The purpose of this study was to determine if persons without a history of low back dysfunction use a statistically consistent muscle firing order of left erector spinae, right erector spinae, right gluteus maximus, and right biceps femoris during active right prone hip extension. Twenty healthy subjects each made 30 hip extension movements while prone. The onset of EMG activity in each of the four muscles was measured for each trial. A Friedman Two-way Analysis of Ranks revealed no significant difference in mean onset times of left erector spinae, right erector spinae, right gluteus maximus, and right biceps femoris muscles. This finding reflects the variability in the relative onset times among the four muscles both within and between subjects. The absence of a consistent firing order indicates that active prone hip extension can be performed in a wide variety ofways in healthy subjects.

Early recognition of imminent pulmonary failure and rapid institution of ECLS are critical in the successful management of severe, life-threatening varicella pneumonia.

The aim of this study was to identify the efficacy of a staged diabetes management (SDM) clinic serving a low socio‐economic Hispanic population in achieving glycaemic goal. We analysed prospectively collected data from patients discharged from the clinic in 2008 with an admission HbA1c >8% (64mmol/mol) and >one clinic visit. Adjusted odds ratios (AOR) were determined for factors significantly associated with glycaemic goal achievement. Both those patients who achieved the clinic HbA1c goal of ≤8% (n=277) and those who did not (n=209) had a clinically significant decrease in HbA1c (‐3.13±1.80, ‐1.08±1.78). After adjustment, the following were associated with failure to achieve goal: higher admission HbA1c (%) 11.0±1.8 vs 10.3±1.7, AOR (95% CI) 1.22 (1.08, 1.37), p=0.0016; higher admission insulin (IU/kg/day) 0.56±0.58 vs 0.26±0.41, AOR 2.08 (1.09, 4.00), p=0.026; greater increase in insulin (IU/kg/day) 0.23±0.46 vs 0.09±0.32, AOR 2.38 (1.15, 5.00), p=0.02; and a longer stay (days) 229±110 vs 172±84, AOR 1.007 (1.003, 1.012), p=0.0008. In this SDM clinic, most patients achieved significant reduction in HbA1c. The study identified factors associated with a lower likelihood of achieving goal thereby demonstrating the value of review of the response to an SDM protocol in indicating areas for further improvement. Copyright © 2010 John Wiley & Sons.

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