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    8 Types of Windows To Consider For Your Home – Forbes - April 24, 2021 by Mr HomeBuilder

    Editorial Note: Forbes may earn a commission on sales made from partner links on this page, but that doesn't affect our editors' opinions or evaluations.

    Free, No-commitment Estimates

    Windows offer a view of the world. But, when you dig deeper, youll see that different window styles have different advantages and disadvantages. From shape to the amount of ventilation they provide to the all-important cost factor, there is a lot to keep in mind as you select window styles.

    Natural light is a popular selling feature for homes, so making a wise choice with your window selection can be a great return on investment. Whether you are building or remodeling, choose the types of windows that meet your needs for lighting, function and price.

    Also known as crank windows for the method used to open them, casement windows swing from a hinge, just like a door. The strong seal around these windows means they are generally weathertight. The swing function also allows for a great amount of airflow when desired.

    Screens can fit securely inside the window, which can be helpful for cleaning purposes. On average, individual casement windows cost $300 to $750 installed.

    With casement windows, youll need to keep in mind the design of your home to ensure open windows match with each other and sides of the home. Casement windows are not ideal for securing window air conditioning units, so beware if you depend on that method of cooling.

    The most common window style, double-hung or single-hung windows slide along a vertical track to open. Although these two types of windows look just about the same, the distinction between them is single-hung windows only open from the bottom half.

    Unlike casement windows that swing outward, you dont need to worry about double- or single-hung windows bumping into each other or anything on the exterior or the house.

    These classic windows provide good ventilation, offer access for cleaning and are easier to replace than more unique window styles. Because they work against gravity, double- or single-hung windows may not stay open as desired if not properly maintained.

    Double-hung windows cost slightly more than their single-hung siblings, but both are relatively budget-friendly window options with an average price point of $200 to $1,000 per window installed.

    Locked in place and unmoving, picture windows dont obstruct the outside view, which can provide a real wow factor. The big drawback? There is no airflow with these windows. Without any opening mechanisms, the upkeep is simple and the seal will be weathertight.

    On the downside, picture windows arent exactly energy-efficient, at least compared to solid walls. The heat from inside the home may escape during cooler months while sunlight streaming through the picture window may overheat the interior space in warmer months.

    Because there are no mechanical elements, picture windows offer good bang for the buck when you want a lot of natural light. Depending on size and shape, each picture window costs an average of $150 to $750 installed.

    Both functional and an interesting design feature, the term bay windows describes windows grouped together to extend from the house. On the inside, this can create a bay or shelf. The individual windows in a bay window group meet at angles. Bow windows are similar, but the design is curved without angles between windows.

    If youre doing a remodel and want to add bay windows where there is currently an exterior wall, expect a significant expense in the $1,150 to $3,550 range. If youre just swapping windows in an existing bay window arrangement, the price will depend on the style of the specific window.

    In a typical bay window arrangement, the center window is a fixed picture window while the two flanking windows may be casement, single- or double-hung windows.

    A more common option for horizontal window orientations, sliding windows work much like they sound: by one section sliding over another, just like sliding glass doors. This can allow for great airflow and relatively good sealing.

    Sliders are often used for basement egress windows but may lack the sophisticated look for areas where curb appeal is a bigger concern.

    Other than a lock, sliders dont have mechanical components, which helps with the upkeep and overall cost. On average, sliders cost $400 to $1,300 to installwith the top range representing quite large sliding windows.

    These windows get their name from the awning-like protection they provide when open. This makes them good options if you like to keep your windows open during rainfall. With hinges at the top, awning windows are paired above, below or to the side of a picture window.

    Unlike casement windows, which open along a vertical plane, awning windows open from the top of the frame. The crank mechanism is easy to operate and creates a tight seal when not in use. When open, they allow for decent airflow.

    The downside of this is awning windows protrude outward and may obstruct walkways. If used on a second floor or higher up on the wall, this issue can be avoided. Average costs to install awning windows are $350 to $900 per window.

    Available in a variety of styles from stained glass to glass blocks, decorative glass windows are generally stationary. The purpose of these windows can be two-fold: They deliver a nice design point and can provide some privacy. For that reason, they are often found near front doors or in bathrooms.

    Although they offer natural light to the interior, decorative glass windows are not the way to go if you want an exterior view. The installation cost for glass blocks ranges from $375 to $800.

    A great solution for providing natural light to interior rooms, skylights are built into the roof. Skylights can be either fixed or ventable. Types that open are similar to a casement or awning window in that they open with a hinge.

    Although you shouldnt expect a skylight to open completely, even a bit of venting can provide welcome airflow to a space.

    The greatest benefit to skylights is the natural light. For new installations, this comes at a price. Average skylight installation costs run from $900 to $2,150 per window.

    Free, No-commitment Estimates

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    8 Types of Windows To Consider For Your Home - Forbes

    Indianapolis Roofing Contractor is Proud to Be Serving the Greater Indianapolis, IN, Area – Press Release – Digital Journal - April 24, 2021 by Mr HomeBuilder

    Indianapolis, IN - Half Price Roof Indianapolis is family-owned and known for offering excellent roofing services. The roofing company has several 5-star customer ratings and has employed experienced roofers to provide quality commercial and residential services. From roof replacement, repair, kitchen remodeling, and more, this company takes pride in assisting clients to get what they need. Clients are welcome to browse the company's portfolios on its site.

    It doesn't matter if one doesn't have the skills or experience to handle roofing tasks because Half Price Roof will ensure professionals with the right tools handle the project. Not only is the team certified, but it understands what techniques to use to ensure the project is completed on time.

    "Roofs are essential components to both residential and commercial properties. They will also increase the property's value, but they will offer protection to you and your loved ones. Half Price Roof Indianapolis provides a wide range of roofing services that will ensure you have a beautiful, high-quality, and durable roof. From ready-made to custom-made, our products and services will be worthwhile," said the company's Oswald Baker.

    Additionally, Half Price Roof's roofing Indianapolis IN team is always prepared to help clients with window, siding, and gutter installation. They will also help them with other roofing projects if required. Homes with cracked siding or windows with warped frames may need to be assessed by a roofer to avoid further damage as there is a chance that the furnace or air conditioning system is overworked. Half Price Roof is there for homeowners who are looking to get the issues resolved.

    When it comes to kitchen or bathroom remodeling, the team at Half Price Roof doesn't think one method is the answer to making sure the project goes smoothly. They will find time to talk to the client, listen to their needs, record the measurements and offer the ideal solution suitable for the client. Half Price Roof can bring to life the client's vision and ensure the client is satisfied with the outcome. The company also provides various designs from which the client can pick.

    Half Price Roof Indianapolis offers waterproof and mold-resistant products that will be helpful in case of water damage. They will detect the water leak issue in the basement and do what they know best to prevent the problem from occurring in the future. The professional team can also offer basement waterproofing. Clients who need same-day estimates can call Half Price Roof to get instant quotes. The company will make sure that the basement waterproofing project is handled with the utmost professionalism. They will strive to make sure the client is satisfied.

    Half Price Roof Indianapolis is located at 4120 W 47th St, Indianapolis, IN, 46254, United States. For roofing services or additional questions, call the team at (513)-440-3580; they are available 24/7. Visit the company's site at https://www.halfpriceroof.com/roofing-indianapolis/ for more information about the roofing services or an instant estimate.

    Media ContactCompany Name: Half Price Roof IndianapolisContact Person: Oswald BakerEmail: Send EmailPhone: (513)-440-3580Address:4120 W 47th St City: IndianapolisState: INCountry: United StatesWebsite: https://www.halfpriceroof.com/roofing-indianapolis/

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    Indianapolis Roofing Contractor is Proud to Be Serving the Greater Indianapolis, IN, Area - Press Release - Digital Journal

    Files of the Times | Community | falloncountyextra.com – Fallon County Extra - April 24, 2021 by Mr HomeBuilder

    Friday, April 29, 2011 --

    Candidates seeking election for school trustee positions are interviewed. Candidates are Steve Baldwin., Kevin Dukart, Shawna Knipp and Tom Muckle. There are two trustee seats open for election. . .High Tech Construction broke ground at the Longfellow School April 20 in preparation for building a new gymnasium. The first phase of the project is building the new gymnasium. Phase two will be the remodeling of the old gym into a music room and classrooms. All this should be done by fall of 2012. . .J & M Lumber will celebrate their eighth anniversary and customer appreciation day May 7. . .Brandon Schmidt is the newest employee at the Fallon County Federal Credit Union. . .The High School/YRA Rodeo held April 23-24 was a great success with approximately 60 entries and close to 200 attendees. Sunday, children participated in an egg hunt immediately followed by Cowboy Church led by Bruce Ketchum. . .Nellie Rost will celebrate her 85th birthday May 8 at the Marmarth Community Center.

    Thursday, April 27, 2001 --

    The Montana liquor store has a change of name, owner and location. Now called Spirits Plus, it is located at 15 South Main, Baker and is owned and operated by Russ Stoddard. . .2001 delegates to the Montana American Legion Auxiliary Girls State from Baker and Plevna schools are Michelle Becker and Maranda Zachmann of Baker and Leanne Klos from Plevna. . .Students in Lynnda Evans after school French class will present their spring program May 2. . .Delphine Maier has taken over the duties as Welcome Wagon representative from Helen Rieger. . .High temperature April 18 was 73 degrees. . .Employees of Fallon County Library served cake and coffee at an open house in honor of their volunteers. Those special ladies are Maxine Winters, Lauretta Stenglein, Eunice Higgins. Betty Kusler and Arleen Graham. . .April 8 a drilling derrick in the South Pine Unit north of Baker collapsed and fell to the ground, seriously injuring Jeff McGillivray of Chinook. McGillivray was at the top of the derrick when it fell. He was transported to Fallon Medical Complex and transfered to Holy Rosary Hospital. He was later transferred to Billings Deaconess and is much improved.

    Thursday, April 25, 1991 --

    Robert Singer, clerk at the Baker Post Office, has been named Local Postal Volunteer of the Year. Postmaster Mike Mangen presented Robert with a certificate of appreciation signed by Postmaster General Anthony M. Frank. . .Bakers interest in developing an industrial park have not been discarded. Monday evening following discussion with Dr. Pierce Parker and Charles Henry of Pierce International, community members who had not pledged funds voted to support the continuation of the project. The Industrial Park complex would consist of a 25 acre core park that would contain diversified support companies to provide services for larger manufacturing plants. . .Statewide average price of unleaded gasoline at self-service pumps is $1.14. . .The benefit dinner and auction for John Reetz, son of James and LaTonne Reetz, netted $6,477.76. John has cancer and may have to undergo a bone marrow transplant.

    Thursday, April 23, 1981 --

    A 1977 black Ford pickup with a yellow stripe was reported missing from the driveway of the Don Groshans, Sr. home April 18. The pickup, belonging to Don Groshans, Jr. of Glasgow, was unlocked and full of gas. . .Prom royalty candidates are Kurt Schell, Barb Mahon, Jeff Varner, Colette Hurley, Marie Lund, Kevin Helfrich and Sandy Engesser. . .Marge Koenig, Lillian Jensen and Frances Sikorski will be attending the Democratic Womens regional conference in Glendive this month. . .Leon Newell, Chief of the local fire unit, presented the city council with a list of specs for a new fire truck, costing $83,000. . .The New Horizons Health Spa has opened. They are located at 207 Young Ave., Stanhope Addition.

    Thursday, April 29, 1971 --

    John Brown is named valedictorian of the class of 1971 at Baker High School. Dennis Bechtold is salutatorian. . .Baker will stay in the same basketball district as last year. . .Harold Jensen is elected president of the OFallon Historical Society. Other officers are Marion Hanson, Lillian Jensen and Forrest Duffield. . .T. V. Critchfield guided representatives from the Montana Fish and Game Department to the Arnold Pinnow and Art Meccage ranches where they planted 7,000 trout. . .Leo Riley recently captured two baby beavers during a trapping expedition. . .Special recognition was given to L. F. Bruggeman, Baker High School Principal, at the District Music Festival in Glendive. Bruggeman has been taking music students to festival for 35 years. . .Bev Breitbach has been named winner of the BHS John Phillip Sousa award as outstanding senior band student.

    Thursday, April 27, 1961 --

    Delila Fried, daughter of Mr. and Mrs. Emil Fried, and Kay Rediske, daughter of Mr. and Mrs. Sheldon Rediske, share the honor of co-valedictorians for the class of 1961. Arthur Linden, son of Mrs. Lena Linden, is salutatorian. . .Lee Stevenson was elected president of the Montana Funeral Directors Association. . .Mrs. Richard Vilhauer is elected president of the Baker Jaycee Jaynes; Mrs. Arlene Steffes, vice president; Mrs. Leland Gundlach, secretary; and Mrs. Bernell Pfeifle, treasurer. . .Frank Lewis, incoming superintendent of Baker schools, visited Baker. . .Mrs. Fredric Bruggeman has prepared a history of the Baker Homemakers Club in recognition of National Home Demonstration Week. . .Delila Fried, Judy Hatton, Art Linden, Tom Olson and Robert Yokley attend the annual High School Week at Montana State in Bozeman.

    Thursday, April 26, 1951 --

    A group of rural farmers and citizens met April 23, in the courtroom of the courthouse to take part in the discussion and planning of a rain-making project. This project is designed to increase the natural rainfall between the dates of May 1 and September 1. Since the western states are so dry, many are participating in rain-making, and more than 100 million acres are already under contract for cloud-seeding. . .Mr. John Gray, manager, Montana State Employment Service, Miles City, MT announces the appointment of Clarence Heiser, Heisers Bar, Baker, MT, as Farm Placement Representative. . .The Baker Library is richer by a number of current best sellers, which were given by Mr. and Mrs. Larry Busch.

    Thursday, April 24, 1941 --

    Lieutenant James Ovens, Army reserve officer, has received notice from district recruiting headquarters in Missoula that he is authorized to assist with the present recruiting drive. . .C. W. Samsel was elected to chairman of the board of school trustees for the coming year, and Evelyn Hitch was named clerk. . .Mrs. Minnie Niccum this week made a contract with Douglas Holmes of Glendive for the erection of a brick and tile one story building with full basement. The location is next to the Green Dragon and upon its completion will be leased to R. Luckow for a bakery. . .Leon LaCross was appointed local liquor vendor to succeed Jack Eichenberger.

    Thursday, April 23, 1931 --

    The William Krukeberg gas and oil filling station will be greatly improved by the addition of three private garages housed in one building at the east side of the lot on First Street. . .Juanita LaCross and Karl Pleissner, Jr. were the local Christian Endeavor delegates to the convention in Miles City last week. . .Eight pupils of Baker High School will take part in the scholarship contest at Bozeman next week. Those to go are Richard Johnson, John Dougherty, Alvin Beckman, Karl Pleissner, Bonita Hythecker, Priscilla Larson, Mildred McDonald and Mary Christopher. . .A disastrous fire Friday night razed Mrs. Elmer Cates house, C. O. Wrights feed barn and partially destroyed the Victor North home.

    Thursday, April 28, 1921 --

    Baseball season opens in Baker next week when Baker meets Westmore on the local diamond. . .To show appreciation of the interest shown in Boy Scouting by Baker people, the boys have offered to load all the rubbish gathered on lots and premises into wagons furnished by the city. . .The Ollie High School gave a party for the graduates, the Misses Lillian Esmay and Ruth Baker, at the farm home of Mr. and Mrs. Ed Wang Friday evening. . .Graduates of the class of 21 in the play Mr. Bob were Roger Silvernale, Alf Trandum, Mel Schneider, Verna Bond, Frances Hiscock and Helen Norman.

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    Files of the Times | Community | falloncountyextra.com - Fallon County Extra

    The Church That Houses the Latent Heart of the Chicano Movement in L.A. – AL DIA News - February 20, 2021 by Mr HomeBuilder

    Writers like the British Ian Sinclair have made the walk an exercise in psychogeography; that is, walking through a place knowing the history of that place totally changes our perception of the space. It literally immerses us in history. Or begins to immerse us...

    From the more than 86,000 landmarks recognized by the National Register of Historic Places, only 8% are associated with African Americans, Latinos, Asians, and other minorities.

    Specifically, in the city of Los Angeles, just 10% of sites associated with women, BIPOC, or LGBTQ communities have become landmarks.

    Last January, the National Register, in another effort to rewrite history and its imprint to make it everyone's, added the iconic Church of the Epiphany in the Lincoln Heights neighborhood of Los Angeles to the list.

    The church, which was built in 1887, became in the 1960s the epicenter of the Chicano Movement and a refuge and space for the civil rights struggle and is still a pillar for the community today, half a century later.

    "I cried because I needed a place as a Chicana and a place as a Christian to call home," Angelina Lydia Lopez recalls the first time she visited Church of the Epiphany in 1968.

    Lopez was demonstrating on a picket line supporting Mexican American activist Sal Castro when recently deceased UCLA professor Juan Gomez-Quiones told Lydia about a party being held at the parish.

    With its high ceilings and religious emblems, the interior was decorated with papel picado, and music from a mariachi band enveloped the attendees.

    It was the first time, said Lopez, who had grown up in a Baptist church, that she saw her identity reflected in a place of worship.

    Everything about the Church of the Epiphany harkens back to the golden years of La Raza; its basement, now being remodeled into an activity room, was the birthplace of the La Raza newspaper, led by Ramses Noriega and Rosalio Muoz, the main organizers of the first Chicano Moratorium against the Vietnam War.

    The Epiphany was also the site chosen by activists during Robert F. Kennedy's presidential campaign and the rallying point for organizing student walkouts to protest inequalities in East Los Angeles schools.

    Activist and farmworker movement leader Cesar Chavez took the pulpit and preached for social justice in that very spot, and, years later, the parish served as a refuge for Central American immigrants fleeing violence in their countries.

    "That's the legacy of the church," its vicar, Father Tom Carey, told the LA Times. "It's a place where people have expressed themselves."

    In fact, Epiphany was among the few temples that became a true supporter of the struggle for equality at a time when Latino Catholics complained about the Catholic Church's lack of involvement in minority causes.

    With notorious clashes such as that of Catholics for La Raza at the neighboring St. Basil's Church in 1969, where one Christmas Eve the police had to mediate, Cardinal James Francis McIntyre tried to close the doors in the noses of the angry congregation.

    The parish has kept holding its bilingual services during the pandemic, albeit virtually. Meanwhile, it attends to local families in need of food and joins protests and calls for small business owners' relief.

    All this, while it undertakes a remodeling process thanks to a crowdfunding campaign launched after learning its conversion to a historical monument in the country.

    What makes a place sacred "is what has happened there in the past," concludes Father Carey. "What continues to happen there."

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    The Church That Houses the Latent Heart of the Chicano Movement in L.A. - AL DIA News

    Remodeling on the Rise in 2021 – CapeGazette.com - February 16, 2021 by Mr HomeBuilder

    Remodeling on the Rise in 2021

    The strength of the current housing marketcombined with continued working and schooling from home for manyis sparking an increase in home improvements and repairs. Whether youre planning to sell your home or adapting it to better suit your familys needs and tastes, the time is ripe for remodeling.

    According to a recent report, the Leading Indicator of Remodeling Activity (LIRA), released by the Remodeling Futures Program at the Joint Center for Housing Studies of Harvard University, annual gains in spending for improvements and repairs to owner-occupied homes are expected to increase slightly this year, from 3.5 percent at the close of 2020 to 3.8 percent by year-end 2021.

    The LIRA provides a short-term outlook of national home improvement and repair spending to owner-occupied homes. As Chris Herbert, managing director of the Joint Center for Housing Studies says, The remodeling market continues to benefit from a strong housing market. In addition to routine replacement and repair projects, homeowners are likely to pursue more and larger discretionary home improvements this year as the broader economy recovers.

    The most popular improvements on the docket this year for homeowners include projects that make life more efficient and enjoyable, such as:

    Updating the kitchen.While a full kitchen remodel may not be within your budget, you can still modernize your kitchen by replacing the floors or backsplash. Painting kitchen cabinets is an inexpensive way to give your kitchen a design refresh, or invest in a new appliance or two to instantly improve functionality and add value.

    Adding a deck or patio.More attention is being given to outdoor living space than ever before. Extend your familys living area by installing decking or creating a spacious patio. Outfit your new outdoor space with comfortable patio furniture, a fire pit, water feature, kitchen set-up and more.

    Creating an exercise space.Many have taken their exercise routines out of the gym and into the home, so carving out a functional, designated space to work out is a popular home-improvement trend this year. Whether its a corner of the basement or unused space in your garage, designing an area specifically for fitness is an on-point trend.

    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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    Remodeling on the Rise in 2021 - CapeGazette.com

    Kentucky Home Improvement Expo to be Held From 27th to 29th August With The Participation of The Gutter Cleaners Association of America – Press… - February 9, 2021 by Mr HomeBuilder

    Las Vegas, NV - February 8th, 2021 - The Kentucky Home ImprovementExpo is the most prominent event among home builders and home renovation contractors based in Kentucky. This event is currently scheduled to be held from 27th to the 29th of August. This is a perfect example of a comprehensive home show that is taking place in Kentucky. The exhibition will bring together homeowners in the Louisville region to some of the best home building and home remodeling experts in the region as well as the Gutter Cleaners Association of America. These experts are experienced and knowledgeable. Hence, it is possible for the participants to share knowledge and gather lots of valuable information, which can contribute a lot towards the success of their construction projects in the future. With valuable contacts and partnerships created at this event, homeowners will be able to proceed with getting the best out of their new home construction or existing home renovation projects.

    The best thing about Kentucky Home ImprovementExpo is that it is allowing participants to explore all the different aspects of constructing a home. Hence, a person who comes to the event will not come across the need to look for a service provider anywhere else. Since the most experienced constructors and contractors are coming to the exhibition to promote their services, there is no need to keep any second thoughts in mind when making the decision to proceed and obtain the services. It is possible to end up making some valuable connections with businesses that are offering the best expertise in services.

    On the other hand, businesses that offer home construction or home remodeling services are using Kentucky Home ImprovementExpo as a great opportunity to get connected with potential customers and offer their services. Regardless of the size of the project that a homeowner wants to go ahead with, Kentucky Home ImprovementExpo will be there to deliver much-needed assistance.

    Another great thing about Kentucky Home ImprovementExpo is that it is allowing business owners and people to get themselves exposed to the latest design trends and industry innovations. The world is moving so fast. These changes are applicable to the home construction and home renovation industries as well. Businesses that get exposed to the latest trends and innovations will be able to get ready to offer them to the customers and create the best customer experiences. On the other hand, people will be able to figure out what amazing options are available to them in the future to go ahead and grab.

    The experts who come to the Kentucky Home ImprovementExpo will help businesses and visitors to get a first-hand experience on numerous aspects that are related to home improvement and construction. They include sunrooms and additions, advancements in flooring, countertops, and cabinetry, basement finishing, energy efficient winters, waterproofing, and exterior home improvement products. Moreover, the participants will be able to learn more about advanced technologies that are revolutionizing the home construction industry, including smart home automation.

    This years event will be scheduled at the Triple Crown Pavilion. Almost all the exhibitors that were present during the previous year's exhibition have announced that they will be coming to this time as well. On top of that, it is possible to see the presence of the Gutter Cleaners Association of America taking part in the event this year. They will be able to contribute a lot towards the beneficiary of the companies that offer gutter cleaning related services at the event. Moreover, people will be able to get useful information by interacting with them.

    Media ContactCompany Name: Gutter Cleaners Association of AmericaContact Person: Jason RandEmail: Send EmailPhone: 702-919-5197Country: United StatesWebsite: https://gcaoa.org/

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    Kentucky Home Improvement Expo to be Held From 27th to 29th August With The Participation of The Gutter Cleaners Association of America - Press...

    Seattle Remodeling LLC Is Helping People To Transform Their Dream Homes Into Reality | The Magazineplus – The Magazine Plus - February 5, 2021 by Mr HomeBuilder

    Being one of the best remodeling contractors in the region, Seattle Remodeling LLC is all geared up to provide unparalleled renovation and remodeling services to its clients in 2021 and beyond!

    (The Magazine Plus Editorial):- Seattle, Washington Feb 2, 2021 (Issuewire.com)Seattle Remodeling LLC is a well-reputed remodeling and general contracting company that is committed to transforming its clients existing space for improved functionality and style. The company has been serving its customers for decades and has become one of the best remodeling and contracting companies in the region due to its excellent quality of service and skilled craftsmanship.

    Seattle Remodeling LLC has established itself as a trusted name when it comes to blending style with performance. The company not only offers reliable kitchen renovations, bathroom renovations, water, and fire damage repair, and any other kind of revamping a house may require, but also help come up with the most innovative and cost-efficient ideas to turn its clients home remodeling project into an affordable one.

    The team at Seattle Remodeling LLC comprises highly talented and professional individuals who are experts at what they do and keep clients satisfaction as their priority.

    While talking about the vision of the leadership at the company, one of the managers at Seattle Remodeling LLC said: At Seattle Remodeling LLC, we are a full-service remodeling and general contracting company serving Seattle, and surrounding areas. We are experts at providing exceptional designs and top-quality workmanship for versatile remodeling services including kitchen renovations, bathroom renovations, water, and fire damage repair, basement and attic finishing and so much more. Whether you need help renovating your existing bathroom or wish to explore custom cabinets and countertops for your home; we will help you get everything done in a hassle-free way with customized solutions that meet each customers specific needs. We pride ourselves to offer the most outstanding customer service and stunning designs that optimize returns for our clients in Seattle and surrounding areas.

    The management at Seattle Remodeling LLC is excited to expand its customer base and serve more households in 2021. The company is all charged up to reach maximum households in the Seattle region and serve them with exceptional designs created by highly skilled craftsmen that ensure 100% client satisfaction. Customers who are specific about attention to detail can sign up with Seattle Remodeling LLC to embark upon a stress-free and cost renovation journey of getting their homes remodeled or renovated.

    The existing customers of Seattle Remodeling LLC cant stop themselves from praising the company for providing excellent services at affordable rates. In the words of one of their customers: I hired Seattle Remodeling to do a renovation of my master bathroom and they executed my design and vision perfectly. All the contracting work was very well done, and the materials were of high quality.

    About the Company:

    Seattle Remodeling LLC is a renowned remodeling and general contracting company that is committed to transforming regular homes into dream homes. They possess the experience and expertise to provide the best remodeling services in Seattle.

    They are fully equipped for value-based engineering, streamlined scheduling, and system operations to deliver perfect performance, even at a grand scale.

    They are also strategically staffed for delivering to their customers needs as and when they need it. Seattle Remodeling LLCs specialized teams come with expertise in home remodeling and can create all types of flooring, custom cabinets, granite, and quartz countertops as well as bathroom renovations to tile work!

    Therefore, if you are looking for professionals to create a new look, and have some specific requirements, get in touch with them today and their team will be happy to discuss the possibilities.

    See the article here:
    Seattle Remodeling LLC Is Helping People To Transform Their Dream Homes Into Reality | The Magazineplus - The Magazine Plus

    Richmond Heights Recreation Commission recommends closing pool in 2021 – cleveland.com - February 5, 2021 by Mr HomeBuilder

    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.

    Read more from the Sun Messenger.

    See the original post here:
    Richmond Heights Recreation Commission recommends closing pool in 2021 - cleveland.com

    Stop and Read This Before You Dress Up Furnishings with Spray Foam – BobVila.com - February 5, 2021 by Mr HomeBuilder

    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

    Determinants of ICS Therapy Adherence in Patients With Asthma – AJMC.com Managed Markets Network - February 5, 2021 by Mr HomeBuilder

    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

    _____

    Takeaway Points

    _____

    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.

    REFERENCES

    1. Manuyakorn W, Howarth PH, Holgate ST. Airway remodelling in asthma and novel therapy. Asian Pac J Allergy Immunol. 2013;31(1):3-10.

    2. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691-706. doi:10.1016/S2213-2600(17)30293-X

    3. Masoli M, Fabian D, Holt S, Beasley R; Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59(5):469-478. doi:10.1111/j.1398-9995.2004.00526.x

    4. Huang K, Yang T, Xu J, et al; China Pulmonary Health (CPH) Study Group. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet. 2019;394(10196):407-418. doi:10.1016/S0140-6736(19)31147-X

    5. British Thoracic Society; Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma. Thorax. 2008;63(suppl 4):iv1-iv121. doi:10.1136/thx.2008.097741

    6. Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008;31(1):143-178. doi:10.1183/09031936.00138707

    7. Peters SP, Ferguson G, Deniz Y, Reisner C. Uncontrolled asthma: a review of the prevalence, disease burden and options for treatment. Respir Med. 2006;100(7):1139-1151. doi:10.1016/j.rmed.2006.03.031

    8. Cazzoletti L, Marcon A, Janson C, et al; Therapy and Health Economics Group of the European Community Respiratory Health Survey. Asthma control in Europe: a real-world evaluation based on an international population-based study. J Allergy Clin Immunol. 2007;120(6):1360-1367. doi:10.1016/j.jaci.2007.09.019

    9. Sullivan SD, Rasouliyan L, Russo PA, Kamath T, Chipps BE; TENOR Study Group. Extent, patterns, and burden of uncontrolled disease in severe or difficult-to-treat asthma. Allergy. 2007;62(2):126-133. doi:10.1111/j.1398-9995.2006.01254.x

    10. Bender BG, Rand C. Medication non-adherence and asthma treatment cost. Curr Opin Allergy Clin Immunol. 2004;4(3):191-195. doi:10.1097/00130832-200406000-00009

    11. Williams LK, Pladevall M, Xi H, et al. Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma. J Allergy Clin Immunol. 2004;114(6):1288-1293. doi:10.1016/j.jaci.2004.09.028

    12. Haughney J, Price D, Kaplan A, et al. Achieving asthma control in practice: understanding the reasons for poor control. Respir Med. 2008;102(12):1681-1693. doi:10.1016/j.rmed.2008.08.003

    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

    15. Kandane-Rathnayake RK, Matheson MC, Simpson JA, et al. Adherence to asthma management guidelines by middle-aged adults with current asthma. Thorax. 2009;64(12):1025-1031. doi:10.1136/thx.2009.118430

    16. Bourdin A, Halimi L, Vachier I, et al. Adherence in severe asthma. Clin Exp Allergy. 2012;42(11):1566-1574. doi:10.1111/j.1365-2222.2012.04018.x

    17. Williams LK, Joseph CL, Peterson EL, et al. Patients with asthma who do not fill their inhaled corticosteroids: a study of primary nonadherence. J Allergy Clin Immunol. 2007;120(5):1153-1159. doi:10.1016/j.jaci.2007.08.020

    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.

    19. Xiang L, Zhao J, Zheng Y, et al. Uncontrolled asthma and its risk factors in Chinese children: a cross-sectional observational study. J Asthma. 2016;53(7):699-706. doi:10.3109/02770903.2016.1144199

    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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