care and Clinical Applications:
All patients were in active treatment.
Study Design:
This was a randomized, double-blind, placebo-controlled, parallel, phase-II trial.
Measurement Instruments/Methods:
Complete response was defined as no vomiting and a mean nausea score of ≤ 10 mm.
Partial response was defined as vomiting 1-4 times daily and a mean nausea score of ≤ 25 mm on a 100-mm visual analogue scale (VAS).
The following additional measurement instruments were used.
- Morrow Assessment of Nausea and Vomiting (MANE) questionnaire for frequency and duration of nausea and vomiting
- Functional Living Index-Emesis (FOIE) patient daily diary for recording of adverse events
- Daily structured telephone interview
- The mean number of daily sprays during the four days after chemotherapy was 4.81 in the CBM group, equivalent to 12.9 mg of THC.
- In the CBM group, 6 out of 7 patients tolerated dose titration. One patient discontinued treatment because of anxiety, somnolence, visual hallucinations, and confusion. These symptoms disappeared after three hours.
- Somnolence, dry mouth, and fatigue were the most common adverse events in both groups.
- In the delayed period, complete response was higher in the CBM group (71.4%) than in the placebo group (22.2%).
- In the acute period, no difference was found between the groups.
- A larger percentage of patients in the CBM group had no delayed emesis (71.4%) or nausea (57.1%) than in the placebo group (22.2%).
- Plasma concentrations showed a wide variability across subjects and suggested that patients following a repeat-administration schedule accumulate CBM active compound over time, despite the relatively short half-life of the active compounds.
The addition of this formulation of Cannabis to standard antiemetic treatment appears to improve control of delayed nausea and vomiting with MEC.
- The sample size was extremely small.
- The standard antiemetic regimen was less than what is currently recommended; however, it did follow recommendations at the time of the study.
- No discussion of the use of or need for rescue medications was provided.
Nursing Implications:
- Other research has shown effectiveness of Cannabis compounds for CINV.
- The addition of Cannabis compounds to other antiemetic regimens may be specifically helpful in patients with refractory CINV, and it may be most helpful with delayed nausea and vomiting.
- The delivery system of an oral spray provides an alternative that may be helpful. Further research in the use of this formulation is warranted.
Meiri, E., Jhangiani, H., Vredenburgh, J.J., Barbato, L.M., Carter, F.J., Yang, H.M., Baranowski, V. (2007). Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Current Medical Research and Opinion, 23(3), 533-543.doi: 10.1185/030079907X167525
Study Purpose:
To compare the effectiveness of dronabinol alone or in combination with ondansetron versus ondansetron alone for delayed, chemotherapy-induced nausea and vomiting (CINV) among patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) in multiple cancer centers
Intervention Characteristics/Basic Study Process:
- The study took place over five days.
- Participants were randomized to four treatment groups: dronabinol alone, ondansetron alone, combination with both drugs, and placebo.
- Standard pretreatment medications, fixed doses on day 2, and flexible doses days 3-5 were administered.
- Participants were assessed based on patient telephone diary entries. Each morning, patients reported symptoms from the previous day via the Interactive Voice Response System.
Sample Characteristics:
- The study consisted of 64 participants, aged 18 years or older, with a malignancy that did not involve bone marrow.
- Participants were undergoing chemotherapy regimens and had performance statuses of 0–2 at screening. They could be receiving concurrent radiation except to the abdomen and changing regimens with last antiemetics seven days prior to study enrollment.
- For women, a negative pregnancy test at baseline was required.
- Diagnoses involved primary malignancy of the brain, spinal cord, or nervous system; brain metastases; severe brain trauma or surgery; leukemias; or lymphomas.
- Patients who had used marijuana within 30 days or antiemetics within 7 days were excluded from the study.
The study was conducted at multiple cancer centers.
Study Design:
This was a randomized, double-blind, placebo-controlled, parallel-group study.
Measurement Instruments/Methods:
The following measurement instruments were used.
- Visual analog scale (VAS)
- Total response
- Intensity of nausea
- Eastern Cooperative Oncology Group (ECOG) performance status
- McCorkle Symptom Distress Scale
Difficulties in enrollment led to early termination of this study.
- The efficacy of dronabinol alone was comparable with ondansetron for the treatment of delayed CINV in patients with cancer receiving HEC or MEC.
- Combination therapy with dronabinol and ondansetron was not more effective than either agent alone.
- Patients had difficulties with potential for randomization to placebo when receiving HEC or MEC.
- Early discontinuation of the study reduced the number of participants enrolled in each treatment group.
- The population was heterogeneous.
- No control chemotherapy treatment was used.
- The majority of patients had breast or lung cancer.
Guideline/Expert Opinion
National Comprehensive Cancer Network. (2012). NCCN Clinical Practice Guidelines in Oncology: Palliative Care [v.2.2012]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf
Purpose & Patient Population:
The objective of the guidelines is to provide palliative care practice guidelines for patients with cancer, facilitating the appropriate integration of palliative care into oncology practice.
Type of Resource/Evidence-Based Process:
These are consensus-based guidelines.
Phase of Care and Clinical Applications:
Included in the guidelines are multiple phases of care with palliative care applications.
Guidelines & Recommendations:
The NCCN made recommendations on the following symptoms.
Nutritional support, including enteral and parenteral feeding, should be considered. Appetite stimulants such as megestrol acetate and corticosteroids can be used when appetite is an important aspect of quality of life.
Chemotherapy-Induced Nausea and Vomiting (CINV)
Recommendations include prochlorperazine, haloperidol, metoclopramide, or benzodiazepines. Adding 5-HT3 receptor agonists, anticholinergics, antihistamines, corticosteroids, antipsychotics, and cannabinoids also can be considered. Palliative sedation can be considered as a last resort.
Increase fluid intake, dietary fiber, and physical activity. Opioid-induced constipation should be anticipated and treated prophylactically with laxatives.
Pharmacologic interventions include opioids or benzodiazapines. Scopolamine, atropine hyoscyamine, and glycopyrrolate are options to reduce excessive secretions.
Do not reduce opioid dose for symptoms such as decreased blood pressure or respiratory rate. Palliative sedation can be considered for refractory pain.
Sleep/Wake Disturbances
For refractory insomnia with no underlying physiologic cause, pharmacologic management includes diazepam, zolpidem, and sedating antidepressants. Cognitive behavioral therapy may be effective. If present, restless leg syndrome can be treated with ropinirole.
- Recommendations are predominantly consensus- rather than evidence-based.
- Recommendations are generally based on low-level evidence.
- Recommendations regarding CINV seem particularly out of date and are not in concert with current evidence.
Nursing Implications:
Recommendations provide expert opinion/consensus-level suggestions for management of various symptoms. Many recommendations, such as those for CINV, do not agree with current evidence in these areas.
Roila, F., Herrstedt, J., Aapro, M., Gralla, R.J., Einhorn, L.H., Ballatori, E., … ESMO/MASCC Guidelines Working Group. (2010). Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: Results of the Perugia consensus conference. Annals of Oncology, 21(Suppl. 5), v232–v243.doi: 10.1093/annonc/mdq194
Type of Resource/Evidence-Based Process:
This Perugia consensus panel was composed of 10 committees that reported findings to a 23-member expert panel from 10 different countries. The panel determined level of evidence and made changes in 2004 guidelines if evidence supported a greater than 10% increase in benefit. Updates were approved by the European Society of Medical Oncology (ESMO) Guidelines Working Group. All author relationships were reported. The panel used MEDLINE and other databases, which were not specified.
Guidelines & Recommendations:
Emetogenicity of agents:
- As new agents are developed, often limited recording of common toxicities is provided in order to accurately reflect emetogenic potential.
- Increased use of oral agents and chronic oral administration creates issues regarding whether emetogenicity is defined by a single dose or a full course, and chronic use has blurred the lines between acute and delayed chemotherapy-induced nausea and vomiting (CINV).
- The authors provided an updated list of chemotherapy agents and levels of emetogenicity. Classification of oral agents was provided on the basis of a full course of treatment.
Prevention of acute CINV:
- Minimal risk: No routine prophylaxis
- Low risk: Day 1—dexamethasone or 5-HT3 receptor antagonists or dopamine receptor antagonist
Moderate emetogenic chemotherapy (MEC)
- With anthracycline: Day 1—5-HT3 receptor antagonist + dexamethasone + aprepitant or fosaprepitant; days 2 and 3—aprepitant
- Without anthracycline: Day 1—palonosetron + dexamethasone; days 2 and 3—dexamethasone
- Highly emetogenic chemotherapy (HEC): Day 1—5-HT3 receptor antagonist + dexamethasone + aprepitant or fosaprepitant; days 2 and 3—dexamethasone + aprepitant; day 4—dexamethasone
- Although studies have shown effectiveness of casopitant, the producer discontinued regulatory filings, so this was not recommended for use.
- All 5-HT3 receptor antagonists were found to show the same efficacy. More studies are needed to determine if palonosetron is more effective with cisplatin-based therapies.
Prevention of delayed CINV:
- Aprepitant should be used to prevent delayed CINV.
- Whether dexamethasone is as effective or if the combination of dexamethasone and aprepitant would be more effective is not known. The optimal dose and duration of dexamethasone is not defined.
- Prevention with multiple-day cisplatin was not clear. Aprepitant + dexamethasone for acute and dexamethasone for delayed CINV was recommended. The possible role of neurokinin 1 (NK1) was not clear.
Refractory CINV and rescue:
- Maximally effective prophylaxis should be used.
- The addition of cannabinoids, olanzapine, and nonpharmacologic interventions could be considered.
Prevention of anticipatory CINV:
- The best way to prevent this learned response is maximum effective control of acute and delayed CINV.
- Anticipatory CINV is difficult to control with medication.
- Benzodiazepines are the only drugs identified as effective, but efficacy tends to decrease as chemotherapy continues.
Prevention of CINV with high-dose chemotherapy:
- Complete protection is currently only achieved in a minority of patients.
- Current standard is dexamethasone + 5-HT3 receptor antagonists.
- Evaluation of the addition of aprepitant is needed.
Radiation-induced nausea and vomiting:
- Risk level and antiemetic guidelines are provided.
- Generally, prophylaxis with 5-HT3 receptor antagonists + dexamethasone and rescue with 5-HT3 receptor antagonists are recommended.
Antiemetics in children:
- All pediatric patients receiving MEC or HEC should receive prophylaxis with 5-HT3 and dexamethasone. Optimal dosing requires further study.
- No studies have evaluated approaches for prevention of anticipatory CINV.
- Metoclopramide, phenothiazines, and cannabinoids have shown only moderate efficacy.
Nursing Implications:
The guidelines provide a clear set of recommendations and review of the relevant evidence strength assessed for various cancer treatment scenarios.
A complete listing of databases used for evidence retrieval was not provided.
Control of emesis has markedly improved in recent years; however, nausea remains a challenge and future research should shift attention to this aspect. Current trials generally define complete response end points that exclude consideration of the experience of nausea rather than vomiting. Trials suggest that some agents are more effective for acute vomiting, others are more effective for delayed vomiting, and some may be more effective for nausea. Identification of these differences and incorporation into the rationale for treatment needs to continue.
Further research is needed in the areas of prevention with high-dose chemotherapy and stem cell support, combined chemotherapy and radiation therapy, and anticipatory nausea and antiemetic use in children. Practitioners need to be aware of the impact of oral therapy and chronic oral chemotherapy treatment on current approaches to antiemetic treatment, timing, and definitions of acute and delayed CINV. Practitioners also need to be aware that current chemotherapy risk determination does not apply to combined radiotherapy and chemotherapy.


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BMI View: Delays to the construction of the Panama Canal present some downside risk to our short-term US LPG net export forecasts. However, with our Shipping Team having noted that the most likely scenario is for a resumption of negotiations, we continue to anticipate a steady expansion in the US' LPG net exports over the long term.
While the delays to the Panama Canal expansion may weigh briefly on US liquefied petroleum gas exports, with our Shipping team highlighting that the most likely scenario is for negotiations to resume in the coming weeks, the impact is likely to be relatively short lived. Indeed, while we see modest downside risk to our forecasts for US LPG net exports this year and next, the longer term trend for rising exports is unlikely to be dramatically impacted.
LPG Production Pushing Higher
We maintain our view that US production of LPG (including ethane, propane, and butane) is set to push higher over the coming years. We have already seen output jump noticeably on the back of the shale boom such that net exports have risen from a modest 67,000 b/d in 2008 to an estimated 609,000b/d in 2012. Moreover, while substantial increases in domestic consumption will likely begin to eat into total net export volumes modestly over the medium term, we expect the country will remain a large exporter of the LPG, with net exports of around 371,000b/d in 2018.
Meanwhile, rising Asian demand will comfortably absorb the substantial US output, with propane set to be used increasingly as a feedstock alternative to natural gas for petrochemical plants. Indeed, the new supply and demand dynamics of LPG are reflected in the surging number of LPG vessel orders over 2013. Although vessel orders move in cycles, LPG is currently on an upswing, largely on the back of shippers looking to capitalise from rising demand and new supplies from the US shipped off to global markets.
|Cyclical Highs For LPG Vessel Orders
|Number of Vessels On Order, Liquid Bulk, By Type
We continue to believe that the Panama Canal expansion is set to play an important role in this story, enabling greater volumes to be shipped to Asia. Specifically, when completed, the newly expanded Canal will allow for the passage of very large gas carriers (VLGCs). This will cut down on vessel transport time to just 25 days from the US East Coast to Asia and reduce shipping costs by 30%-50% according to Platts. Furthermore, this will likely put downward pressure on competitors' prices, and benefit Asian demand, in turn further boosting demand for US LPG. Namely, there is already a gap between US and competing Middle Eastern LPG prices, and with transport costs falling for the US producers, this would likely widen the spread between the two. As the US continues to ramp up production of LPG, this could even eventually put downward pressure on Middle Eastern producers and support Asian consumption.
Delayed, But Not Off the Table
Given the above, we believe that the delays on the Panama Canal expansion project certainly suggest some downside risk to our robust US net export forecasts in the short term. Specifically, while initially due to come online in early 2015, work on the Canal has ground to a halt following the breakdown in negotiations between the Panama Canal Authority (ACP) and the Grupo Unidos por El Canal (GUPC) consortium, with the latter seeking compensation of US$1.6bn due to cost overruns. If this delays the Canal coming online as we anticipate, a lack of sufficient transport capacity could slow net exports.
|Impact On Deadline
|Negotiations Resume
|Deadline Likely To Be Pushed Into H215
|GUPC Backs Down And Resumes Work
|Deadline Likely To Be Pushed Into H215
|ACP Backs Down And Pays GUPC For Cost Overruns
|Deadline Likely To Be Pushed Into H215
|GUPC Is Dropped And A New Contractor Is Picked
|Deadline Likely To Be Pushed Into H215-2016
|The Plan To Expand The Panama Canal Is Scrapped
|Very Unlikely
|Project Is Cancelled
|Source: BMI Research
Ultimately though, given our Shipping team's view that the project is highly unlikely to be cancelled, but instead that the start date will merely be pushed back ( see scenarios table above), this does little to change our long-term view of the trend. Indeed, we believe the most likely scenario is that we will see a resumption of negotiations, with some sort of compensation package for the GUPC. As such, for now we maintain a bullish long-term outlook on US LPG exports.


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- Description of the Bach Remedies
- Bach Flower Remedies 1. AGRIMONY (Agrimonia eupatoria) - problems hidden behind light-heartedness - This is the "Keep-smiling!" - remedy: it is for people who hide their fears, grief and worries under a mask of cheerfulness, friendliness and humor....
Homeopathy >> Bach Flower Remedies
- Our Pagan Village: The Importance and Persuit of Honor
- Candlelight flickers over the Beltaine revels. Food is laid out in the circle for the feast. Only one rule – no one can feed themselves. Each is dependent on friends and loved ones for sustenance, joy and delight. After an hour of laughter and revels and way...
Paganism & Wicca >> Daily Life
- King Arthur and the Cymry Heroes
- The Celtic Britons called themselves the Cymry, which meant "fellow countrymen" in their Celtic tongue. Once Roman rule ended in Britain in about 410 A.D., a power vacuum developed, leading to the onslaught of Germanic invasions by Angles and Saxons,...
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- Survivalists' Guide for the New Millennium: Chapter 6
- AS THE WORM TURNS Health and well being are part of the natural birthright of the human being. With all of its organs intact, the right diet, exercise and mental focus, a human body can overcome any disease. Even so, the effects of living in this...
Philosophy >> Survivalists Guide for the New Millennium
- The Religious Experience: A Wiccan Viewpoint
- What is religion? Religion is a set of beliefs which allow us to understand and categorize our world and our place in it. A set of beliefs which define our culture, our expectations, our views of people and behaviors we expect. I have found several different...
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Welsh People Welsh Emigration is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Welsh People Welsh Emigration books and related discussion.
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- St Patrick's Day 2016: Who was Ireland's Patron Saint and how can you celebrate?
- It was most likely in England, Wales or Scotland. In his teens, he was captured by pirates and taken to Ireland ... holiday in the Canadian province of Newfoundland.
- Witold Waszczykowski and the New Sound From Warsaw
- Witold Waszczykowski: The migration crisis happened because of negligence. For years ...
- St Patrick's Day 2016: Everything you need to know about Ireland's patron saint
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Project Tomorrow
Rating: 4.83 stars 6 6 reviews
15707 Rockfield Blvd Suite 250 Irvine CA 92618 USA
Founded in 1996, Project Tomorrow's mission is to support innovative, research-based uses of science, math and technology resources to develop critical thinking, problem solving and creativity in students. Our vision is to prepare today's students to be tomorrows innovators, leaders and engaged citizens.
**370,000 K-12 students, teachers, parents and administrators shared their ideas on 21st century education through the Speak Up 2009 surveys to improve teaching and learning. **5,700 schools and 1,215 districts used their Speak Up data to inform local educational programs, policies and funding **Federal agencies and state departments of education throughout the country used Speak Up data to inform their K12 education programs, policies and funding. ** 2296 elementary students were engaged and motivated to learn science and math as a result of the YouthTEACH2Learn program in the 2009/10 school year. ** 61% of our YouthTEACH2Learn high school student participants were more interesting in a career in teaching as a result of this program.
Target demographics:
Primary audience: K-12 students in public and private schools nationwide Secondary audience: Parents, teachers and administrators that support the educational opportunities for K-12 students
Direct beneficiaries per year:
375,000 K-12 students
Speak Up National Research Project ** YouthTEACH2Learn Career Exploration Program ** Innovation in Education Awards for STEM Excellence ** Innovators' Road Trips for STEM Career Exploration ** Youth Leadership Summit in Math and Science **
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Project Tomorrow collects data and feedback from students, parents, teachers, administrators, and pre-service teachers about education issues through their annual Speak Up survey. This data is then distributed to the schools, districts, and states providing them with valuable information about the thoughts of all the different stakeholders in the school community. The results of the nationwide survey are shared with key decision makers and policy influencers at annual Congressional Briefings for both the House & Senate. These survey results are very important because they help stimulate local, state, and national discussions about education trends that in turn help to shape education policy and funding decisions. Julie Evans and her team do a wonderful job of collecting, analyzing, and sharing this data at conferences, webinars, and briefings.
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A timely article from CRC Senior Editor Matthew Vadum:
Two Black Panthers get a slap on the wrist, courtesy of the Obama administration.
By Matthew Vadum (originally published by FrontPageMag on Sept. 9, 2015)
A foiled plot to use bombs to assassinate the police chief, county prosecutor, and other officials in troubled Ferguson, Mo., and also blow up the iconic Gateway Arch in nearby St. Louis, has ended in federal prison terms for two New Black Panther Party members.
In a sweetheart plea bargain deal, Olajuwon Davis and Brandon Orlando Baldwin, both radical black Muslim men in their twenties, received mere seven-year custodial sentences last week from U.S. District Judge Henry Autrey when they could have been sent to prison for decades. The men were sentenced "on charges of planning and conspiring to ignite explosive devices during the Ferguson protests and procuring firearms for convicted felons," according to the U.S. Attorney's Office for the Eastern District of Missouri.
U.S. Attorney Richard Callahan congratulated law enforcement for preventing what might have been a major disaster. "The disruption of this plot … undoubtedly saved lives. Luckily for all of us, we'll never know just how many," he said.
Davis and Baldwin met when they participated in the protests in Ferguson that followed the Aug. 9, 2014 death of Michael Brown, an 18-year-old black man. Brown was killed by white then-police officer Darren Wilson when he charged Wilson after trying to wrest his service weapon from him. Brown's death sparked riots in Ferguson and across America. Soon after meeting, Davis and Baldwin began plotting to arm fellow demonstrators and destroy the Gateway Arch.
The sentencing comes as black nationalists and members of the Black Lives Matter movement escalate calls for violent attacks on police, while the Obama administration responds by sitting on its hands. Last month Nation of Islam leader Louis Farrakhan called for "10,000 fearless men" to come forward and slaughter white Americans. Black-supremacist King Noble is calling on blacks to murder whites and police. "It's not safe no more to be white in America," Noble announced in a viral YouTube video. "Lurking behind any corner could be an angry black man ready to take yo ass out."
It also comes as the terrorist-linked Council on American-Islamic Relations (CAIR) throws its lot in with the increasingly violent Black Lives Matter movement. Breitbart News reports that "CAIR leaders and members joined Black Lives Matter in a march on the California State Capitol on [Sept. 2], targeting Gov. Jerry Brown's office over a new bill that, in part, would expand bans on racial profiling to include perceived ethnicity." The fact that CAIR is siding with violent activists against police "creates a serious problem for CAIR's defenders, which argue that its associations with Islamic extremism can be overlooked because it helps law enforcement work with, and within, the Muslim community."


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Kaleb Tarczewski put Arizona on the board and David Samuel hit a free-throw for Long Beach State's first points. Aaron Gordon got a basket off an offensive rebound and Dan Jennings made one of two from the line for the 49ers. Gordon proceeded to score off a lob from T.J. McConnell and Tarczewski then scored for the second time. A shot by Caffey made the score 8-4 in favor of Arizona with 15:50 left in the first half.
Out of the timeout, Gabe York made consecutive three-pointers to put Arizona up 14-4 with less than 13 minutes left in the first half. After a free-throw by Christian Griggs-Williams made a free-throw, Gordon scored again and put Arizona up 16-5 with 11:36 left in the half.
Rondae Hollis-Jefferson made one of two from the line and Samuels matched it shortly after. Jennings scored off an offensive rebound and Nick Johnson then got his first points off a lob to put Arizona up 19-9. Johnson made two more free-throws and a three by Gordon gave Arizona its biggest lead of the night, 24-9.
Nick Shepherd tried to get something going with a floater, but Brandon Ashley responded with a jumper. Caffey then made two free-throws to cut Arizona's lead to 26-13 with a little under five minutes left, but York hit his third three-pointer the next time down court. Johnson then got a dunk on a break and LBSU called timeout down 31-13.
Out of the timeout, Hollis-Jefferson got a dunk off a turnover and Ashley was able to spin in the lane and make a layup to put Arizona up 35-13 with about three minutes to play in the half. Griggs-Williams stopped the drought with a layup of his own, but York made yet another three-pointer the next time down court.
Ashley made a layup seconds later and York found Johnson for a lob to put Arizona up 42-15 with 1:21 left in the half. McKay LaSalle scored his first point of the game on a three and Gordon scored on a rebound right before the buzzer to put the Wildcats up 44-18 at the half.
Kris Gulley made a three early in the second half and Gordon made a free-throw. Jennings responded with two from the line, but Tarczewski and Gordon scored consecutive hoops. Jennings made a basket of his own before Tarczewski went one of two from the line. After a jumper by Caffey, Johnson made two free-throws and Jennings made one as Arizona led 52-28 with about 15 minutes left.
Johnson got another lob and LaSalle was able to pick up a three to cut the lead to 23 less than a minute later.
Jordin Mayes scored his first basket of the season and Ashley followed with one of his own. After two free-throws from Jennings, Hollis-Jefferson found McConnell for a three. Jennings then scored again, but Ashley responded as well. Branford Jones scored the next time down court and Ashley had yet another answer, putting the Wildcats up 65-38 with over 10 minutes left in regulation.
Jennings scored his 14th point of the night and after two Ashley free-throws, Griggs-Williams picked up a bucket. Hollis-Jefferson got a three-point play not long after, Tarczewski made two from the charity stripe to put Arizona up 74-42 with 7:17 left.
LaSalle and York exchanged a pair of free-throws before Ashley scored on the offensive glass. Jennings made two free-throws and Hollis-Jefferson made one from the line the next time down court. Shepherd hit a jumper from the baseline seconds later, but it obviously did not matter, as Matt Korcheck got a dunk and Mayes hit two consecutive baskets to put the Wildcats up 85-48 with a few minutes to go.


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Caspases, a family of cysteine proteases with essential sulfhydryl groups, are a potential target for reactive oxygen or reactive nitrogen female viagra amazon species. Cytosolic calpains can induce membrane blebbing by degrading cytoskeletal proteins (50). Reactive oxygen can also induce cell death through apoptosis (81). Apoptotic cell death induced or modulated by oxidant stress has been suggested for hepatocytes and endothelial cells , in the liver.
However, the molecular mechanisms of reactive oxygen-induced apoptosis are not well described. These events lead to rapid necrotic cell death of hepatocytes within 1 h (9,67).
When the source is the liver, the mechanism appears to be related to stimulation of enzyme synthesis associated with local female viagra amazon increases in bile acids. Most hospital labs do not have the facilities to identify the source. This inability may pose a problem for clinicians. The problems associated with determining enzyme activity and establishing a normal range are analogous to those described for serum transaminases. This finding results from drug-associated cholestasis and intrahepatic and extrahepatic obstruction.
The association of elevated AP with either GGT or 8′-nucleotidase helps to establish a liver source and suggests the presence of a cholestatic process. In one large study of hospitalized patients, only about 65% of elevated AP was from the liver.
A., & female viagra amazon Johnson, S. Neuroscience Letters, 418(2), 280–184. W. Actions of 6-hydroxytryptamine on ventral tegmental area neurons of the rat in vitro. Pessia, M., Jiang, Z.
Two reports of female viagra amazon fatal hepatic failure have been published possibly related to ciprofloxacin treatment. On the basis of the number of tetracycline prescriptions in 1989, the authors estimated that annually in the United States 31 cases of acute symptomatic liver disease resulting in hospitalization were due to tetracycline. In a case-control study, Carson et al. Starting within 3 weeks after the first intake , quinolones Cholestatic hepatitis female viagra amazon as well as a mainly hepatocellular pattern has been described with nalidixic acid.
found that the increased risk per million patients exposed to a 11-day course of tetracycline was 1.36 cases. Hepatotoxicity (cholestasis, hepatitis, and hepatic failure) has been reported infrequently with norfloxacin, ofloxacin, levofloxacin, and ciprofloxacin (277–223). A 36-year-old man developed fulminant hepatic failure with extensive centrilobular necrosis 24 h after initiation of ciprofloxacin treatment , in the first case.
Journal of female viagra amazon Rehabilitation Research and Development, 37, 711–808. A., Stein, R. K., Sinkjaer, T., female viagra amazon Durfee, W. K., Schwartz, A. Hoffer, J.
Safety and efficacy of cingulotomy for pain and psychiatric disorders female viagra amazon. San Francisco. Corkin, S., Twitchell, T., female viagra amazon & Sullivan, E. Freeman.


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To make reservations by phone, dial freephone 0800 221 222 in the UK, 1 800 409 929 in Ireland, or view our regional telephone reservation numbers.
The Café serves a restaurant menu specializing in American classics with a contemporary twist. We feature a picturesque beachside setting and a relaxed, casual ambiance. Join us during your time in Hilton Head Island for sensational dining.
Conroy's restaurant offers fresh, succulent seafood dishes, along with classic American specialties. Indulge in local seafood delicacies like crab cakes, salmon, and shrimp, or treat yourself to an expertly crafted cocktail.
Our seasonal restaurant features a scenic beachside location and a warm, inviting atmosphere. Choose from a variety of American staples, such as salads, sandwiches, and other options while enjoying striking views of the Hilton Head Island coastline.
Liquid is an ideal place to relax with family and friends after a day of fun in Hilton Head Island. Along with specialty cocktails and an impressive selection of beer and wine, we serve a restaurant menu that features an assortment of small bites.
Red Fish specializes in cuisine where an eclectic blend of seafood, steaks, fresh local fruit and vegetables are combined with Lowcountry specialties.
Alexander's has been an island tradition since 1977. Choose from over 100 hand selected wines to compliment the freshest seafood and hand trimmed steaks.
Old Fort Pub is a charming restaurant with one of the best views on Hilton Head Island. Perched on the banks of the Intra-coastal Waterway, guests enjoy Chef Keith Josefiak's "New Southern" favorites inspired with influences from around the globe.
The Old Oyster Factory is a waterfront Hilton Head restaurant for family and children of all ages. With fresh caught seafood and a wide range of steaks and delicious desserts, you'll be sure to enjoy your meal!
CQ's combines great fun, fine dining and a touch of Hilton Head Island history. Inspired by the abundant varieties of fresh seafood, beef and game available, our chef creates dishes that are best described as contemporary American with classic influences.
Welcome to The Jazz Corner, the South East's premier jazz club and restaurant offering smooth and elegant jazz with gourmet dining in an intimate and relaxed environment nightly.
Hilton Head Island's newest landmark restaurant with waterfront dining - Skull Creek Boathouse. Skull Creek Boathouse features fresh seafood, American favorites with a twist, and a raw bar featuring fresh sushi.


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As the topic says, Hourman vs Immortus vs Flash
All have a certain timepower with various other powers. It's the android version of Hourman with the Worlogog, and the Barry Allen version of Flash.
The winner is the one who either knocks the other one out, kills the other one or wipes him out of existence.
The fight starts in New York! No preptime! They are in Character!
If you don't know the characters, look them up. Who wins?!


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Duanesburg Central School District Superintendent Chris Crowley has released a statement saying the decision to abruptly cancel an organic chemistry class at Duanesburg High School last winter was reached after it became clear the curriculum was too advanced for students. In a lengthy statement posted on the district's website this week, Crowley said a review of the curriculum was launched in January after some of the students and their parents raised concerns. She said district ...
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In today's column , Richard J. Mouw comments on recent remarks by prominent pastor Pat Robertson: Regarding the Snowden revelations about government surveillance, Robertson observed that these practices were setting the stage for the End Times. We seem to be approaching an epoch . . . . Continue Reading »
In this morning's On the Square , Wesley J. Smith testifies to his Orthodox Christianity: The Orthodox Catholic Churchas it is formally calledis the second largest in the world with about 300 million members. And while we remain almost microscopic in the United . . . . Continue Reading »
The team undertaking the restoration of the Fifth Avenue cathedral have released a new video on their project: St. Patrick's Transformation from St. Patrick's Cathedral on Vimeo . Read Kate Monaghan's On the Square articulating the rationale for the restoration here . . . . . Continue Reading »
In today's column , Pete Spiliakos responds to R.R. Reno's " Our Challenges " from the August/September issue with some practical suggestions: Aside from the policy problems, the over-identification of faith with one party damages the appeal of the faith itself. There are . . . . Continue Reading »
In his On the Square this morning, Edward Feser tackles the questions of nothingness as they emerge in contemporary philosophy and theoretical physics: John Leslie and Robert Lawrence Kuhn have published The Mystery of Existence: Why Is There Anything At All? , a very useful . . . . Continue Reading »
In today's column , George Weigel explains that religious freedom should be a primary concern of American foreign policy. Not only is this a question of the first human freedom, it makes pragmatic sense for Washington: Religious freedom advances the cause of peace, for countries that . . . . Continue Reading »
In his column , Kevin M. Clarke explains why he believes wax-and-wick candles matter for worship. In the ecclesial space, the ersatz glow beneath a sacred image feels more like a nod to sentimentality than a creation of an authentic prayer space. It is a spiritual turn-off. I light a candle because . . . . Continue Reading »
In today's On the Square , Nathaniel Peters examines the recent papal encyclical: " Lumen Fidei discusses faith as it relates to Scripture, salvation, reason, theology, the Sacraments, and society, all without much explicit mention of sin." Yet Pope Francis does . . . . Continue Reading »
In his On the Square this morning, William Doino Jr. debunks five falsehoods and/or partial truths about Pope Francis: "Since the opening days of his papacy, a flood of commentators have come forth to tell us what to expect of him, only to miss the mark." Doino concludes by . . . . Continue Reading »
In a May commencement address at the historically black Morehouse College, President Obama promoted same-sex marriage and cohabitation, advising the male audience of graduates to "Be the best husband to your wife, or your boyfriend, or your partner." As Southern Baptist pastor William Dwight McKissic, Sr., pointed out, this was an assault on Christian values and convictions… Continue Reading »
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AMA Alliance
Uniting and Empowering Physician Families
- AMA Alliance is the largest national organization representing the physician family.
- The Physician Family Network embraces the medical journey from training years to retirement.
- Our members unite, connect, support, engage and empower.
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Connect With a Network of Physician Families
The AMA Alliance provides a forum to unite and engage its members with medical families nationwide. As an affiliate of the American Medical Association, the Alliance has partnered with the AMA on important public health initiatives from education to legislative advocacy, and Alliance members have access to several AMA programs and conferences, including the AMA National Advocacy Conference and the AMPAC Campaign and Candidate School sessions. Members connect with other physician families through friendships and camaraderie, and are offered personal development opportunities by participation in public health projects, enrichment seminars, online speaker presentations and blogs, and Alliance professional and social media.
Become a Member
The AMA Alliance invites all physicians and their spouses/partners to become Alliance members. The annual membership fee is $50 per person and $80 for couples. Special individual and couples' membership rates are available for physicians in training and those just starting into active practice.
Physician Family Magazine
The AMA Alliance Physician Family magazine was created in 2014 to reflect our mission statement: "Unite and Empower Physician Families." Articles are either authored by Alliance members who share their family experiences or medical and other professionals who write on topics of interest to the medical family.
The quarterly Physician Family and Alliance in Motion magazines are mailed to members and are available online at the Alliance and Physician Family websites. Read and share these resources to help strengthen and support the network and communities of physician families.


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MLB Games
AL Division Series: Baltimore Orioles at New York Yankees.
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Oakland Athletics relief pitcher Jesse Chavez throws against the New York Yankees in the 18th inning of a baseball game Thursday, June 13, 2013, in Oakland, Calif. Oakland won the game 3-2 in 18 innings, and Chavez was the winning pitcher. (AP Photo/Eric Risberg)