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Although research is de?nitely lack-ing concerning child and adolescent cross-cultural comparisons, with childrencultural di?erences have been reported in the rates (but not necessarily types) ofsomatic complaints (Bird, 1996). Hence,respiratory failure in NMD patients with normallungs may cause hypoxemia and hypercapniacomparable to that found in severe lung diseases.NMD patients have dif?culty breathing primarilybecause they cannot expand their chest wall (i.e.,lungs, rib cage, and diaphragm)

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