Almost Home: An Interim Solution to Homelessness

In 2015 there were 4,627 homeless individuals unsheltered in Santa Clara County (Home Not Found, 2015). With very few housing options available many homeless individuals are forced to camp illegally in conditions that are unsafe and inhumane. The Gilroy Compassion Center has addressed the need for an interim solution to homelessness with its Almost Home Camping Program. This program provides stability to individuals who participate by providing transitional housing in a campground setting as an alternative to camping illegally. Participants address their own personal barriers whether it is substance abuse, mental or physical health, as well as other barriers identified through case management. Participants of this program are entered in a data base, Homeless Management Information System, and work closely with a case manager, set goals, and contribute to the camping program by volunteering at the center and various events. In the development of this program, policies and procedures were created that not only could be used to replicate for other agencies interested in developing a camping program for the homeless but also as a model that can be used for a tiny home village in Santa Clara County

It Wont Sink. A Story for the New Year

It was as we sat together at daybreak, on a lovely morning in June, that he told me this story... - how happenings in a man\u27s life and the prayers of his mother are remembered on the last night of the year brought about self-examination and turning to God.https://place.asburyseminary.edu/ecommonsatsdigitalresources/1222/thumbnail.jp

Extending the role of lactate measurement into the prehospital environment

Early identification of haemodynamic shock is widely acknowledged as a vital step towards improving survival. A report in the previous issue of Critical Care describes the relationship between lactate concentrations in blood samples analysed in the prehospital environment and subsequent hospital mortality. These preliminary data indicate a promising avenue of research into the treatment of haemodynamic shock. Larger observational and interventional trials are needed to confirm the clinical value of serum lactate measurement in the prehospital environment

The whole truth and nothing but the truth: the need for full reporting of randomised trials.

The use of cardiac output monitoring to guide fluid and inotropic therapy in surgical patients has remained a controversial topic for more than 40 years. The reasons for this are numerous and complex, but key amongst them is the interplay between poor research methodology and the likely selective reporting of randomised trials. In this issue of Perioperative Medicine, we find a very unusual report, one which describes a randomised trial stopped for futility after the recruitment of only a small proportion of the target patient sample (Jammer et al. Periop Med). The authors offer no statistical analysis of their findings but simply an explanation of what went wrong. On the face of it, this exercise would seem to offer little of value to the general reader. How can publication of the findings of an unsuccessful trial contribute to the evidence base on this topic? To understand this, we must delve a little deeper into the evidence and see how these trials were designed

The Old Clock

A story about the change and salvation in a young man\u27s life.https://place.asburyseminary.edu/ecommonsatsdigitalresources/1219/thumbnail.jp

A Statistical Analysis of the Solar Phenomena Associated with Global EUV Waves

Solar eruptions are the most spectacular events in our solar system and are associated with many different signatures of energy release including solar flares, coronal mass ejections, global waves, radio emission and accelerated particles. Here, we apply the Coronal Pulse Identification and Tracking Algorithm (CorPITA) to the high cadence synoptic data provided by the Solar Dynamic Observatory (SDO) to identify and track global waves observed by SDO. 164 of the 362 solar flare events studied (45%) are found to have associated global waves with no waves found for the remaining 198 (55%). A clear linear relationship was found between the median initial velocity and the acceleration of the waves, with faster waves exhibiting a stronger deceleration (consistent with previous results). No clear relationship was found between global waves and type II radio bursts, electrons or protons detected in-situ near Earth. While no relationship was found between the wave properties and the associated flare size (with waves produced by flares from B to X-class), more than a quarter of the active regions studied were found to produce more than one wave event. These results suggest that the presence of a global wave in a solar eruption is most likely determined by the structure and connectivity of the erupting active region and the surrounding quiet solar corona rather than by the amount of free energy available within the active region.Comment: 33 pages, 6 figures, 1 table. Accepted for publication in Solar Physic

Dopexamine can attenuate the inflammatory response and protect against organ injury in the absence of significant effects on hemodynamics or regional microvascular flow

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Should we use central venous saturation to guide management in high-risk surgical patients?

Measurements of central venous oxygen saturation (ScvO(2)) have been successfully used to guide haemodynamic therapy in critical care. The efficacy of this approach in the treatment of severe sepsis and septic shock has stimulated interest in the use of ScvO(2 )to guide management in patients undergoing major surgery. The physiological basis of ScvO(2 )measurement is complex. A number of outstanding issues will need to be resolved before incorporating ScvO(2 )measurement into routine practice. First, it is not yet clear which value of ScvO(2 )should be targeted. Second, there is some uncertainty as to which interventions are the most effective for achieving the desired value of ScvO(2 )or how long this value should be maintained. The study by The Collaborative Study Group on Perioperative ScvO(2) Monitoring published in this edition of Critical Care may help provide answers to some of these questions. Our understanding of ScvO(2 )measurement remains limited, however, and the routine use of peri-operative ScvO(2)-guided goal-directed therapy cannot be recommended until a large randomised trial has confirmed the value of this approach

Prevention of postoperative pulmonary complications in the hypoxaemic patient - gathering the evidence for noninvasive respiratory support

This is the accepted manuscript of article published in European Journal of Anaesthesiology. The final published version is available online at doi: 10.1097/EJA.000000000000118