Key4OI Recommendations for Lung Function Guidance in Osteogenesis Imperfecta: Based on an Internationally Performed Comprehensive International Consortium for Health Outcomes Measurement Procedure.

Introduction: Pulmonary involvement in Osteogenesis Imperfecta (OI) can be severe but may be overlooked in milder cases. The Care4BrittleBones Foundation initiated this project to develop a set of global outcome measures focusing on respiratory-related issues in patients with OI. The objective was to reach an international consensus for a standardized set of outcomes and associated measuring instruments for the pulmonary care of individuals with OI.

Cultural competence in a context of ethnic tension.

This commentary describes how the first program for enhancing cultural competence in an Israeli healthcare facility was implemented at the ALYN Hospital Pediatric and Adolescent Rehabilitation Center in Jerusalem, and the lessons that can be learned from the ALYN experience for other healthcare facilities attempting to enhance their cultural competence, particularly in environments of heightened inter-cultural tension. A structured program was developed to educate hospital staff and optimize the hospital's administrative functioning towards the goal of enhanced cultural competence. The program was initiated with an international conference on site to promote awareness of the concept, and included, among other steps, the appointment of a senior administration "Coordinator of Cultural Competence", improvements in translation services, regular educational seminars, the opening of a Muslim prayer room in the hospital, and accommodations for Sabbath and Ramadan observance.

A Chemical-Biological-Radio-Nuclear (CBRN) Filter can be Added to the Air-Outflow Port of a Ventilator to Protect a Home Ventilated Patient From Inhalation of Toxic Industrial Compounds.

Objectives: Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients.

Impact of adding a filter for protection from toxic inhalational compounds to the ventilation circuit of mechanically ventilated patients.

Background: Standard-issue Chemical-Biological-Radio-Nuclear (CBRN) gasmasks, as used for protection from non-conventional warfare agents or toxic industrial compounds, cannot be used by ventilated patients, leaving them exposed to toxic agents inhaled via their ventilators. This study was conducted to determine the safety of a CBRN filter added to the patient circuit of a ventilator, as a method for affording inhalational protection to ventilated patients.

Methods: A Landrace pig was ventilated sequentially with 3 types of ventilators according to 17 different ventilation protocols, with and without a CBRN filters added in-line to the ventilation tubing for each protocol.

Discharge of respiratory-compromised children after respiratory rehabilitation.

Background: There is a growing demand for respiratory rehabilitation services for children dependent on tracheostomy and/or chronic mechanical ventilation. Discharging these patients home following their rehabilitation can be an arduous process.

Objectives: To define the length of time required to rehabilitate and discharge these patients, and to identify predictors of a prolonged or failed discharge process.