Sodium thiopental known as Sodium Pentothal, thiopentone, or Trapanal, or Fatal-Plus in veterinary euthanasia contexts, is a rapid-onset short-acting barbiturate general anesthetic. It is the thiobarbiturate analog of pentobarbital, an analog of thiobarbital. Sodium thiopental was a core medicine in the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system, but was supplanted by propofol. Despite this thiopental is still listed as an acceptable alternative to propofol, depending on local availability and cost of these agents, it was the first of three drugs administered during most lethal injections in the United States, but the US manufacturer Hospira stopped manufacturing the drug and the EU banned the export of the drug for this purpose. Although thiopental abuse carries a dependency risk, its recreational use is rare. Sodium thiopental is an ultra-short-acting barbiturate and has been used in the induction phase of general anesthesia.

Its use has been replaced with that of propofol, but retains popularity as an induction agent for rapid-sequence intubation and in obstetrics. Following intravenous injection, the drug reaches the brain and causes unconsciousness within 30–45 seconds. At one minute, the drug attains a peak concentration of about 60% of the total dose in the brain. Thereafter, the drug distributes to the rest of the body, in about 5–10 minutes the concentration is low enough in the brain that consciousness returns. A normal dose of sodium thiopental given to a pregnant woman for operative delivery makes her unconscious, but the baby in her uterus remains conscious. However, larger or repeated doses can depress the baby. Sodium thiopental is not used to maintain anesthesia in surgical procedures because, in infusion, it displays zero-order elimination pharmacokinetics, leading to a long period before consciousness is regained. Instead, anesthesia is maintained with an inhaled anesthetic agent. Inhaled anesthetics are eliminated quickly, so that stopping the inhaled anesthetic will allow rapid return of consciousness.

Sodium thiopental would have to be given in large amounts to maintain an anesthetic plane, because of its 11.5- to 26-hour half-life, consciousness would take a long time to return. In veterinary medicine, sodium thiopental is used to induce anesthesia in animals. Since it is redistributed to fat, certain lean breeds of dogs such as sighthounds will have prolonged recoveries from sodium thiopental due to their lack of body fat and their lean body mass. Conversely, obese animals will have rapid recoveries, but it will be some time before it is removed from their bodies. Sodium thiopental is always administered intravenously, as it can be irritating. Sodium thiopental produces less hypotension than an equivalent dose of propofol when used for induction of anaesthesia; this is because both drugs decrease systemic vascular resistance, but thiopentone tends to preserve the reflex tachycardia seen in states of acute hypotension, which can restore cardiac output. In addition to anesthesia induction, sodium thiopental was used to induce medical comas.

It has now been superseded by drugs such as propofol because their effects wear off more than thiopental. Patients with brain swelling, causing elevation of intracranial pressure, either secondary to trauma or following surgery, may benefit from this drug. Sodium thiopental, the barbiturate class of drugs, decrease neuronal activity thereby decreasing cerebral metabolic rate of oxygen consumption, decrease intracranial vascular response to carbon dioxide, which in turn decreases intracranial pressure. Patients with refractory elevated intracranial pressure due to traumatic brain injury may have improved long term outcome when barbiturate coma is added to their neurointensive care treatment. Thiopental has been shown to be superior to pentobarbital in reducing intracranial pressure; this phenomenon is called a reverse steal effect. In refractory status epilepticus, thiopental may be used to terminate a seizure. Sodium thiopental is used intravenously for the purposes of euthanasia. In both Belgium and the Netherlands, where active euthanasia is allowed by law, the standard protocol recommends sodium thiopental as the ideal agent to induce coma, followed by pancuronium bromide to paralyze muscles and stop breathing.

Intravenous administration is the most rapid way to accomplish euthanasia. Death is quick. A coma is first induced by intravenous administration of 20 mg/kg thiopental sodium in a small volume. A triple dose of a non-depolarizing neuromuscular blocking drug is given, such as 20 mg pancuronium bromide or 20 mg vecuronium bromide; the muscle relaxant should be given intravenously to ensure optimal availability but pancuronium bromide may be administered intramuscularly at an increased dosage level of 40 mg. Along with pancuronium bromide and potassium chloride, thiopental is used in 34 states of the United States to execute prisoners by lethal injection. A large dose is given to ensure rapid loss of consciousness. Although death occurs within ten minutes of the beginning of the injection process, some have been known to take longer; the use of sodium thiopental in execution protocols was challenged in court after a study in the medical journal The Lancet reported autopsies of executed inmates showed the level of thiopental

Ephraim Grizzard and Henry Grizzard were African-American brothers who were lynched in Middle Tennessee in April 1892 as suspects in the assaults on two white sisters. Henry Grizzard was hanged by a white mob on April 24 near the house of the young women in Goodlettsville, Tennessee. Ephraim and another brother, John Grizzard, had been arrested and taken to jail in Nashville, along with two other suspects. John Grizzard and another detainee were released because there was no evidence that they had been involved in the alleged assaults. However, on April 30, a white mob estimated to number as many as 10,000 overpowered the police guards and took Ephraim Grizzard from the jail, he was drag through the streets to the Woodland Street Bridge. Members of the mob shot his dead body more than two hundred times. In June 2017 Ephraim Grizzard's memory was honored with a church service at Fisk University and a plaque was dedicated at St. Anselm's Episcopal Church in Nashville. An historical commemoration was planned for a week in June 2019 by "We Remember Nashville" and the Equal Justice Initiative to acknowledge the Grizzard brothers and two victims of an earlier lynching in Nashville.

In April 1892, Mollie and Rosina Bruce, two daughters of the Bruce family in Goodlettsville, were assaulted by several African-Americans. They were the daughters of the late Lee Bruce, a veteran of the Confederate States Army during the American Civil War; the Bruce daughters lived in Goodlettsville with their widowed mother, who served as a tollkeeper, younger siblings. Henry Grizzard was caught first and confessed, implicating another man named Mack Harper. Grizzard was hanged by a mob at 10 AM on April 28, 1892 near Goodlettsville, which spans Davidson and Sumner counties, his brothers John and Ephraim Grizzard were both arrested and jailed as suspects in Nashville, the county seat of Davidson County. Mack Harper and Manuel Jones were arrested, but the police soon released John Grizzard and Jones for lack of evidence; the two Bruce girls did not make a positive identification of Grizzard and Harper as their assailants. At 10 p.m. on April 29, 1892, a mob of 300 white men from Goodlettsville went to the Nashville jail to try to take Ephraim Grizzard from jail for lynching.

Governor John P. Buchanan and Adjutant General Norman went to the jail a little before 2 a.m. A shooting occurred at 2:25 a.m.. Two white men, Charles Rear and N. D. Guthrie, were mortally wounded and died. At 2:45 a.m. Governor Buchanan asked the mob to let Grizzard be tried in a court of law; the mob dispersed shortly before 5 a.m. At 2 p.m. on April 30, 1892, a mob of 6,000 men from 20 towns gathered in Nashville. A "wealthy merchant" from Goodlettsville gave a speech in front of the crowd, which had grown to 10,000; the mob returned to the Nashville jail. He was "dragged through the streets in broad daylight", taken to the east side of the Woodland Street Bridge over the Cumberland River. Grizzard was shot to death. Riddled with bullets, he was shot 200 times, his corpse was taken back to Goodlettsville, shown to the Bruce family, burned. A fund was set up for the Bruce family by The Daily American on May 1, 1892. One of the donors was Edmund William Cole, the president of the Nashville, Chattanooga and St. Louis Railway.

Civil rights activist Ida B. Wells investigated the lynching, she found that Ephrain Grizzard had visited one of the Bruce daughters. Wells maintains that Grizzard was punished for this interracial contact, rather than an actual assault on the daughter, she noted that a white man, in jail charged with raping an eight-year-old black girl was not harmed by the mob. She described Grizzard's murder as "A naked, bloody example of the blood-thirstiness of the nineteenth century civilization of the Athens of the South." She added, "No cannon nor military were called out in his defence."On May 2, 1892, African Americans in Triune killed at least three white resident as retaliation for the Grizzard lynching. In June 2017, the Episcopal Diocese of Tennessee Task Force on Anti-Racism and Lipscomb University's Christian Scholars' Conference organized a service, held in honor of the 1892 lynching victim Ephraim Grizzard, at the Fisk University Memorial Chapel, it was followed by the dedication of a plaque in his memory in the St. Anselm's Episcopal Church in Nashville.

This historic plaque honors the memory of two other lynching victims: his brother Henry Grizzard, Samuel Smith of Nolensville, killed in relation to another incident. The Grizzard brothers and Smith were three of the six blacks documented as lynched in Davidson County in the post-Reconstruction period. According to Natasha Deane, who researched the article for St. Anselm's website on the history of the lynchings and memorial marker, issues of the Nashville Banner from the days following the report of Grizzard's lynching are missing from the archive at the Nashville Public Library. In May 2019, the Metropolitan Nashville Davidson County Community Remembrance Project announced its plans together with the Equal Justice Initiative to conduct several days of remembrance and education to mark the local history of lynchings of black men. Brothers Ephraim and Henry Grizzard, killed on April 30 and 24, 1892 were to be recognized with a historical marker in downtown Nashville. A second marker will be installed downtown to recognize David Jones and Jo Reed, black men who were lynched during Reconstruction, in 1872 and 1875, respectively.

The year 1877 marked the withdrawal of federal troops from the South at the end of th

Dr Gavin Brown Clark was the MP for Caithness from 1885 to 1900. He was educated at the University of Glasgow, the University of Edinburgh and King's College London, graduating in Medicine. An active campaigner for social reform issues against an official Liberal candidate, he joined the Crofters Party parliamentary group and gave general support to the Liberal Party, while in opposition, he was re-elected as the official Liberal candidate in 1886, 1892 and 1895. Spending the time in opposition he spoke in the Commons in favour of measures to ameliorate poverty. Crofters were hard-bitten in the far north of Scotland by the clearances and low wages, he was the Honorary Secretary of the Transvaal Independence Committee, for which he wrote the pamphlet The Transvaal and Bechuanaland. For the 1900 general election he was replaced as Liberal candidate and defeated, he unsuccessfully stood for the Labour Party in Glasgow Cathcart in the 1918 general election. Hansard 1803–2005: contributions in Parliament by Gavin Brown Clark

Stockport NHS Foundation Trust runs Stepping Hill Hospital. Stockport NHS Foundation Trust provides hospital services for children and adults across Stockport and the High Peak area of Derbyshire, as well as community health services for Stockport and Glossop. Ann Barnes is the Trust's Chief Executive and Adrian Belton is the Trust's Chairman, who took over as Chair in June 2017. On 1 April 2004 Foundation Trust status was established, one of the first NHS organisations in the country to achieve the foundation trust position; the Trust provides acute hospital care predominantly across Stockport and the High Peak and employs over 5,800 staff working across two hospital sites and over 41 community clinics. A new £20 million medical and surgical centre with 120 bed spaces, an acute medical unit, a surgical assessment unit, a short stay surgical unit and 18 operating theatres opened in October 2016 for emergency and high risk general surgery, it has capacity for more than 30,000 operations every year.

Stockport NHS Trust formed in April 2000, following the merger of Stockport Acute Services and Stockport Healthcare NHS Trust. The organisation became a foundation trust in 2004 - one of the first ten foundation trusts in the UK; the Trust was the first in the country to achieve Clinical Pathology Accreditation for their point of care testing in December 2011. Stockport NHS Foundation Trust was the first in the country to be awarded international ISO accreditation for emergency planning - April 2013, it was agreed in July 2015 that Stepping Hill Hospital should be one of the four centres for emergency surgery in Greater Manchester. In July 2016 the trust announced plans that could reduce its staffing establishment by 7% after it ended 2015-16 with a deficit of £12.9 million. It formed a partnership, Stockport Together, with Stockport Council, the Stockport Clinical Commissioning Group and Pennine Care NHS Foundation Trust in 2017; the initial plans envisaged a single accountable care organisation run by a new care trust but an alliance model to progress the integration plans and service developments was proposed.

The trust was one of the beneficiaries of Boris Johnson's announcement of capital funding for the NHS in August 2019, with an allocation of £30.6 million for a new Emergency Care Campus at Stepping Hill Hospital. In the last quarter of 2015 it had one of the worst performances of any hospital in England against the four hour waiting target; the Care Quality Commission rated the A&E department inadequate both in safety and leadership in October 2017. They noted low nurse staffing levels and shift fill rates, poor compliance with the early warning score system and infection control. In 2017-18 only 78.7% of A&E patients were seen within four hours. Healthcare in Greater Manchester List of NHS trusts

Italian Costa Ricans are citizens of Costa Rica who are of Italian ancestry. Most of them reside in the capital city of the Coto Brus Canton. After Cristoforo Colombo's discovery of Costa Rica in 1502, only a few Italians - mostly from the Republic of Genova - moved to live in the Costa Rica region; the italo-costarican historian Rita Bariatti named Girolamo Benzomi, Stefano Corti, Antonio Chapui, Jose Lombardo, Francesco Granado, Benito Valerino between those who created important families in colonial Costa Rica. In the 1883 census of Costa Rica there were only 63 Italian citizens and most of them living in the San José area, but soon in 1888 there were 1433 Italians working in the creation of new railways. In 1888, the railroad brought in laborers from Italy as an alternative workforce; the terrible work conditions prompted them to leave the railroad project although many remained in Costa Rica, settling in a government-sponsored colony known as San Vito in the Southern Pacific region. However, one third of those Italian workers of the railways remained in Costa Rica: they created a small but important community.

In the 1920s and 1930s the Italian community grew in importance because some Italo-costaricans reached top levels in the political arena: Julio Acosta - descendant from a Genoese family in San Jose since colonial times - served as President of Costa Rica from 1920 to 1924. In 1939 there were nearly 15000 Italians resident in Costa Rica and many suffered persecutions during WW2In 1952, there was an influx of Italian immigrants farmers, who arrived in San Vito armed with tractors and other farm machinery, began to farm the land intensively and to raise cattle. An Italian organization for agricultural colonization purchased 10,000 hectares of land from the government of Costa Rica. Indeed in the 1950s a group of 500 Italian colonists settled in the area of San Vito. In 1952, in the midst of the post-war socio-economic crisis in Europe, the two brothers Ugo and Vito Sansonetti organised a group of Italian pioneers from forty different places, from Trieste to Taranto, including a handful from Istria and Dalmatia.

This Italian immigration is a typical example of directed agricultural colonisation, similar in many ways to the process in other places in Latin America. The European immigrants were helped by the Comité Intergubernamental para las Migraciones Europeas. Vito Sansonetti, a seaman by profession, was the founder of the colonising company which he named Sociedad Italiana de Colonización Agricola, was in charge of negotiations with the Costa Rican authorities represented by the Instituto de Tierras y Colonización. San Vito is the only place in Costa Rica in which the teaching of the Italian language is compulsory in the educational system, promoted by the Ministerio de Educación Pública in order to save Italian customs and traditions. Additionally there it is an Italian cultural center in San Vito as well as several Italian restaurants, but the Italian language is spoken only by the older citizens of San Vito if many young people have some superficial knowledge. There are cultural associations in Costa Rica.

The historical nucleus of the Italian community in Costa Rica was the city of San José: this community is the one that has received more Italian immigrants in all Central America. Nowadays, the capital still has this centralization role for the local Italians, since it shelters the majority of the Italian citizens residing in the country, although there are now other centers that concentrate considerable numbers of immigrants. In 1890, the Italian Philanthropic Society was created, just two years after the first mass immigration from Lombardy and northern Italy, it would evolve in several Italian Organizations of Mutual Aid until 1902, when it was beginning the massive immigration from southern Italy and was created the Italian Society of Mutual Help. In addition, in the capital was inaugurated the "Italian Club" in 1904, the "Italian Center" in 1905 and the "Casa d'Italia" in the second half of the 20th century. In 1897 Italian engineer Cristoforo Molinari created the Teatro Nacional de Costa Rica, considered the finest historic building in the capital, it is known for its exquisite interior which includes lavish Italian furnishings.

On the other hand, many Italian cultural and educational institutions were established in the country. The "Bologna Institute" and the "Italy-Costa Rica Cultural Center" are important in the capital. Furthermore, in the small city of San Vito, where 3000 of the 5000 inhabitants are descendants of Italian colonists, the "Centro Cultural Dante Alighieri" offers historical information on the Italian immigration. There is an Italian "meeting" center in San Vito's Catholic church, as well as several Italian restaurants. In San Vito there is the Liceo Bilingüe Ítalo-Costarricense, where it is taught the Italian language as an official compulsory subject; the Italian language is spoken by some of the older citizens of San Vito who moved from Italy in the 1950s. Costa Rica is the Central American country with the largest and flourishing Italian-speaking community. Apart fro

José Andres Salvatierra López is a Costa Rican football player playing for Liga Deportiva Alajuelense, for the Costa Rica national football team. He plays as a fullback. Salvatierra made his professional debut on 7 April 2010 for Liga against Águilas Guanacastecas. Salvatierra moved to Major League Soccer side FC Dallas on 16 December 2016. On 24 January 2017, FC Dallas announced the club and Salvatierra agreed to part ways due to the player failing his physical and medical exams before the MLS Preseason. Salvatierra made his senior debut for Costa Rica in a June 2011 CONCACAF Gold Cup match against Cuba and earned a total of 26 caps, scoring no goals, he represented his country in 5 FIFA World Cup qualification matches and played at the 2011 CONCACAF Gold Cup, 2011 Copa América and 2013 Copa Centroamericana. José Salvatierra at National-Football-Teams.com Soccerway Profile