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Prime Care Physicians, P.L.L.C. - NPI #1801016894

Cardiovascular Disease Doctor located in Kingston, NY

New York Kingston Cardiovascular Disease Prime Care Physicians, P.L.L.C. Information

Prime Care Physicians, P.L.L.C. is a Cardiovascular Disease Doctor (taxonomy code 207RC0000X) located in Kingston, New York. Prime Care Physicians, P.L.L.C. primarily specializes in Cardiovascular Disease but also specializes in Clinical Cardiac Electrophysiology, Critical Care Medicine (Internist), Internal Medicine, Nuclear Cardiology and Public Health & General Preventive Medicine. Prime Care Physicians, P.L.L.C.'s NPI Number is #1801016894 and has been listed in the NPI registry for 10 years. Prime Care Physicians, P.L.L.C.'s practice location is listed as: 111 Marys Ave Suite 3 Kingston, NY 12401-5852 and can be reached via phone at (845) 339-3663.

Cardiovascular Disease Taxonomy

The taxonomy code for Prime Care Physicians, P.L.L.C.'s main specialty, Cardiovascular Disease, is 207RC0000X. An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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Health Care Provider Information
 NPI # 1801016894
 Phone (845) 339-3663
 Fax (845) 339-3629
111 Marys Ave
Suite 3
Kingston, NY 12401-5852
 Gender N/A
 Website Not provided
  • Cardiovascular Disease (NY)
  • Clinical Cardiac Electrophysiology (NY)
  • Critical Care Medicine (Internist) (NY)
  • Internal Medicine (NY)
  • Nuclear Cardiology (NY)
  • Public Health & General Preventive Medicine (NY)
Business Information
  • Sole Proprietor? Not Available
  • Is Sub-Organization? No
  • Parent Org Name: Not Available
 Updated 3/28/2012
 Added 5/1/2007
 Viewed on 10/22/2017
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Jane I. Belcher - NPI #1366405128

Certified Registered Nurse Anesthetist located in Roanoke, VA

Jane I. Belcher is a female Certified Registered Nurse Anesthetist (taxonomy code 367500000X) located in Roanoke, Virginia. Jane I. Belcher's NPI Number is #1366405128 and has been listed in the NPI registry for 11 years. Jane I. Belcher's practice location is listed as: 1906 Belleview Ave Se Roanoke, VA 24014-1838 and can be reached via phone at (540) 400-1982.

Certified Registered Nurse Anesthetist Taxonomy

The taxonomy code for Jane I. Belcher's main specialty, Certified Registered Nurse Anesthetist, is 367500000X. (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

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Health Care Provider Information
 NPI # 1366405128
 Phone (540) 400-1982
 Fax Not Available
1906 Belleview Ave Se
Roanoke, VA 24014-1838
 Gender F
 Website Not provided
  • Certified Registered Nurse Anesthetist (VA)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 5/7/2008
 Added 4/11/2006
 Viewed on 10/22/2017
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text:
Dr. Daniel Q Cofie - NPI #1023063005

Emergency Medical Services Doctor located in Williamsville, NY

New York Williamsville Emergency Medical Services Dr. Daniel Q Cofie Information

Dr. Daniel Q Cofie is a male Emergency Medical Services Doctor (taxonomy code 207PE0004X) located in Williamsville, New York. Dr. Daniel Q Cofie's NPI Number is #1023063005 and has been listed in the NPI registry for 11 years. Dr. Daniel Q Cofie's practice location is listed as: 6245 Sheridan Dr Suite 212 Williamsville, NY 14221-4834 and can be reached via phone at (716) 204-4500.

Emergency Medical Services Taxonomy

The taxonomy code for Dr. Daniel Q Cofie's main specialty, Emergency Medical Services, is 207PE0004X. An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

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Health Care Provider Information
 NPI # 1023063005
 Phone (716) 204-4500
 Fax (716) 204-4501
6245 Sheridan Dr
Suite 212
Williamsville, NY 14221-4834
 Gender M
 Website Not provided
  • Emergency Medical Services (AR)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 9/18/2009
 Added 5/24/2006
 Viewed on 10/22/2017
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text:
Dr. David J Lane - NPI #1538169172

Emergency Medicine Doctor located in Tucson, AZ

Arizona Tucson Emergency Medicine Dr. David J Lane Information

Dr. David J Lane is a male Emergency Medicine Doctor (taxonomy code 207P00000X) located in Tucson, Arizona. Dr. David J Lane's NPI Number is #1538169172 and has been listed in the NPI registry for 12 years. Dr. David J Lane's practice location is listed as: 630 N Alvernon Way Suite 250 Tucson, AZ 85711-1843 and can be reached via phone at (520) 647-8854.

Emergency Medicine Taxonomy

The taxonomy code for Dr. David J Lane's main specialty, Emergency Medicine, is 207P00000X. An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

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Health Care Provider Information
 NPI # 1538169172
 Phone (520) 647-8854
 Fax (520) 647-8851
630 N Alvernon Way
Suite 250
Tucson, AZ 85711-1843
 Gender M
 Website Not provided
  • Emergency Medicine (AZ)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 10/7/2014
 Added 7/26/2005
 Viewed on 10/22/2017
Health Care Providers Nearby

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text:
Alessandro Medical Professional Corporation - NPI #1881941409

Family Medicine Doctor located in Moreno Valley, CA

California Moreno Valley Family Medicine Alessandro Medical Professional Corporation Information

Alessandro Medical Professional Corporation is a Family Medicine Doctor (taxonomy code 207Q00000X) located in Moreno Valley, California. Alessandro Medical Professional Corporation's NPI Number is #1881941409 and has been listed in the NPI registry for 5 years. Alessandro Medical Professional Corporation's practice location is listed as: 13925 Indian St Moreno Valley, CA 92553-5718 and can be reached via phone at (951) 354-3173.

Family Medicine Taxonomy

The taxonomy code for Alessandro Medical Professional Corporation's main specialty, Family Medicine, is 207Q00000X. Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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Health Care Provider Information
 NPI # 1881941409
 Phone (951) 354-3173
 Fax (951) 848-9968
13925 Indian St
Moreno Valley, CA 92553-5718
 Gender N/A
 Website Not provided
  • Family Medicine (CA)
Business Information
  • Sole Proprietor? Not Available
  • Is Sub-Organization? No
  • Parent Org Name: Not Available
 Updated 8/14/2012
 Added 8/14/2012
 Viewed on 10/22/2017
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text:
Dr. Thad Clements - NPI #1982676565

Family Medicine Doctor located in Charlotte, NC

North Carolina Charlotte Family Medicine Dr. Thad Clements Information

Dr. Thad Clements is a male Family Medicine Doctor (taxonomy code 207Q00000X) located in Charlotte, North Carolina. Dr. Thad Clements's NPI Number is #1982676565 and has been listed in the NPI registry for 11 years. Dr. Thad Clements's practice location is listed as: 8310 University Exec Park Dr Suite 550 Charlotte, NC 28262-3383 and can be reached via phone at (704) 384-1225.

Family Medicine Taxonomy

The taxonomy code for Dr. Thad Clements's main specialty, Family Medicine, is 207Q00000X. Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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Health Care Provider Information
 NPI # 1982676565
 Phone (704) 384-1225
 Fax (704) 384-1226
8310 University Exec Park Dr
Suite 550
Charlotte, NC 28262-3383
 Gender M
 Website Not provided
  • Family Medicine (NC)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 3/18/2015
 Added 2/7/2006
 Viewed on 10/22/2017
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text:
Jeffery Garrard, M.D., P.C. - NPI #1558536474

Family Medicine Doctor located in Huntsville, AL

Alabama Huntsville Family Medicine Jeffery Garrard, M.D., P.C. Information

Jeffery Garrard, M.D., P.C. is a Family Medicine Doctor (taxonomy code 207Q00000X) located in Huntsville, Alabama. Jeffery Garrard, M.D., P.C. primarily specializes in Family Medicine but also specializes in and Sports Medicine (Family Medicine). Jeffery Garrard, M.D., P.C.'s NPI Number is #1558536474 and has been listed in the NPI registry for 9 years. Jeffery Garrard, M.D., P.C.'s practice location is listed as: 4205 Balmoral Dr Sw Ste 200 Huntsville, AL 35801-7421 and can be reached via phone at (256) 382-7767.

Family Medicine Taxonomy

The taxonomy code for Jeffery Garrard, M.D., P.C.'s main specialty, Family Medicine, is 207Q00000X. Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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Health Care Provider Information
 NPI # 1558536474
 Phone (256) 382-7767
 Fax (256) 880-5262
4205 Balmoral Dr Sw Ste 200
Huntsville, AL 35801-7421
 Gender N/A
 Website Not provided
  • Family Medicine
  • Sports Medicine (Family Medicine)
Business Information
  • Sole Proprietor? Not Available
  • Is Sub-Organization? No
  • Parent Org Name: Not Available
 Updated 4/23/2008
 Added 4/23/2008
 Viewed on 10/22/2017
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text:
Dr. Richard Davis Shell - NPI #1497741110

Pediatric Pulmonologist located in Columbus, OH

Ohio Columbus Pediatric Pulmonology Dr. Richard Davis Shell Information

Dr. Richard Davis Shell is a male Pediatric Pulmonologist (taxonomy code 2080P0214X) located in Columbus, Ohio. Dr. Richard Davis Shell's NPI Number is #1497741110 and has been listed in the NPI registry for 12 years. Dr. Richard Davis Shell's practice location is listed as: 555 S 18Th St Columbus, OH 43205-2654 and can be reached via phone at (614) 722-4766.

Pediatric Pulmonology Taxonomy

The taxonomy code for Dr. Richard Davis Shell's main specialty, Pediatric Pulmonology, is 2080P0214X. A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.

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Health Care Provider Information
 NPI # 1497741110
 Phone (614) 722-4766
 Fax (614) 722-4755
555 S 18Th St
Columbus, OH 43205-2654
 Gender M
 Website Not provided
  • Pediatric Pulmonology (OH)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 11/26/2008
 Added 9/27/2005
 Viewed on 10/22/2017
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text:
Dr. Michael I Lewis - NPI #1801824941

Pulmonary Disease Doctor located in Los Angeles, CA

California Los Angeles Pulmonary Disease Dr. Michael I Lewis Information

Dr. Michael I Lewis is a male Pulmonary Disease Doctor (taxonomy code 207RP1001X) located in Los Angeles, California. Dr. Michael I Lewis's NPI Number is #1801824941 and has been listed in the NPI registry for 11 years. Dr. Michael I Lewis's practice location is listed as: 8700 Beverly Blvd. Los Angeles, CA 90048-1865 and can be reached via phone at (310) 423-1837.

Pulmonary Disease Taxonomy

The taxonomy code for Dr. Michael I Lewis's main specialty, Pulmonary Disease, is 207RP1001X. An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

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Health Care Provider Information
 NPI # 1801824941
 Phone (310) 423-1837
 Fax (310) 423-0129
8700 Beverly Blvd.
Los Angeles, CA 90048-1865
 Gender M
 Website Not provided
  • Pulmonary Disease (CA)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 5/2/2014
 Added 6/29/2006
 Viewed on 10/22/2017
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text:
Dr. Vince J. Rogenes - NPI #1346204492

Urologist located in Plano, TX

Texas Plano Urology Dr. Vince J. Rogenes Information

Dr. Vince J. Rogenes is a male Urologist (taxonomy code 208800000X) located in Plano, Texas. Dr. Vince J. Rogenes's NPI Number is #1346204492 and has been listed in the NPI registry for 11 years. Dr. Vince J. Rogenes's practice location is listed as: 5300 W Plano Pkwy Plano, TX 75093-4821 and can be reached via phone at (972) 612-8037.

Urology Taxonomy

The taxonomy code for Dr. Vince J. Rogenes's main specialty, Urology, is 208800000X. A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

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Health Care Provider Information
 NPI # 1346204492
 Phone (972) 612-8037
 Fax (972) 867-6049
5300 W Plano Pkwy
Plano, TX 75093-4821
 Gender M
 Website Not provided
  • Urology (TX)
Business Information
  • Sole Proprietor? No
  • Is Sub-Organization? Not Available
  • Parent Org Name: Not Available
 Updated 4/11/2011
 Added 4/14/2006
 Viewed on 10/22/2017
Health Care Providers Nearby

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text:
Wearable devices way out,how to design and technology perfect fusion

By Monica Wagner,2015-02-11 11:09
11 views 0
Wearable devices way out,how to design and technology perfect fusion

    Wearable devices way out: how to design

    and technology perfect fusion

    IDC's latest data, in the third quarter of this year global wearable equipment sales rose 200%, total shipments to 21 million, although the wearable device overall popularization speed is slow, but still in rapid growth.Apple released this year Apple Watch, has become the world's second largest wearable equipment manufacturers, with 3.9 million shipments take 18.6% of the share.Is the number one cause of Fitbit, intelligent bracelet is still the first big market, but market share have been signs of apple away.

    Wearable intelligent equipment market is still in the early development, fierce competition between manufacturers, while Chinese manufacturers, taking advantage of the early accumulation of capture a

    significant portion of the market share and become a wearable domain of the fastest growing market in China, from IDC's latest data show that in the third quarter of this year global wearable equipment sales ranking, millet and, third, fifth BBK, so to speak, wearable devices in China is developing very rapidly, in the short term is showing no sign of slowing down, according to IDC predicts that by 2019, global shipments of wearable equipment will soar to 126 million.

    The rapid growth of the market But it is still a niche market

    In sensing founder of iot Yang Jianyong view, although the wearable device already has a significant impact on the Internet of things market, growing fast, but is still a niche market, far into the public daily consumer electronics products, consumers are still struggling to find wearable intelligent device of practical value.Wearable device is a kind of high visibility of the product, need to blur the line between fashion and science and technology, whether worn on the wrist, the head or other parts, consumers want wearable equipment can completely fused with their own style, Apple Watch welcomed by men and women doubt is the best example.

    Wearable device design and the perfect combination of science and technology

    Will tell from fashion, cool and fuzzy boundaries of science and technology, Apple's Watch is a good example of the sensing founder of

    iot Yang Jianyong view, Apple Watch popular with the men and women, namely all wear so natural, fashion and the boundaries of science and technology perfect fusion.Highlighted by function such as Apple Apple Watch, so Apple watches now certainly cannot achievement, for Apple, is a new product has entered the global ranked second, wearable devices bring billions of dollars of business, has been very successful.Apple Apple Watch fashion and the combination of science and technology, I will no longer wordy, information about Apple Watch too much, will not repeat the Apple Watch, considering that China is the world's wearable devices, the most important market and millet, BBK also entered the top five in the world, the success of millet has two aspects, one is hand ring tool, as I mentioned in an article, a simple, single function, is the most popular products.Second, the marketing strategy of millet.

    Wearable devices has been developing rapidly in China, there are a large number of domestic innovative entrepreneurial teams wearable, intelligent equipment, bracelets, watches, glasses, etc. All kinds of entrepreneurial teams.Said the glasses and had to ask Google glasses, is a direct pull up Google glasses wearable intelligent device heat, for market, Google glasses is a failure product, function is too strong, for the mass consumers, no need, of course, from the Google Glass to launch at the beginning, Google can't locate it for commercial products of the company.If Google glasses, all existing rumors, Google glasses will

    restart, according to the U.S. patent and trademark office, according to the latest information on Google glasses may return to the market in the form of a monocle.

    Mention glasses, let domestic a glasses, by otto technology to create "cool", absorbing the experience of Google glasses to locate the main tide cool fashionable gens, fashion sense is very strong in the Design, sensing founder of iot Yang Jianyong learned that "cool" is which adopt international famous Frog Design team, in the previous article, I have a point: if you want to enter the wearable devices, choose their good at areas, rather than doing a powerful hardware, positioning in the young fashionable gens, products from the Design will be cool, cool, designers and developers to keep efficient interaction, focus, to cultivate the personality of brand culture."Cool" in the team to the maximum, at least in the national team, I had not seen, if you have better, please introduce me.

    Wearing a "cool" cool is cool

    Worn worn equipment intellectualization, itself is the traditional equipment, watches, rings or clothes, we take its intelligent, if consumer groups is the public, then do not need to emphasize function superposition and main young fashion, cool, then do brand guide in this direction.Now wearable device heat degree, the surface scenery, the actual days is difficult, most in order to improve the difficult situation, product launch, sales, spell price, spell hardware, making smartphones that play, but in fact, at this stage wearable devices or niche markets, even to fight the price again, also does quantity, the last cycle, don't rule out the possibility that the industry martyrs.

    Glasses, for example, is a traditional device, it must be a conform to the consumer oneself glasses, taste perfect fusion device with its own style.As an intelligent device, the premise to fuzzy design with the

    boundaries of science and technology, naturally, is very perfect fusion of science and technology, promoting the value of traditional equipment after the intelligent.Like as Google glasses kept insisting glasses how cow force function, so can only be engineering machine, consumers do not necessarily buy of the masses.Talked about the "cool", first, through new, cool, cool into science and technology, photography, and virtual reality or other valuable services, according to the figure technology CEO ye shuai (leaves the morning is too handsome, habits of his ye shuai for short) is introduced, spent two years to find "cool" killer app, "thousand eyes plan", live everyone's eyes.Sensing founder of iot Yang Jianyong said: after all for trendy young people wear equipment priority look tall, with armed. To perfect fusion, again through its function, the cool a higher level, the same cool, through science and technology to promote their own cool a hierarchy, want is this effect.Ye shuai itself cool gens, is said to jump down from space, the combination of science and technology to be cool, isn't it cool?

    Compared to other hardware innovation team, whether bracelet or watch, especially children watch, smartphones that set of play, the road is actually is not long, spelling a hardware spell price in niche markets, and its difficult, through the accumulation of product brand culture is a very good choice, another team at home soil, smart watches, through a variety of sports such as basketball, soccer, through the graphic way to

    shape the brand value.In the smart hardware layout, itself is accumulation stage, far not outbreak of mass consumer market, should focus on the future, the layout in the long run, rather than how much money now.Same investment institutions, the layout of the intelligent hardware itself is layout, no hurry at that time the sales, the core is the team to create a true from design and technology perfect combination of technology wearable devices, only in this way in the future have a chance.

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text:
Pediatric Acute Infectious Otitis Externa

By Hazel West,2014-01-28 01:57
11 views 0
TITLE: Pediatric Acute Infectious Otitis Externa SOURCE: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology DATE: November 22, 2010 RESIDENT PHYSICIAN: S. Ross Patton, MD FACULTY PHYSICIAN: Shraddha Mukerji, MD DISCUSSANT: Shraddha Mukerji, MD SERIES EDITOR: Francis B. Quinn, Jr., MD ARCHIVIST: Melinda Stoner Quin..

TITLE: Pediatric Acute Infectious Otitis Externa

    SOURCE: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology

    DATE: November 22, 2010

    FACULTY PHYSICIAN: Shraddha Mukerji, MD

    DISCUSSANT: Shraddha Mukerji, MD

    SERIES EDITOR: Francis B. Quinn, Jr., MD

    ARCHIVIST: Melinda Stoner Quinn, MSICS

     "This material was prepared by resident physicians in partial fulfillment of educational requirements established for the Postgraduate Training Program of the UTMB Department of Otolaryngology/Head and Neck Surgery and was not intended for clinical use in its present form. It was prepared for the purpose of stimulating group discussion in a conference setting. No warranties, either express or implied, are made with respect to its accuracy, completeness, or timeliness. The material does not necessarily reflect the current or past opinions of members of the UTMB faculty and should not be used for purposes of diagnosis or treatment without consulting appropriate literature sources and informed professional opinion."

    Otitis externa can be defined as inflammation or infection of the external ear. It includes all inflammatory conditions of the auricle, the external ear canal, and the outer surface of the tympanic membrane. It is a very common childhood disease which is also known as ―swimmers ear‖ and ―tropical ear.‖ It can be either an acute or a chronic condition which has multiple etiologies including infectious, traumatic, and allergic. Otitis externa encompasses a spectrum of disease severity ranging from minor infection to life threatening disease.

    History of Otitis Externa

    Otitis externa has been treated a number of different ways over the last three thousand years. Some common treatments around 1500 B.C. included a combination of red lead (lead tetroxide, a red pigment used in ancient Rome) with resin, olive oil, frankincense, and goose grease. Ear candling, a technique in which a hollow candle is inserted into the ear, began around 1000 A.D. thIn the early 20 Century, ear potions containing various ingredients such as turpentine, camphor, sassafras, and menthol were popular. Alcohols and other topical astringents were used in the thmid-20 Century to treat otitis externa before topical antibiotics were available.

    Mayer is credited with first formally describing otitis externa in the literature in 1844 when it was believed to be primarily of fungal origin. Its etiology was re-examined during WWII by the Army because a high percentage of soldiers stationed in the South Pacific were diagnosed with otitis externa. In fact, up to 70% of the caseload for military ENT’s was dealing with OE.

    During this time, it was found to be largely an infection of bacterial causes. Review of Anatomy

    The outer ear contains multiple structures. The pinna is visible on gross inspection and is supported by an elastic cartilage framework. The external auditory canal is divided into two parts. First, the outer third is the cartilaginous portion which contains sebaceous and apocrine

    Pediatric Acute Infectious Otitis Externa

    glands. Cerumen, a combination of gland secretions and desquamated cells, is produced in this segment of the canal. The inner two thirds is the inner osseous portion. Containing no adnexal structures, this section is lined by squamous epithelium. Normal ear flora includes S. epidermidis, Corynbacterium, and alpha hemolytic streptococcus species.

    Some controversy exists over cerumen, but most experts believe that cerumen aids in defense against organisms that cause otitis externa. Ear wax contains the enzyme lysozye, which possesses anti-bacterial properties. In addition, is creates an acidic environment in the external auditory canal (pH 6-6.5). Staph aureus and pseudomonas (the two most common otitis externa pathogens) grow best at pH 8-10.

    Infection happens when there is a breakdown in the skin/cerumen protective barrier of the external ear canal. If left untreated, the infection progresses through three different phases: pre-inflammatory, inflammatory, and chronic. During the pre-inflammatory stage an insult occurs such as moisture getting trapped or trauma to the external ear. The skin becomes edematous, which blocks the glands. The next stage is the inflammatory stage, which can be divided into three phases. During the mild phase the canal begins producing clear secretions in addition to edema and erythema. If the infection progresses into the moderate phase the secretions become sero-purulent and the pain and edema worsen. The severe phase is characterized by severe pain. Often the ear canal lumen becomes obstructed with purulent drainage and debris in the canal. This phase is associated with pre-auricular edema and adenopathy. If the infection spreads to the tissue surrounding the EAC it is known as necrotizing otitis externa. Finally, the chronic stage is define as an episode of otitis externa lasting for at least four weeks or a minimum of four episodes in one year.

    Microbiology of Otitis Externa

    Rates of infection due to each microbe vary depending on the source but the two most common pathogens are Pseudomonas and Staph aureus. One study found in the population sampled that 53% of cases of otitis externa were caused by gram negative organisms (Roland et al 2002. Pseudomonas was by far the most common gram negative bacteria isolated in this group. 46% of microbe isolates were gram positive bacteria including Staph Aureus and other staph species. Only 1.7% of external ear infections were due to yeast/fungal causes. There are also viral causes of external ear canal inflammation including herpes virus and varicella-zoster virus.

    Age/Seasonal Distribution

    Otitis externa affects patients of all age groups. In particular, however, there is a peak incidence between the ages of 7 and 12 years. There is also a decline after the age of 50. Children under 12 have a lower likelihood of otitis externa due to Staph Aureus (4%) than children over 12-18 (8%) (Rolland et. al). Rates of pseudomonas, however, are the same regardless of age. Over 80% of cases occur during the summer months when it is warmer and more humid.

    Pediatric Acute Infectious Otitis Externa

Clinical Presentation

    Children most commonly present with ear pain. The pain can be quite severe because the skin of the ear canal is closely adherent to the underlying perichondrium/periostium. Any manipulation of the pinna or tragus exacerbates the symptom. Patients can also complain of itchy ears, which is associated with fungal otitis externa. Often, itchy ears is precedes the ear pain. A draining ear is sometimes the chief complaint which may or may not be accompanied by hearing loss and a feeling of aural fullness.

    Untreated or severe otitis externa can progress to a number of complications. The infectious process can produce stenosis of the ear canal. The infection can also spread and cause cellulitis or chondritis in the surrounding area. If the infection continues to expand, it can involve the parotid gland. When the infection spreads to the structures surrounding the external ear, it is known as malignant or necrotizing otitis externa. Fortunately, this spectrum of the disease is rarely seen in children and is almost never fatal for them (adult mortality rate for malignant otitis externa approaches 20%). Children who suffer from malignant otitis externa are typically immune-compromised (e.g. leukemia, drug-induced leucopenia, immunoglobulin deficiency, or diabetes).

    Differential Diagnosis

    When suspecting otitis externa, there are a number of other diseases one must consider. The differential for otalgia is very broad because pain from many other structures is frequently referred to the ear. Any process involving the teeth, tonsils, TMJ, larynx, neck, and sphenoid sinus can be perceived as otalgia (cranial nerves 5, 6, 9, and 10 all provide sensory innervation to the middle and external ear). In addition to these, there are a few other specific conditions that are local in the ear to consider. Furunculosis occurs in the hair bearing (lateral third) portion of the external ear canal. It is differentiated from otitis externa because the swelling associated with it tends to be localized to a single quadrant. Swelling in the ear canal seen in otitis externa is usually concentric and involves the entire length of the canal.

    Otitis media must also be considered. The examiner must visualize the tympanic membrane to differentiate it from otitis externa. In addition, whether or not the TM is intact may affect treatment options. Mastoiditis can be diagnosed if the post-auricular fold is obliterated (it is preserved in otitis externa). Patients also have pain to palpation over the mastoid process in mastoiditis rather than pain with manipulation of the pinna.

    Relevant History

    Assess the pain level. Otitis externa is painful, but very severe pain is more characteristic of a furuncle. Children who develop otitis externa frequently have a history of recent swimming. Also ask about any recent ear trauma (q tip use, ear syringing, hearing aide use, ear plugs, or foreign body in the ear canal). Inquire about immune status. Immunocompromised patients are at risk of severe/necrotizing infection. Other dermatologic conditions such as contact dermatitis, eczema, and psoriasis predispose to otitis externa. Previous history of ear disease or ear surgery is also significant.

    Pediatric Acute Infectious Otitis Externa

Physical Exam

    On inspection, observe if there is ear drainage. Thick and clumpy secretions are typical of otitis externa. In particular, green and foul smelling discharge is classic of pseudomonas infection. Mucoid drainage is more characteristic of middle ear pathology rather than otitis externa. Also observe if there is surrounding cellulitis. If there is, it is important to mark the edge to monitor response to treatment. A protruding pinna can also be visualized by inspection alone. This finding is associated with a post-auricular abscess (complication of mastoiditis). Observe any facial paralysis, which is a sign of severe infection. Palpate the mastoid for tenderness (a sign of mastoiditis) and feel for any lymph nodes in the peri and pre-auricular areas (markers of severe infection).

    Perform otoscopy and look for several key findings. Edema/erythema of the canal, narrowing of the canal, debris in the canal, and purulent secretions are all typical findings in otitis externa. Determine if the TM is intact or perforated. In the case of aspergillus infection, black fungal hyphae can be seen on the TM. Otoscopic exam may reveal vesicles in the canal, a condition known as herpes zoster-oticus. The tympanic membrane itself can also be inflamed. This condition, myringitis, can be due to primary or secondary causes.

    Diagnostic Testing

    There is no consensus in the literature concerning culturing. Many clinicians culture initially if physical exam findings lead them to suspect a fungal cause. In addition, culture of ear secretions is warranted after the first treatment failure to identify the organism and prescribe effective anti-microbial therapy. Imaging may be obtained based on clinical suspicion. In the event of suspected malignant otitis externa, CT scan or isotope bone scan can help make the diagnosis.

    Treatment Goals

    When treating otitis externa, the physician should take into account several goals. First, prescribe antimicrobial therapy that eradicates the 2 most common bacterial causes: Pseudomonas and Staph aureus. Second, achieve aural toilet. It is imperative to remove as much debris as possible from the ear canal so topical medications can be effective. Third, achieve pain control. Otitis externa is a painful condition. Fourth, have the patient keep his/her ears dry. Continued exposure to moisture can slow recovery. Fifth, instruct the patient in the proper use of topical ear drops. For a child, the parent/caretaker should place the drops. The child should lie on his/her side with the affected ear up. The drops should be placed in the canal and the tragus should be pumped several times so the medication can get deeper into the canal. The child should remain in the same position for 5 minutes. Finally, use an ear wick when appropriate. Ear wicks are typically warranted if there is significant canal narrowing (50%) which indicates significant infection.

    Non-Antibiotic Topical Treatments

    Boric acid, acetic acid (available commercially in combination with a steroid: Vosol HC) and alcohols are commonly used to treat otitis externa. Boric acid is used in solution at a concentration of 2.75%. Commercial preparations of acetic acid use a concentration of 2%.

    Pediatric Acute Infectious Otitis Externa

    Alcohol is effective at concentrations between 90-95%. Each agent works by creating an acidic or toxic environment that is not conducive for bacterial/fungal growth. They are very inexpensive and work against both bacteria and fungi. They have a number of downsides, however, which limit their use. They only work well when used early in the disease process. In addition, they can be painful to use. They also require multiple treatments per day for a long treatment period (up to 3 weeks). Finally, they can be ototoxic if they get into the middle ear cavity.

    Topical Antibiotic Treatment Options: Aminoglycosides

     Amingoglycosides were used as first-line therapy durin the 1970’s through the late 1990’s

    for treatment of otitis externa. Neomycin is often combined with a second antibiotic (polymixin) and a steroid. The polymixin adds pseudomonas coverage. Polymixin/neomycin combination has an 87-97% cure rate and is relatively inexpensive. Gentamicin is also sometimes used as a topical agent.

    Aminoglycosides have several drawbacks that limit their use. Hypersensitivity reactions to neomycin (up to 53% of patients) and its preserving agent thimerisol (up to 18%) occur frequently. Although ototoxicity with topical aminoglycosides is rare, it can happen with a tympanic membrane perforation. This is particularly significant because treatment for otitis externa is sometimes started without being able to adequately visualize the eardrum. Finally, aminoglycoside topical antibiotics require QID dosing.

    Topical Antibiotic Treatment Options: Quinolones

    Floroquinolones were developed in the 1980’s, but became available as otic topical preparations in the late 1990’s. Three different commercial preparations are available: ciprodex (Ciprofloxacin0.3% and dexamethasone 0.1%), CiproHC (ciprofloxacin 0.2% and 1% hydrocortisone) and Floxin Otic (Ofloxacin 0.3%). They are currently first-line therapy for otitis externa. Quinolones offer several advantages. First, they cover both gram positive and gram negative organisms and their efficacy is considered equivalent to aminoglycosides. Second, they only require BID dosing. Third, there is negligible systemic absorption which allows use in pediatric populations. Fourth, there is no known ototoxicity associated with quinolones. Fifth, Floxin Otic and Ciprodex are FDA approved to treat otitis externa with a perforated tympanic membrane. Finally, allergies to quinolones are very rare and are usually associated with oral use. The drawback of quinolones is their cost.

    Quinolones vs. Aminoglycosides and Oral Antibiotics.

    In the late 1990’s a significant percentage of primary care physicians were prescribing topical antibiotics and oral antibiotics to treat otitis externa. Rolland et. al. performed a study in 2008 in which topical quinolones were compared with topical aminoglycosides plus oral amoxicillin. This prospective randomized controlled trial showed equivalent outcomes in both groups. These findings provide evidence that topical quinolones are as effective as topical aminoglycosides and that oral antibiotics are not necessary in the treatment of routine otitis externa.

    Pediatric Acute Infectious Otitis Externa

Topical Antifungals

    There are a few commercially available anti-fungal preparations to treat fungal otitis externa. These products are well known as creams, but can also be used in a solution for the ear. Lotrimin (1% clotrimazole) and Tinactin (tolnaftate) are effective to treat fungal infections. Many treatment algorithms add anti-fungal coverage if suspected upon initial presentation and/or after the first treatment failure with a quinolone.

    Prevention of Otitis Externa

    Patients can employ several strategies for avoiding otitis externa. Ear plugs can be used to prevent moisture in the external ear. Over-the-counter ear plugs are available, but cotton balls with petroleum jelly also work well. Astringents (e.g. alcohols) are also effective as a preventative after water exposure to the ear. Drying the ear with a hair dryer held 1 ft from the ear can aid inmoisture evaporation from the ear canal. Finally, avoidance of Q-tips in the ear is crucial to prevent otitis externa.

    Prevention of Otitis Externa: Q-Tips

    Nussinovitch et al conducted a study of all children diagnosed with acute otitis externa over a 3 year period at their medical institution. When compared to age-matched controls without otitis externa, they found a statistically significant difference between the use of Q-tips in the group diagnosed with otitis externa.

    Martin et al conducted a study examining the rates of infection due to different pathogens. They noticed a sharp increase in the number of fungal otitis externa cases in the years after the topical quinolone preparations became available. They theorize that quinonlones are so effective in eradicating bacteria in the ear canal, that fungi and yeast are selected to replicate normal ear flora as a result. These studies were observational which can only show a correlation and further studies are needed to prove a causal relationship. The authors state. However, that quinolones are still an excellent choice to treat otitis externa.

    DISCUSSION: Shraddha Mukerji, MD

    Acute infectious otitis externa is very common in children. It is particularly troublesome during the summer months when majority of the kids are actively swimming. The most important infectious agents are bacterial (staph and pseudomonas), but as pedi ENT physicians, we see a lot of children with fungal otitis externa. The main reason for this is chronic use of quinolone ear drops which is the first line treatment for otitis externa in children. Chronic use of these drops alters the normal flora of the skin of the EAC and predisposes to fungal infection.

    The treatment consists of aural toilet and keeping the ear dry along with ear drops to fight infection and relieve pain. Fever and other systemic symptoms are absent, so I usually do not start the child on oral antibiotics for OE alone.

    Pediatric Acute Infectious Otitis Externa

    Beers SL, Abramo TJ. Otitis Externa Reivew. Pediatric Emergency Care. 2004; 20: 250-253.

    Dohar JE. Evolution of Management approaches for Otitis Externa. Pediatric Infectious Disease Journal. 2003; 22: 299-305.

    Lum CL, Jeyanthi S, Prepageran N, Vadivelu J, Raman R. Antibacterial and antifungal properties of human cerumen. The Journal of Laryngology & Otology. 2009;123: 375378.

    Martin TJ, Kerschner JE, Flanary VA. Fungal causes of otitis externa and tympanostomy tube otorrhea. International Journal of Pediatric Otorhinolaryngology. 2005;69: 15031508.

    Klein JO, Mccracken GH. Summary and conclusions. The Pediatric Infectious Disease Journal.

    2001;20: 123-125

    Rolland PS, et al. A single topical agent is clinically equivalent to the combination of topical and oral antibiotic treatment for otitis externa. American Journal of OtolaryngologyHead and

    Neck Medicine and Surgery. 2008;29:255261.

    Roland PS, Stroman DW. Microbiology of Acute Otitis Externa. Laryngoscope. 2002;

    Besser RE, McCoy SI, Zell ER. Antimicrobial Prescribing for Otitis Externa in Children. The

    Pediatric Infectious Disease Journal. 2004;23:181-183.

    Nussinovitch M, Rimona A, Volovitz B, Ravehb E, Prais D, Amira J. Cotton-tip applicators as a leading cause of otitis externa. International Journal of Pediatric Otorhinolaryngology.

    McKean S.A,. Hussain S.S.M. Otitis externa. Clinical Otolaryngology. 2007; 32:457459.

    Wall GM, Stroman DW, Roland PS, Dohar J. Ciprofloxacin 0.3%/Dexamethasone 0.1% Sterile Otic Suspension for the Topical

    Treatment of Ear Infections. The Pediatric Infectious Disease Journal . 2009;28:141-144.

    Osguthorpe JD,Nielsen DR. Otitis Externa: Review and Clinical Update. American Family

    Physician. 2004;74: 1510-1516.

    Rosenfeld RM, Singer M, Wasserman JM, Stinnett SS. Systematic review of topical antimicrobial therapy for acute otitis externa. OtolaryngologyHead and Neck Surgery.

    2006;134: S24-48.

    Rosenfeld RM et. al. Clinical practice guideline: Acute otitis externa. OtolaryngologyHead and

    Neck Surgery 2006;134: S4-S23.

    Ramsey AM. Diagnosis and Treatment of the Child With a Draining Ear. JOURNAL OF

    PEDIATRIC HEALTH CARE. 2002;16: 161-169.

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A Short Guide to a Long Life

By David B. Agus, MD

In his #1 New York Times bestselling book, The End of Illness, Dr. David B. Agus shared what he has learned from his work as a pioneering cancer doctor and researcher, revealing the innovative steps he takes to prolong the lives of not only cancer patients but all those hoping to enjoy a vigorous, lengthy life. Now Dr. Agus has turned his analysis into a practical and concise illustrated handbook for everyday living. He believes optimal health begins with our daily habits. A Short Guide to a Long Life is divided into three sections (What to Do, What to Avoid, and Doctor’s Orders) that provide the definitive answers to many common and not-so-common questions: Who should take a baby aspirin daily? Are flu shots safe? What constitutes “healthy” foods? Why is it important to protect your senses? Are airport scanners hazardous? Dr. Agus will help you develop new patterns of personal health care using inexpensive and widely accessible tools that are based on the latest and most reliable science. Now go live life!

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The Society of Friends of Ulises Carrión

Evelyn Taocheng Wang, Perfect Slander, 42 × 59,4 cm, ink on watercolor paper, 2015

Coordinated by Arnisa Zeqo

Je m’appelle Ulises
et toi comment t’appelles-tu?

The Society of Friends of Ulises Carrión takes the work and methods of the Mexican artist Ulises Carrión (1941–89) as a starting point in order to explore cultural strategies and practices at the intersection between literature, performance art, conceptual art, and life. This Society opens up paths of research and thinking about art, culture, and the stories circulating through unread pages, through regular meetings with artists, curators, writers, fans and scholars alike. More than just consisting in a discussion of the artist’s work, the meetings try to challenge the participants’ political imagination in the manner of Carrión.

Ulises Carrión began his artistic life in the literary circles of Mexico in the 1950s and left to study literature in France and England in the 1960s. He settled in Amsterdam in the early 1970s, where he could freely live his personal relations and reinvent himself as an artist. He called himself a “wetback,” a derogatory term for foreign citizens, and his writing mutated from Spanish into English, Dutch, and French. A combination of these languages can be found in both his work and his diaries. It has been said that Ulises Carrión was actually several Carrións. Through the years his practice and engagement shifted from literature to performance, artist’s books, archives, mail art, popular culture and theory, yet always with a precise interest in cultural strategies and daily life. In 1975 he initiated the gallery bookshop Other Books and So in Amsterdam, where he organized performances and presentations on an irregular basis. He engaged with good manners and rumors on several occasions. In 1984 he brought the Mexican actress Lilia Prado to Amsterdam to attend The Lilia Prado Superstar Film Festival, organized by Carrión. His inquiry into cultural strategies and communication tactics relied on his transnational relationships with different agents. He asked: Where does the border lie between an artist’s work and the actual organization and distribution of work?

With Carrión, the Society is interested in encountering bookworks, rumors, plagiarism, chewing gum, dispersed archives, a new art of making books, emotions, weather reports, soap operas, burglaries, rubber stamps, mirror sonnets, erratic desires, registries, plastic flowers, alphabets, idioms of everyday life, secret alphabets, trios and boleros, performances, stars, disseminations.

All events of the Society of Friends of Ulises Carrión are free and open to the public.

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Diaries as a space of histories

with Murat İssi, Katerina Tselou, and Arnisa Zeqo

This public presentation takes the work developed by Banu Cennetoğlu for documenta 14 in Athens as a departure point for opening a discussion on diaries—the intimate annotations of one’s life—as…

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Is Modernity Our Antiquity?

with Yannis Hamilakis and Arnisa Zeqo

(Starting at the pavilion and then walking towards the hill)

Is modernity our antiquity? This was a question posed by documenta 12 in 2007. In light of the social, political…

Blood Memory

with Lala Meredith-Vula and Arnisa Zeqo

In the 1990s, a civil movement organized at grassroots level by students and villagers to try to reconcile the thousands of feuding families around Kosova. These blood feuds were based on an old law that…

Bookworks Revisited: This Is a Poem

with Tina Pandi and Kyrillos Sarris

For the second public meeting of The Society of Friends of Ulises Carrión we invite you to Bookworks Revisited: This Is a Poem, a presentation and discussion focusing on different strands of and correspondences between art and poetry, writing as art, and the stories around the artists and writers of the Visual Poetry Group, active mainly in Athens since 1981…

Encountering: Gesture as Event, or The Conceptual Body

with Hendrik Folkerts, Amelia Jones, and Arnisa Zeqo

We warmly invite you to the inauguration of The Society of Friends of Ulises Carrión. This Society takes the work and methods of Mexican artist Ulises Carrión (1941–89) as a starting point in order…


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Five Reasons a Rope Should Be in Your Survival Kit

Many people all over the world have taken it upon themselves to prepare for a natural disaster or societal upheaval. They assemble survival kits with the latest gear and gadgets in preparation for this catastrophe, but one of the most crucial items is often left out. That item is a high quality nylon rope. Here are just a few of the most common uses for nylon rope in a survival situation.

Building Shelters

A simple tent can be made by tying a rope between two trees, folding a tarp over the rope, then securing the corners down with tent stakes. Larger and more elaborate types of structures can be created with logs and lashings made from the nylon rope.

Traversing hilly or mountainous terrain can be problematic when carrying loads of survival gear. A strong rope will allow you to rappel down steep hills and mountainsides. Before adding the rope to your survival pack, make sure that it is capable of supporting the weight of you and your gear.

Procuring Food

There are several ways to turn a rope into a tool for hunting or trapping animals for food. A snare trap can be constructed with rope and a thin sapling. Making a bow and arrow out of the rope and a curved tree branch is another option. Finally, the rope could be unraveled into thin stands that can be used as fishing line.

First Aid Applications

A rope can be used to secure bandages to a wound, sling a broken arm, or serve as a tourniquet. It can even be unraveled into threads and used to stitch up wounds. The items designed for these functions will take up space in your survival pack, but a few extra feet of rope will not add much bulk at all.

Starting Fires

By constructing a bow out of wood and rope, you can make use of a tedious but reliable fire starting method that requires neither fuel nor flints. The bow and drill fire starting method is one of the oldest ones around. Fortunately, it is just as effective today as it was thousands of years ago. It essentially works by rotating one piece of wood against another at high speed, mechanically aided by the use of the bow. The friction produced will ignite the kindling.

It’s hard to believe that a simple item like nylon rope can have so many uses in a survival situation. It is truly an item that no survival pack is complete without. Someday, it could save your life in a number of ways.

Annette Hazard is a freelance writer that usually writes about home and family issues. She is a mother of one and spends her free time exploring the outdoors with her family.

6 thoughts on “Five Reasons a Rope Should Be in Your Survival Kit

  • August 3, 2014 at 1:10 pm

    Not all ropes are the same. There really isn't a catch all rope. Paracord is great fit general use and is light and small but had limitations as well. Be aware of what your rope can do before you use it.
    In other words, if you need to lift something heavy, you may need something besides paracord.

  • August 1, 2014 at 1:38 pm

    A rope is so handy, even if you're not in a survival situation. But for sure, you would want one. Wouldn't the paracord take the place of a rope? It's lighter and more easily carried?

  • February 26, 2014 at 10:52 pm

    Rope is definitely a must have for survival gear kits and I'm glad you suggested it. My only hesitation would be if there was enough room to fit it in but after your post I'm convinced it's a necessity.

  • February 7, 2014 at 8:29 pm

    I'm going to add a printed knot guide to my kit as well, as an app on my smartphone.

  • January 30, 2014 at 12:13 am

    This is a great point and I think that every survival kit should have one for sure!

  • January 26, 2014 at 6:10 am

    Are they saying natural rope or synthetic ?

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First Aid Firsts: What Basics Your Kids Should Learn

Any child could encounter an emergency at some point, perhaps even on the playground. Children who are prepared have greater self-confidence in these situations, and can even save a life. Here are basic first aid skills to start teaching your child.

First Aid for Choking

Even young children can be taught the lifesaving Heimlich maneuver. Discuss what commonly causes choking and how to tell if someone might need help. Have your child practice the Heimlich maneuver on a stuffed toy. Children can also practice the basic movement on each other as long as they understand not to use the pressure they would use in a real emergency.

Young children can be introduced to CPR, and older children can easily master it. Explain the basics of when and how to use CPR. Avoid creating fear or anxiety about heart functions by answering their questions candidly. Tell them that CPR is only needed when someone’s heart has stopped. Call a cardiovascular clinic in your area like the ICE, Institute of Cardiovascular Excellence to see if they have illustrated pamphlets you can use to explain CPR and basic heart functions to a child.

    The basic steps your child should know are:

  • To listen to the chest and see if the person is breathing, or if they can hear a heartbeat.
  • How to call 911.
  • To start chest compressions — You can teach chest compressions using a stuffed toy.
  • Rescue breathing is more difficult to teach unless you have access to a CPR mannequin. Explain the steps as thoroughly as you can, and look for instructional videos online.

Stop Wound Bleeding

Profuse bleeding requires immediate care. Teach your child how to apply pressure on wounds using bandages or available cloth. The bandage shouldn’t be removed when the bleeding has stopped. Instead, instruct the child to call 911 or look for an adult.

Stop a Nosebleed

Nosebleeds become an emergency when the bleeding is profuse and shows no signs of stopping on its own. Kids should learn how to help the victim lean his head forward slightly, and pinch his nostrils shut for 10 minutes. If the bleeding continues, instruct children to call 911.

Treating Burns

Burns are one of the most common injuries. All children can be taught to cool burns with running water as soon as possible. When your child is old enough to understand, you can go into detail about the different degrees of burns. Burn cream in a first aid kit can be applied to first-degree burns after the burn has been cooled by water.

Avoid filling your child with anxiety about emergencies. Make the teaching process into a game or song to keep things lighthearted, and go over the steps often to help your child retain the information. With a few lessons they can be prepared and confident no matter what happens.

Brooke Chaplan is a freelance writer, recent graduate from the University of New Mexico, and avid runner. She loves to blog about fitness, health, home and family. Contact her via twitter @BrookeChaplan.

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Entry Price: $22,890
Price as Tested: $28,895

This week, we’re driving Kia’s all-new 2017 Niro Hybrid, built to take sales away from Toyota Prius and conceived from the very beginning to be a new compact crossover hybrid. This five-door design delivers crossover looks, ease of city driving and impressive road handling.

Similar to other hybrids on the road today, Niro utilizes an electric motor, battery and internal combustion engine for motivation, resulting in a combined 139-horsepower and impressive 195 lb. ft. of torque. The fuel mileage is very impressive as the mid-level EX model (our tester this week) delivers 51 city and 46 highway MPG thanks to a 104-horse 1.6-liter Atkinson four cylinder engine that works in tandem with a 43-horsepower electric motor and Lithium-polymer battery mounted under the rear seat.

Kia calls its hybrid combo a “Full Parallel Hybrid System” that combines the power of its hybrid-optimized engine with a highly efficient, lightweight electric motor and a powerful lithium-ion polymer battery. The result is a smooth, reliable performance that delivers outstanding hybrid efficiency. (Don’t add the horsepower of the engine and electric motor together as neither ever works in unison at 100 percent capacity. Thus the 139-horse total instead of 147 horses for my mathematical conscious readers).

A fine shifting six-speed dual clutch automatic transmission delivers the power to the 16-inch Michelin tires on alloy wheels. The front drive Niro handles extremely well, and all suspension components are of strong yet lightweight components that assist in delivering better fuel mileage. Notable is that the current Niro is not available in an all-wheel-drive (AWD) format, which is puzzling since every other crossover on the market today offers both two-wheel and four-wheel drive models.

The upper class Touring models receive 18-inch Michelin tires, and a host of other amenity features. The result is a Niro that is heavier and thus impacts the MPG numbers lower, with 46 city and 43 highway the EPA estimates.

Niro offers a driver switchable Economy and Sport mode option. The Sportmatic transmission mode offers a more aggressive (read that less MPG) approach as the engine will rev higher before shifting giving better acceleration and throttle response. Listed as a small station wagon by the EPA, Niro is a little longer in wheelbase (1.2-inches) compared to compact Kia Sportage, and just as good looking in its final pattern.

Our tester arrived in mid-level EX trim, ($25,700 entry) while the aforementioned upper class Touring models (start at $28,000), which ups the creature comfort quotient substantially. The entry Niro FE starts at just $22,890, followed by the LX at $23,200. Remember that regardless of choice, you receive the exact same drivetrain in every model.

Every Kia Niro comes with a pretty nice UVO infotainment stereo system that offers eServices technology and numerous functions via your smart phone. Android Auto and Apple CarPlay are standard, as is SiriusXM radio. The FE, LX and EX touch-screens are of seven-inch design with six-speaker stereo, while the Touring versions receive eight-inch screens and enhanced Harmon Kardon stereos with navigation and eight-speakers.

Kia’s advertising pushes for Niro to be accepted as a crossover, as they call it a “new crossover” vehicle. However, until they offer a 4x4 or AWD system, Niro to me is a very nice front drive hybrid wagon that I doubt will deliver acceptable traction in a major snowstorm.

Our EX had one option, a recommended safety upgrade called Advanced Technology and Sunroof. Included in addition to the sunroof are smart cruise control, automatic emergency braking, forward collision control and a lane-departure warning system. This option costs $2,300 but is well worth it from a security aspect.

Another consumer wellbeing feature is a no extra cost blind-spot detection system with lane-change assist and rear cross-traffic alert that is standard on the EX and Touring models. Add all expected modern day vehicle safety items, from four wheel discs ABS brakes to all the airbags, and Kia Niro is one safe vehicle.

I was impressed with the pep of the Niro under full throttle, especially from a dead start. The excellent torque available should erase any concerns of Niro being a “turtle” when it comes to acceleration or merging on a crowded, higher-speed freeway. And, unlike other hybrids that utilize CVT automatic transmissions (continuous variable), the better acclimated six-speed dual clutch makes Niro feel like a “real car” when it comes to shifting.

A very composed highway cruiser in Eco mode, we gave Niro a pretty good country road run in Sport mode with good results. The 16-inch Michelin tires grab in the tighter corners yet still deliver excellent easy roll resistance that equates to better MPG numbers. With a full fuel tank, Niro has a 500-mile cruising range.

Important numbers include a wheelbase of 106.3 inches, 3,161 lb. curb weight, 11.9 gal. fuel tank, 17.5 ft. turn circle, 6.3-inch ground clearance, and from 19.4 to 54.5 cu. ft. of cargo space.

Niro’s good exterior looks and comfortable EX model leather cabin surroundings are noted. In summary, Kia Niro indeed looks like a crossover and drives as good if not better than its number one competitor, Toyota Prius. It’s going to be interesting to see what Niro can do at the showroom sales office, where your Kia dealer is waiting to explain everything, including the 10-year, 100,000-mile limited powertrain and battery warranty Kia is noted for.

Likes: Looks, safety, hybrid powertrain, six-speed automatic.
Dislikes: high tech safety features not available on entry FE, no AWD makes no sense if it’s really a crossover.

— Greg Zyla writes weekly for More Content Now and other Gatehouse Media publications.


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Sponsor Spotlight: ATI Performance Products
ATI Performance Products is a family owned and operated company that has been in business for over 50 years. The company specializes in racing transmissions, torque converters, engine dampers and the internal parts for each. ATI races what they sell so you can be sure what you’re buying has already been race proven. Everything they make is manufactured under the roof of their 30,000+ sq/ft facility located in Baltimore Maryland.

ATI manufactures its own SFI cases for the Power Glide and TH400 and offers many different bell housings and options to fit what you race. ATI 8" and 9" torque converters are made from 100% new parts, no old cores here. ATI’s Super Damper is the industry leading damper and is used exclusively in NASCAR, NHRA Pro-Stock, and by every quality engine builder in the world.

In the transmission department, you can find plenty of models to choose from. Based on the weight & horsepower of your combination, ATI can spec you a transmission and converter combination to guide you to the winner’s circle no matter what your combination is. Whether its aluminum drums, Vasco shafts or trick trans brake valve bodies, ATI makes the parts to put in anything from a basic foot brake Glide for your bracket car, to an all-out Outlaw TH400 Lock Up for your Pro-mod. ATI has the parts and the knowledge to build you a reliable transmission to fit your specific needs. They also supply a wide variety of torque converters; each one specifically made to order. ATI offers everything from light weight 8” units for NHRA Stock class racing all the way up to 10.5” Outlaw Lock UP converters for 3000+HP door cars. They even offer a line of StreetMaster Converters for your hot rod or street car.

When it comes to a harmonic balancer the ATI Super Damper has the best design on the market, period! The design is simply the best piece available and provides the most protection you can get for your engine. After spending a significant amount of your hard earned money on a new power plant, an ATI Super Damper is the best insurance policy you could purchase to protect that new investment. A damper plays such an important role in both absorbing harmonics and preventing torsional twist of the crank shaft. With the best technology readily available, why would you want to risk your investment on anything else? Plus, the ATI damper is completely rebuild-able and every individual part is available separately and service is easy. Only ATI offers a damper that will last the entire life of your engine and then some.

For more information, visit www.ATIRacing.com.

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Flapjack Recipe

Oats are my new favourite ingredient.

Now I have got into the habit I love having porridge in the morning with fresh and dried fruit. It doesn’t even matter if we’ve forgotten to get milk in as it’s just as nice with water

Cookies and Flapjack

Anyway, I made some lovely flapjacks and cookies for Sunday afternoon tea yesterday and they are delicious as well as so easy and quick to make.

  • 75g Butter

  • 75g Soft brown sugar (pretty much any is fine though. I just mixed up what I had!)

  • 2-3 Tbsp golden syrup

  • 150g oats

Preheat the over to 180ºC/160ºc (fan) Melt the butter, sugar and syrup over a lowish heat, making sure you don’t burn the mixture.
When it is melted and combined add the oats gradually making sure they are fully coated.
Empty the mixture into a greased tin and place in the oven for 15-20 minutes.

The flapjack will not be crispy until it’s cooled so it’s best to cut it into squares when it first comes out of the oven (that’s if you’re patient enough to let it cool – I just eat it all gooey and hot!)

  1. Did you take that photo? It looks very professional and that flapjack looks textbook! Perfect flapjack and a perfect photo? Marvelous.

    I made flapjack with 200g melted milk chocolate in it and as many sultanas as I could safely manage, that was tasty. I'm going to try chocolate lumps next time, or perhaps a layer on top.

    However, I burnt mine a bit (only on the outside) so I didn't take a photo of it. But I ate it anyway, I wasn't going to let half a kilo of oats go to waste!

    Cool blog, too. Keep it up.

  2. Good post! I'm gonna go and read some more.


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Hawaii Wedding News

Terrorist Alert not affecting Hawaii

There is no terrorism alert for travelers coming into Hawaii.  The terrorism alert only currently only affects American’s traveling or living in European and Middle Eastern countries.  Just as a precaution, homeland security is on the lookout for any potential threats within our country, even though the warning only applies to American’s overseas.   The increased terrorism alert comes on the reports of credible increased chatter among Al-Queda.  Georgia Senator  Saxby Chambliss said that the chatter is “very reminiscent of what we saw pre-9/11.”

I expect longer security lines will follow, but flight cancellations or delays have not been happening so far.

me Terrorist Alert not affecting Hawaii
I'm self-employed, so I pretty much do everything around here, from photography and video production, to the organization of all of my weddings. As you can see, I'm also the head writer too! If for some reason you can't reach me at my direct line, or my toll free number, feel free to hit me up on my personal cell at (808) 489-7633. Call anytime...well, almost anytime. Don't call on Superbowl Sunday or when the Philadelphia Eagles are playing!
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Owen Thomson

Magician Cosentino star and car

Magician tells of his escapades driving around the country.

Magician Cosentino star and car

Owen Thomson

The lowdown: the hugely popular illusionist and escapologist loves to get away from slow and inattentive drivers.

Career highlights: being named International Magician of the Year; writing, producing and starring in four prime-time TV specials; having them air in 40 countries so far including Spain, India and New Zealand.

See him: appearing in his new live show, Twisted Reality, during April and May. Visit cosentino.com.au for details.

18 - the age I got my Ps

$15,000 – the cost of my Mitsubishi van

What was your first car?

A blue Mitsubishi Express van. We bought it new at the end of 2000, and the reason was that I needed to travel around doing lots of school incursions and shows. All my friends had really cool Lancers and things like that at the time. I had to have this van that had no airconditioning, no electric windows, and no carpet on the floor. It was more of a business decision than a teenage fashion statement. Believe it or not, we still have it. It was always garaged and kept in good condition, so we still use it today to move things around every now and then.

What are you driving now?

A Jeep Commander that I got in 2006. I really love it. It's more practical on a day-to-day basis in that it allows me to tow a three-tonne trailer with my equipment, as well as drive it around town or use it as a weekender.

How do we know the Jeep's real and not just an illusion? It mightn't really be there at all.

(laughs) That's true. But it's served me well. I think I've crossed the Nullarbor twice with it with my gear. I've travelled all around Australia in that Jeep.

Magician Cosentino with his Jeep at Southbank. Photo: Penny Stephens

What's been your favourite drive so far?

I don't necessarily think it's my favourite or most enjoyable, but the one that sticks in my mind the most is definitely crossing the Nullarbor. It was such a long drive - four-days straight. We saw camels, cows and crows on the side of the road, and you had these big road trains going past you, which was pretty daunting and scary. You see everything on the Nullarbor.

What's your pet road peeve?

I get more frustrated by the fact that people drive super-slow. I'm like, 'come on guys, we need to go, let's move'. I'm kind of that person. If the lights go green, go! If you're going to turn, go! Be aware on the road. You've got to concentrate and be in that moment.

If you could go on a Nallarbor road trip with absolutely anyone, who would it be?

Harry Houdini. Imagine having him as a passenger for four days. He couldn't escape. I could ask him anything.

Actually, he probably could escape.

(laughs) That's true. But you know what? I'd be respectful. I wouldn't ask him about his methods or his secrets. I'd just talk to him in general about what it was like to be a performer in the 1900s and what was the tipping point that really changed the game for him, when he went from being a standard magician to the world's first superstar. How did that feel? How did he deal with it? I'd love that.

Magician Cosentino with his Jeep at Southbank. Photo: Penny Stephens
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It will be similar to the sample below.


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Droid Life Logo MarkPodcastDealsContactNewsletter Sign-UpNew User GuideSearchArrowSwipe ArrowEnvelopeClose

Insider Tips New YouTube App, Will Allow for Video Search Multitasking

YouTube logo

Ryan Socio, the gentleman who first reported the name Hangouts in regards to Google’s “Babel” project, recently got his hands on an unreleased version of the YouTube app for Android. According to Socio, the app has some sweet new features on the way.

Without giving any info on when we could expect the new version to hit Google Play, the insider states that the app will feature real multitasking capabilities, allowing watchers to view their videos, while also searching for other videos at the same time.

While inside a video, a little arrow will appear – with a quick swipe with your finger on the arrow, a browser will appear, allowing you to search simultaneously for more content as the video plays inside of a smaller box. According to the source, the app performs very smoothly and will retain the YouTube app’s current aesthetics.

We will definitely keep you posted.

Via: The Verge


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Droid Life Logo MarkPodcastDealsContactNewsletter Sign-UpNew User GuideSearchArrowSwipe ArrowEnvelopeClose

Uber Opens Up Android Beta Program, Try Features Ahead of Everyone Else

Uber, the taxi service which has swept the entire globe, announced a special Android beta program for users today, one which will allow users to access a completely revamped taxi experience.

For anyone who is unfamiliar, Uber allows users to request car service right from their smartphones, then lets you track the driver as he approaches your pickup point. If you know how awful it is waiting for a taxi, then Uber is an absolute treat.

So, what’s in the beta? Well, apparently it’s quite substantial, with Uber stating they have completely rewritten the app and enhanced many of its features. To start, the app should be much faster, as well as more responsive. In addition, users will find it easier to access important features like Fare Split and Share My ETA.

Here is what they state in the official blog post.

We’ve rebuilt the app from the ground up, and — simply put — it works much faster and better. Expect enhanced performance, revamped design, and easier access to your favorite features like Fare Split and Share My ETA.

Ready to get your beta on? Head on over here and enter the Google+ community to start the process.

Via: Uber


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Thor 272 Cover Hulk Captain America by Adi Granov Thor 272 Cover Red Sonja by Adam Hughes Wonder Woman by Adam Hughes Avengers 30th Anniversary Poster by George Perez superman ice blue Marvel Universe Captain America by John Byrne Power Girl by Adam Hughes superman fire Green Lantern logo Thor by Michael Turner Avengers Poster by George Perez Captain America by John Byrne


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Team Sponsorships

Bar Games and Team Sponsorships | Rochester, NY

At the Dr.'s Inn, we do everything we can to live up to our reputation as Rochester's premier community dive bar. That's why we proudly sponsor local teams for community sports and games, including softball, kickball, darts, pool, and more. Read on to learn more, and give us a call at (585) 271-0820 today!

Let us sponsor your team!

We have long been a premier partner to the areas teams of all shapes and sizes. Whether it is kickball, softball, darts, pool, or anything else, contact us or stop down to find out what sort of sponsorship package we can put together for you.

We not only sponsor your team, but give you a great place to enjoy the camaraderie that comes with the competition.

Bar Games Galore

Whether you're looking to spectate or participate,Dr's Inn is the place to be for all types of games. Not only are we always playing sports and horse racing on our TVs — we also have a host of bar games, including pool, darts, and cornhole right here. Join us for OTB or one of our many great bar activities today!

Contact Us!

Looking for a place to enjoy great drinks, bar food, and bar games, all at great prices? The Dr.'s Inn is the place for you. Give us a call at (585) 271-0820 to learn more about our team sponsorships, or come in and visit us.
Call us at (585) 271-0820 today!
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Residents reject Act 46 merger plans
by Rolf Parker
Mar 10, 2017 | 4973 views | 0 0 comments | 54 54 recommendations | email to a friend | print
Mary Beth Porter asks for clarification on an issue at the Wardsboro Town Meeting.
Mary Beth Porter asks for clarification on an issue at the Wardsboro Town Meeting.
Close vote shoots down merger

WARDSBORO- In a ballot vote by a small fraction of registered voters, Wardsboro townspeople rejected the proposed Act 46 school district merger with Dover and Marlboro on Tuesday. At Town Meeting, they approved their town budget unanimously, heard concerns about the discontinuation of a bridge, and reelected Peter Sebastian to another three-year term on the selectboard.

Rep. Laura Sibilia and Sen. Becca Balint stopped in to speak with townspeople. Balint said she had worked as a public school teacher, her children were in public schools, and she knew that people in Wardsboro were wrestling with the Act 46 ballot question. “I know that these are not easy conversations. I also know no matter what happens, we will be working on your behalf to make sure that your school stays open.” Sibilia agreed, saying, “No one knows what will happen with this vote, but we promise to keep working with you. You are not alone.”

Voters rejected the Act 46 merger 79-62. According to town clerk Jackie Bedard, there are 528 registered voters in Wardsboro.

Bedard said that school budget of $1,983,726 passed unanimously, as did the the article to set the tuition rate for middle and highschool students at an amount not to exceed the Leland & Gray Union High School tuition. The CLA for the town increased from 107.57% to 108.12%, and the homestead residential tax rate for 2018 is $1.4296, a decrease of 5 cents. Mike Murphy and Jim Thomas were elected to one-year positions on the school board. The three-year school board slot was not filled.

Joe Novick wanted Sibilia and Balint to know that the emission standards that were part of the new vehicle inspection process were overly stringent. “We don’t live in Mexico City, where the air is dangerous to breathe” he said. Novick also said that legislators that pushed for the new standards and penalties did not take the financial impact on rural residents into consideration. “This is a huge problem,” he said. “If people get stopped and are given a $100 fine, that has a tremendous impact (on the finances of many residents of rural Vermont). Sibilia and Balint agreed that there was a lack of awareness on the part of many people in state government about the economic realities of people in rural areas. “We have a rural-urban split,” said Balint. “We have to deal with the issue of affordability and this pushes up against the things that people in Franklin and Chittenden counties are concerned with,” said Balint. “I know that this (divide) is absolutely something that the governor cares about.”

Fire chief Chris Lillersaid that the department anticipated replacing one of its pumper trucks which was 27 years old. He said that while he was going to be working on obtaining a funding for the truck, which could cost in the neighborhood of $350,000. He noted that the town received assistance for other equipment last year and the department might need to ask for assistance from the town. “We will try for another grant but we’re not sure lightning will strike twice. Three hundred and fifty thousand dollars, that’s a lot of raffle tickets and turkey dinners.”

Moderator Dr. Robert Backus reminded people of the importance of civility. “You are democracy in action,” he said. “Civility of discourse is extremely important. It is at the heart of democracy. Civility gets things done.”

Selectboard chair Sebastian gave a brief presentation on the town budget. He said that the highway budget was up by 6% but that a considerable surplus from the previous winter, which was mild, was alleviating that increase. The total amount of taxes to be raised was $728,843. The townspeople passed the budget unanimously.

Backus asked Bedard to explain Article 2, which asked whether the town constable should be prohibited from exercising any law enforcement authority. She said that in the past, some constables who were inadequately trained had gotten involved in law enforcement. Sebastian said that it was a liability issue and therefore an expense issue, as the VLCT would charge more to insure a town that had a constable with law enforcement powers.

Novick, who is the first constable, said that during a disaster such as Irene, having a constable who could perform law enforcement duties could be important and valuable. He also said there were no extra costs being incurred by the town currently, because he was barred from law enforcement as he lacked the appropriate training.

While Sebastian agreed that was currently the case, he said that any constable could seek such training on their own, and there was nothing preventing a constable from doing so.

The floor vote on the matter was inconclusive, so the question was put to a paper ballot. The article passed by a vote of 39 to 29.

In Wardsboro, all town offices are nominated and elected from the floor. Selectboard member Kathy Anderson was nominated to a three-year position, but she declined it, saying that she nominated Sebastian. Selectboard member Mitchell Plimpton also declined the honor. Bedard was unanimously reelected as the town treasurer, the town clerk, and collector of delinquent taxes, and Novick was unanimously reelected as first constable. Requests for funding for the Wardsboro Fire Department, the public library, the community food pantry and other nonprofit organizations were all passed unanimously.

Russell Ayers asked to speak about the town’s decision to relinquish ownership of the bridge on Ayers Road. He said that he lived in a house that was 200 feet beyond the bridge, with two people who used wheelchairs. According to Ayers, the bridge had fallen into a state of disrepair and was no longer rated as being capable of supporting the weight of emergency vehicles.

Sebastian said the selectboard thought the cost of repairing the bridge was too high to justify when only one home was served by the bridge. “The town decided to discontinue the bridge on Ayers Road,” said Sebastian. “The board was very concerned about pouring money into it.” Sebastian disagreed that ambulances could no longer pass over the bridge.

Backus suggested that the conversation was one that could not be solved at Town Meeting, and that it might be best if Ayers talked with the selectboard face to face at another time. “He has tried that,” said former selectboard member Eugene Bills. “The town took over the bridge and road in 1938. Now he can’t get an ambulance across the bridge to his home.”
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