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RICHMOND HEIGHTS, Ohio -- The Recreation Department is recommending that the city pool at Community Park remain closed for 2021.

The department is also recommending completion of upgrades at the citys Kiwanis Lodge, and making improvements to Desan Park and Greenwood Farm, Recreation Director Rick Dula said during Tuesdays (Feb. 2) online City Council Service and Recreation Committee meeting.

Dula shared these recommendations -- and more -- gleaned from a series of meetings of the citys Recreation Board with Dula and Assistant Recreation Director Anthony Gimellia in recent months.

We started this exercise back in October with over 50 potential budget items and personnel moves and equipment suggestions, and weve narrowed it down to a final three recommendations we are presenting tonight, Dula said.

Dula said the city has done an admirable job of building up funds since the citys fiscal crisis of 2013, and that 2021 is the right time to spend some of our money -- the taxpayers money -- to improve our recreational leisure programs and facilities in Richmond Heights.

Speaking about the 44-year-old pool, which was closed in 2020 due to COVID-19 and the need for costly repairs, Dula said those repairs are still needed.

We do recommend keeping it closed in 2021, he said. Our wish is to have it remain closed until a final decision can be made about the future status of any type of aquatic facility here in Richmond Heights.

Weve been patching and repairing and opening and closing it. We have the stats to show that the attendance has been very dismal the last three years that weve been open -- especially compared to other Hillcrest communities, he said.

The picture for opening the pool this year is very gloomy.

The Kiwanis Lodge

Dula noted that the city-owned lodge at Community Park, 27285 Highland Road, is turning into one of our showcase facilities because of work done there over the past couple of years.

We would like the city to consider to finally finish remodeling the (lodges) first floor, which would include a new (audio-visual) system; new flooring in the Kiwanis Hall, the smaller of the two (halls in the lodge); a new HVAC system; new energy-efficient windows and new lights in the Kiwanis Hall; four energy-efficient windows on the east wall of the Senior Hall; (and) new round tables and chairs in both halls. That would basically finish off the lodge.

The kitchen was remodeled in 2020 by the citys service department, and grants have been used to upgrade the basement for a broader range of uses, to upgrade the first floor and to add an outside ramp for better access to and from the basement.

Its getting there, Dula said of the lodge. We figure lets just do it all in 2021. Lets finish what we have to do, and if we cant get (more) grant money, lets not wait. Lets just spend the money we have in our $10 million (city budget) carry-forward and move forward.

Hiring a part-time staff person

The next recommendation from the commission is to rehire a part-time staff person, at 28 hours per week, to assist with programming, special events, rentals, marketing, deposits, program evaluations, event evaluations, surveys and handling social media work.

The commission suggests not hiring the part-timer until after the pandemic has passed and life in the Recreation Department returns to whatever the new normal is going to be.

Obviously, if were not doing activities, we dont need that (part-time) person onboard yet, but we need to position ourselves in case the pandemic is done sometime in 2021 and we can move forward with more activities, Dula said.

Desan Park

Of the third recommendation -- concentrating on Desan Park, located off Trebisky Road -- Dula said: Wed like to either remodel, renovate the restrooms/concession stand/pavilion structure, (and) complete the work on the two baseball infields, which is pretty minor. We have applied for a grant for a new playground there, and were looking at possibly repurposing the old tennis courts.

Its a wonderful space, he said of the long-closed tennis courts. Its kind of growing weeds right now, and wed like to come up with something that we can put there and make it an asset instead of a liability.

While the commission made recommendations in these three areas, it went on to list several other items on its wish list.

At Community Park, it is looking at improving the asphalt trail, something for which the city has already applied for a $150,000 share of 2021 federal Community Development Block Grant money, as distributed by Cuyahoga County.

Also discussed were options regarding the pool. Those options include repairing the current pool; adding an aquatics facility, such as a spray park, for use by children and teens, on the site of the current pool; or building a smaller pool, depending on study results.

Dula also mentioned working next year with the school district to replace the worn tennis courts with new courts, fencing and lighting. The improved courts could the be used by the schools for physical education.

At city-owned Greenwood Farm, 264 Richmond Road, Dula said the commission would like to build a permanent heated restroom, as the city has received a grant and has installed sewers running to the farm property.

Ward 3 Councilwoman Cassandra Nelson asked if tables and grills would be installed at Greenwood Farm, and Service Director Don Kerniskey said the plan for spring was to add both.

Meanwhile, Ward 1 Councilwoman Kim Thomas suggested installing a larger sign that lets people know that Greenwood Farm is a community park, as the current sign makes that statement in comparatively small letters.

Of Greenwood Farm, Dula said: Thats a wonderful piece of property sitting there screaming to be utilized and (for the city to) put some money into that. Its just a beautiful property that needs to be tweaked a little bit, put some money into it, and allow people, residents to enjoy the beautiful nature back there.

Although it did not have to do with recreation, the commission also recommended that Richmond Heights, at $60,000 to $70,000 per year, turn on all of its street lights to make the city safer and more welcoming.

The commission consists of residents Charlotte Camp, Angela Jordan, Patricia Thompson, Anna Cifranic and Mary Mehring.

Speaking in response to Dula and the commissions call for the city to spend money on upgrading its recreational facilities, Councilwoman and Committee Chair Juanita Lewis said, Well do some spending, but weve got to be careful.

Council took no action on the recommendations.

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Richmond Heights Recreation Commission recommends closing pool in 2021 - cleveland.com

Transforming mirrors, chairs, and other furnishings from dull to dramatic is quick and easy with spray foam insulation. The quirky look is trending on social media, but while this DIY project is fun and simple, its not risk-free. Several expanding spray foam products are available online and in home improvement stores. One thats especially well-suited to creating puffy projects is Great Stuff Big Gap Filler, a DuPont product designed to fill gaps in walls and around pipes to help keep outside air from seeping into a house or basement.

If youre looking to add a bit of foamy fun to household itemsand this project does create a pretty cool effectkeep reading to find out how to use it safely and how to get the best results.

RELATED: Hardware Store Decor: 9 Ways to Repurpose Tools

This polyurethane foam product is in liquid form in the can, but as soon as it comes into contact with air, it expands, similar to how canned whipped topping swells into billowy froths. Spray foam, however, becomes rigid as it cures, which makes it well-suited as an artistic medium for creating a bubbly frame around a mirror or a foamy-looking seat on a chair or stool. It takes about 15 minutes for the polyurethane foam to cure to a non-tacky state. Depending on humidity, it will harden in about an hour, and then the user can trim or carve it with a utility knife, if desired.

A nearly unpronounceable list of chemicals, including isobutene, methyl ether, and polymeric diisocyanate, should immediately alert users to the sealants potentially toxic nature. During applicationwhen the product is still in liquid formit off-gasses poisonous fumes that can lead to serious respiratory problems if inhaled. The fumes are also highly flammable, so using spray foam near a pilot light or lit cigarette can result in a dangerous flash-fire. For safety, create spray foam pieces outdoors where the fumes can disperse into the breeze. According to Great Stuffs manufacturer, once the foam is fully hardened and cured, it no longer presents a toxic fume threat, but remains flammable. Keep finished dcor items away from fireplaces, gas stoves, candles, and other open flames.

RELATED: A Home You Both Love: 12 Solutions for Your Biggest Decor Disputes

While its imperative to use this polyurethane spray foam outdoors for ventilation purposes, the cured foam will not withstand the elements. Rain and harsh UV rays will break down the foams structure, causing it to disintegrate. After the foam on the new project dries and hardens, bring your creation indoors to enjoy.

When used safely, spray foam insulation offers a creative way to update household furnishings; users can impart a foamy look on everything from vases and stools to picture frames. The foam expands to a bubbly, bumpy surface right out of the can, but when sprayed into a closed form, it will mold to the forms inner configuration, maintaining its shape once the form is stripped away.

With spray foam insulation, crafters and artisans are limited only by their creativity. They can even paint the foam after it hardensbut like many products used in the construction and remodeling trades, its essential to follow safety precautions to ensure a successfuland harmlessproject.

RELATED: 7 Instagrammers to Follow for the Best Home Decor Inspo

Read more:
Stop and Read This Before You Dress Up Furnishings with Spray Foam - BobVila.com

Study Design: A 2-stage study was conducted. In stage1, we performed nonassumptive deep-dive qualitative scoping to investigate the determinants of poor adherence in patients with asthma, and in stage 2 we developed a new questionnaire for cross-sectional surveys to obtain more accurate information about critical issues related to asthmamanagement.

Methods: Patients with asthma who were 18 years and older in the outpatient clinic of The First Affiliated Hospital of Xian Jiaotong University from November 2016 to January 2018 were investigated.

Results: In the 350 patients with asthma recruited, 32% of patients showed good adherence, whereas 68% of patients displayed poor adherence to inhaled therapy due to various reasons. Further analysis indicated that inadequate understanding of asthma treatment and control, poor self-management, financial burden, adverse reactions, and the fear of potential adverse reactions were significant independent risk factors for poor ICS inhalation adherence in patients with asthma.

Conclusions: Our research shows that many patients with asthma in western China have poor disease control and poor inhalation therapy adherence. We hope this research can alert clinicians and help them identify patients who may be experiencing uncontrolled asthma due to poor adherence to inhaled therapy, and we suggest that clinicians help those patients obtain appropriate information about asthma control and self-management.

Am J Manag Care. 2021;27(2):In Press

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Takeaway Points

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Asthma is a common chronic respiratory disease characterized by airway inflammation, airway hyperresponsiveness, and airway remodeling.1 It is a public health problem that causes increasing mortality and disability.2 By 2025, there will be 400 million patients with asthma in the world.3 Asthma has a negative impact on the quality of life of patients with the disease and leads to an increase in social and economic burdens.3 In recent years, the incidence of asthma in China has been rising. A national epidemiological survey from 2012 to 2015 showed that the total prevalence of asthma in China was 4.2%.4 At present, asthma prevention and control are significant challenges in China.

Inhaled drugs, the main treatment for asthma, can significantly improve asthma control.5,6 However, uncontrolled asthma is still common and a considerable burden for patients and society.7-9 An important reason for poor asthma controland, therefore, for rising costs of health careis suboptimal adherence to prescription regimens.10-13 Study findings have shown that the rate of inhaled glucocorticosteroid (ICS) adherence is less than 50% in adults.14-17 A survey based on the Australian Tasmanian cohort study reported that only 28% of patients with moderate persistent asthma and 48% of patients with severe persistent asthma were using ICS treatments regularly.15 In fact, poor patient adherence is the most frequently mentioned challenge (by 41% of physicians) in the treatment of asthma.9,18

The adherence of patients with asthma to ICS or ICS/long-acting inhaled 2 agonist (LABA) treatment depends on a number of factors that are closely related to the patients economic status, social status, and culture. Although some studies have reported risk factors or determinants of poor adherence in Chinese patients with asthma,19,20 there is very limited evidence for the determinants of adherence to inhaled asthma-control therapy across different age groups. It is still necessary to conduct in-depth research, especially to understand the reasons for poor adherence from the patientsperspective.

METHODS

Objectives

The study aimed to evaluate factors affecting adherence to ICS therapy in patients with asthma to further identify the determinants most closely associated with adherence to inhaled asthma-control therapy. This study was approved by the Ethics Committee of the First Affiliated Hospital of Xian Jiaotong University (approval No. 2016-409).

Study Design

This study included 2 stages: Stage 1 was a structured patient interview, and stage 2 was a cross-sectional survey. In stage 1, 40 patients with inadequate asthma control were invited to participate in a 1-time face-to-face interview. We interviewed patients or their guardians within the framework of 5 categories, which were summarized based on publications and the specific characteristics of Chinese society, including therapy-related factors, patient-related factors, provider-related factors, disease-related factors, and practice- and system-related factors. Then, all the factors reported by patients in stage 1 were collected and analyzed, and the top 10 factors were incorporated into the paper questionnaire (case report form [CRF]) of stage 2 to further explore the risk factors affecting patients adherence to inhalation therapy. In stage 2,350 outpatients with asthma who were 18 years or older and who visited a respiratory or asthmatic outpatient clinic in the First Affiliated Hospital of Xian Jiaotong University were invited to participate in a face-to-face interview. Each patient was interviewed only once, and informed consent and all information collection were completed at the time of visit.

Inclusion Criteria

In each study site, outpatients who met all the following criteria were included: (1) were 18 years or older, (2) lived in the same city as the study site for at least 2 years, (3) had a history of at least 1year of diagnosed asthma based on the criteria established by the Global Initiative for Asthma (GINA), (4) had inhaled ICS or ICS/LABA treatment in the past 6 months, and (5) were willing to sign the informed consent form.

Exclusion Criteria

Outpatients who met any of the following criteria were excluded: (1) patients with active cardiac or pulmonary disease (eg, bronchiectasis, chronic obstructive pulmonary disease, cystic fibrosis, pulmonary tuberculosis, lung cancer, severe heart disease) or other disorders (eg, HIV/AIDS), or patients undergoing therapy that, according to their physician, would interfere with the aim of the study; (2) patients with mental or neurological disorders, or those who were unable to understand and honestly answer questions due to alcohol or substance abuse, or those who refused to answer questions; and (3) patients with other conditions judged by the investigators as unsuitable for this study.

CRF Survey in Stage 2

Related factors (10 determinants explored from stage 1) affecting adherence to inhaled therapy were collected; to fill out the CRF in stage 2, each of the 350 patients was asked to choose yes or no for each of the 10 items. Then, all data were inputted into the online electronic questionnaire data capture system by the investigator(s), and the valid data were included in the statistical analysis.

Adherence Rate Assessment

The Medication Adherence Report Scale for Asthma (MARS-A) questionnaire is a self-reported measure of adherence to inhaled therapy. The MARS-A scale has 10 questions; it assesses intentional and unintentional nonadherence. Patients completed the scale based on their medication adherence over the past 4 weeks, and the investigator calculated the total score for each patient based on the scale. According to the score, asthma medication adherence status was divided into 2 levels: good adherence (45 points) and poor adherence (<45 points).

Asthma Control Assessment

The Asthma Control Test (ACT) was used to assess asthma control over the past 4 weeks. A score less than or equal to 19 was considered to signify asthma that was out of control. Scores greater than 19but less than 25 were considered to signify partial control. A global score of 25 indicates complete control of asthma.

Statistical Analysis

Descriptive statistics were used to summarize the study characteristics and adherence measurement. Continuous variables were presented as the mean and SD, whereas categorical variables were presented as proportions. Variables were entered into a final model using a multivariate logistic regression analysis to identify significant factors associated with asthma medication adherence status. All statistical tests were 2-sided; a P value<.05 was considered significant. All statistical analyses were performed using SPSS 22.0 software (IBM).

RESULTS

Study Characteristics

As shown in Table 1, 350 participants were recruited in stage 2 of this study. Among them, 128 (36.6%) were men and 222 (63.4%) were women. The patients were aged between 18 and 84 years, with a mean (SD) age of 43.80 (15.59) years. Among the patients, 59 (16.9%) were aged 18 to 30 years, 95 (27.1%) were aged 31 to 45 years, 59 (16.9%) were aged 46 to 60 years, and 137 (39.1%) were older than 60 years. The asthma duration of the included patients ranged from 1 to 70 years, with a mean (SD) duration of 19.51 (18.82) years. Univariate logistic statistical analysis showed no significant difference in gender, age, and duration of treatment for ICS adherence in asthma patients (P>.05) (Table 2).

Status of Adherence to Inhaled Therapy

Among these 350 outpatients with asthma included in this study, some patients discontinued ICS treatment for various reasons. According to the MARS-A questionnaire scores, 238 (68%) of the 350 patients had poor adherence to inhaled therapy and 112 (32%) had good adherence. The top 10 determinants explored from stage 1 are listed in Table3, and according to the CRF survey in stage 2, 52.9% of included patients believed that their condition had been controlled or cured, so they stopped using ICS or ICS/LABA therapy; 45.7% of patients used inhaled therapy only when their asthma symptoms were worsening or asthma was in acute attack; 30.3% of patients were afraid of potential adverse reactions, which means that these patients had suspended their treatment due to concerns about possible adverse effects of ICS treatment; 25.1% of patients had poor adherence due to forgetting to use inhaled treatment; and 15.1% of patients were unable to afford medicine because of the financial burden. In addition, other factors could also affect ICS treatment adherence in patients with asthma. For example, patients forgot to replenish with new drugs after the existing inhaled drugs were used up (12.3%); patients were unclear about the reasonable dosage, frequency, and course of inhaled treatment due to insufficient communication with doctors (12.0%); patients had an adverse reaction (eg, fungal infection of the oropharynx; hoarseness and cough due to respiratory tract irritation) after using inhaled therapy (11.7%); inhalation therapy was considered ineffective by the patient and was abandoned because the effect of inhaled treatment was not fast or not significant after treatment (10.0%); and patients were reluctant to use inhalation therapy because inhalation device operation was considered cumbersome or complicated (9.7%). At the same time, our study found that some patients had multiple risk factors that affected their treatment adherence. Among the included outpatients, 68 (19.4%) reported 2 risk factors affecting their inhaled treatment adherence, 59 (16.9%) reported 3 risk factors, and 81 (23.1%) reported 4 or more risk factors.

Determinants of ICS Treatment Adherence

To further clarify the independent risk factors affecting adherence to inhaled ICS therapy for asthma, we performed a multivariate logistic regression analysis. As shown in Table 4, the multivariable analysis indicated that independent risk factors lowering the odds of ICS therapy adherence were patients believing that their condition had been controlled or cured (odds ratio [OR], 0.28; 95% CI, 0.16-0.48; P<.01), patients using inhaled therapy only when asthma symptoms were worsening or asthma was in acute attack (OR, 0.26; 95% CI, 0.15-0.46; P<.01), patients being unable to bear the financial burden (OR, 0.36; 95% CI, 0.17-0.75; P<.01), patients having adverse reactions after using inhaled therapy (OR, 0.26; 95% CI, 0.08-0.81; P=.02), and the fear of potential adverse reactions (OR, 0.59; 95% CI, 0.49-0.95; P=.04).

Determinants Across Age Groups

In the study, included outpatients were divided into groups according to age. To further investigate the most significant independent risk factor affecting ICS therapy adherence in patients of different age groups, we performed a subgroup multivariate logistic regression analysis based on age. As shown in Table 5, subgroup multivariate analysis showed that forgetting to use inhaled drugs for a variety of reasons was the most significant independent risk factor lowering the odds of inhaled therapy adherence in patients aged 31 to 45 years (OR, 0.33; 95% CI, 0.10-0.91; P=.04). Meanwhile, insufficient communication with doctors leading to the inability to obtain adequate drug information was the most significant independent risk factor lowering the odds of inhaled therapy adherence in patients older than 60 years (OR, 0.29; 95% CI, 0.10-0.86; P=.03). However, we did not find significant independent risk factors affecting inhaled therapy adherence in patients aged 18 to 30 years and aged 46 to 60 years (P>.05).

Determinants Across Asthma Control Status

Of the 350 outpatients with asthma included in the study, most patients had poorer disease control. According to the ACT score, 119(34%) patients had asthma that was completely out of control, 201(57.4%) patients had asthma that was partially controlled, and only 30 (8.6%) patients reported complete control of their condition. To further clarify the most significant independent risk factor for ICS therapy adherence in patients with different asthma control status, we performed a subgroup multivariate logistic regression analysis. The logistic analysis indicated that adverse reaction was the most significant independent risk factor lowering the odds of inhaled therapy adherence in patients whose asthma was completely out of control (OR, 0.03; 95% CI, 0.01-0.58; P=.02). However, in patients who reported partially controlled or fully controlled asthma, we did not find significant independent risk factors affecting adherence to inhaled therapy (data shown in the eAppendix Table [available at ajmc.com]).

DISCUSSION

To our knowledge, this is the first study to assess the determinants of ICS adherence among outpatients with asthma in western China from the patients perspective. Asthma is a common chronic respiratory disease worldwide, and it is reported that there will be 400 million patients with asthma in the world by 2025.1,3 Uncontrolled asthma is common and represents a considerable burden to patients and society in western China,4 so it is necessary to have an in-depth understanding of the current state of asthma treatment and asthma control.

The GINA guideline has indicated that ICSs are currently the most effective anti-inflammatory medications for the treatment of persistent asthma, although they do not actually cure asthma.6,21-26 Compared with noninhaled administration, the ICS can be delivered directly into the airways, producing higher local concentrations with a significantly lower risk of systemic adverse effects.6 Meanwhile, LABA combined with ICS will usually be more effective when a medium dose of ICS alone fails to achieve control of asthma.27-29 Therefore, for patients with asthma, adherence to inhaled therapy is very important for controlling their condition. However, uncontrolled asthma is still a common phenomenon among outpatients with asthma.9 ICS or ICS/LABA treatment adherence in patients with asthma depends on a number of factors that are closely related to the patients economic status, social status, and culture.

Nonadherence to medical advice is common in patients with asthma and is a major cause of uncontrolled asthma. Failure to adhere to medical advice is a complex social issue in western China. Exploring patients cognition and drug preference status for their asthma treatment from their perspective can help establish effective doctor-patient relationships and improve asthma treatment adherence. In this study, our results showed that most outpatients with asthma had poorer disease control, and only 8.6% of patients reported complete control of their condition. According to the MARS-A questionnaire, 68% of the patients reported poor adherence to ICS therapy due to various reasons. The multivariate logistic regression analysis indicated that the belief that their condition had been controlled or cured, using inhaled therapy only when asthma symptoms were worsening or asthma was in acute attack, financial burden, adverse reactions after using inhaled therapy, and the fear of potential adverse reactions were the significant independent risk factors associated with ICS treatment adherence. Further subgroup analysis indicated that forgetting inhalation therapy for a variety of reasons was the most significant independent risk factor associated with inhalation treatment adherence in patients aged 31 to 45years, and the inability to obtain adequate drug information due to insufficient communication with doctors was the most significant independent risk factor in patients older than 60 years. Additionally, our results indicated that an adverse reaction was the most significant independent risk factor associated with ICS therapy adherence in patients whose asthma was completely out of control. Therefore, based on our results, we recommend that clinicians should help those patients obtain appropriate information about asthma control and self-management, and should instruct those patients not to stop ICS or ICS/LABA irregularly. Meanwhile, effective replacement treatment is necessary and important for patients with adverse reactions after inhaled therapy. If clinicians understand the risk factors affecting asthma treatment adherence from the patients perspective, they can use patient-centered communication skills to improve patients adherence to asthma treatment and improve their asthma control.

Limitations

This study had some weaknesses. First, only 350 outpatients with asthma from one tier-3 hospital in western China were recruited in this research. This is not enough to ascertain the exact extent of nonadherence to inhaled treatment in the whole population of patients with asthma. Secondly, asthma is a complex disease with many therapeutic medicines,1,30-32 including ICS,21 leukotriene modifiers,33,34 LABA,35,36 theophylline,37,38 rapid-acting inhaled 2 agonists, and so on.6 Our study focused only on the current status of ICS or ICS/LABA in asthma control and did not further explore the role of other drugs in asthma control. When considering these limitations, the results of this research should be interpreted carefully.

CONCLUSIONS

This studys findings indicate that there are multiple independent risk factors that influence ICS therapy adherence in patients with asthma, including inadequate understanding of asthma treatment and control, poor self-management, financial burden, adverse reactions, and the fear of potential adverse reactions. Thus, we hope this research can alert clinicians and help them identify patients who may be experiencing uncontrolled asthma due to poor adherence to ICS therapy. We suggest that clinicians should help those patients obtain appropriate information about asthma control and self-management. For patients with adverse reactions after ICS therapy, effective replacement treatment is strongly recommended.

Author Affiliations: Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xian Jiaotong University (JW, CZ, QW, WS, WF, XY, QZ, XX, SL, ML), Xian, Shaanxi, China.

Source of Funding: This study was supported by AstraZeneca China (study code: ESR-16-12138).

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (JW, CZ, QW, WS, XX, SL, ML); acquisition of data (CZ, QW, WS, WF, XY, QZ); analysis and interpretation of data (JW, QW, WS, WF, XY, QZ); drafting of the manuscript (JW, CZ, ML); critical revision of the manuscript for important intellectual content (JW, WF, XY, QZ); statistical analysis (CZ, QW, WS, WF, QZ, XX, SL, ML); provision of patients or study materials (JW, QW, WS, WF, XY, QZ, XX, SL); obtaining funding (ML); administrative, technical, or logistic support (CZ, XX, SL); and supervision (ML).

Address Correspondence to: Manxiang Li, PhD, MD, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Rd, Xian, Shaanxi, 710061, China.

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13. Normansell R, Kew KM, Stovold E. Interventions to improve adherence to inhaled steroids for asthma. Cochrane Database Syst Rev. 2017;4(4):CD012226. doi:10.1002/14651858.CD012226.pub2

14. Gamble J, Stevenson M, McClean E, Heaney LG. The prevalence of nonadherence in difficult asthma. Am J Respir Crit Care Med. 2009;180(9):817-822. doi:10.1164/rccm.200902-0166OC

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18. Ma Q, Wang C, Zhang Q. What are reasons for non-adherence in patients with asthma? a 24 weeks prospective telephone follow-up research. Eur Resp J. 2013;42(suppl 57):963.

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20. Zhong N, Lin J, Zheng J, et al. Uncontrolled asthma and its risk factors in adult Chinese asthma patients. Ther Adv Respir Dis. 2016;10(6):507-517. doi:10.1177/1753465816663978

21. Juniper EF, Kline PA, Vanzieleghem MA, Ramsdale EH, OByrne PM, Hargreave FE. Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis. 1990;142(4):832-836. doi:10.1164/ajrccm/142.4.832

22. Jeffery PK, Godfrey RW, Adelroth E, Nelson F, Rogers A, Johansson SA. Effects of treatment on airway inflammation and thickening of basement membrane reticular collagen in asthma. a quantitative light and electron microscopic study. Am Rev Respir Dis. 1992;145(4, pt 1):890-899. doi:10.1164/ajrccm/145.4_Pt_1.890

23. Waalkens HJ, Van Essen-Zandvliet EE, Hughes MD, et al; The Dutch CNSLD Study Group. Cessation of long-term treatment with inhaled corticosteroid (budesonide) in children with asthma results in deterioration. Am Rev Respir Dis. 1993;148(5):1252-1257. doi:10.1164/ajrccm/148.5.1252

24. Pauwels RA, Lfdahl CG, Postma DS, et al; Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. Effect of inhaled formoterol and budesonide on exacerbations of asthma. N Engl J Med. 1997;337(20):1405-1411. doi:10.1056/NEJM199711133372001

25. Szefler S, Weiss S, Tonascia J, et al; Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med. 2000;343(15):1054-1063. doi:10.1056/NEJM200010123431501

26. Perera BJ. Successful withdrawal of inhaled corticosteroids in childhood asthma. Respirology. 2005;10(3):385-388. doi:10.1111/j.1440-1843.2005.00708.x

27. Lazarus SC, Boushey HA, Fahy JV, et al; Asthma Clinical Research Network for the National Heart, Lung, and Blood Institute. Long-acting beta2-agonist monotherapy vs continued therapy with inhaled corticosteroids in patients with persistent asthma: a randomized controlled trial. JAMA. 2001;285(20):2583-2593. doi:10.1001/jama.285.20.2583

28. Lemanske RF Jr, Sorkness CA, Mauger EA, et al. Inhaled corticosteroid reduction and elimination in patients with persistent asthma receiving salmeterol: a randomized controlled trial. JAMA. 2001;285(20):2594-2603. doi:10.1001/jama.285.20.2594

29. Gibson PG, Powell H, Ducharme FM. Differential effects of maintenance long-acting beta-agonist and inhaled corticosteroid on asthma control and asthma exacerbations. J Allergy Clin Immunol. 2007;119(2):344-350. doi:10.1016/j.jaci.2006.10.043

30. Levy ML, Fletcher M, Price DB, Hausen T, Halbert RJ, Yawn BP. International Primary Care Respiratory Group (IPCRG) Guidelines: diagnosis of respiratory diseases in primary care. Prim Care Respir J. 2006;15(1):20-34. doi:10.1016/j.pcrj.2005.10.004

31. Pelaia G, Vatrella A, Maselli R. The potential of biologics for the treatment of asthma. Nat Rev Drug Discov. 2012;11(12):958-972. doi:10.1038/nrd3792

32. Papi A, Brightling C, Pedersen SE, Reddel HK. Asthma. Lancet. 2018;391(10122):783-800. doi:10.1016/S0140-6736(17)33311-1

33. Barnes NC, Miller CJ. Effect of leukotriene receptor antagonist therapy on the risk of asthma exacerbations in patients with mild to moderate asthma: an integrated analysis of zafirlukast trials. Thorax. 2000;55(6):478-483. doi:10.1136/thorax.55.6.478

34. Dicpinigaitis PV, Dobkin JB, Reichel J. Antitussive effect of the leukotriene receptor antagonist zafirlukast in subjects with cough-variant asthma. J Asthma. 2002;39(4):291-297. doi:10.1081/jas-120002285

35. Kesten S, Chapman KR, Broder I, et al. A three-month comparison of twice daily inhaled formoterol versus four times daily inhaled albuterol in the management of stable asthma. Am Rev Respir Dis. 1991;144(3, pt 1):622-625. doi:10.1164/ajrccm/144.3_Pt_1.622

36. Wenzel SE, Lumry W, Manning M, et al. Efficacy, safety, and effects on quality of life of salmeterol versus albuterol in patients with mild to moderate persistent asthma. Ann Allergy Asthma Immunol. 1998;80(6):463-470. doi:10.1016/S1081-1206(10)63068-2

37. Evans DJ, Taylor DA, Zetterstrom O, Chung KF, OConnor BJ, Barnes PJ. A comparison of low-dose inhaled budesonide plus theophylline and high-dose inhaled budesonide for moderate asthma. N Engl J Med. 1997;337(20):1412-1418. doi:10.1056/NEJM199711133372002

38. Ukena D, Harnest U, Sakalauskas R, et al. Comparison of addition of theophylline to inhaled steroid with doubling of the dose of inhaled steroid in asthma. Eur Respir J. 1997;10(12):2754-2760. doi:10.1183/09031936.97.10122754

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Determinants of ICS Therapy Adherence in Patients With Asthma - AJMC.com Managed Markets Network

How to Choose the Right Flooring for Your Finished Basement

If youre planning to finish your basement, you will want to cover up the concrete floor with a material that is more attractive and comfortable. Here are some important things to know and some flooring materials to consider.

You May Need to Repair the Floor and Install a SubfloorBefore you or a contractor can install new flooring, the concrete floor may need to be fixed. Any gaps, sections that have shifted, water damage and areas that are rough or uneven will need to be addressed.

Although many flooring materials can be installed directly on top of concrete, that may not be a good idea for a finished basement, since it can cause the floor to be cold. Installing a subfloor can provide a layer of insulation to keep the floor warm.

A subfloor can also prevent moisture damage. Since a concrete slab is porous, moisture and water vapor can travel through it. That can allow mold and mildew to form under the flooring. A vapor barrier or a waterproof subfloor can prevent that.

Popular Flooring Choices for a Finished BasementCeramic tile can be installed directly on top of concrete, as long as the surface is smooth. You may want to install a subfloor, however, to avoid having a cold floor. Ceramic tile will not be damaged by moisture. Tile flooring is available in a wide range of styles and sizes.

Rubber flooring can come in tiles or sheets. It can be a good choice because rubber is easy to keep clean, durable and waterproof, and can also provide cushioning.

Vinyl flooring is another popular choice for finished basements. Its available in planks and tiles with interlocking joints that make installation easy. Vinyl planks and tiles can be manufactured to resemble wood or ceramic tile. They can be installed right on top of concrete and can resist minor water damage.

Another option is sheet vinyl. Its durable and easy to clean, but it can be difficult to cut and install. Vinyl sheet flooring should only be installed over a subfloor. If it isnt, any rough areas on the concrete floor will be visible after the vinyl flooring has been laid.

Although many types of flooring can be installed in a basement, solid hardwood and untreated laminate flooring should not be used because they can warp and buckle from exposure to moisture. Engineered wood flooring can give you the attractive look of real hardwood with the moisture-resistant benefits of laminate construction. Engineered wood flooring has a thin layer of real wood on top of other types of wood or composite board and can give your finished basement a refined appearance.

Talk to Your ContractorSelecting the right flooring for your basement remodeling project will be one of your most important decisions. Speak with your contractor about various options and discuss the pros and cons of each so you can make the right choice.

Michael Kogler,REALTORMIKE KOGLER TEAM: #1 Sales TeamLong & Foster Real Estate, Inc. | Christies International Real EstateDelaware Coastal Properties Division37156 Rehoboth Ave., Ext.Rehoboth Beach, DE. 19971Cell:(302) 236-7648Email:michael.kogler@LNF.comWeb:www.MikeKogler.comHenlopen Sales & Rentals:www.HenlopenRB.com

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How to Choose the Right Flooring for Your Finished Basement - CapeGazette.com

KENNEBUNK Homeowners, motorists and others will have noticed some work at the sea wall between Boothby Road and Narragansett Point began a week ago.

Large boulders are being replaced with bigger boulders part of the project to repair damage caused by storms.

The project involves of replacement of 1,065 feet of stone revetment and associated restoration of the sidewalk and road.

Director of Community Development and town engineer Chris Osterrieder told the select board Jan. 26 that the work schedule is driven by tide cycles, and is expected to continue until late April.

A portion of Beach Avenue in the area is reduced to one lane and is controlled by traffic signals.

The select board on Nov. 10 approved a bid by BREX Corp. of Kennebunk for $820,000, the bulk of which will be paid by the Federal Emergency Management Agency. Kennebunks portion of the project is $82,000. The state picks up $123,000 of the tab.

BREX Corp. delivered the lowest of eight bids for the project. The most expensive bid came in at $2.1 million.

Another project, at Goochs Beach, is targeted to start in mid-February, Osterrieder said.

The $1.4 million Goochs Beach project involves replacement of 620 feet of timber sea wall with a steel sheet pile wall and associated restoration of the sidewalk and roadway. The town is responsible for about 10 percent of the cost.

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Middle Beach retaining wall project is underway - Portland Press Herald - pressherald.com

Wednesday, February 03, 2021

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KINGSTON, Jamaica Cabinet gave approval for the award of a contract in the amount of $187,662,532 to N F Barnes Construction and Equipment Company Limited for the construction of a retaining wall along Gordon Town Road, St Andrew.

Minister of Education, Youth and Information Fayval Williams made the disclosure at a Post-Cabinet Press Briefing today.

The roadway collapsed during heavy rains associated with Tropical Storm Eta in November 2020, which left many residents marooned.

While touring the area shortly after the heavy rains, the Prime Minister indicated that it would cost the Government $200 million to effect repairs to the road, Minister Williams said.

The approval of this contract means that work will begin post haste and once complete, residents will be able to utilise the corridor, she noted.

Cabinet also sanctioned the award of a contract to Health Brands Limited in the amount of $331,603,157 for the provision of X-ray films and chemicals to the National Health Fund (NHF) for a period of two years on an as-needed basis.

Approval was also given for the provision of laboratory services within the South East Regional Health Authority (SERHA) for a period of three years to Lasco Distributors Limited, in the amount of US$3,719,297.46 and a contract to GraceKennedy Payment Services Limited for the provision of coin collection services, on behalf of the Bank of Jamaica (BOJ), for a period of one year beginning February 1, 2021, in the amount of $63,344,875.

Cabinet further agreed to the variation of contract in the amount of US$540,000, by the Jamaica Tourist Board (JTB), to Finn Partners for the provision of global public relations services for a six-month period from October 2020 to March 2021.

Meanwhile, staff at the National Water Commission (NWC) will receive new uniforms following Cabinet's award of a contact in the amount of $96, 042,348 to Designs by Marc Limited, for supply and delivery.

Cabinet also gave approval for the work on the Barron Hill to Samuel Prospect Transmission Main replacement, in the amount of $200,596,875 to Bacchus Engineering Works Limited.

The project falls under phase one of the Dornoch and Greater Dornoch Water Supply Rehabilitation and Upgrading Project Trelawny/St Ann.

Now you can read the Jamaica Observer ePaper anytime, anywhere. The Jamaica Observer ePaper is available to you at home or at work, and is the same edition as the printed copy available at http://bit.ly/epaper-login

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Contract approved for construction of retaining wall along Gordon Town Road - Jamaica Observer

ANDERSON, S.C. (WSPA) The South Carolina Law Enforcement Divisions investigative report on a deputy-involved shooting in Anderson provides more details about the experiences of the deputies and teenager involved.

A 16-year-old girl was shot by deputies five times on August 11, 2020, according to her attorneys, but survived. The man she was with, Bryan Hamilton Jr., died after shooting himself in the head, the coroner determined.

Investigators used surveillance video, medical records, probation files, crime scene evidence and interviews to determine what happened on the night of August 11.

The teen told SLED investigators she was in the car with Hamilton, who had recently made a sale of marijuana when he began to flee from law enforcement. She said after they crashed, he yanked her from the car and threatened to kill her if she didnt go with him. She said he grabbed a backpack containing marijuana and a revolver and ran.

Deputies and a K9 searched for them in a wooded area by the Lowes parking lot.

Once the dog indicated they were close, his handler braced himself as if he were entering combat. He told investigators he pulled out his gun as he came around the retaining wall up the steep hill. He said through his military and SWAT training, he knew that the subjects higher advantage point would put him and his colleagues at a great disadvantage.

The teen said she and Hamilton hid in the woods in silence and were lying on their backs when the dog bit her.

Body cam time logs in the SLED report showed seconds later, a shot was heard. Deputies said they believed they were being ambushed and returned fire, with one of the deputies shooting multiple rounds one handed while trying to control the dog leash with the other.

The teen was handcuffed before being treated for her injuries, the report said.

The 16-year-old described Hamilton as psychotic and not afraid to die. Medical records obtained by SLED showed Hamilton struggled with mental health issues.

Records also revealed Hamilton had been facing the possibility of going back to prison at the time, related to his probation for assault and battery and property damage. According to SLED, records showed he had been previously been charged with possession of marijuana, domestic violence, criminal sexual conduct with a minor, assault and battery, probation violation, and burglary.

Based on the SLED investigation, the South Carolina Attorney Generals Office found the deputies use of force at the time was appropriate to the situation.

A lawsuit has been filed on behalf of that teen. A statement from one of the law firms representing her said they feel strongly that the SLED investigation is consistent with their arguments.

Anderson County Sheriff Chad McBride said in a statement they look forward to having the entirety of the evidence provided and heard in a court setting.

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SLED report reveals new details about deputy-involved shooting that injured teen, led to K9s death - WSPA 7News

Department of Public Works Deputy Mayor FitzgeraldIn regards to DPW, it has been a very busy couple of days due to the snow storm. Id like to quickly walk through a timeline of the storm over the last 48 hours.

At 9 PM Sunday night, DPW crews pre-treated the roads. Around 2 AM Monday morning when snow levels reached 4 inches, the DPW crews started plowing. At 4 AM, the full operation of plowing through the night began. At 7 AM we started picking up garbage and recycling as scheduled. Plowing continued all the way through 4 AM this morning so the full operation was going for a minimum of 24 hours; inclusive of the pre-treating, we are looking at somewhere in the neighborhood of 36 hours. This morning, once again, as scheduled we picked up garbage and recycling.

At 8 AM, the team started to do clean-ups of the intersections. It was a tremendous job. The Mayor, myself, Superintendent Ginnane, were out last night looking at all of the work. At 9 PM last night, there was still a lot of work to get done. This morning you could see the difference that was made. I would just like to point out that it is not just the roads that the Village is responsible for. It is also all of the properties, the sidewalks around the properties, the pocket parks, the Library and obviously the Firehouses, which are very important spots.

I think this storm as I was out driving around last night, that one of the biggest differences I noticed was there were hardly if any, cars on the street. That made a really big difference for the teams that are plowing, and that will make a bigger difference if there is another storm behind this storm. They were able to open up the roads to allow the residents to transverse the roads but more importantly the emergency vehicles.

There is still plenty of work to be done. They called it night a little while ago. They will be out there tomorrow morning. I really want to give a sincere thank you to the entire department for working the last 36 hours for getting the Village to where it is now. And especially a big thank you to DPW Superintendent Kevin Ginnane for orchestrating the entire operation great job. Thank you.

Recreation Department Trustee PombonyoWith February comes the start of our Winter Session II Youth, Adult and Senior Recreation Programs. Get fit and have fun with indoor, outdoor and virtual classes aerobics, yoga, zumba and tennis, to name a few. Register on February 10th and 11th at the Rec Center. See the flyer that comes in your mail or on the Village of Floral Park, Recreation Department website. For information and assistance, call 326-6336.

Conservation Society Trustee PombonyoSave the dates for the global Great Backyard Bird Count right here in our very own Centennial Gardens on Friday, February 12th, noon to 4 pm; Saturday, Feb. 13, noon to 1 pm; and Sunday, February 14th, 1 to 2 pm.

Come to the main gate on Floral Parkway and join your neighbors and friends to see and hear local ornithology expert and enthusiast Don Haug tell the fascinating stories of the many species of birds who call Centennial Gardens home or stop there during their travels. If youre a child or teen, bring your camera and enter your favorite bird photo in our Great Backyard Bird Count contest. To learn more about this very special event, check the beautiful Floral Park Centennial Gardens Facebook page, the Conservation Society website at fpgarden.org and the global website at birdcount.org for fabulous facts and photos.

Covert Avenue Chamber of Commerce and Our Businesses Trustee PombonyoRegarding the September 27th fire follow-up, please refer to the Village of Floral Park website Village News for a January 27th Building Department summary of recent fire restoration activity. As of now, the asbestos abatement has been completed. Mondays snowstorm may delay debris clean-up until the contractors once again have safe access to the buildings. As the interior debris is fully removed, the property owners architects will continue to work with Renee Marcus, our Building Department Superintendent, to develop plans for the future use of the property, the details of which remain uncertain until the viability of the remaining parts of the structure is fully assessed.

And, today, as we all get back to normal after the big snowstorm and thank our Village DPW staff for spending over thirty-six hours clearing snow from our streets, visit our local businesses. You wont have to drive very far to SHOP, DINE AND TAKE OUT LOCAL. Enjoy winter in the Village of Floral Park, its beautiful!

Fire Department Trustee ChengThank you to DPW for the snow removal at all of the Village Firehouse. The Fire Department calls for the month of January were Rescue-92; rest of Department-24. As a reminder, if there is a fire hydrant in front of your house, please clear snow in a three (3) foot radius of the hydrant and create a path from the street to the hydrant. Every second counts in responding to a fire. The officer and the chauffeur may not know the location of the nearest hydrant and even if they do, members have to waste valuable time to dig out the hydrant. If the nearest hydrant on your block has not been dug out, please adopt that hydrant and do the job your neighbor couldnt or wouldnt. This act might save you or your neighbors.

Third Track & LIRR Trustee ChengBird netting will be installed underneath the newly modified Plainfield Avenue Bridge this month. Intermittent lane closures will be necessary to facilitate this work. Crews are continuing the process of testing the new Floral Park Station elevators to ensure complete functionality and that safety requirements are met. The elevators are expected to be open for public use this winter.Retaining wall construction is underway along the Hempstead Branch, from Tunnel Street heading east into the sump along the north side of the tracks. This retaining wall is being installed to support new railroad switches on the Hempstead Branch and will allow trains to move from track to track more easily. Throughout the month of February, crews will continue to set steel posts, pour concrete, and set wall panels along the right-of-way. Retaining wall construction is beginning along the right-of-way, on the south side of the tracks, from Carnation Avenue to Childs Avenue. As a result, Atlantic Avenue, between Carnation Avenue and Childs Avenue, will be limited to local traffic only for the duration of this activity. Permanent wooden utility poles have been installed along the railroad right-of-way throughout the Village of Floral Park. Crews will safely relocate cables from temporary poles to permanent poles. Once utility lines have been relocated, temporary utility poles will begin to be removed throughout the Village. Intermittent lane closures may be necessary in order to facilitate this work and heavy construction equipment including cranes, bucket trucks, and more will be utilized.I am very thankful for our creative library staff for their continued efforts, constantly offering new activities to our community during these times. They are really showing their talents and abilities, by keeping connected to our community, encouraging us to stay active and vibrant. Continue to check the Library website http://www.floralparklibrary.org and Facebook page for current events and programs.

Police Department Trustee ChiaraOur Police Department continues to increase traffic enforcement efforts to keep our streets safe and to help with a reduction of vehicle accident. Recently the Department conducted a Truck Safety Inspection where 75 summonses were issued. Hopefully this will send a strong message that unsafe trucks will not be tolerated in our Village.

Last year Governor Cuomo directed all Police Departments in New York State to conduct an inclusive process as part of the New York State Police Reform and Reinvention Collaborative. We here in the Village of Floral Park formed a committee, a cross sections of individuals who are representative of our community. The committee, with the assistance of guidelines issued by the State, has met a number of times. During these meetings the members discussed the Floral Park Police Departments current policies and practices relative to how they meet the needs of our community. A draft document is being created that will eventually be ratified and adopted by our local government, then submitted to the State.

Most importantly, BEFORE, being ratified and submitted to the State, this draft document will be distributed to our residents for review and input. Our residents will have the opportunity to make comments, recommendations, and ask questions concerning the Villages Police Reform and Reinvention Collaborative. Residents who wish to participate will be able to do so by sending in their comments, suggestions or questions to the committee via an established email address. There will also be a meeting scheduled for an open forum to discuss the presented document.

I would like to encourage all residents to take some time to read this draft document and participate in the process. It is a good opportunity to learn about how our Police Department is currently performing their duties and how they interact with our community. All recommendations, questions and comments are welcome.

Library Trustee ChiaraThe library is encouraging all its patrons to continually check their Library homepage for updates on their offered programs. New and exciting program are scheduled throughout the month. The Library will be closed on Presidents Day, February 15, 2021.

Mayors Report Mayor LongobardiMayor Longobardi thanked the Floral Park Department of Public Works, Fire Department, Police Department and Village staff for their outstanding efforts during the storm. This coordinated response kept the residents safe and sound, the roads open, and the ability to provide emergency response up to par. Accomplishing this is no easy feat and takes a lot of effort and tireless dedication by all officers and employees involved. It is still snowing as I speak, and again thank you to everyone for an amazing job. Thank you and stay safe.

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Floral Park Board of Trustees reports Feb. 2 - The Island Now

District 47 - West TN NorthernDYER COUNTY, SR-3 (US-51): The repair of bridges on US 51 (SR 3) over SR 211 in Dyersburg will cause temporary lane closures throughout the project. *Speed limit has been reduced to 55 MPH.

DYER COUNTY, SR-3 (US-51): The repair of bridges on US 51 (SR 3) over the South Fork Forked Deer River will cause temporary lane closures throughout the project. *Speed limit has been reduced to 55/45 MPH.Restrictions: Beginning January 25, 2021, Traffic will be reduced to one lane in each direction with a 12 6 lane restriction.

DYER COUNTY, SR-20: The repair of bridge on US 412 (SR 20) over Hogwallow Road will cause temporary lane closures throughout the project. *Speed limit has been reduced to 55 MPH

GIBSON COUNTY, SR-43 (Non-TDOT work):Wednesday, February 3, 7:00 a.m.-1:00 p.m.: There will be a temporary lane closure to cut asphalt, remove and replace with 33c crushed stone temporary based (left overnight).

Thursday, February 4, 7:00 a.m.4:00 p. m.: There will be a temporary lane closure to excavate for the point repair and complete repair, backfill with TDOT No. 57 crushed stone and 33c base (left overnight)

Friday, February 5, 11:00 a.m.1:00 p.m.: There will be a possible temporary lane closure for asphalt repair.

HENDERSON COUNTY (New Lexington By-Pass): The grading, drainage, construction of bridges and retaining walls, signals and paving on US 412 (SR 459) from US 412 (SR 20) west of Lexington to near SR 22 south of Lexington. Motorists should watch for trucks entering and exiting the roadway.

HENRY COUNTY, SR-54: The grading, drainage, construction of bridges, retaining wall and paving on SR 54 from near Rison Street to near Smith Road. Motorists should watch for trucks entering and exiting the roadway. *Speed limit has been reduced to 35 MPH.

OBION COUNTY, Future I-69 (Phase 3): Grading, drainage, construction of bridges and paving on future I-69 from west of SR 21 to US 51 (SR 3) will cause possible lane closures throughout the project.

Tuesday, October 13, 2020: Bethlehem Road north from Clifford Rives Road to Lindenwood Road will be closed. Claude Tucker Road north from Cloys Road to Section Line Road will be closed. Detour routes are posted.

WEAKLEY COUNTY, US 45E (SR-43): The repair of bridge on US 45E (SR 43) over the North Fork Obion River and Overflow will cause possible temporary lane closures throughout the project.

TDOT District 47 MAINTENANCE:

Wednesday, February 3 through Wednesday, February 10, 9:00 a.m.-3:00 p.m.: There will be possible lane closures at various locations in Region IV in order to repair pavement on an as needed basis.

District 48 - West TN Middle/Southern

CROCKETT COUNTY, SR-20 (US 412) (Non-TDOT work):

Wednesday, February 3 through Wednesday, February 10, 7:00 a.m.-5:00 p.m.: There will be possible lane closures on SR 20 (US 412) east and westbound in Bells, TN at SR 88, for the installation of a turning lane in the median and shoulder upgrades.

DECATUR COUNTY, I-40: Wednesday, February 3, 8:30 a.m.-2:30 p.m.: There will be lane closures on I-40 east and westbound in Henderson and Decatur counties MM 95-126 for pothole repair.

HARDIN COUNTY, SR-69: The construction of a Bulb Tee bridge over Doe Creek along with grading, drainage, and paving may cause temporary lane closures on SR 69 at LM 10.06. Motorists should watch for trucks entering and exiting the roadway.

HARDIN COUNTY, SR-128: The grading, drainage and paving on SR 128 from south of Pyburns Drive (LM 3.11) to north of SR 226 (Airport Road) (LM 6.54). Motorists should watch for trucks entering and exiting the roadway.

HAYWOOD COUNTY, SR-19 (Brownsville Bypass): The construction of an I-Beam bridge along with grading, drainage, and paving may cause temporary lane closures on SR 19 (Brownsville Bypass) from east of SR 87 to west of Windrow Rd. One lane will remain. Motorists should watch for trucks entering and exiting the roadway. Speed limit is reduced to 45 MPH within the project limits. Shaw Chapel and King Road are closed at SR 19 and a detour put in place. Haralson St (Old SR19) will be closed at SR19 Bypass beginning Wednesday 11-4-2020 and a detour put in place.

HENDERSON COUNTY, S.R. 22: The repair of the bridges on S.R. 22 over Big Beaver Creek (L.M. 19.51) and Little Beaver Creek (L.M. 20.01). Restrictions: Beginning February 1, 2020 there will be a 12 width restriction put in place. Motorists should watch for crews and equipment in the roadways. One lane will remain open in both directions.

HENDERSON COUNTY, I-40: Wednesday, February 3, 8:30 a.m.-2:30 p.m.: There will be lane closures on I-40 east and westbound in Henderson and Decatur counties MM 95.0-126.0 for pothole repair.

MADISON COUNTY, I-40: Thursday, February 4, 8:30 a.m.-2:30 p.m.: There will be lane closures on I-40 east and westbound in Madison county MM 67.0-95.0 for pothole repair.

MADISON COUNTY, I-40: The widening of I-40 east of US 45 (SR 5) MM 82.0 to east of US 70

(SR 1) MM 87.0 in Jackson, including bridges, retaining walls and installation of TDOT Smartway Intelligent Transportation System.

Wednesday, February 3 through Wednesday, February 10, 7:00 a.m.-6:00 p.m.: Campbell St. will be down to one lane in each direction over I-40 for Phase 1 bridge construction activities.

Wednesday, February 3, and Thursday. February 4, 7:00 p.m.-6:00 a.m.: I-40 east and westbound will have intermittent left and right lane closures from Exit 79 to Exit 82 for hydro blasting and placing of barrier rail.

Sunday, February 7 through Tuesday, February 9, 7:00 p.m.-6:00 a.m.: I-40 east and westbound will have intermittent left and right lane closures from Exit 79 to Exit 82 for hydro blasting and placing of barrier rail.

Closed until Summer of 2021: Old Henderson Rd. Bridge over I-40 will be closed to thru traffic for Phase 1 bridge demolition activities. Detours will be posted for traffic.

Closed until Summer of 2021: Watson Rd. Bridge over I-40 will be closed to thru traffic for Phase 1 bridge demolition activities. Detours will be posted for traffic.

LOOK AHEAD

Wednesday, February 10 through Wednesday, February 17, 7:00 a.m.-6:00 p.m.: Campbell St. will be down to one lane in each direction over I-40 for Phase 1 bridge construction activities.

MADISON COUNTY, SR-186 (US 45 Bypass) and I-40: Interchange improvements on SR 186 (US 45) north and southbound from the I-40 ramps to Old Hickory Blvd for paving and construction of retaining walls. Widening of I-40 from just east of Exit 79 to just east of Exit 82.

Thursday, February 4 and Friday, February 5, 9:00 a.m.3:00 p.m.: SR 5 (Highland Avenue) will have intermittent left and right lane closures both north and southbound from Vann Drive to the Carriage House/Ridgecrest intersection for signal installation activities.

Monday, February 8 through Wednesday, February 10, 9:00 a.m.3:00 p.m.: SR 5 (Highland Avenue) will have intermittent left and right lane closures both north and southbound from Vann Drive to the Carriage House/Ridgecrest intersection for signal installation activities.

LOOK AHEAD

Thursday, February 11 and Friday, February 12, 9:00 a.m.3:00 p.m.: SR 5 (Highland Avenue) will have intermittent left and right lane closures both north and southbound from Vann Drive to the Carriage House/Ridgecrest intersection for signal installation activities.

Monday, February 15 through Wednesday, February 17, 9:00 a.m.3:00 p.m.: SR 5 (Highland Avenue) will have intermittent left and right lane closures both north and southbound from Vann Drive to the Carriage House/Ridgecrest intersection for signal installation activities.

Monday, February 15 through Wednesday, February 17, 8:00 p.m.6:00 a.m.: I-40 east and westbound will have intermittent left and right lane closures from mile marker 79 to mile marker 82 for overhead sign installation.

MADISON COUNTY, SR-198 (East Chester) (Non-TDOT work):

Wednesday, February 3, 9:00 a.m.-4:00 p.m.: There will be a temporary lane closure on SR 198 eastbound between Belmont Avenue and Lenoir Street for sewer work.

TDOT District 48 MAINTENANCE:

Wednesday, February 3 through Wednesday, February 10, 9:00 a.m.-3:00 p.m.: There will be possible lane closures at various locations in Region IV in order to repair pavement on an as needed basis.

HQ BRIDGE REPAIR AND INSPECTION:

Wednesday, February 3, 8:00 a.m.-12:00 p.m.: There will be temporary closures on SR-1 (US 70) east and west bound for deck sounding at LM 26.89.

District 49 - West TN Southwest

FAYETTE COUNTY, I-40:

February 4, 9:00 a.m.-5:00 p.m.: There will be a temporary lane closure I-40 eastbound near

SR-196 for bridge deck repair.

FAYETTE COUNTY, SR-196: The repair of bridge over Shaw Creek will cause a lane closure with temporary traffic signal near MM 7.0.

SHELBY COUNTY, I-40 & I-240: ITS Preventative Maintenance Contract lane and ramp closures to install overhead signs.

LOOK AHEAD:

Friday, February 12, 8:00 p.m.-6:00 a.m.: There will be nighttime ramp closures in Shelby County to install overhead signs at the I-240 northbound EXIT 31 to I-40 westbound and the I-240 northbound EXIT 31 On ramp from Madison Ave to I-40 westbound. Traffic will be detoured via Exit 2 to Chelsea Ave during operation.Weather Permitting.

Friday, February 12, 8:00 p.m.-6:00 a.m.: There will be intermittent lane closures on I-40 east and westbound between MM 1.0 and MM 2.0 for installing overhead signs. Traffic will be reduced to one lane westbound. Weather Permitting.

SHELBY COUNTY, SR-14: The grading, drainage, construction of concrete Bulb-Tee and I-beam bridges, signals and paving on SR 14 from east of Old Covington Pike to SR 385 will cause possible lane closures throughout the project. *Speed limit has been reduced to 45 MPH.

SHELBY COUNTY, SR-14: Construction on SR 14 for a widening project from SR 385 to east of Kerrville Rosemark Rd. There will be possible temporary lane closures throughout the project. Access to SR 14 from McCalla Rd West will be permanently detoured to Donnell Rd. *Speed limit has been reduced to 45 MPH.

SHELBY COUNTY, SR-205: The addition of turn lanes on SR 205 (Airline Rd) from Brooks River Drive to south of I 40 will have lane closures throughout the project.

Thursday, February 4 through Wednesday, February 10, 9:00 a.m.-3:00 p.m.: There will be intermittent lane closures on SR 205 north and southbound from Brooks River Drive (LM 15.75) to just south of I-40 (LM 16.07) to perform temporary road widening work. There will be one lane traffic with flaggers present at times. *Speed limit has been reduced to 35 MPH. Weather Permitting.

TIPTON COUNTY, SR-59: The Emergency Slide Repair of SR 59 near MM 1.0 will cause a road closure with full detour signed.

TDOT District 49 On-Call Guardrail/Concrete Barrier Rail Repair

Thursday, February 4 through Wednesday, February 10, 9:00 a.m.-12:00 p.m.: There will be daytime lane closures at various locations on SR 195, MM 3.0-MM 3.4 (Fayette County) and SR 206, MM 2.3 (Tipton County.) One lane will be closed. Flagmen will be used to direct traffic. Weather Permitting.

Wednesday, February 3 through Tuesday, February 9, 8:00 p.m.-6:00 a.m.: There will be night time lane closures at various locations on SR 3 (Shelby County), SR 385 (Shelby County), SR 14 (Shelby County), SR 15 (Shelby County), I-40 (Fayette and Shelby Counties), I-269 (Shelby and Fayette Counties), I-55 and I-240. One lane will be CLOSED to repair damaged guardrail. THP will assist with traffic control. Weather Permitting.

Wednesday, February 3 through Tuesday, February 9, 8:00 p.m.-6:00 a.m.: There will be nighttime ramp closures in Shelby County at the I-55 southbound EXIT 6B to I-240 northbound,

I-240 westbound EXIT 25A to I-55 southbound, and the SR 385 westbound On ramp from Hacks Cross. Weather Permitting.

LOOK AHEAD:

Wednesday, February 10 through Tuesday, February 16, 8:00 p.m.-6:00 a.m.: There will be nighttime ramp closures in Shelby County at the I-55 southbound EXIT 6B to I-240 northbound,

I-240 westbound EXIT 25A to I-55 southbound, and the SR 385 westbound On ramp from Hacks Cross. Weather Permitting.

TDOT District 49 MAINTENANCEThursday, February 4 through Wednesday, February 10, 9:00 a.m.-3:00 p.m.: There will be possible lane closures on all interstates and state routes in District 49 for routine maintenance activities on an as needed basis.

TDOT District 49 On-Call Sweeping and Drain Cleaning

Monday, February 8 through Thursday, February 11, 8:00 p.m.-6:00 a.m.: There will be nighttime lane closures on I-240 north and southbound from I-40 (MM 13.0 to MM 26.0) and I-40 east and westbound from Summer Avenue (MM 11.0) to Germantown Parkway (MM 16.0) for the purpose of drain cleaning. Weather Permitting.

From your desktop or mobile device, get the latest construction activity and live streaming SmartWay traffic cameras at http://www.TNSmartWay.com/Traffic. Travelers can also dial 511 from any land-line or cellular phone for travel information, or follow us on Twitter at http://www.twitter.com/TN511 for statewide travel or for West Tennessee follow https://twitter.com/NicLawrenceTDOT.

As always, drivers are reminded to use all motorist information tools wisely and Know Before You Go! by checking travel conditions before leaving for your destination. Drivers should never tweet, text or talk on a cell phone while behind the wheel.

In 2016, the Tennessee Department of Transportation lost three workers in the line of duty. All three were struck by passing motorists. Those tragedies bring the total number of TDOT lives lost to 112. We dont want to lose another member of our TDOT family. Were asking you to WORK WITH US. Click on the WORK WITH US logo to learn more.

Read the rest here:
West Tennessee Weekly Construction February 3-10, 2021 - tn.gov

ANDERSON, S.C. (WSPA) The South Carolina Law Enforcement Divisions investigative report on a deputy-involved shooting in Anderson provides more details about the experiences of the deputies and teenager involved.

A 16-year-old girl was shot by deputies five times on August 11, 2020, according to her attorneys, but survived. The man she was with, Bryan Hamilton Jr., died after shooting himself in the head, the coroner determined.

Investigators used surveillance video, medical records, probation files, crime scene evidence and interviews to determine what happened on the night of August 11.

The teen told SLED investigators she was in the car with Hamilton, who had recently made a sale of marijuana when he began to flee from law enforcement. She said after they crashed, he yanked her from the car and threatened to kill her if she didnt go with him. She said he grabbed a backpack containing marijuana and a revolver and ran.

Deputies and a K9 searched for them in a wooded area by the Lowes parking lot.

Once the dog indicated they were close, his handler braced himself as if he were entering combat. He told investigators he pulled out his gun as he came around the retaining wall up the steep hill. He said through his military and SWAT training, he knew that the subjects higher advantage point would put him and his colleagues at a great disadvantage.

The teen said she and Hamilton hid in the woods in silence and were lying on their backs when the dog bit her.

Body cam time logs in the SLED report showed seconds later, a shot was heard. Deputies said they believed they were being ambushed and returned fire, with one of the deputies shooting multiple rounds one handed while trying to control the dog leash with the other.

The teen was handcuffed before being treated for her injuries, the report said.

The 16-year-old described Hamilton as psychotic and not afraid to die. Medical records obtained by SLED showed Hamilton struggled with mental health issues.

Records also revealed Hamilton had been facing the possibility of going back to prison at the time, related to his probation for assault and battery and property damage. According to SLED, records showed he had been previously been charged with possession of marijuana, domestic violence, criminal sexual conduct with a minor, assault and battery, probation violation, and burglary.

Based on the SLED investigation, the South Carolina Attorney Generals Office found the deputies use of force at the time was appropriate to the situation.

A lawsuit has been filed on behalf of that teen. A statement from one of the law firms representing her said they feel strongly that the SLED investigation is consistent with their arguments.

Anderson County Sheriff Chad McBride said in a statement they look forward to having the entirety of the evidence provided and heard in a court setting.

More:
SLED investigative report reveals new details about deputy-involved shooting that injured teen and led to K9s death - WSPA 7News