Our findings suggest that air-fluidized beds are more effective than conventional therapy, particularly for large pressure sores. Studies are needed to determine the effectiveness of air-fluidized beds in long-term care settings.

The use of office spirometry was recommended by the National Lung Health Education Program (NLHEP) consensus conference in 1999 for detection and management of COPD. Since that time, spirometry utilization has increased, but its role in the diagnosis of COPD is still evolving. This update reviews the role of spirometry for screening and case finding in COPD as well as for asthma. Spirometry has been used for disease management in patients with airway obstruction, with varying results. The diagnostic criteria for COPD using spirometry have also evolved in the past 17 years, with differences arising between the Global Initiative for Chronic Obstructive Lung Disease and NLHEP recommendations. More sophisticated spirometers as well as new reference equations are widely available. Standardization guidelines from the American Thoracic Society/European Respiratory Society published in 2005 provide a robust framework for performing and interpreting spirometry, but clinicians still need hands-on training and meaningful feedback to perform high-quality spirometry in the office setting.

Clinicians can consider water-based PR exercise program as another treatment option, if available, for patients with COPD and expect similar benefits to traditional land-based PR programs including improved walk distances, strength, and perception of well-being.

Five high school students with ASD (autistic spectrum disorder) participating in the Excel/Autism study were able to demonstrate mastery of a set of Excel topics. The Excel curriculum covered approximately the same topics as are covered in the Excel portion of Computer Business Applications, a class for regular education students at Fox Chapel Area High School, a high school in suburban Pittsburgh. The students with ASD were provided with one-on-one tutoring support. Two of the five ASD participants self-initiated activities and engaged in generative thinking to a substantial degree over the course of the eight instructional sessions for which data was recorded. Two others demonstrated lesser amounts of this behavior, and one participant did not demonstrate any. The ASD experimental participants, as compared to a treatment group of three students with ASD who did not receive instruction in Excel, demonstrated improvement in a multistep planning task which was significant.

Exercise training is an essential component of pulmonary rehabilitation and is associated with improved function and other important outcomes in persons with chronic lung disease. A subset of pulmonary rehabilitation patients experience hypoxemia that may occur or worsen with exercise. For the purpose of this review, severe exercise-induced hypoxemia is defined as an S(pO(2)) of < 89% during exercise, despite use of supplemental oxygen delivered at up to 6 L/min. There is a paucity of evidence and clinical guidelines that address assessment and management of this important manifestation of chronic lung disease. This review presents background of this topic and suggests strategies for assessment, management, and safety measures for patients with severe exercise-induced hypoxemia.