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• To understand general principles of health of people with intellectual disability and how this affects the healthcare professional’s approach to asthma management.
• To understand how intellectual disability affects cognition, autonomy and communication, and therefore the ability of a person to self-manage asthma.
• To recognise ways of mitigating respiratory disease risk in people with intellectual disability.
• To describe ways for healthcare professionals to support people with intellectual disability and their caregivers in asthma management.

Short abstract

• A common feature of muscular dystrophy is respiratory failure, i.e. the inability of the respiratory system to provide proper oxygenation and carbon dioxide elimination.
• In the lung, respiratory failure is caused by recurrent aspiration, and leads to hypoxaemia and hypercarbia.
• Ventilatory failure in muscular dystrophy is caused by increased respiratory load and respiratory muscles weakness.
• Respiratory load increases in muscular dystrophy because scoliosis makes chest wall compliance decrease, atelectasis and fibrosis make lung compliance decrease, and airway obstruction makes airway resistance increase.
• The consequences of respiratory pump failure are restrictive pulmonary function, hypoventilation, altered thoracoabdominal pattern, hypercapnia, dyspnoea, impaired regulation of breathing, inefficient cough and sleep disordered breathing.

• To understand the mechanisms leading to respiratory disturbances in patients with muscular dystrophy.
• To understand the impact of respiratory disturbances in patients with muscular dystrophy.
• To provide a brief description of the main forms of muscular dystrophy with their respiratory implications.

Short abstract

• Respiratory impairment following spinal cord injury (SCI) is more severe in high cervical injuries, and is characterised by low lung volumes and a weak cough secondary to respiratory muscle weakness.
• Autonomic dysfunction and early-onset sleep disordered breathing compound this respiratory compromise.
• The mainstays of management following acute high cervical SCI are tracheostomy and ventilation, with noninvasive ventilation and assisted coughing techniques being important in lower cervical and thoracic level injuries.
• Prompt investigation to ascertain the extent of the SCI and associated injuries, and appropriate subsequent management are important to improve outcomes.

• To describe the anatomical and physiological changes after SCI and their impact on respiratory function.
• To describe the changes in respiratory mechanics seen in cervical SCI and how these changes affect treatments.
• To discuss the relationship between injury level and respiratory compromise following SCI, and describe those at increased risk of respiratory complications.
• To present the current treatment options available and their supporting evidence.

Short abstract

• The costs of care assistance in chronic disease patients are dramatically increasing.
• Telemedicine may be a very useful application of information and communication technologies in high-quality healthcare services.
• Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients’ needs.
• The legal problems associated with telemedicine are still controversial.
• National and European Union governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine.
• The economic advantages, if any, of this new approach must be compared to a “gold standard” of homecare that is very variable among different European countries and within each European country.
• The efficacy of respiratory disease telemedicine projects is promising (i.e. to tailor therapeutic intervention; to avoid useless hospital and emergency department admissions, and reduce general practitioner and specialist visits; and to involve the patients and their families).
• Different programmes based on specific and local situations, and on specific diseases and levels of severity with a high level of flexibility should be utilised.
• A European Respiratory Society Task Force produced a statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues also of telemonitoring of ventilator-dependent chronic obstructive pulmonary disease patients.
• Much more research is needed before considering telemonitoring a real improvement in the management of these patients.

• To clarify definitions of aspects of telemedicine
• To describe different tools of telemedicine
• To provide information on the main clinical results
• To define recommendations and limitations

Short abstract