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Norfolk island
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Re: Norfolk island
I spent 4 fantastic days there in early-Nov. 2012, just a few weeks before you!, albeit in very settled weather. We spent the first day in Cascade Bay and then moved around to Ball Bay for the next three. Landing the dinghy was much more difficult there but it was great holding and very minimal swell. I was nervous at first about the weather but I watched carefully for changes and went back to the boat a couple times a day to check on things. The people are so friendly that I never had trouble getting a ride there or back. However, I was a bit surprised by the number of tourists. When weather approached, I bailed for NZ. There are four anchorages, one on each side of the island, and it is possible to move to stay in the lee but I was not interested in being chased around the island. Friday and Staurday nights are very festive with the majority of the locals staying out till all hours!
"The notion of life implies a certain absoluteness of self-enjoyment." -Alfred North Whitehead
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Television Celebrity Ranking
Check out the most updated and latest information about Suruchi Verma's on the Internet.Suruchi Verma has over 21 Fans registered on India-Forums.com. We have 1 Television News articles related to Suruchi Verma.Do share your criticism, comments and feedback for the Actor on Suruchi Verma's comments page. We have over 1 Photos of Suruchi Verma to view and download including Suruchi Verma's Wallpapers.
Suruchi Verma Fan Club (21)
Comment on Suruchi Verma
(everything from quick facts, opinions, fanmails to controversies goes here)
Join India Forums for free to comment on this celebrity. Have an account already? use Quick Login to comment.Read more comments on Suruchi Verma
love your comments kalsanwali..your still on my like list...lol
Great acting Suruchi! (LOL) Oh daughter of Kalsan, you are afraid of a Nautanki?
Kalsanwa y u r doing neelu's work,u r the daughter of kalsan mantri,u r acting superb
O daughter of Kalsan How could you let Nilu push you around like that?
Kalsanwali you should kick Vishnu and not defending him
Suruchi Verma, everyone call you Kalsanwali,do you have any name in this show.
Dont give up...keep on digging..you will find the truth...I just hope you will do something good with it...
You are only lady in LN who give good lesson to neelu
Edited on:07 December 2011 at 7:01pm
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reconditioning is a valid word in this word list. For a definition, see the external dictionary links below.
The word "reconditioning" uses 14 letters: C D E G I I I N N N O O R T.
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p - preconditioning
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So.. it's 2015 We are back.
Quite a few things have happened in the last year. The biggest thing has to be the Sony hack late 2014. Linux got a bashing and everyone scrambled to patch aftershock/shellshock.
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I finally get to play these games now and enjoying it, I was recommended this series years ago
User Profile
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- Fri 17th May, 2013
Recent Comments
@Waann Me too! I was hoping Child of Light would go on sale on Wii U so I can get it on there instead of PC and support the Wii U a bit more.
@readyletsgo Thanks man
Damn it, I'm struggling with storage space atm... Might have to finally get a new external HDD D: Question for anyone who knows: The HDD is formatted for use with the Wii U right? The only data on it will be from the Wii U, and I can't use the external HDD with any other device at the same time, unless I format it again?
Oh. It looks like I purchased Art of Balance (was only just released in Aus) last night before the 25% discount was active... Oh well :
@Tsurii897 This was my first time buying anything like this and they look nice in their box, but... there was no way I wasn't taking them out! I cut the bottom of all mine and pulled them all out, if I really want I can put them back in and they'll still look nice because the boxes aren't torn! I agree, I don't understand why people just let them sit in their box, they look great putting them places outside of their box instead
I never did get to play these games, although they were recommended to me. Will probably grab this and finally give them a go!
I actually wanted to try the first game way back in 2011, but I don't think it ever came to the Australian eShop...
Oh man... I never did get many GBA games (sadly) so I'm pretty happy about some coming to Wii U. Getting Mario & Luigi: Superstar Saga for sure ;D I would get Metroid too if I didn't already have it on the 3DS.


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I will be continually updating this same Blog Page with different Photography of each adventure. Please come back and enjoy.
2/14/12 - I felt great this whole day. We waited 45 minutes for the Heavy Rains to stop and trusted the weather report for a weather window. Once we ascended to higher elevations the rains turned into Snowflakes. It was very enjoyable.
Once back down at the Lake. I wondered around to watch the Sunset on the Lakes edge. It was very inspiring day.
Along a Ridge Line in Snowflakes |


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Waikiki Aquarium celebrating 110 years!
UPDATED 7:33 PM HST Mar 18, 2014The Waikiki Aquarium is celebrating 110 years with events on Wednesday.
Video Transcriptme now is Dr. Rossiter... 110th Birthday Celebration Tomorrow, 9 AM - 1 PM $1.10 Admission LEGO Aquarium Royal Hawaiian Band Performance New Medallion Machine Family Fun Day This Saturday, 9 AM - 2 PM $1.10 Admission Great Marine Chalk Art Free Crayola products for kids Lots of Live Entertainment Coming up -- CONTROVERS Y over the nomination of a 2 C1 Coming ip--
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use.blog comments powered by Disqus


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First time I see a Safavieh product of such poor quality. I ordered two desks, one was missing the screw which holds the drawer knob, so I had to go find one that would fit at Orchard Supply. Finish is very "raw", just a very thin coat of white paint with fingerprints all over... I am glad that the purpose of these desks was home staging, or else I think I would have returned them. They just don't look new and seem pretty cheap.
Stay away - Do not purchase. I wouldn't pay fore than $10 at a gargage sale for this. Sending it back
Leaves our warehouse in 1-5 business days. * *
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FINAL SALE EXCLUSION: Items marked as FINAL SALE are not returnable unless the problem you experience is the result of our error.
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** Most Oversize orders are delivered within 1-4 weeks. Some orders may take 6 weeks to be delivered.


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What is it? Unlike the regular Prius, which you never have to plug in, this one takes part of its power from an electrical cord. The plug-in Prius uses an estimated 4 kwh lithium-ion battery pack that can be charged from a plug in place of the standard nickel-metal hydride battery pack.
What's new or notable? Toyota claims it can go up to 10 miles on electricity and reach speeds of more than 60 miles per hour without starting the gas engine. (The gas engine is the same 1.8-liter Atkinson-cycle four-cylinder used in the regular Prius.) An EV-mode switch prevents the engine from starting unless the driver steps hard on the accelerator to demand extra power.
CR's take Consumer Reports had an opportunity to drive a prototype of Toyotas plug-in Prius last year. It wouldnt go 10 miles on electric power at 60 mph, but we drove all around downtown Portland, Ore., at speeds exceeding 40 mph in electric power, and the system worked seamlessly.
When will it be available: Toyota says it will sell about 350 plug-in Prius models to fleet customers worldwide, starting in January 2010. About 150 of those will be in California, New York, Washington, D.C., and some smaller U.S. markets. The company plans to gather data on how and when the cars are charged to help inform any wider rollout of plug-in hybrids and electric cars.
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Special Agent in Charge of the FBI's Boston Field Office Richard... News PhotoBombing,Boston - Massachusetts,Boston Marathon,Boston Marathon Bombing,FBI,Horizontal,Law,Massachusetts,People,Press Conference,Speech,The Media,Track And Field,USAPhotographer Boston GlobeCollection: Boston Globe 2013 - The Boston GlobeBOSTON - APRIL 18: Special Agent in Charge of the FBI's Boston Field Office Richard DesLauriers, center with glasses, addresses the media during today's press conference where photos of two persons of interest in the Boston Marathon bombing investigation were unveiled. Also appearing were BPD Commissioner Ed Davis, United States Attorney Carmen Ortiz, and FBI JTTF law enforcement partners. (Photo by Barry Chin/The Boston Globe via Getty Images)


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Tags: artist's way, journal, julia cameraon, morning, notebook, notes, Writing
Are you familiar with the concept of "Morning Pages" from Julia Cameron's popular book The Artist's Way?
From Julia's website: "Morning Pages are three pages of longhand, stream of consciousness writing, done first thing in the morning. *There is no wrong way to do Morning Pages*– they are not high art. They are not even "writing." They are about anything and everything that crosses your mind– and they are for your eyes only. Morning Pages provoke, clarify, comfort, cajole, prioritize and synchronize the day at hand. Do not over-think Morning Pages: just put three pages of anything on the page…and then do three more pages tomorrow."
Morning Pages – The Artist's Way at Healthy Crush
5 Reasons Why You Should Start Writing Morning Pages – Right Now! at Tumble Design
Basic Tool: Morning Pages from Julia Cameron on Vimeo.
Image above courtesy of vindicarblack on Instagram.
2 thoughts on "Write Every Day: Morning Pages"
I used to do the morning pages years ago and after reading Writing Down the Bones, I am planning to start again. It really does get things out of my head and onto paper, where I can either do something about them or let them go.
Morning pages start my day and keep me focused. I get to explore myself, my plots, and bleed off brain clutter so I can write without all those background thoughts bouncing around getting in the way.


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The MoboFree technological platform is reportedly making buying and selling online easy for all African users - not only via PCs and smartphones, but also via older/feature phones.
18 Aug 2014 11:17
One of Nigeriay's biggest assets is its 170m-strong population, which continues to spark the interest of consumer facing companies.
By Kate Douglas 4 Jun 2014 05:44
Aegis Media were asked to do a campaign for Baileys, a Diageo brand, in both Nigeria and Kenya, and 72 hours later had a creative concept and execution plan that fully answered and met the client's brief and saw three of their network brands - Posterscope, Isobar and Carat working as one integrated unit.
9 Jul 2013 12:19
E-commerce in Africa has grown dramatically over the past year, says Robin Philip of payment services provider PayGate, and is now in a position to support the massive consumer boom that's happening across the continent.
2 Jul 2013 09:46
AdFu, the audience and display inventory network of sites owned by Kagiso Media, has extended its reach into the African online market by adding the Africa-born social network, Yookos, to its portfolio. This adds even more inventory to AdFu's African value proposition while also helping Yookos to drive revenue growth by maximising inventory yield.
14 Jun 2013 11:10
Airtel Ghana has been recognised with two awards for its Customer Care and Mobile Broadband Services respectively. The awards, Best Customer Care and Best Mobile Broadband Service of the Year were handed to Airtel at the 3rd Ghana Telecoms Awards 2013 organised by Mobile World magazine at a ceremony in Accra, Ghana.
3 Jun 2013 12:20
2012 saw the BuzzCity network grow by 67% with over 210.8 billion ads served across the globe and this extensive growth in mobile usage is certain to continue as we move through 2013.
By Dr KF Lai 21 Feb 2013 11:07
The year 2013 for most brands, especially the ones coping with saturated markets in developed countries, will be a decisive one. Incorporating Africa into their corporate brand strategy, if they haven't done so, will be the better part of valour, so to speak.
By Obaika Consulting Team 31 Jan 2013 13:20
No, the concepts of "tribalism", "gamification" and "engagement" aren't a promo for the latest computer game, but are in fact the trends that will characterise the way companies and consumers interact in 2013. The branding industry is constantly developing and. while the following trends are evolutions rather than dynamic, short-term changes, we believe there are 10 areas that will define the brandscape over the next year.
By HKLM Exco Team 31 Jan 2013 12:33
Young South Africa is savvier than ever before. If you are looking for a smart and discerning prosumer, this group of kids, teens and young adults will give you more kicks than you've ever bargained for. They know just what they are looking for from any brand, and this makes them that much more satisfying to please. Here are a few trends to look out for in 2013.
By HDI Youth Marketeers Team 31 Jan 2013 11:30
As 2013 commences, afro-pessimism seems to cede to afro-optimism. There is a global consensus: Africa is poised for a great future. What will be the impact of Africa's growth on our industry? What will be the major trends of the year? In the business world, predicting the future is a crucial exercise.
By Nandkishor Buty 30 Jan 2013 12:39
There are several key trends that will present themselves in 2013. From m-payments to HIV/AIDS prevention, emerging markets are leading the way when it comes to innovative uses of mobile technology. Marketers, too, are seeing their roles and responsibilities expand.
By Dr KF Lai 25 Jan 2013 10:57
Many companies talk about expanding into Africa. It's the next obvious frontier. However, it would be wrong to assume that a week's visit to Nigeria for example, with a population of over 160 million and 350 ethnic groups with twelve languages, will give you a true understanding of how to operate your brand in that market.
By Nonye Mpho Omotola 8 Nov 2012 09:53
Glo Ghana has recorded its first loss in subscribers after five months of operations in the West African country.
By Masahudu Kunateh 5 Nov 2012 12:20


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We know that anything we want to create is in our hands. No matter our craft of choice, from quilting, to knitting, to sewing, to cake decorating, and more, together we take our skills to new heights alongside the world's best instructors. We inspire and support each other with helpful tips and positive feedback along the way. We pour our hearts and – more... souls into our projects and take pride in what we make.
We believe in providing the best education. We believe in handmade. We believe in you.
Join us to begin your crafting adventure! – less – More from ZoomInfo »


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Scam scenarios Different scenarios used by dating scammers |
Thread Tools | Search this Thread | Display Modes |
Common scenarios used by Nigerian scammers
1. The girl is involved with contract negotiations, has discovered a supplier has been overinvoiced and wishes to share the money with you.
2. The girl has a relative who is unable to access money for some reason, such as wrongful imprisonment. 3. The girl knows a Nigerian who has died and they can't access the money for some reason. 4. The girl has discovered a foreigner died with money invested somewhere, and they want to steal it and share the money with you. 5. The girl has stolen the money and wants to share it with you. 6. The girl has a business and wants to go into a joint venture with you. |
One sure method to know that the person you just met is going to take you to the cleaners is their email address...I didnt realize it until this week after running into professional college educated scammers...all of those emails with numbers in them...such as yemijohnson004 tells you that this is the 4th reincarnation of that email address...all they do is change one number in their email address and completly lose their last contact while at the same time presenting a fresh clean email for their next victim...go back through your known scammers addresses and check it out, I was even looking at some of the posts right here on this string...look at those addresses in most of them...they are the professionals who know how to get the most out of their email provider without arousing too much suspision while being able to lose any tail or hurt crying man that may be on to them...some of these people make better money then we do at this stuff....check out the various addresses of potential scammers you may be in contact with....when you see all of these hypens and numbers they are there for the purpose of being able to change addresses with altering one charater...2sweet2you@ can be changed to 2sweet4you and it is a brand new email..this happened to me just this week which opened my eyes to this tactic......so whenever you see one of those 001..300..etc. being used by your brand new internet lover.....be ready to open your wallet and shed some tears. Patrick Little |
Can you add to to the admin message.
Relative who has died in any country i.e. Nigeria, America. Daughter cannot access money because insurance company cannot pay out unless she marries. Oh and the email address fastermail.com seems to have a common theme. Beware these people are willing to keep at you for however long it takes, by that I mean over a year if necessary. Oh and they are getting cleverer at this by the day. However they still make mistakes. They will forget who they are writing to and say the wrong name. First time this happens you are being scammed. If you don't believe me they will do it again because they are scamming more than you. Other thing is they use the same email address and add a number onto it. Any numbers do not believe. Oh and in Nigeria they will not accept you buying them a plane ticket over the internet to pick up at the check in desk. Of course why not because they don't exist!!!!!!!!!!!!!!!!!!!! They will tell you that they love you time and time again. They will tell you that they cry all the time when you doubt them. You can speak to this person. This of course is the wife/girlfriend/sister of the scammer. You have more chance of Gengis Khan and Adolf Hitler coming back from the dead than your girlfriend being real. Even when this gets out of hand and this person says they will meet you at the airport. When you have been so gullible to send the money!!! They will of course not be there. But guess what the person will have had an accident and will now be in hospital and is being initially treated free of charge. But guess what - they are asking you to pay for her release. Its a crock of ****. Do not under any circumstances send any money through western union or otherwise to nigeria. Send it to good causes instead. |
Re: Common scenarios used by Nigerian scammers
Its really great posts.
Re: Common scenarios used by Nigerian scammers
This really makes me wonder are people that dumb? how can they not realize that this is a scam. why will someone want to share his wealth with unknown person?
Self Managed Super Fund AU |
Bookmarks |
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Display Modes | |
Similar Threads | ||||
Thread | Thread Starter | Forum | Replies | Last Post |
safety tips for men: correspondence | ham | Scam or not? | 0 | 12-27-2006 10:05 AM |
She called me back | Detective | Scam or not? | 0 | 02-25-2006 02:28 AM |
The more... | Detective | Scam or not? | 18 | 02-16-2006 04:14 AM |
small comment to elenag | Detective | Scam or not? | 16 | 01-16-2006 03:35 PM |
Why do Names here NOT appear in Wed Search | juxone | Scam or not? | 0 | 05-18-2005 10:30 PM |


text: I am a grad student and lab instructor in Tyler, TX. My boyfriend is originally from Brazil and so misses the beach terribly. We want our young daughter to grow up knowing the ocean as much as possible, and so wanted to take this anniversary trip and show her the beach for the first time:)


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Credits & Info
- Uploaded
- Nov 16, 2011 | 4:38 PM EST
- Daily Feature November 17, 2011
If you liked this, check these out!
Feed Us 4 by PopBrain
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Author Comments
The deadly piranha is back and hungrier than ever! This time around you must complete objectives such as eating certain targets or more challenging combinations. Complete all objectives to get to the top of the food chain.
Rated 2 / 5 stars
What's going on?
Fun and original but there's no instructions. I had no idea what I was doing at first and even after few tries I still wasn't entirely confident that I was playing the game properly/efficiently. Plus what does weight have to do with my fish? How exactly do you collect blood(is it each bite)?
I didn't enjoy the main menu as it confused me a bit at first and appears to me as more of a sub menu with the way the options are laid out.
Lastly I wasn't a big fan of the music and was sad to see I had to turn off the sound as well if I didn't want to hear any music.
Overall the game seemed fun and original but I wasn't a fan of the menus, music and lack of instructions.
Rated 2.5 / 5 stars
A Second Helping of the Same Shit
Feed Us 2 is the second game in this series where a player can control a piranha and devour hapless swimmers, scuba divers, and schools of fish to satisfy its lust for blood, which you can use to upgrade five different attributes, along with adding your own school of bloodthirsty piranhas. As much as I want to like this game, it still retains the same bugs that plagued the original, and the control is no more refined, either. The collision detection is just plain bad, because every time you hit the island, you bounce off of it, causing unnecessary delay in finishing levels, especially when they're timed. Furthermore, as JapeSkydrake pointed out, you can literally get stuck IN an island if you try to attack a boat as it goes through one (sometimes the game corrects it, other times it just freezes). The control with the mouse is just as shoddy as ever, because you have to lead the piranha with the cursor and the movement is rough and inconsistent, and this makes ramming boats irritating in the earlier levels. And even at ramming speed, missing a boat sends you flying into the air and the lack of gravity keeps you suspended to a ridiculous degree. This sequel really could have used a keyboard-cum-mouse control scheme as it would have made eating your victims easier and the game a lot more fun.
Rated 2.5 / 5 stars
Buggy as Hell
the concept is good. The gameplay is original, but it bugs out like mad. I keep getting stuck in the islands (IN the islands, not ON) can't tell if the crocidile is gonna kill me or not. At one point i was eating a dude and then my little spawns decide to rocket off into space. But the ultimate deal breaker would be the crocidle kill I mentioned before: Where I bounced off an island when i wasn't even facing in that direction and landed right in his mouth apparently.
Rated 5 / 5 stars
To people having problems with controls
to eat people you have to swim through the person at a relatively fast speed, youll know when you do, and you have to make contact
left mouse- speed boost when purchased
great game, something to get used to, fantastic graphics
Rated 3 / 5 stars
How do you eat!?
Looks promising, but I've been trying every button including the mouse button but nothing happens :/ NEED instructions...


text: We were delighted with this motel and found it clean, comfortable and well-appointed. Just off the freeway (and away from any traffic noise), with helpful staff and good air conditioning (which is needed in Delano). There is a great Pizzeria/Sports Bar just across the road and you can charge your meal directly to your room. Breakfast is included in the... More


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I will never stay there again
the room needs to be remodeled there room. there was mold and odor in the room. we had to go and buy a air freshner
a/c was poor, run down, shower would go from cold to scalding hot without warning,
location, friendly staff
room was old and tired - soft beds, worn pillows...
Everything was nice and clean. Great free breakfast!
high speed internet did not work in room we were in and is advertised heavily online and on billboards. This may need an upgrade.
Friendly staff , room was spacious and clean. Nice quiet stay- comfy bed!
Wish we could have slept in longer but had a schedule to keep- lol
The staff was very courteous. The pool was the highlight of our trip and the breakfast was great.
Easy to get to and from the interstate
The whole place seemed a bit shabby, but for an overnight crash, it was just perfect. The room was clan and facilities in working order.
The room was clean and comfortable. The shower was fantastic. The staff was helpful and some of them very friendly. The pool area was very enticing. Vending options were good. Location was easily accessed.
Only a desk, one office chair, and one sitting chair available outside of the beds. I would like to have had more sitting options available, as I was visiting family.
Because they stereo typed me soon as I walked thru the doors. Said I could not bring my daughter birthday balloons or cake in the hotel. I believe they racially profiled me and my family
Hot tub very hot!
Cold pool
Not much
bathroom fixtures were beyond worn, bed was lumpy, coffee maker was filthy, manager was rude, barely coherent and he was actually asleep in the office when I tried to check in.
Absolutely nothing!!! This place was horrible
The room smelled so bad we could not stay there and the rude manager told us we would not get our money back so we had to drive thru the nite to go back home! I hope someone shuts this hotel down it is the worst I have ever been in!!!!!
Here's why:
We're not the seller At KAYAK we don't set prices, so it's not possible for us to guarantee what other companies are selling.
We aggregate tons of data for you Our service lets you quickly and easily compare results from hundreds of travel sites at once. In this sense, KAYAK is a search engine and we don't guarantee prices we find.
Why aren't prices accurate 100% of the time? Prices on airline seats, hotel rooms and car rentals can change frequently. Several people may also be trying to buy the same travel option simultaneously. As a result, you may find on occasion that certain prices are no longer available.
More questions or if you have a bad price to report to us Please send us an email and someone from our team will get back to you promptly.


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It turns out I was wrong about The Killing.
Monthly Archives: April 2015
The Video Game Plot Scale
The Well-Made (Video Game) Plot, Part 1
Episode 165: Mandatory Post-Colonial Guilt
The Overthinkers tackle storms in pop culture, Lt. Dan's CGI legs, the MTV Video Music Awards, and Colombiana.
Open Thread for August 26, 2011
In the event of a weather emergency, Open this Thread to its full 90 degrees dilation and activate the solar panel. Oh man! We have Columbiana and My Idiot Brother opening this weekend, which look decidedly average. But we also … Continued
OTI Meetup Recap
Overthink This! A Call For Submissions.
Dear Overthinkers: We don't usually do this thing, but I'm making a request. I'm making a request to all you people out there in OTI land who think you can write a good article for our site. I'm specifically addressing … Continued


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This website is scheduled to undergo routine maintenance on Saturday, 18 April from 5:00 p.m.-10:00 p.m. CDT. During this time, you may not be able to schedule, reschedule or cancel test appointments. We apologize for this inconvenience and thank you for your patience.
OSS-DB Certification Testing
OSS-DB is a qualification certification for engineers involved in OSS-DB system. OSS-DB system is commonly used as PostgreSQL9.0 RDBMS and the number of company is increasing each year relying on the system.
OSS-DB Exam Silver
OSS-DB Silver exam is not only the certification for the system development engineer and maintenance engineer, but for the engineer who has multiple skills of using OSS-DB.
OSS-DB Exam Gold
OSS-DB Gold exam is the certification for the system consultant and the engineer who deliver the best solutions for costing, planning and trouble shooting of using OSS-DB.
Before scheduling an appointment with Pearson VUE, you must first register with LPI and obtain an LPI ID. You will need this number to create an account.


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http://www.w3.org/Bugs/Public/show_bug.cgi?id=8827 Michael Cooper <firstname.lastname@example.com> changed: What |Removed |Added ---------------------------------------------------------------------------- Keywords| |TrackerIssue CC| |email@example.com --- Comment #6 from Michael Cooper <email@example.com> 2010-09-14 15:56:27 --- Bug triage sub-team thinks this bug is one of several related to ISSUE-31 http://www.w3.org/html/wg/tracker/issues/31. Adding the TrackerIssue keyword just to formalize this relationship. It's already back-referenced from that issue. -- Configure bugmail: http://www.w3.org/Bugs/Public/userprefs.cgi?tab=email ------- You are receiving this mail because: ------- You are on the CC list for the bug.Received on Tuesday, 14 September 2010 15:56:30 UTC
This archive was generated by hypermail 2.3.1 : Wednesday, 7 January 2015 16:25:50 UTC


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- Find a rental
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Booking Summer: Family Reunions. Special Occasions
From $5,500 / night
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Description from the owner
- 7 bedrooms
- 8 bathrooms
- Sleeps 16
- Chalet
Bedrooms: 7
Bathrooms: 8
Sleeps: 16
Type: Chalet
Booking Summer: Family Reunions. Special OccasionsDescription from the owner
The Over The Edge Chalet is undoubtedly Colorado's finest ski-in, ski out home available for rental. This newly constructed home is nestled high alongside Steamboat's legendary Mt. Werner, offering guests over 10,000 square feet of living space. Perfect for large families and friends, corporate retreats, or family, friends and bridal party* who who don't want to be cramped in a hotel room, we have no doubt that you will find our wonderful mountain retreat exceeds all of your expectations.
A stunning architectural achievement, this spectacular 7 bedroom, 7.5 bath home boasts an incredible facade of stone block, field stone and mahogany that blend ...Read more
About the owner
About the owner
Elisabeth Mullen
Elisabeth Mullen
Response rate 60%
Response time A few hours
Calendar updated today
Overall rating5.0 / 5.0 based on 14 reviews and 2 properties
Booking Summer: Family Reunions. Special Occasions
Steamboat Springs, Colorado
Additional Location Information
The Steamboat Luxe Chalet is nestled slopeside along a green run in the heart of Steamboat's most exclusive slopeside neighborhood. Guests of all abilities ski directly to the back door for Steamboat's finest access.
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Mountain nearby
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Nearest airport: Yampa Valley Regional (HDN), 22 miles
Car is recommended
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So very pretty and made me feel like spring is right around the corner!
love the colours and the wire word..its been getting a bit milder here so cant wait till spring comes and the lighter nights
lovely :-)
Green and purple is one of my favorite color combos.
very cute
Thanks so much for visiting my blog - I look forward to visiting yours, too!


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Allegro Dance Theatre presents the happily-ever-after ballet Cinderella for the 22nd year Sunday.
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Canadian investors and the discount on closed-end funds
dc.contributor.author | Wang, Yue | en_US |
dc.date.accessioned | 2010-03-09T20:22:57Z | |
dc.date.available | 2010-03-09T20:22:57Z | |
dc.date.issued | 2010-03-09T20:22:57Z | |
dc.identifier.uri | http://hdl.handle.net/10464/2939 | |
dc.description.abstract | Small investors' sentiment has been proposed by behaviouralists to explain the existence and behavior of discount on closed-end funds (CEFD). The empirical tests of this sentiment hypothesis so far provide equivocal results. Besides, most of out-of-sample tests outside U.S. are not robust in the sense that they fail to well control other firm characteristics and risk factors that may explain stock return and to provide a formal cross-sectional test of the link between CEFD and stock return. This thesis explores the role of CEFD in asset pricing and further validates CEFD as a sentiment proxy in Canadian context and augments the extant studies by examining the redemption feature inherent in Canadian closed-end funds and by enhancing the robustness of the empirical tests. Our empirical results document differential behaviors in discounts between redeemable funds and non-redeemable funds. However, we don't find supportive evidence of CEFD as a priced factor. Specifically, the stocks with different exposures to CEFD fail to provide significantly different average return. Nor does CEFD provide significant incremental explanatory power, after controlling other well-known firm characteristics and risk factors, in cross-sectional as well as time-series variation of stock return. This evidence, together with the findings from our direct test of CEFD as a sentiment index, suggests that CEFD, even the discount on traditional non-redeemable closed-end funds, is unlikely to be driven by elusive sentiment in Canada. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | St. Catharines, Ont. : Brock University, Dept. of Management, 2010. | en_US |
dc.subject | Closed-end funds. | en_US |
dc.subject | Stockholders--Canada. | en_US |
dc.subject | Stocks--Prices | en_US |
dc.title | Canadian investors and the discount on closed-end funds | en_US |
dc.type | Electronic Thesis or Dissertation | en_US |
dc.degree.name | M.Sc. Management | en_US |
dc.degree.level | Masters | en_US |
dc.contributor.department | Faculty of Business Programs | en_US |
dc.degree.discipline | Faculty of Business | en_US |


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Are this toy and meal OK with you? Karen Bleier/AFP hide caption itoggle caption Karen Bleier/AFP Shots - Health News Parents Or Judges: Who Should Rule On Happy Meals? December 15, 2010 When it comes to what kids eat, who should have the biggest say? People are chiming in on a post about a lawsuit filed against McDonald's in California. Vote in our survey.
David Paul Morris/Getty The Two-Way McDonald's Loses Customer Information In Database Breach December 14, 2010 The Hamburglar didn't do it, but someone has broken into a database containing the personal information of McDonald's customers. The company says that financial information, such as credit card numbers, was not lost.
Blog Of The Nation Happy Meals Defy The Test Of Time September 1, 2010 Rarely do we keep -- and consume -- our fast-food meals past the day we buy them. But really, how long do they last? New York-based photographer Sally Davies' latest project documents one Happy Meal for 5 months. Somehow, it hasn't changed much.
Tell Me More The McOlympian? February 17, 2010 At the day of the opening ceremony American snowboarder and medalist Lindsey Jacobellis told NBC she eats only organic food. Not much of that at Mickey D's.


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Start a hangout
Donn Silberman
206,476 views
Just want to see how this works. Not too sure about it yet.
Basic Information
I have been going to this Sport Clips since it opened and get the best treatment every time. I get the MVP Season Pass and usually have the manager, Lauren, cut my hair. She is always mutlitasking (cutting hair, answering the phone and welcoming guests) and keeping up with some nice conversation too.
Its a pretty busy place, so I always call about 30 minutes before I leave my office to make sure I can get my hair cut during my lunch hour.
Three Cheers for Sport Clips Woodbury,
Public - a year ago
reviewed a year ago
Guest apartment for visiting faculty is amazing. Thanks
Public - 2 years ago
reviewed 2 years ago
This is my second year using Woodbury Family Optometry and this year's experience is even better. The doctor and his staff are very professional, friendly and helpful. As a professional optical engineer and instructor myself, it was easy for me to follow the doctor's explanations of all the points about my exam and the results. However, I believe that any person using this doctor's services will be able to understand his very clear explanations of the exam and its results. The technician that used the automated exam systems was also very good at his job. I highly recommend using Woodbury Family Optometry, the products and services are the best I have encountered.
Public - 2 years ago
reviewed 2 years ago


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Explore Seoul The palace district The business district Itaewon Hongdae South of the river Bukhansan National Park Share Seoul's burgeoning queer nightlife scene has come on in leaps and bounds since 2000, when star actor Hong Seok-cheon came out of the closet – the first Korean celebrity to do so. He has since opened up a whole raft of gay-friendly bars and restaurants in Itaewon, which remains the best gay area for foreigners. Seoul does have other gay zones; the area around Jongno 3-ga station has long been home to underground gay bars, and recent years have seen the scene becoming more and more open. Unfortunately, few venues are foreigner-friendly, though the Starmoon café attracts all sorts – it's in the ground floor of the tall Fraser Suites building. Additionally, the university district of Sinchon is popular with the local lesbian community, many of whom congregate of an evening in "Triangle Park", a patch of concrete near exit 1 of Sinchon subway station (take the first right). Read More
Explore South Korea Seoul Gyeonggi and Gangwon Gyeongsang Jeolla Chungcheong Jeju Island Inspiration Things not to miss Explore South Korea Features Gallery Where Next? Check out Gyeonggi and Gangwon Book a hostel in South Korea Latest Discussion Essentials Essentials Fact file Getting there Getting around Accommodation Food and drink The media Festivals Sports and outdoor activities Culture and etiquette Travel essentials


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Yes, you can change the playback speed between normal, slow and very slow.
Can I change the playback speed of my cinemagraphs on my Nokia Lumia with Windows Phone 8?
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- Charge your phone wirelessly
- How can I share Cinemagraphs on my Lumia phone?
- How can I personalise my Lumia phone?


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Released: Feb 01st, 1998
Running Time: 84
Director: James Knight
Company: Notorious Productions
Sophia (I), Jessica Darlin, Scarlett, Victoria Lee, Celine Deavoux, Santino Lee, Jonathan Morgan, Tony (I) (Hungarian), Alexis (I)
Critical Rating: AA 1/2
Genre: All-Sex
This gonzo release is a mixed bag - three b/g, one lesbo duo, one solo - that fails to satisfy, partly because too much time is spent interviewing fresh faces. While most of the girls don't even approach knockout status, a standout returnee to the X biz is Celine Deavoux, who resembles a cross between Blythe Danner and '70s mainstream star Kay Lenz. And it's certainly Celine who achieves the vid's high point when sharing a double-headed dildo with gal pal Scarlett.


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Elect Dawn McCravey
McAuliffe, who chairs the Early Learning and K-12 Education Committee, has served in the state senate for 20 years and was called out this past session for throttling reform legislation. Fending off the special-interest moniker, McAuliffe remains a committed public servant, but her thinking and leadership style no longer align with a chairmanship that demands innovation (all the more imperative with the state Supreme Court's McCleary decision mandating full funding of K-12.)
Her opponent, Republican Dawn McCravey, is a former special-ed teacher and a Northshore School Board member. McCravey looks at basic education through a fresh, school-board-tested lens, tying board and district goals with student achievement and advancing a more rigorous curriculum. Her willingness to explore education options that put students ahead of administration, as well as her grounding in small-business issues, make McCravey the more appealing choice.
In Position 1, Rep. Derek Stanford has matured into an able lawmaker who is making his mark as a member of the Business and Financial Services Committee. Stanford, who also serves on the Education Appropriations and Oversight Committee, labored to secure funding for a science facility at the UW/Bothell and also passed a bill targeting predatory debt collectors. His Republican opponent, former Bothell Deputy mayor Sandy Guinn, likewise deserves credit for the growth of the UW/Bothell, advancing downtown re-development and transportation projects that have enhanced local infrastructure and campus capacity.
Guinn dings Stanford for a poor rating by the National Federation of Independent Business and what she sees as a higher-tax MO. Her budget suggestions, including liquidating some state lands, need to be more detailed and, arguably, more politically tenable. Stanford is also better versed on the district's transportation needs. Ultimately, Guinn does not advance a sufficiently convincing argument to replace Stanford.
In Position 2, Rep. Luis Moscoso, a rising-star progressive, has successfully navigated the transition from activist to lawmaker. A champion of gang prevention, civil rights and small business, Moscoso would be the ideal sponsor of the Washington Voting Rights Act this next session. Political smarts braided with judgment (and an indefatigable campaigner) Moscoso faces an equally committed challenger in conservative Republican Mark Davies. Submitting a petition in lieu of a filing fee, Davies qualified as an undeclared write-in candidate. A transportation wonk and Boeing programmer, Davies advocates repeal of the Growth Management Act and criticizes Moscoso for being too much of a spendthrift Democrat.
Six good candidates with the public interest in mind. The Herald Editorial Board recommends Dawn McCravey, Derek Stanford, and Luis Moscoso.
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Cystic hypersecretory hyperplasia is a rare histologic change. Its significance is still unclear but it is important to identify these histologic changes because of its resemblance to ductal carcinoma in situ.
- Lobulocentricity of breast hypersecretory hyperplasia with cytologic atypia: infrequent association with carcinoma in situ.
Kasami M, Jensen RA, Simpson JF, Page DL.
Departments of Pathology, Shizuoka Cancer Center, Shizuoka (formerly at Nagoya National Hospital, Nagoya), Japan.
Am J Clin Pathol. 2004 Nov;122(5):714-20. Abstract quote
Intracytoplasmic and extracytoplasmic features of secretion, similar to lactational changes, occasionally are seen in the nonparous human breast, usually are lobulocentric, and often have aberrant cytologic and nuclear changes. In these "hypersecretory hyperplasias" (HHs; 38 women) there is bubbly cytoplasm with irregular apical cytoplasmic and/or nuclear protrusions.
In a review of 138 HH cases the following additional associated changes were found: nuclear atypia (HHA, 22 women), atypical ductal hyperplasia (ADH-HH, 24 women), and ductal carcinoma in situ (DCIS-HH, 54 women). A diagnosis of DCIS-HH requires involvement of true duct(s) and of several contiguous lobular units, emphasizing the importance of extent and overall size and similar cytology and histologic arrangement of intercellular spaces indicating a homogeneous cell population. Cases of HH regularly are characterized as having adjacent and nearby lobular units with quite diverse cytologic patterns.
The major impact of this study is to recognize that HHA may be regarded as having uncertain significance when found alone in the usual presentation in a single unit, but that formally defined ADH and/or DCIS may be locally present. Carcinoma arising from preexisting pregnancy-like and cystic hypersecretory hyperplasia lesions of the breast: a clinicopathologic study of 9 patients.
Shin SJ, Rosen PP.
Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
Am J Surg Pathol. 2004 Jun;28(6):789-93. Abstract quote
The intimate histologic relationship of pregnancy-like hyperplasia (PLH) and cystic hypersecretory hyperplasia (CHH) has been previously reported. However, none of these published cases contained coexisting carcinoma.
In this study, we describe 9 additional cases of this lesion, all of which also revealed ductal carcinoma in situ (DCIS) as well as invasive carcinoma in 1 case. Hematoxylin and eosin-stained slides were reviewed for all cases.
All were women who ranged in age from 35 to 49 years (mean 42.0 years; median 42.5 years). Reasons for surgical biopsy were calcifications in 6, breast mass in 2, and nipple discharge in 1. One patient with a mass also experienced nipple discharge. Three women initially underwent needle core biopsy and 6 had an excisional biopsy. Six women ultimately had mastectomies.
Histologically, 5 had CHH merging with coexisting PLH. Atypia was seen in one or both components. All 9 cases contained DCIS. Two cases showed micropapillary DCIS, one of which appeared to arise from atypical PLH, while 4 of the 7 cases containing cystic hypersecretory DCIS appeared to arise from coexisting atypical CHH. Well-differentiated invasive carcinoma was identified in 1 case adjacent to cystic hypersecretory DCIS. Subsequent sentinel lymph node biopsy in this case revealed micrometastatic disease. Clinical follow-up was obtained in 9 patients and ranged from 10 to 69 months. All patients were free of disease at the time of last follow-up.
Careful clinical follow-up is recommended for lesions that display atypia in PLH, CHH, or a histologically combined lesion. If these lesions are found on a needle core biopsy specimen, an excisional biopsy is recommended. DCIS, usually micropapillary or cystic hypersecretory types, and rarely invasive carcinoma can arise in this setting. Affected patients are typically younger than those with more common types of breast carcinoma.
Cystic hypersecretory hyperplasia and cystic hypersecretory duct carcinoma of the breast. Pathology, therapy, and follow-up of 39 patients.Guerry P, Erlandson RA, Rosen PP.
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Cancer 1988 Apr 15;61(8):1611-20 Abstract quote The study documented in this article was performed to define the clinical and morphologic features of cystic hypersecretory carcinoma (CHC) and cystic hypersecretory hyperplasia (CHH) of the breast. Both lesions are characterized by the formation of cystically dilated ducts containing a homogeneous eosinophilic secretion that resembles thyroid colloid.
In most cases CHC features micropapillary intraductal carcinoma, occasionally giving rise to a high-grade, invasive carcinoma that is absent from CHH. Electron microscopy of the cystic component in one case of CHC showed ultrastructural characteristics of metabolically active cells, but few secretory granules.
Twenty-nine patients with CHC were observed for up to 23 years. Twenty-five women who had intraductal carcinoma were well or died of other causes. Of the four patients who had invasive carcinoma, one died 9 months after being diagnosed as having systemic metastases, and the other three remained disease-free. Ten cases of CHH were reviewed; follow-up information was available for eight patients for up to 5 years. Six women were alive and well. One woman died of contralateral invasive carcinoma, and a second was well having had a modified radical mastectomy for a separate, coexisting intraductal carcinoma in the same breast.
These findings indicate that intraductal CHC has the same low-grade clinical course as other forms of intraductal carcinoma. Because invasive carcinoma arising in this setting appears to be histologically high-grade, it is important to recognize and promptly treat the lesion while still in its in situ phase. Foci with the appearance of CHH may be found in CHC, but in this study progression from CHH to CHC was not observed. A thorough histological examination is needed to distinguish between CHC and CHH.
Lesions judged to be CHH are adequately treated by wide excision. Additional long-term, follow-up studies will be necessary to define the precancerous potential of CHH.
Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Sixth Edition. WB Saunders 1999.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.
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The Geology of Northern Ireland: Our Natural Foundation
Mitchell, William. 2004 The Geology of Northern Ireland: Our Natural Foundation. Belfast, Geological Survey of Northern Ireland, 318pp.
Full text not available from this repository. (Request a copy)Abstract/Summary
This New Regional Geology Guide to Northern Ireland (second edition) provides a comprehensive account of the geology of the region. Northern Ireland represents a small area of the Earth's surface, but contains a huge variety of rock types, representing many different geological ages which are reflected in the sheer variety of landscape. Landscape reflects the interaction of rock type and geological processes which give rise to the environmental niches supporting the varied flora and fauna to be found in Northern Ireland. This book presents detailed, comprehensive information in a user-friendly way; sites of national or international significance are described and illustrated through photographs and large-scale maps. Published by the Geological Survey of Northern Ireland, 298pp plus index, full colour.
Item Type: | Publication - Book |
Programmes: | BGS Programmes > Geological Survey of Northern Ireland |
Additional Information. Not used in RCUK Gateway to Research.: | Copies of this publication are available from the BGS sales desk. firstname.lastname@example.com |
Additional Keywords: | Geology, Northern Ireland, Hydrogeology, Minerals, Geohazards, Bedrock Geology, Superficial Geology |
NORA Subject Terms: | Earth Sciences |
Date made live: | 12 Dec 2007 14:11 |
URI: | http://nora.nerc.ac.uk/id/eprint/1582 |
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At Deerborne Insurance Inc. we believe that superior service is the key quality that has allowed us to emerge as a first-class corporate brokerage. Our primary
More$1 mil. - $5 mil.in Revenue
10 - 20Employees
Contact people at this company185 Bridgeland Avenue, Suite 200TorontoOntarioM6A 1Y7Canada
view map(416) 223-9000x238(416) 488-7300Fax
Pro2015_Iteration3.189[04] SEIDXWK-17


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"Shopping for wines in Yapp is the stuff of wine lovers' dreams." - The Wine Gang, February 2015.
Our latest Easter Offers includes a mixed case of our best-selling wines, as well as an awesome selection of red Côtes du Rhône from world famous winemakers Chave, Clape and Vernay. Add to that line-up a sextet of wines that have been recommended in the press, as well as part two (of our series) of six regional focuses this time out Bordeaux and the South-West.
As always, the price of the mixed case wine offer includes delivery. (See our delivery page for offer terms).
Joyeuse Pâques
Read more about this mixed case wine offer »


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Experience the latest in consumer VR tech for yourself and see how much better our demos look in 1080p low persistence OLED with positional tracking. If you've never tried on an HMD before, this is a perfect time to start.
Dear VR Members,
If you missed the meetup that showcased the new DK2, dont worry the videos here.
Check out all of the videos on Google+: https://plus.google.com/108738674427832385715/posts
or just see them individually here:
Jim (combined DK2 with motion sensing controller): http://youtu.be/YNCryHo4N_w
Michael (explained the benefits of DK2): http://youtu.be/ijkYQIyoet8
Kelly (provided feedback on the DK2): http://youtu.be/9XcH6R8IOww
Steve (informed us of how to make 3D printed prosthetics): http://youtu.be/bamsmHlyo_g
September 8
Nice event. Everyone is very nice and the location was perfect. Got to see some great demos and participate in some good conversation.
1 · August 28
Sorry I will not make it with my demo, ran into issues making everything work. I would rather show something that is working then something that is kinda working.
August 26
Sorry I can't make it this time but hopefully next time I'll be there with my demo ported to the DK2!
August 26
We've been speaking at all the West Coast VR events (SVVR, SFVR, VRLA) and demo'ing our Smartphone VR kits. Any way we can get involved remotely at the next event?
August 18
Hi! I am NOT a developer of VR tech neither a programmer… Is the event open for people like me, just interested in trying it out?
August 18
Meetup has allowed me to meet people I wouldn't have met naturally - they're totally different than me.
— Allison, started Women's Adventure Travel
Meetup members, Log in
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Library Services Division
Learn. Lead. Live. With Your Library!The Torrance Public Library provides outstanding services, exceptional resources, and accessible spaces to support an independent, literate, and informed public.
Renaissance Tween - 21st Century Careers Panel DiscussionSaturday, April 25 at 2:00 p.m. in the Community Meeting RoomFeaturing Pat Furey, Mayor of the City of Torrance; Hillary Theyer, City Librarian; Scott Langteau, Children's Book Author; and Steve Firchow, Middle-Earth Shadow of Mordor Sr. Concept Artist. Join us for an interactive discussion with our panel members. This program is part of the Renaissance Tween Grant Program."This project was supported in whole or in part by the U.S. Institute of Museum and Library Services under the provisions of the Library Services and Technology Act, administered in California by the State Librarian"
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Friends of the LibraryWant to know more about the Friends of the Library? Here's an opportunity to meet some of the friendliest Friends we know! Reporter Hope Witkowsky has done an excellent job profiling them in this episode of Senior Scene. Senior Scene is produced by Torrance CitiCABLE and is on daily at 11:30 a.m. and 5:30 p.m. If you are interested in becoming a member of the Friends, click here. If you would like to volunteer with the Friends, click here. The Library would like to give the Friends a big thank you for all they do for the Library and our patrons!MAIN LIBRARY RENOVATIONAs part of the Library's continuous effort to improve services to the community, we will be undergoing a renovation to the first floor lobby of the Katy Geissert Civic Center Library. The renovation will open up traffic flow through the lobby; install a new ergonomic service desk that is attractive and inviting to patrons, while also allowing the Library to use our limited staff more efficiently. Construction will begin February 2nd and is due for completion by May 2015. In the mean time, the circulation desk has been temporarily relocated. We apologize for any inconvenience to Library patrons. However, we will carry out this construction without having to close, reduce hours, or modify services at the main Library. THE GET PROJECT: A HEALTHIER FAMILY INITIATIVETorrance Public Library presents a series of programs in which we encourage everyone to get moving, get informed, and get healthy! See the online Calendar of Events at www.TorranceCA.Gov/Events for a complete schedule, download a PDF calendar of events, or call 310-530-5044.Free computer assistance for adults. Is all of this talk of technology leaving you with a headache? Torrance Public Library is proud to offer free computer assistance to adults of all ages on the first Saturday of the month at the Katy Geissert Civic Center Library from 10:30 a.m. - 4:00 p.m. Please call 310-618-5964 for more information.
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n engl j med 364;13 nejm.org march 31, 2011
videos in clinical medicine
The new england journal of medicine
Hand Hygiene
Yves Longtin, M.D., Hugo Sax, M.D., Benedetta Allegranzi, M.D.,
Franck Schneider, and Didier Pittet, M.D.
From the Infection Control Program, Uni-
versity of Geneva Hospitals and Faculty
of Medicine (Y.L., H.S., D.P.); World
Health Organization (WHO) Patient Safe-
ty, WHO Headquarters (B.A., D.P.); and
the Communication Service (F.S.) and
WHO Collaborating Center for Patient
Safety (D.P.) — all in Geneva. Address re-
print requests to Dr. Pittet at the Infection
Control Program, University of Geneva
Hospitals and Faculty of Medicine, 4 Rue
Gabrielle-Perret Gentil, 1211 Geneva 14,
Switzerland, or at email@example.com.
* Drs. Longtin and Sax contributed equally
to this article.
N Engl J Med 2011;364:e24.
Copyright © 2011 Massachusetts Medical Society.
Health-care associated infections are a threat to patient safety and the most com-
mon adverse events resulting from a stay in the hospital.1 Approximately 5 to 10%
of hospitalized patients in the developed world acquire such infections, and the
burden of disease is even higher in developing countries. Proper use of hand hy-
giene is a critical to the prevention of these infections, but compliance among
health care workers is most often below 40%.
Hand hygiene serves many purposes in the health care setting.1 It prevents both
endogenous and exogenous infections in patients, contamination of the hospital
environment with potential pathogens, and cross-transmission of microorganisms
between patients. When used in conjunction with the appropriate protective equip-
ment, it also protects health care workers from the hazards of occupational infections.
Essential equipment for the performance of adequate hand hygiene includes an al-
cohol-based hand-rub formulation or soap, water, and drying agents such as dis-
posable paper or cloth towels. Alcohol-based hand rubs with optimal antimicrobial
efficacy usually contain 75 to 85% ethanol, isopropanol, or n-propanol, or a com-
bination of these products.1 Formulations containing lower alcohol concentrations
(i.e., 60 to 70%) are acceptable provided that they have been tested in the labora-
tory in accordance with the standards established by the European Committee for
Standardization or the American Society for Testing and Materials.1 Hand rubs
must be supplemented with emollients to protect the skin. Product containers
should be easily available at the point of care — within 3 ft (1 m) of the most likely
area of use — or should be carried in small bottles by health care workers for their
own personal use.1,2
Soaps are detergents that can remove lipids and dirt. Their antibacterial effect
results from their capacity to dislodge bacteria from the skin when combined with
the rubbing of hands and the rinsing effect of running water.1
Indications for hand hygiene are clearly defined by authoritative bodies, including the
Centers for Disease Control and Prevention3 and the World Health Organization
(WHO).1 To better understand these indications, it is necessary to have a knowledge
of the basic principles of microbial pathogen cross-transmission in the health care
The skin and mucous membranes of humans are colonized by various micro-
bial species. When hospitalized, patients gradually shed these microorganisms
onto inanimate objects in their immediate surroundings (e.g., bed linens and
bedside furniture).4 Consequently, hospitals contain a multitude of microbial en-
vironments. Some, dubbed "patient zones," consist of a patient and the patient's
immediate surroundings. Others, such as corridors and public areas, are also
The New England Journal of Medicine
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Copyright © 2011 Massachusetts Medical Society. All rights reserved.
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Hand Hygiene
n engl j med 364;13 nejm.org march 31, 2011
colonized with microorganisms as a result of contamination by health care work-
ers, patients, and even visitors. Cross-transmission of potential pathogens from
one environment to another occurs mainly through health care workers' hands.4
To prevent cross-transmission from one patient to another, health care workers
must perform hand hygiene immediately before touching a patient or when enter-
ing a patient zone. The correct moment to perform hand hygiene before touching a
patient is critical.5 Hand hygiene should be performed close to the site of care to
avoid recontamination if hands come into contact with an object distant from the
patient, such as a doorknob.4,5 Hand hygiene must be performed between the last
hand-to-surface contact with an object located outside the patient zone and the
first within the patient zone — ideally, immediately before touching the patient.5
Hand hygiene should also be performed just after leaving the patient and before
touching any object located outside the patient zone.5 Completion of this step will
limit the risk of germ dissemination to the health care environment. Since the
patient's immediate surroundings are also contaminated by the patient's skin
flora, contact with objects located in the patient's environment, such as a monitor,
bedside table, or bed rail, must be followed by the use of hand hygiene even if
there is no direct contact with the patient.
Certain body regions must also be kept as free as possible of microorganisms.
These include zones of impaired host defense, such as mucous membranes and
breaks in skin (e.g., surgical wounds) and sites of invasive device insertion (e.g.,
vascular or urinary catheters and endotracheal tubes).4 Microorganisms that colo-
nize the health care worker's hands, the patient's skin, or the immediate sur-
roundings must not be introduced into these zones of lowered immune protection.
For these reasons, it is essential to perform hand hygiene immediately before
touching nonintact skin and mucous membranes and before manipulating invasive
devices5 to prevent colonization that may subsequently lead to infection.
Finally, hand hygiene protects health care workers. Some patient care activities
expose workers to potentially infectious body fluids, such as blood or respiratory
secretions. To prevent infection and colonization, hand hygiene must be performed
immediately after completing a task associated with a risk of hand exposure to body
fluids, even in the absence of visible soiling and when gloves have been used.1,4,5
According to the WHO, the five moments that call for the use of hand hy-
giene1,4,5 include the moment before touching a patient, before performing
aseptic and clean procedures, after being at risk of exposure to body fluids, after
touching a patient, and after touching patient surroundings.
Hand-Hygiene Technique
There are two recognized techniques for performing hand hygiene: hand rubbing
with an alcohol-based hand-rub formulation and hand washing with soap and water.
To perform hand rubbing, apply a palmful of alcohol-based hand rub to a
cupped hand and rub hands together to cover all surfaces.1 Then rub hands again,
palm to palm. To reach the dorsal interdigital area of the hand, rub the fingers of
one hand over the dorsum of the other hand and interlace the fingers. Repeat the
procedure on the palmar side of the hands to reach the palmar interdigital area.
To cleanse the dorsal aspect of the distal phalanges, rub the back of the fingers
across the palm of the other hand with fingers interlocked. Decontaminate fin-
gertips and the subungual region by rotating them in the palm of the other hand.
To cleanse the base of the thumb, clasp it in the palm of the other hand and rotate
the thumb. Each sequence should be repeated on both hands. The entire procedure
should take 20 to 30 seconds to complete (Fig. 1). Hands should be rubbed until
dry to ensure maximum efficacy. Complete drying of the hands in less than 20
seconds is usually due to insufficient application of the product.
Figure 1. Steps Performed When an
Alcohol-Based Hand-Rub Formulation
Is Used for Hand Hygiene.
The New England Journal of Medicine
Downloaded from nejm.org on April 1, 2011. For personal use only. No other uses without permission.
Copyright © 2011 Massachusetts Medical Society. All rights reserved.
Page 3
The new england journal of medicine
n engl j med 364;13 nejm.org march 31, 2011
To hand wash, wet with water and apply the amount of soap necessary to
cover all surfaces. Rub hands vigorously together to cover all surfaces and com-
plete the procedure by following the steps described for hand rubbing (Fig. 1).
When hands have been thoroughly decontaminated, rinse with water and dry with
the use of a disposable paper towel, cloth towel, or a hot-air dryer. Gently pat skin
rather than rubbing it to protect hands from cracking. Avoid reusable towels, as
they are a possible source of cross-infection.1 When hands are dry, turn off the
faucet using a paper towel to prevent recontamination. The entire procedure
should take at least 40 to 60 seconds to complete.
Choice of Technique
Hand rubbing with an alcohol-based formulation is the preferred hand-cleansing
procedure in most clinical situations.1-3 The main advantages of alcohol-based
hand rubs as compared with soap and water include availability at the point of care,
a higher level of antimicrobial efficacy, faster use, and better skin tolerability.1 Spe-
cific indications for hand washing instead of alcohol-based hand rubbing include
visible hand contamination with blood, body fluids, or proteinaceous material and
exposure of hands to spore-forming organisms (e.g., Clostridium difficile or Bacillus
anthracis).1,3 Hand washing must also be performed after use of the restroom.
Appropriate Use of Gloves
Gloves prevent the transmission of microorganisms from the health care worker's
hands to the patient1,4 and reduce the health care worker's risk of acquiring infec-
tions from patients. Clean, nonsterile examination gloves must be worn during
patient care activities that may involve exposure to potentially infectious material
(e.g., blood, body fluids, mucous membranes, or nonintact skin) or to patients who
are colonized or infected with selected pathogens transmitted through contact
(e.g., C. difficile or methicillin-resistant Staphylococcus aureus).
Glove use does not replace the need to perform hand hygiene.1,5 When an in-
dication for hand hygiene occurs during glove use, the health care worker must
remove the gloves, perform hand hygiene, and don another pair of gloves, if still
indicated. Hand hygiene must always be performed after glove removal because
gloves may have defects and because hand contamination may occur during re-
moval (Fig. 2). Do not disinfect or reuse gloves, since alcohol may degrade glove
material and lead to holes and leakage.1
Jewelry and Fingernails
Do not wear rings or bracelets during patient care, since they increase the bacterial
load of the skin.1,3 If you have a wedding ring, a simple alternative is to wear it on a
chain around your neck. In some health care environments, wedding rings may be
tolerated. Review and comply with the policy in place at your facility.
Long fingernails are associated with infection outbreaks of resistant pathogens
at health care facilities.1,3 Fingernails should be kept short (<0.2 in. or 0.5 cm in
length), and artificial nails or nail extenders should not be worn, since they are
associated with outbreaks of cross-transmission and infection with resistant patho-
gens.1 Nail polish is acceptable, providing its integrity is preserved. Fingernail
diseases, such as onychomycosis, should be treated promptly; they may reduce the
efficacy of hand hygiene.
Irritant dermatitis can occur after repeated use of hand-hygiene products.1 Com-
mon symptoms include dryness, itching, and sometimes cracking and bleeding. In
rare cases, allergic dermatitis can occur. Damaged skin is more difficult to clean
Figure 2. Hand Hygiene after Gloves
Are Removed.
Figure 3. Use of a Skin-Care Product
Helps to Prevent Irritation.
The New England Journal of Medicine
Downloaded from nejm.org on April 1, 2011. For personal use only. No other uses without permission.
Copyright © 2011 Massachusetts Medical Society. All rights reserved.
Page 4
Hand Hygiene
n engl j med 364;13 nejm.org march 31, 2011
and may be more susceptible to skin colonization, thus leading to microbial trans-
mission. To prevent skin irritation, use skin-care products frequently during work
shifts (Fig. 3),1 favor the use of alcohol-based hand rubs rather than soap,1,2 avoid
the use of hot water when hand washing,1 refrain from using gloves unless spe-
cifically needed,1 and dry hands completely before donning gloves.1
Although exceedingly rare, flash fires involving health care workers' hands
have been reported,1 mostly caused by a static spark that occurred while hands
were still impregnated with alcohol. To prevent such events, make sure that hands
are fully dry before touching objects.
Some hand-hygiene agents (particularly hand-rub gels) may give those using
them a sense of product buildup after repeated use. Occasional hand washing can
correct this problem, but it is preferable for health care institutions to select hand
rubs that do not induce this feeling of buildup to maximize compliance with re-
quirements for hand hygiene.1
Religious Issues
Although some religions prohibit the use of alcohol, all accept its use as a medical
agent and recognize the unique value of using alcohol-based hand rubbing in health
care settings.6 For example, the Islamic religion permits the use of alcohol as a
medicinal agent.
Promotion of Hand Hygiene
Successful promotion of hand hygiene results from the implementation of multiple
strategies. These strategies include instituting system change (e.g., making hand-
hygiene products available at the point of care), educating health care workers,
monitoring compliance and providing feedback, and embedding the practice of
hand hygiene in the institutional safety culture.1,2
Hand hygiene is a procedure that should be mastered by all health care workers.
Hand hygiene is not optional — it is mandatory. It must be used conscientiously to
decrease the occurrence of infections associated with health care and to increase
patient safety. Proper use of hand hygiene is a sign of competency, professionalism,
and respect.
The WHO takes no responsibility for the information provided or the views expressed in this article.
Supported in part by a grant from the Swiss National Research Fund (FN 3200B0-122324) and by the
University of Geneva Hospitals.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
We thank all members of the Infection Control Program, University of Geneva Hospitals and Faculty of
Medicine, for their dedication to improving patient safety, Rosemary Sudan for editorial assistance, Otto Zingg
for his technical assistance with the video, and Christa Prins for the photographs in this article.
1. WHO guidelines on hand hygiene in
health care. Geneva: World Health Orga-
nization, 2009. (http://whqlibdoc.who
2. Pittet D, Hugonnet S, Harbarth S, et
al. Effectiveness of a hospital-wide pro-
gramme to improve compliance with
hand hygiene. Lancet 2000;356:1307-12.
[Erratum, Lancet 2000;356:2196.]
3. Boyce JM, Pittet D. Guideline for hand
hygiene in health-care settings. recom-
mendations of the Healthcare Infection
Control Practices Advisory Committee
and the HICPAC/SHEA/APIC/IDSA Hand
Hygiene Task Force. MMWR Recomm
Rep 2002;51(RR-16):1-45, CE1-CE4.
4. Pittet D, Allegranzi B, Sax H, et al.
Evidence-based model for hand transmis-
sion during patient care and the role of
improved practices. Lancet Infect Dis
5. Sax H, Allegranzi B, Uckay I, Larson
E, Boyce J, Pittet D. 'My five moments for
hand hygiene': a user-centered design ap-
proach to understand, train, monitor and
report hand hygiene. J Hosp Infect 2007;
6. Allegranzi B, Memish ZA, Donaldson
L, Pittet D. Religion and culture: poten-
tial undercurrents influencing hand hy-
giene promotion in health care. Am J In-
fect Control 2009;37:28-34.
Copyright © 2011 Massachusetts Medical Society.
The New England Journal of Medicine
Downloaded from nejm.org on April 1, 2011. For personal use only. No other uses without permission.
Copyright © 2011 Massachusetts Medical Society. All rights reserved.