title: Catholic Church in the United States

text: In the era of intense emigration from the 1840s to 1914, bishops often set up separate parishes for major ethnic groups, from Ireland, Germany, Poland, French Canada and Italy. In Iowa, the development of the Archdiocese of Dubuque, the work of Bishop Loras and the building of St. Raphael's Cathedral, to meet the needs of Germans and Irish, is illustrative. Noteworthy, too, was the contribution of 400 Italian Jesuit expatriates who, between 1848-1919, planted dozens of institutions to serve the diverse population out West. By century's end, they had founded colleges (later to become universities) in San Francisco, Santa Clara, Denver, Seattle and Spokane to meet the cultural and religious needs of people of that region. They also ministered to miners in Colorado, to Native Peoples in several states, and to Hispanics in New Mexico, "building churches [in the latter state], publishing books and newspapers, and running schools in both the public and private sectors."


title: Catholic Church in the United States

text: By the beginning of the 20th century, approximately one-sixth of the population of the United States was Catholic. Modern Catholic immigrants come to the United States from the Philippines, Poland and Latin America, especially Mexico and Central America. This multiculturalism and diversity has influenced the conduct of Catholicism in the United States. For example, most dioceses offer Mass in a number of languages, and an increasing number of parishes offer Masses in the official language of the church, Latin, due to its universal nature.


title: Catholic Church in the United States

text: Sociologist Andrew Greeley, an ordained Catholic priest at the University of Chicago, undertook a series of national surveys of Catholics in the late 20th century. He published hundreds of books and articles, both technical and popular. His biographer summarizes his interpretation:


title: Catholic Church in the United States

text: In the later 20th century "[...] the Catholic Church in the United States became the subject of controversy due to allegations of clerical child abuse of children and adolescents, of episcopal negligence in arresting these crimes, and of numerous civil suits that cost Catholic dioceses hundreds of millions of dollars in damages." Because of this, higher scrutiny and governance as well as protective policies and diocesan investigation into seminaries have been enacted to correct these former abuses of power, and safeguard parishioners and the church from further abuses and scandals.


title: Catholic Church in the United States

text: One initiative is the "National Leadership Roundtable on Church Management" (NLRCM), a lay-led group born in the wake of the sexual abuse scandal and dedicated to bringing better administrative practices to 194 dioceses that include 19,000 parishes nationwide with some 35,000 lay ecclesial ministers who log 20 hours or more a week in these parishes.


title: Catholic Church in the United States

text: According to a 2015 study by Pew Researchers, 39% of Catholics attend church at least once a week and 40%, once or twice a month.


title: Catholic Church in the United States

text: Although the issue of trusteeism was mostly settled in the 19th century, there have been some related issues. In 2005, an interdict was issued to board members of St. Stanislaus Kostka Church (St. Louis, Missouri) in an attempt to get them to turn over the church property to the Archdiocese of St. Louis. In 2006, a priest was accused of stealing $1.4 million from his parish, prompting a debate over Connecticut Raised Bill 1098 as a means of forcing the Catholic church to manage money differently. Related to issues of asset ownership, some parishes have been liquidated and the assets taken by the diocese instead of being distributed to nearby parishes, which in violation of church financial rules.


title: Catholic Church in the United States

text: In 2009 John Micklethwait, editor of "The Economist" and co-author of "God Is Back: How the Global Revival of Faith Is Changing the World", said that American Catholicism, which he describes in his book as "arguably the most striking Evangelical success story of the second half of the nineteenth century," has competed quite happily "without losing any of its basic characteristics." It has thrived in America's "pluralism."


title: Catholic Church in the United States

text: In 2011, an estimated 26 million American Catholics were "fallen-away", that is, not practicing their faith. Some religious commentators commonly refer to them as "the second largest religious denomination in the United States." Recent Pew Research survey results in 2014 show about 31.7% of American adults were raised Catholic, while 41% from among that group no longer identify as Catholic.


title: Catholic Church in the United States

text: In a 2015 survey by researchers at Georgetown University, Americans who self identify as Catholic, including those who do not attend Mass regularly, numbered 81.6 million or 25% of the population, and 68.1 million or 20% of the American population are Catholics tied to a specific parish. About 25% of US Catholics say they attend Masses once a week or more, and about 38% went at least once a month. The study found that the number of US Catholics has increased by 3 to 6% each decade since 1965, and that the Catholic Church is "the most diverse in terms of race and ethnicity in the US," with Hispanics accounting for 38% of Catholics and blacks and Asians 3% each. The Catholic Church in the US represents perhaps "the most multi-ethnic organization of any kind, and so is a major laboratory for cross-cultural cooperation and cross-cultural communication completely within the nation's borders." It is as if it wishes to forge a broader ecclesial identity to give newcomers a more inclusive welcome, similar to the aspirations of 19th century church leaders like Archbishops John Ireland and James Gibbons who "wanted Catholic immigrants to become fully American, rather than 'strangers in a strange land.' " Only 2 percent of American Catholics go to confession on a regular basis, while three-quarters of them go to confession once a year or less often; a valid confession is required by the Church after committing mortal sin in order to return to the State of Grace, necessary to receive Holy Communion. As one of the precepts of the church, it is also required that every Catholic makes a valid confession at least once a year.


title: Catholic Church in the United States

text: Since 1970, weekly church attendance among Catholics has dropped from 55% to 20%, the number of priests declined from 59,000 to 35,000 and the number of people who have left Catholicism has increased from under 2 million in 1975 to over 30 million today. In 2022, there were fewer than 42,000 nuns left in the United States, a 76% decline over 50 years, with fewer than 1% of nuns under age 40.


title: Catholic Church in the United States

text: The RealClear poll data indicates that the Latino element has now reached 37 percent of the Catholic population, and growing. It is 60 percent Democratic, while the non-Latinos are split about 50-50 politically. Although many Americans still identify as Catholics, their religious participation rates are declining. Today only 39% of all Catholics go to Mass at least weekly. Nearly two-thirds of Catholics say that their trust in the church leadership has been undermined by the clergy sex abuse crisis. Nevertheless, 86% of all Catholics still consider religion important in their own lives.


title: Catholic Church in the United States

text: The following are some notable Americans declared as Servants of God, venerables, beatified, and canonized saints:


title: Dan Povenmire

text: Daniel Kingsley Povenmire ( ; born September 18, 1963) is an American animator, writer, director, producer, and voice actor. With Jeff "Swampy" Marsh, Povenmire co-created the Disney animated series "Phineas and Ferb" and "Milo Murphy's Law", in both of which he voiced the character Heinz Doofenshmirtz. In October 2020, Povenmire announced a new series for Disney Channel titled "Hamster & Gretel", which premiered in 2022.


title: Dan Povenmire

text: Povenmire grew up in Mobile, Alabama, where he was an art student, and where he spent summers outdoors and making movies. Povenmire attended the University of South Alabama before deciding to pursue a film career and transferring to the University of Southern California.


title: Dan Povenmire

text: Povenmire has been a long-time contributor to the animation business, working on several different animated television series such as "Hey Arnold!", "The Simpsons", "Rocko's Modern Life", and "SpongeBob SquarePants". He was a longtime director on the prime time series "Family Guy", where he was nominated for an Annie Award in 2005. He left the series to create "Phineas and Ferb" with Jeff "Swampy" Marsh. Povenmire has been nominated for several awards for his work on the show, including a BAFTA, an Annie, and two Emmy Awards. Following the success of "Phineas and Ferb", he and Marsh created and produced a second show for Disney titled "Milo Murphy's Law", which premiered in 2016. In 2020, the duo made a second "Phineas and Ferb" film, "".


title: Dan Povenmire

text: Povenmire was born in San Diego, California on September 18, 1963, and grew up in the city of Mobile, Alabama. A child prodigy, he began drawing at age two; by the time he was ten, his work was displayed in local art shows. His first efforts in animation included a series of flip books that he produced in his school text books. As a child, Povenmire considered animator Chuck Jones his hero; in a 2009 interview, he stated that "every drawing he [Jones] did was beautiful to look at and had so much energy in it". Hayao Miyazaki was also an early influence.


title: Dan Povenmire

text: Povenmire received his secondary education at Shaw High School in Mobile. Initially, he attended the University of South Alabama, where he created his first popular comic strip, "Life is a Fish", devoted to the life of Herman the goldfish and the college students he lives with. Povenmire also supported himself as a waiter and performer at a dinner theater. In 1985, he transferred to the University of Southern California (USC), planning to pursue a career in film.


title: Dan Povenmire

text: Soon after arriving at USC, he pitched "Life is a Fish" to Mark Ordesky, the editor-in-chief of the "Daily Trojan", the university newspaper. Ordesky first "basically brushed [him] off", but, after viewing Povenmire's portfolio, accepted the strip. "Fish" ran daily in the paper. Though the rapid pace left Povenmire afraid he was "running out of ideas", he never missed a deadline and made $14,000 a year through "Fish" merchandise, which included T-shirts, books, and calendars sold at the campus craft fair. The discipline of regular production also helped teach Povenmire to "represent something in the least amount of lines".


title: Dan Povenmire

text: Povenmire left USC without finishing the degree requirements, and used the money from "Fish" merchandise to fund a short-lived career as a street artist. His first professional animation commission came on the Tommy Chong project "Far Out Man", for which Povenmire produced two minutes of animation. By age 24, Povenmire was freelancing on several animated television series, including "Teenage Mutant Ninja Turtles". In 1989, he appeared in a small role as a band member in Adam Sandler's first film, "Going Overboard".


title: Dan Povenmire

text: In the 1990s, Povenmire secured a job as a character layout animator on the hit animated series "The Simpsons". His desk placed him opposite Jeffrey Marsh, another up-and-coming animator. They shared similar tastes in humor and music, and later became colleagues on other projects.


title: Dan Povenmire

text: Povenmire's experience, from both previous industry work and from his own projects, earned him respect at "The Simpsons". He worked on layout animation and collaborated on storyboard production for the series, recalling later that staff were handed pages of production notes and instructed to "Do the [creative consultant] Brad Bird notes and any others that make sense." He maintained a side interest in film, writing scripts and the screenplay for a low-budget horror movie, "Psycho Cop 2". The movie's producers offered Povenmire the opportunity to direct the film, but its terms required that he quit "The Simpsons". Povenmire chose to stay with "The Simpsons", which he enjoyed and considered a better fit with his future ambitions. Rif Coogan ended up directing the picture instead.


title: Dan Povenmire

text: Work on "The Simpsons" involved an irregular schedule. The producers laid off the animation staff for two-to-three-month periods, and rehired the staff later in the production cycle. During one of these layoffs, Povenmire found a temporary job on the series "Rocko's Modern Life", Nickelodeon's first in-house cartoon production. The show's creator, television newcomer Joe Murray, hired Povenmire solely on the strength of his "Life is a Fish" comic strips, which proved he could both write and draw.


title: Dan Povenmire

text: Though Povenmire started on "Rocko" simply to occupy his downtime from "The Simpsons", he found the greater creative freedom he enjoyed on his temporary job compelling, and quit "The Simpsons" to work on "Rocko" full-time. There, he reunited with Jeff Marsh, this time as a writing partner; Marsh claimed the crew hoped Povenmire's neatness would offset his own sloppy storyboarding. The pair developed a distinctive style characterized by characteristic musical numbers and chase scenes. Povenmire and Marsh won an Environmental Achievement Award for a 1996 "Rocko" episode they had written.


title: Dan Povenmire

text: Povenmire later became a director on "Family Guy", starting with the season two episode "Road to Rhode Island". Creator Seth MacFarlane granted Povenmire substantial creative freedom. Povenmire recalled that MacFarlane would tell him "We've got two minutes to fill. Give me some visual gags. Do whatever you want. I trust you." Povenmire praised MacFarlane's management style for letting him "have [...] fun."


title: Dan Povenmire

text: Povenmire brought realism and material from his own experiences to the visual direction of "Family Guy". For "One If by Clam, Two If by Sea" (August 1, 2001), several characters demonstrate Fosse-like moves in prison. To correctly depict the moves, Povenmire asked color artist Cynthia MacIntosh, who had been a professional dancer, to strike poses so he could properly illustrate the sequence. In the episode "To Love and Die in Dixie" (November 15, 2001), Povenmire drew on his childhood in the Deep South to create and sequence a background scene in which the redneck character nonchalantly kicks a corpse into the nearby river.


title: Dan Povenmire

text: "Brian Wallows and Peter's Swallows" (January 17, 2002), a "Family Guy" episode which Povenmire directed, won the Emmy Award for Best Song. Creator MacFarlane, the recipient of the award, noted that Povenmire deserved to have received the award for the contribution the visuals made to the episode's win. Povenmire responded in jest, "That's a nice sentiment and all, but did he offer to give me his? No! And it's not like he doesn't already have two of his own just sitting in his house!" Povenmire was nominated for an Annie Award for Directing in an Animated Television Production for the episode "PTV" (November 6, 2005) but lost out to a fellow "Family Guy" director, Peter Shin, who had directed the episode "North by North Quahog". Povenmire and several others were also nominated for their work on "PTV" in the Outstanding Animated Program (for Programming Less Than One Hour) category at the Primetime Emmy Awards. Povenmire also received the same nomination for "Road to Rhode Island."


title: Dan Povenmire

text: During "Family Guy"s brief cancellation, Povenmire was offered a job as storyboard director of the series "SpongeBob SquarePants". He also became a writer for the show, writing the season 2 episodes "Graveyard Shift", "The Fry Cook Games" and "Sandy, SpongeBob and the Worm", all of which premiered on Nickelodeon between 2001–2002. He also wrote "The Campfire Song Song" for the Season 3 episode "The Camping Episode", for which he was also a storyboard director on alongside Jay Lender (April 3, 2004).


title: Dan Povenmire

text: In 1993, Povenmire and Marsh conceived the series "Phineas and Ferb", based on their similar experiences of childhood summers spent outdoors. Povenmire spent 14–16 years pitching "Phineas and Ferb" to several networks. Most rejected it as unfeasible for the complexity of its plots, but Povenmire persevered, later observing "It was really the show we wanted to see: if this was on the air, I'd watch it, and I don't always feel that about every show I work on." Even the Walt Disney Company initially rejected Povenmire's pitch, but asked to keep the proposal packet: "Usually that means they throw it in the trash later," Povenmire recalled. Eventually Disney called Povenmire back with an acceptance, on the condition that he would produce an 11-minute pilot. He called Marsh, who was living in England, to ask him if he would like to work on the pilot; Marsh accepted immediately and moved back to the United States.


title: Dan Povenmire

text: Instead of a conventional script, the pair pitched the pilot by recording reels of its storyboard, which Povenmire then mixed and dubbed to produce action and vocals. The network approved the show for a 26-episode season. As a result, Povenmire left "Family Guy" to create the series.


title: Dan Povenmire

text: Povenmire and Marsh wanted to incorporate into "Phineas and Ferb" the kind of humor they had developed in their work on "Rocko's Modern Life". They included action sequences and, with Disney's encouragement, featured musical numbers in every episode subsequent to "Flop Starz". Povenmire described the songs as his and Marsh's "jab at immortality", but the pair have earned two Emmy nominations for "Phineas and Ferb" songs to-date. A third Emmy nomination, for the episode "The Monster of Phineas-n-Ferbenstein" (2008), pitted the show against "SpongeBob SquarePants", although neither nominee received the award due to a technicality. In 2010, Povenmire was nominated amongst several other "Phineas and Ferb" crew members for the Daytime Emmy Award for both "Outstanding Writing in Animation" and "Outstanding Original Song – Children’s and Animation" for their work on the show, winning for "Outstanding Writing in Animation". In 2021, Povenmire, among other writers, won an Emmy Award for "Outstanding Writing Team for a Daytime Animated Program" for their film "".


title: Dan Povenmire

text: The distinctive style of the animation legend Tex Avery influenced the show's artistic look. Like Avery, Povenmire employed geometric shapes to build both the characters and the background. The style developed almost accidentally, with Povenmire's first sketch of title character, Phineas Flynn, which he produced while eating dinner with his family in a restaurant in South Pasadena, California. He doodled a triangle-shaped child on the butcher paper covering the table. He was so taken with the sketch he tore it out, kept it, and used it as the prototype for Phineas and as the stylistic blueprint for the entire show.


title: Dan Povenmire

text: During his college years, Povenmire had performed with a band that played at clubs and bars across Los Angeles, California. His current band, Keep Left, releases albums through Arizona University Recordings. Their second CD, "Letters from Fielding", became available for download on aurec.com during 2004. They have an official website maintained and updated by artist Larry Stone. A 2004 email exchange about the website between Stone and Povenmire resulted in a "clever and twisted" series of comic strips drawn by the two, eventually moved to the website Badmouth.


title: Dan Povenmire

text: Povenmire joined TikTok on November 26, 2019. Since then, he has amassed more than 6 million followers and 188 million likes. Povenmire often reacts to and interacts with young artists and creators, giving them advice and encouragement, while also providing behind-the-scenes information and debunking fan theories about his various projects, including "Phineas and Ferb", "Milo Murphy's Law" and more.


title: Class diagram

text: In software engineering, a class diagram in the Unified Modeling Language (UML) is a type of static structure diagram that describes the structure of a system by showing the system's classes, their attributes, operations (or methods), and the relationships among objects.


title: Class diagram

text: The class diagram is the main building block of object-oriented modeling. It is used for general conceptual modeling of the structure of the application, and for detailed modeling, translating the models into programming code. Class diagrams can also be used for data modeling. The classes in a class diagram represent both the main elements, interactions in the application, and the classes to be programmed.


title: Class diagram

text: In the design of a system, a number of classes are identified and grouped together in a class diagram that helps to determine the static relations between them. In detailed modeling, the classes of the conceptual design are often split into subclasses.


title: Class diagram

text: In order to further describe the behavior of systems, these class diagrams can be complemented by a state diagram or UML state machine.


title: Class diagram

text: UML provides mechanisms to represent class members, such as attributes and methods, and additional information about them like constructors.


title: Class diagram

text: To specify the visibility of a class member (i.e. any attribute or method), these notations must be placed before the members' name:


title: Class diagram

text: A derived property is a property whose value (or values) is produced or computed from other information, for example, by using values of other properties.


title: Class diagram

text: The UML specifies two types of scope for members: "instance" and "class", and the latter is represented by underlined names.


title: Class diagram

text: To indicate a classifier scope for a member, its name must be underlined. Otherwise, instance scope is assumed by default.


title: Class diagram

text: A relationship is a general term covering the specific types of logical connections found on class and object diagrams. UML defines the following relationships:


title: Class diagram

text: A "dependency" is a type of association where there is a semantic connection between dependent and independent model elements. It exists between two elements if changes to the definition of one element (the server or target) may cause changes to the other (the client or source). This association is uni-directional. A dependency is displayed as a dashed line with an open arrow that points from the client to the supplier.


title: Class diagram

text: An "association" represents a family of links. A binary association (with two ends) is normally represented as a line. An association can link any number of classes. An association with three links is called a ternary association. An association can be named, and the ends of an association can be adorned with role names, ownership indicators, multiplicity, visibility, and other properties. There are four different types of association: bi-directional, uni-directional, aggregation (includes composition aggregation) and reflexive. Bi-directional and uni-directional associations are the most common ones. For instance, a flight class is associated with a plane class bi-directionally. Association represents the static relationship shared among the objects of two classes.


title: Class diagram

text: "Aggregation" is a variant of the "has a" association relationship; aggregation is more specific than association. It is an association that represents a part-whole or part-of relationship. As shown in the image, a Professor 'has a' class to teach. As a type of association, an aggregation can be named and have the same adornments that an association can. However, an aggregation may not involve more than two classes; it must be a binary association. Furthermore, there is hardly a difference between aggregations and associations during implementation, and the diagram may skip aggregation relations altogether.


title: Class diagram

text: "Aggregation" can occur when a class is a collection or container of other classes, but the contained classes do not have a strong "lifecycle dependency" on the container. The contents of the container still exist when the container is destroyed.


title: Class diagram

text: In UML, it is graphically represented as a "hollow" diamond shape on the containing class with a single line that connects it to the contained class. The aggregate is semantically an extended object that is treated as a unit in many operations, although physically it is made of several lesser objects.


title: Class diagram

text: The UML representation of a composition relationship shows composition as a "filled" diamond shape on the containing class end of the lines that connect contained class(es) to the containing class.


title: Class diagram

text: Thus the aggregation relationship is often "catalog" containment to distinguish it from composition's "physical" containment.


title: Class diagram

text: It indicates that one of the two related classes (the "subclass") is considered to be a specialized form of the other (the "super type") and the superclass is considered a Generalization of the subclass. In practice, this means that any instance of the subtype is also an instance of the superclass. An exemplary tree of generalizations of this form is found in biological classification: humans are a subclass of simian, which is a subclass of mammal, and so on. The relationship is most easily understood by the phrase 'an A is a B' (a human is a mammal, a mammal is an animal).


title: Class diagram

text: The UML graphical representation of a Generalization is a hollow triangle shape on the superclass end of the line (or tree of lines) that connects it to one or more subtypes.


title: Class diagram

text: The "superclass" (base class) in the generalization relationship is also known as the ""parent"", "superclass", "base class", or "base type".


title: Class diagram

text: The "subtype" in the specialization relationship is also known as the ""child"", "subclass", "derived class", "derived type", "inheriting class", or "inheriting type".


title: Class diagram

text: Note that this relationship bears no resemblance to the biological parent–child relationship: the use of these terms is extremely common, but can be misleading.


title: Class diagram

text: In UML modelling, a realization relationship is a relationship between two model elements, in which one model element (the client) realizes (implements or executes) the behavior that the other model element (the supplier) specifies.


title: Class diagram

text: The UML graphical representation of a Realization is a hollow triangle shape on the interface end of the "dashed" line (or tree of lines) that connects it to one or more implementers. A plain arrow head is used on the interface end of the dashed line that connects it to its users. In component diagrams, the ball-and-socket graphic convention is used (implementors expose a ball or lollipop, whereas users show a socket).


title: Class diagram

text: A realization is a relationship between classes, interfaces, components and packages that connects a client element with a supplier element. A realization relationship between classes/components and interfaces shows that the class/component realizes the operations offered by the interface.


title: Class diagram

text: Dependency can be a weaker form of bond that indicates that one class depends on another because it uses it at some point in time.


title: Class diagram

text: One class depends on another if the independent class is a parameter variable or local variable of a method of the dependent class. Sometimes the relationship between two classes is very weak. They are not implemented with


title: Class diagram

text: This association relationship indicates that (at least) one of the two related classes make reference to the other. This relationship is usually described as "A has a B" (a mother cat has kittens, kittens have a mother cat).


title: Class diagram

text: The UML representation of an association is a line connecting the two associated classes. At each end of the line there is optional notation. For example, we can indicate, using an arrowhead that the pointy end is visible from the arrow tail. We can indicate ownership by the placement of a ball, the role the elements of that end play by supplying a name for the role, and the "multiplicity" of instances of that entity (the range of number of objects that participate in the association from the perspective of the other end).


title: Class diagram

text: Entity classes model long-lived information handled by the system, and sometimes the behavior associated with the information. They should not be identified as database tables or other data-stores.


title: Class diagram

text: They are drawn as circles with a short line attached to the bottom of the circle. Alternatively, they can be drawn as normal classes with the «entity» stereotype notation above the class name.


title: Judy Carne

text: Joyce Audrey Botterill (27 April 1939 – 3 September 2015), known professionally as Judy Carne, was an English actress best remembered for the phrase "Sock it to me!" on "Rowan & Martin's Laugh-In".


title: Judy Carne

text: Carne was born in Northampton, England. Her parents, Harold and Kathy, were greengrocers in Kingsthorpe.


title: Judy Carne

text: She received training at the Pitt-Draffen Academy of Dance before being accepted into the prestigious Bush-Davis Theatrical School for Girls in East Grinstead, West Sussex.


title: Judy Carne

text: An instructor at the school began calling her "Judy," telling her that Joyce was not a good professional name. The second part of Judy's stage name was taken from a character named Sarat Carn in the play "Bonaventure" by English playwright Charlotte Hastings.


title: Judy Carne

text: She made her first British television appearances on the series "Danger Man" (1961) and episodes of "The Rag Trade" (also 1961), a BBC sitcom.


title: Judy Carne

text: She moved to the US not long afterward. Her first regular role was in the sitcom "Fair Exchange" (1963) as an English teenager who goes to the US to live with an American couple whose daughter (played by Lynn Loring) has gone to live in England. That was followed by "The Baileys of Balboa" (1964). She later co-starred with Pete Duel in "Love on a Rooftop" (1966). She made several appearances on the adventure series "The Man from U.N.C.L.E."


title: Judy Carne

text: She had a small part in the ninth episode of the TV series "Gidget" (1965), guest-starred as Jill in first-season episode 2, "Follow the Leader," and as Floy in second-season episode 3, "Then Came The Mighty Hunter," of "12 O'Clock High" (1965), and appeared in an episode of "I Dream of Jeannie" & "Gunsmoke" (both in 1966). She appeared in the "Bonanza" episode "A Question of Strength" (1963) as Sister Mary Kathleen and two episodes of "The Big Valley" (1967) and guest-starred in episode 11 of the first season of "Alias Smith and Jones" (1971), an hour-long TV special, "Super Plastic Elastic Goggles" (1971) as a part of the short-lived NBC series, Children's Theater, and the TV adaptation of "QB VII" (1974). She had roles in the films "A Pair of Briefs" (1962), "The Americanization of Emily" (1964), "All the Right Noises" (1971), and Rachel Amodeo's street movie "What About Me" (1993) opposite Richard Hell and Johnny Thunders.


title: Judy Carne

text: On "Rowan & Martin's Laugh-In" (Monday nights, 1968–1970), Carne gained stardom. Her most popular routine ended with her saying "Sock it to me!," at which point she was doused with water or assaulted in some other way. Carne was a regular in the first two seasons (1968–1969); then, having decided the show had become "a big, bloody bore," made occasional guest appearances in the remaining 1969–1970 seasons. A cast recording, on the CBS label, (#63490), was released in 1968. Her recording of "Sock It To Me," with "Right Said Fred" on side 2, (Reprise RS 20680), was released in the UK on 9 May 1969.


title: Judy Carne

text: Carne starred in a revival of the musical "The Boy Friend", which opened on Broadway on 14 April 1970 and ran for 111 performances.


title: Judy Carne

text: In 1993, Judy attended the 25th anniversary of "Laugh-In" and appeared on a televised "Laugh-In" Christmas show.


title: Judy Carne

text: Carne was married to actor Burt Reynolds from 1963 to 1965 and to producer Robert Bergmann from 3 May 1970 to 1971. Both marriages were brief and childless, and ended in divorce. In 1978, after beating a heroin possession charge, she and her second husband were involved in a car accident. Her neck was broken in the accident, but she recovered. She was later arrested again for heroin possession. In 1986, she was arrested at London's Heathrow Airport and convicted of drug possession. She served two months of a three-month prison sentence in HM Prison Cookham Wood.


title: Judy Carne

text: Her autobiography, "Laughing on the Outside, Crying on the Inside: The Bittersweet Saga of the Sock-It-To-Me Girl" (1985), detailed her bisexuality, marriage to Burt Reynolds (who unsuccessfully tried to prevent publication), and her experiences with drugs.


title: Judy Carne

text: Carne moved back to Northamptonshire, England, in the 1980s, living quietly in the village of Pitsford.


title: Buddhism by country

text: This list of Buddhism by country shows the distribution of the Buddhist religion, practiced by about 535 million people as of the 2010s, representing 7% to 8% of the world's total population.


title: Buddhism by country

text: Buddhism is the dominant religion in Bhutan, Myanmar, Cambodia, Mainland China, Hong Kong, Japan, Tibet, Laos, Macau, Mongolia, Singapore, Sri Lanka, Taiwan, Thailand, Kalmykia and Vietnam. Large Buddhist populations live in North Korea, Nepal, India and South Korea. China is the country with the largest population of Buddhists, approximately 244 million or 18.2% of its total population. They are mostly followers of Chinese schools of "Mahayana", making this the largest body of Buddhist traditions.


title: Buddhism by country

text: "Mahayana", also practised in broader East Asia, is followed by over half of the world's Buddhists. The second largest body of Buddhist schools is "Theravada", mostly followed in Southeast Asia and Sri Lanka. The third largest body of schools "Vajrayana", is followed mostly in Tibet, Bhutan, Nepal, Mongolia and parts of Russia, but is disseminated throughout the world. The fourth largest body of Buddhist schools is "Navayana", mostly followed in Maharashtra, India.


title: Buddhism by country

text: According to scholar Peter Harvey, the number of adherents of Eastern Buddhism ("Mahayana") is 360 million, Southern Buddhism ("Theravada") 150 million, and Northern Buddhism ("Vajrayana") 18.2 million. Seven million additional Buddhists are found outside Asia.


title: Wudu

text: Wuḍūʾ ( "" ) is the Islamic procedure for cleansing parts of the body, a type of ritual purification, or ablution. The 4 Fardh (Mandatory) acts of "Wudu" consists of washing the face, arms, then wiping the head and the feet with water.


title: Wudu

text: Wudu is an important part of ritual purity in Islam. It is governed by "fiqh" (Islamic jurisprudence), which specifies rules concerning hygiene and defines the rituals that constitute it.


title: Wudu

text: It is typically performed before prayers ("salah or salat"). Activities that invalidate "wudu" include urination, defecation, flatulence, deep sleep, light bleeding, menstruation, postpartum and sexual intercourse.


title: Wudu

text: "Wudu" is often translated as 'partial ablution', as opposed to "ghusl" as 'full ablution' where the whole body is washed. It also contrasts with "tayammum" ('dry ablution'), which uses sand or dust in place of water, principally due to water scarcity or other harmful effects on the person. Purification of the body and clothes is called "taharah".


title: Wudu

text: Wudu by itself is a mustahabb (recommendable act) in Islamic rites, but it becomes obligatory in Special conditions such as Daily prayers (salah) and Tawaf and worship.


title: Wudu

text: Wudu in Hadith Abu Hurairah, in reference to the Day of Resurrection, reported that Muhammad, when asked if he would be able to recognize Muslims, said, "Yes, you would have a mark which other people will not have. You would come to me with a white blaze on your foreheads and white marks on your feet because of the traces of ablution."


title: Wudu

text: Abu Hurayra said, "I have heard prophet (may peace be upon him) say, "In a believer adornment would reach the places where ablution reaches."


title: Wudu

text: Uthman stated that Muhammad said, "He who performed ablution well, his sins would come out from his body, even coming out from under his nails."


title: Wudu

text: Umar reported that Muhammad said, "No one among you does wuḍūʾ and does wuḍūʾ thoroughly – or adequately – and then testifies, 'There is no god but Allah Alone with no partner and I testify that Muhammad is Allah's Messenger', without the eight doors of the Garden being opened to him so that he can enter by whichever of them he wishes."


title: Wudu

text: It is mentioned in numerous Hadiths by Ja'far al-Sadiq that it is permissible to make wudu with water that is not overwhelmed with the smell of dead animals. If there is a dead animal, it is recommended to take wudu from the opposite side of the location of the animal. He also said it is permissible to take wudu from the ponds between Mecca and Medina in which people perform ghusl, dogs and beasts drink, and animals die so long as the water level is at least up to the knees.


title: Wudu

text: It has been narrated by Ali al-Ridha that if a drop of urine, blood or animal feces falls into a well, one must remove about ten buckets from it before performing wudu. If the feces has disintegrated into the water, forty to fifty buckets must be removed. Ja'far al-Sadiq has also mentioned that if an animal falls into the well, and has not disintegrated in it, remove five to seven buckets of water from it or until the smell or taste of the water changes. However, If the animal is bleeding or has an open wound, one must draw out thirty to forty buckets before it becomes purified for wudu. If a camel dies in the well or wine is poured into the well, all the water must be drained.


title: Wudu

text: The water of Wudu must be "mutlaq" meaning pure or unmixed (Not necessarily chemically pure). The name of a liquid that is normally regarded by individuals as water.


title: Wudu

text: There are other acts that are performed during wuḍūʾ and the detailed acts of the wuḍūʾ can be classed into 3 types:


title: Wudu

text: According to Sunni Muslims, the Qur'anic mandate for wudu comes in the sixth "ayah" of "sura" 5. The ayah has been translated by Muhammad Muhsin Khan, Rashad Khalifa, Abdullah Yusuf Ali, Pickthall and Maulana Muhammad Ali as follows. Note that these scholars' translation refer to washing the feet.


title: Wudu

text: Referencing the above verse, the Sunni schools of thought have consensus that the following four actions are obligatory in wudu ("Farā'id", aka Faraid, is the singular of "fard" and means "Obligatory ritual duties commanded by God. Generally refers to the five daily prayers, charity, fasting, and pilgrimage"), i.e. necessary for wudu to be valid:


title: Wudu

text: The obligation of the following actions is debated among the fiqh schools of thought, though if not deemed obligatory they are considered recommended:


title: Wudu

text: It is not sufficient for one to pass wet hand over the feet. Under certain conditions masah can be done over leather footgear known as khuffs. This is confirmed in several


title: Wudu

text: Shia Muslims also believe the Qur'anic mandate for wuḍūʾ comes in the sixth ayat of Al-Ma'ida, the 5th sura. The ayat has been translated by Muhammad Habib Shakir as follows. (Note this scholar's translation refers to wiping the feet.)


title: Wudu

text: A handful of "mustahabb" (recommended and meritorious but not required) acts that are considered to make the wuḍūʾ better. If one of these acts is omitted, the wuḍūʾ is still considered valid.


title: Wudu

text: Muslims who are unable to perform the prevailing form of ablution, due to skin disease, a disability or lack of clean water, etc. are recommended to perform "tayammum", sometimes called 'dry ablution', using sand or dust instead of water. Such an alternative form of ritual purity may also be accepted in cases where one fears hypothermia in cold weather.


title: Wudu

text: Tayammum is also to be performed when one is defiled (on "janabah") and could not perform "ghusl", and is authorised under specific circumstances.


title: Wudu

text: Theoretically, one can perform one wuḍūʾ for salat and this wudu would be considered valid for the rest of the day, unless you nullify it by certain means. Muslims believe that certain acts invalidate the wudu (often referred to as 'breaking wudu' and 'losing wudu'), although the Qur'an does not explain most of these, and rules differ among schools. According to Hidden Pearls website,


title: Wudu

text: During the research and production of this video & blog post, we came across so many conflicting opinions on what breaks wudu and what doesn’t. Different schools of thought vary widely on this issue unfortunately. Especially in the cases of ruling on general bleeding & vomiting, we were even surprised that there seems to be no correct answer.


title: Wudu

text: Belching and vomiting do not invalidate wudhu, however it is strongly recommended that the individual rinses his or her mouth following the latter. Bleeding is not considered to invalidate wudhu either, as Ja'far al-Sadiq made it clear in Hadith that a bad wound is not cause to repeat wudhu. This concept further extends to parasites that may exit the body through the two extremities. Cutting one's hair or nails does not invalidate wudhu but he or she should wipe the area with water.


title: Mary Holland

text: Holland was born and raised in Galax, Virginia. She attended Interlochen Center for the Arts and earned a Bachelor of Fine Arts from Northern Illinois University.


title: Mary Holland

text: After graduating from college, she began performing at the Upright Citizens Brigade Theatre. She is a cast member of UCB's flagship show Asssscat.


title: Mary Holland

text: Holland is a member of the comedy improv group Wild Horses, along with Lauren Lapkus, Erin Whitehead, and Stephanie Allynne.


title: Mary Holland

text: In 2015, Holland was cast in the Starz series "Blunt Talk", playing Shelly Tinkle until the series' cancellation after two seasons. In 2016, she was cast in a recurring role on the HBO series "Veep" and in the film "Unicorn Store". On February 28, 2017, Holland was cast in the ABC comedy pilot "Household Name" alongside Carol Burnett.


title: Mary Holland

text: On July 26, 2020, Holland participated in the Sequester: Undercover Mini in which she played as the Lemon. All donations for Holland's participation went to the Black Trans Travel Fund. Also in 2020, she guest starred in the final episode of season ten of "Curb Your Enthusiasm". In 2022 she portrayed principal Martha Reiser in "Senior Year", a comedy movie produced by Rebel Wilson. The movie got generally negative reviews but Holland's performance was praised.


title: Trevor Philips

text: Trevor Philips is a fictional character and one of the three playable protagonists, alongside Michael De Santa and Franklin Clinton, of "Grand Theft Auto V", the seventh main title in the "Grand Theft Auto" series developed by Rockstar Games. He also appears in the game's multiplayer component, "Grand Theft Auto Online". A career criminal and former bank robber, Trevor leads his own organisation, Trevor Philips Enterprises, and comes into conflict with various rival gangs and criminal syndicates as he attempts to secure control of the drugs and weapons trade in the fictional Blaine County, San Andreas. He is played by actor Steven Ogg, who provided the voice and motion capture for the character.


title: Trevor Philips

text: Rockstar based Trevor's appearance on Ogg's physical appearance, while his personality was inspired by Charles Bronson. "Grand Theft Auto V" co-writer Dan Houser described Trevor as purely driven by desire and resentment. To make players care for the character, the designers gave the character more emotions. Trevor is shown to care about people very close to him, despite his antisocial behavior and psychotic derangement.


title: Trevor Philips

text: Trevor is considered one of the most controversial characters in video game history. The general attention given to Trevor by critics was mostly very positive, although some reviewers felt that his violent personality and actions negatively affected the game's narrative. His design and personality have drawn comparisons to other influential video game and film characters. Many reviewers have called Trevor a likeable and believable character, and felt that he is one of the few protagonists in the "Grand Theft Auto" series that would willingly execute popular player actions, such as murder and violence.


title: Trevor Philips

text: "Grand Theft Auto V" co-writer Dan Houser explained that Trevor "appeared to pretty much out of nowhere as the embodiment of another side of criminality [...] If Michael was meant to be the idea of some version of criminal control [...] what about the guy who didn't do that?" He later described Trevor as "the person who's driven purely by desire, resentment, no thought for tomorrow whatsoever, completely id rather than ego-driven." He stated that Trevor "kills without remorse, like a true psychopath, but very sentimental for the right reasons when it suits him."


title: Trevor Philips

text: Rockstar drew upon game protagonist archetypes while scripting the characters; Trevor was considered to embody insanity. Houser said the team characterised Michael and Trevor as juxtapositions of each other. He said, "Michael is like the criminal who wants to compartmentalise and be a good guy some of the time and Trevor is the maniac who isn't a hypocrite". He said that having three lead characters would help move the game's plot into more original territory than its predecessors, which traditionally followed a single protagonist rising through the ranks of a criminal underworld. Steven Ogg was cast as Trevor. During the initial audition process, Ogg noticed an on-set chemistry between him and Ned Luke (who portrayed Michael), which he felt helped secure them the roles. Ogg said, "When [Luke] and I went in the room together we immediately had something". While the actors knew their auditions were for Rockstar Games, it was when they signed contracts that they learned they would be involved in a "Grand Theft Auto" title.


title: Trevor Philips

text: Ogg felt Trevor's characterisation developed over time. He said, "Nuances and character traits that began to appearhis walk, his manner of speech, his reactions, definitely informed his development throughout the game". Ogg cites Tom Hardy's portrayal of English criminal Charles Bronson in the 2008 biopic "Bronson" as a strong stylistic influence. He opined that while Trevor embodies the violent, psychopathic "Grand Theft Auto" anti-hero archetype, he wanted to evoke player sympathy to Trevor's story. "To elicit other emotions was tough, and it was the biggest challenge and it's something that meant a lot to me", Ogg explained. The actors began working on the game in 2010. Their performances were mostly recorded using motion capture technology. Dialogue for scenes with characters seated in vehicles was recorded in studios. Because the actors had their dialogue and movements recorded on-set, they considered their performances were no different from those of film or television roles. Their dialogue was scripted so that it did not allow the actors to ad-lib; however they sometimes made small changes to the performance with approval from the directors.


title: Trevor Philips

text: Trevor was born in Canada, just north of the border of the United States. He grew up with a physically abusive father and an emotionally abusive mother. Trevor loved planes, and at some point entered the military as a pilot, but was quickly forced to leave after being reproved in a psychological evaluation. Later on, Trevor committed crimes, the first one being a small robbery that landed him in jail for six months. Due to good behavior, he was out in four. He would continue his criminal ways, including using his piloting skills to become a smuggler. Trevor met Michael Townley in 1993 and they realised that they wanted to earn money by performing large heists, so they joined forces and became successful in doing so over the following years. Their partnership began to strain after Michael married a stripper named Amanda and started a family with her. Despite this, Trevor grew close to Michael's children, who came to see him as their uncle.


title: Trevor Philips

text: In 2004, during a heist in Ludendorff, North Yankton, Michael and mutual accomplice Brad Snider are shot by police while Trevor escapes. While on the run, Trevor is led to believe that Michael died and Brad was sent to jail. Trevor eventually settles in Sandy Shores, a small town in Blaine County, San Andreas, where he establishes a small criminal enterprise that smuggles weapons and manufactures methamphetamine, which he hopes will grow into a large empire. Due to raging abandonment issues, Trevor surrounds himself with two loyal friends that he kidnapped and brainwashed from their previous lives named "Nervous" Ron Jakowski and Wade Hebert. Trevor enters an uneasy truce with his competitors in Sandy Shores, including the Lost Motorcycle Club led by Johnny Klebitz, the Varrios Los Aztecas gang, and the O'Neil Brothers.


title: Trevor Philips

text: In 2013, Trevor finds out that Michael faked his death, and is so spooked and enraged that he breaks the truce and kills most of his competition in one outburst of violence, a deadly streak that continues when a potential game-changing deal with a group of triads falls through. He later drives to Los Santos, taking over the apartment and ruining the life of Wade's cousin Floyd, and reunites with Michael, who took on the surname "De Santa" and is supposedly living in witness protection. Though Michael is reluctant to have Trevor back in his life again, he eventually introduces him to Franklin Clinton, after which the two perform heists again, this time including Franklin. Trevor is determined to rob anything guarded by Merryweather Security Consulting, a private security firm that he dislikes, but he often fails.


title: Trevor Philips

text: When corrupt Federal Investigation Bureau (FIB) agents Dave Norton and Steve Haines contact Michael after he breaks his agreement with them by committing heists again, they force him to carry out a number of operations alongside Trevor and Franklin to undermine the rival International Affairs Agency (IAA). Steve later introduces the trio to Devin Weston, a billionaire investor who hires them to steal a number of rare cars, but ultimately cheats them out of their money. During this time, Trevor begins to bond with Franklin, as they carry out several jobs together without Michael, some of which involve Franklin's friend Lamar Davis, whom Trevor also befriends. Later, after not getting paid for a job, Trevor kidnaps Patricia, the wife of drug kingpin Martin Madrazo. Due to her kind maternal nature and his own abandonment issues, Trevor falls in love with her and only returns her after much demanding from Michael. However, the two stay in contact until the end of the game.


title: Trevor Philips

text: Trevor eventually discovers that the Ludendorff heist from nine years prior was a set up planned by Michael and Dave, meant to allow the former to retire and escape from Trevor, and that Brad was not arrested, but rather killed and buried in Michael's fake grave. Feeling betrayed, Trevor vows to kill Michael, but later comes to his and Dave's aid when they are betrayed by Steve, because he needs Michael alive for one last heist. When that heist is successful, Trevor is so pleased that he lifts the death vow but still hates Michael. Near the end of the game, Franklin is approached separately by Dave and Steve, who contend that Trevor is a liability, and by Devin, who seeks revenge against Michael for an earlier incident. This leaves Franklin with three choices: kill Trevor, kill Michael, or try to save them both in a suicide mission.


title: Trevor Philips

text: Trevor is a main character in "Grand Theft Auto Online", the online multiplayer mode of "Grand Theft Auto V", set several months before the single-player story. He provides missions to the player after they reach Rank 13 and steal Trevor's rolling meth lab during a job. When the player arrives at his trailer, Trevor demands compensation for the stolen meth lab and has them complete several jobs, which generally consist of stealing drugs from rivals, mainly the Lost MC, and killing the dealers. Trevor later plays a major role in the 2015 "Heists" update, where he masterminds one of the heists featured in the update. This "heist" consists of the theft of drugs from various gangs, including the Lost, the O'Neil Brothers, the Los Santos Vagos, and the Ballas, which Trevor plans to sell for a large profit. After all drug shipments are collected, Trevor and the players deliver them to the deal's location, whereupon Trevor gives the players their cut in advance and they leave. When the buyer arrives, Trevor quickly realizes that the deal is a sting operation, at which point he is ambushed by the Drug Observation Agency (DOA), but manages to escape, albeit without the drugs.


title: Trevor Philips

text: Although Trevor makes no further appearances in the game, he is mentioned by Ron in the 2017 update "Smuggler's Run", which is set in 2017, a few years after the single-player story. Ron, after being abandoned by Trevor, contacts the player to start their own smuggling operation, and when they meet, the former briefly talks about Trevor, saying he has "gone Vinewood" and has become a guru and lifestyle coach; this confirms Trevor is still alive after the events of "Grand Theft Auto V". Furthermore, the 2019 update, "The Diamond Casino & Resort", includes a mention of the events of "The Third Way," implying that both Trevor and Michael canonically survive the events of the single-player story.


title: Trevor Philips

text: Trevor's character was met with generally positive feedback following the release of "Grand Theft Auto V". "Edge" singled out Trevor as the stand-out of the three protagonists, which they owed to his volatile personality. Like "Edge", Caroline Petit of "GameSpot" considered Trevor "a truly horrible, terrifying, psychotic human being—and a terrific character." "Eurogamer"s Tom Bramwell, however, felt that Trevor undermined the other characters because he was a "shallow and unconvincing" sensationalised anti-hero, and that "his antics derail[ed] the narrative" and overshadowed the character development of Michael and Franklin. Xav de Matos of "Joystiq" found all three characters unlikable to the extent that they had an alienating effect on the story, noting that "though each character has a valid motivation for his journey, it's difficult to want them to succeed." He also felt that the ambivalence between Trevor and Michael was a tired device by the conclusion of the story as it became a "seemingly endless cycle" of conflict between them.


title: Trevor Philips

text: Lucas Sullivan of "GamesRadar" praised Trevor for being the first character in the series that "makes sense". He stated that, upon their first playthrough of a "Grand Theft Auto" game, most players "carjacked some poor schlub, then started doing 90mph on the sidewalk, mowing over civilians", as opposed to playing peacefully. "Trevor's existence isn't a commentary on any group of people–he's just the first logical fit to the way people have been playing "GTA" games for the past decade," he said. Sullivan concluded that Trevor is one of the few protagonists in "Grand Theft Auto" that would willingly execute popular player actions, such as murder and violence. Andy Corrigan of "IGN" compared Trevor to Heath Ledger's Joker in the 2008 film "The Dark Knight". Corrigan felt that Trevor is the only character in "Grand Theft Auto V" not trying to fake his persona, stating "Trevor absolutely knows that he's a monster but just doesn't care. He enjoys causing misery and harm, lives for it and embraces it and – much like Heath Ledger's Joker – he exists purely for unadulterated anarchy." He also felt that Trevor's only reasoning for hurting people and messing everything up around him is simply because it's just too much fun not to. Corrigan concluded saying that it's clear that the world through the eyes of Trevor is already royally broken and he sees no harm in messing it up some more, hence the reason for Trevor's actions.


title: Trevor Philips

text: Trevor was named Best Character for the "Official Xbox Magazine" Game of the Year Awards 2013. The character was nominated for Character of the Year at VGX, Best New Character from "Hardcore Gamer", and Best Character from "Destructoid". Steven Ogg was also nominated for his work as Trevor from VGX, "The Telegraph", and the 10th British Academy Video Games Awards.


title: Trevor Philips

text: The mission "By the Book" from "Grand Theft Auto V" was criticised for its depiction of torture. In the mission, Trevor interrogates Ferdinand "Mr. K" Kerimov for information about a suspected Azerbaijani fugitive who poses a threat to the FIB (the game's version of the FBI). Trevor uses torture equipment on the restrained man, which players select from a table. Once Mr. K provides the FIB with the information, Trevor is asked to kill him, but instead drives him to the airport, providing him an opportunity to escape. While driving Kerimov, Trevor monologues about the ineffectiveness of torture, pointing out Kerimov's readiness to supply the FIB with the information without being tortured, and expressing that torture is used as a power play "to assert ourselves".


title: Trevor Philips

text: Reviewers echoed that while the mission served as political commentary on the use of torture by the United States government, its use of torture was in poor taste. "GameSpot"s Petit felt that placing the torture scene in context with the monologue created a hypocrisy in the mission's function as a commentary device, and "IGN"s Keza MacDonald felt it "pushed the boundaries of taste". In an editorial, Bramwell discussed whether the political commentary was overshadowed by the violent content, comparing the mission to ""s "No Russian" controversy. He considered the sequence lacking enough context to justify its violence and summarised its function as "flawed". Labour MP Keith Vaz expressed concern that underage players could be exposed to the mission. Keith Best of Freedom from Torture said the torturer role-play "crossed a line". Tom Chick defended the torture sequence, and wrote that unlike the "No Russian" mission or the 2012 film "Zero Dark Thirty", the underlying political commentary on torture in "By the Book" necessitated the violent content.


title: Educated (book)

text: Educated (2018) is a memoir by the American author Tara Westover. Westover recounts overcoming her survivalist Mormon family in order to go to college, and emphasizes the importance of education in enlarging her world. She details her journey from her isolated life in the mountains of Idaho to completing a PhD program in history at Cambridge University. She started college at the age of 17 having had no formal education. She explores her struggle to reconcile her desire to learn with the world she inhabited with her father.


title: Educated (book)

text: As of the September 13, 2020, issue of "The New York Times", the book had spent 132 consecutive weeks on the Hardcover Non-Fiction Best Seller list. It won a 2019 Alex Award and was shortlisted for the "Los Angeles Times" Book Prize, PEN America's Jean Stein Book Award, and two awards from the National Book Critics Circle Award.


title: Educated (book)

text: Westover is raised in isolation in Buck's Peak, Idaho by her parents, pseudonymously referred to as Gene and Faye Westover respectively. Gene was paranoid about hospitals, public education, and the government, partially due to the siege at Ruby Ridge. Faye consequently homeschools the Westover children.


title: Educated (book)

text: Gene denies Westover's attempts to seek normality in her life. Her brother Shawn initially helps her and the two grow closer but he starts physically abusing her as she befriends Charles, a boy she meets while performing in theater. Another of Westover's brothers, Tyler, learns of the abuse and encourages her to leave home and take the ACT to be able to apply to Brigham Young University (BYU). Westover is later admitted to BYU under a scholarship. Shawn reconciles with her after standing up to Gene on her behalf.


title: Educated (book)

text: Sometime later, Westover studies at the University of Cambridge and receives scholarships that allow her to continue attending. The pressure of maintaining her grades in order to keep her scholarship results in Westover feeling stressed. Additionally, her alienation from the outside world and lack of formal schooling become issues.


title: Educated (book)

text: Later, Westover reconnects with Charles, but is unable to act romantically towards him because of her conservative upbringing. Remembering Gene's and Shawn's abuse towards her, results in Westover terminating her relationship with Charles.


title: Educated (book)

text: Westover now feels alienated in Idaho and worries that Gene may have bipolar disorder. She cuts ties with him, but reconnects after he expresses interest in her life at school. After Shawn marries Emily, a young woman he was dating, Westover worries about Emily who previously expressed fear of Shawn.


title: Educated (book)

text: Westover confides to one of her professors about her family. Her professor encourages her to apply for the studying abroad program at Cambridge. After arriving at King's College, Westover is assigned to work with Professor Jonathan Steinberg. Both of her professors encourage her to attend graduate school. Westover applies for and wins the Gates Scholarship and forms a temporary truce with Gene. The two previously fell out over how she chronicled her past to local news outlets and her decision to attend school in England.


title: Educated (book)

text: After returning to Cambridge, Westover takes steps to be part of the world, including getting immunized for vaccinations her family rejected. She occasionally returns to Idaho where she learns that Shawn is still abusing Emily. Her sister, Audrey, learned about Shawn's behavior, but Faye does not believe her. Westover and Faye take up email correspondence through which the latter suggests that Gene is mentally ill and writes about how they plan to get Shawn the help he needs. On another trip home, Shawn briefly shows signs of change, but later accuses Audrey of lying about his abusive behavior and threatens to kill her. Gene and Faye do not take Westover seriously when she tells them about Shawn's threat.


title: Educated (book)

text: Westover encounters Shawn with a bloody knife on another visit home. Terrified, she lies that Gene lied about Shawn's treatment to Audrey. Later, she realizes that Faye had never been on her or Audrey's side. After returning to England, Shawn threatens her life. Audrey also cuts ties with Westover, claiming she is under Satan's control. Westover then begins graduate school at Harvard and her parents briefly visit and try to convince her to come home.


title: Educated (book)

text: After returning home again, Westover discovers that Erin, Shawn's ex-girlfriend, wrote to Faye that she was delusional and demonizing her brother. Westover returns to Harvard and eventually England. After suffering panic attacks, she ends contact with her parents for a year, attempting to recover. She struggles in her studies, but Tyler encourages her and she successfully completes her PhD.


title: Educated (book)

text: Years later Westover returns to Idaho for her maternal grandmother's funeral. She reunites with Tyler, his wife, two maternal aunts and her other siblings, most of whom still take Gene's and Shawn's side. At the end of the memoir, Westover is in touch with only a few family members and accepts that she needs to be away from the mountain.


title: Educated (book)

text: Of her upbringing, Westover has said, "My father created our reality in a really meaningful way because we were so isolated. He would say these things about public education and doctors and the government and we didn't know any better. We didn't go to school so as far as we knew the world was exactly the way our father described it." Westover got her undergraduate degree at Brigham Young University and her PhD at Cambridge.


title: Educated (book)

text: Westover decided to write the book after she confronted her parents about her brother's abuse, and the resulting conflict led to her becoming estranged from some members of her family. She began searching for stories to help her understand what had happened. In 2018, she told "The New York Times", "I wrote the book I wished I could have given to myself when I was losing my family. When I was going through that experience, I became aware of how important stories are in telling us how to live — how we should feel, when we should feel proud, when we should feel ashamed. I was losing my family, and it seemed to me that there were no stories for that — no stories about what to do when loyalty to your family was somehow in conflict with loyalty to yourself. And forgiveness. I wanted a story about forgiveness that did not conflate forgiveness with reconciliation, or did not treat reconciliation as the highest form of forgiveness. In my life, I knew the two might always be separate. I didn't know if I would ever reconcile with my family, and I needed to believe that I could forgive, regardless."


title: Educated (book)

text: Westover has said that she set out to explore the complexity of difficult family relationships. In an interview with "The Irish Times", she said, "You can love someone and still choose to say goodbye to them, and you can miss someone every day and still be glad they're not in your life."


title: Educated (book)

text: Her parents' attorney has said that "Her parents raised their family in what Tara described as an extremist mindset, but what they felt was self-sufficiency." They maintain that there is only a "little germ of truth" in her book. Their attorney said Westover's parents were hurt that Westover would write a book that slanders her upbringing and that she would accuse her brother [Shawn] of the abuse described.


title: Educated (book)

text: "Educated" was an instant #1 "New York Times" bestseller, and was positively reviewed by "The New York Times", "The Atlantic", "USA Today", "Vogue", and "The Economist", among others. The book was also nominated for a number of national awards, including the "Los Angeles Times" Book Prize, PEN America's Jean Stein Book Award, and two awards from the National Book Critics Circle Award.


title: Educated (book)

text: "Educated" spent more than two years in hardcover on the "New York Times" bestseller list and is being translated into 45 languages. "The New York Times" ranked "Educated" as one of the 10 Best Books of 2018,  and The American Booksellers Association named "Educated" the Nonfiction Book of the Year. As of December 2020, the book had sold more than 6 million copies.


title: Comorbidity

text: In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary condition. Comorbidity describes the effect of all other conditions an individual patient might have other than the primary condition of interest, and can be physiological or psychological. In the context of mental health, comorbidity often refers to disorders that are often coexistent with each other, such as depression and anxiety disorders. The concept of multimorbidity is related to comorbidity but presents a different meaning and approach.


title: Comorbidity

text: Comorbidity can indicate either a condition existing simultaneously, but independently with another condition or a related derivative medical condition. The latter sense of the term causes some overlap with the concept of complications. For example, in longstanding diabetes mellitus, the extent to which coronary artery disease is an independent comorbidity versus a diabetic complication is not easy to measure, because both diseases are quite multivariate and there are likely aspects of both simultaneity and consequence. The same is true of intercurrent diseases in pregnancy. In other examples, the true independence or relation is not ascertainable because syndromes and associations are often identified long before pathogenetic commonalities are confirmed (and, in some examples, before they are even hypothesized). In psychiatric diagnoses it has been argued in part that this "'use of imprecise language may lead to correspondingly imprecise thinking', [and] this usage of the term 'comorbidity' should probably be avoided." However, in many medical examples, such as comorbid diabetes mellitus and coronary artery disease, it makes little difference which word is used, as long as the medical complexity is duly recognized and addressed.


title: Comorbidity

text: Comorbidity is often referred to as multimorbidity even though the two are considered distinct clinical scenarios.


title: Comorbidity

text: Comorbidity means that one 'index' condition is the focus of attention, and others are viewed in relation to this. In contrast, multimorbidity describes someone having two or more long-term (chronic) conditions without any of them holding priority over the others. This distinction is important in how the healthcare system treats people and helps making clear the specific settings in which the use of one or the other term can be preferred. Multimorbidity offers a more general and person-centered concept that allows focusing on all of the patient's symptoms and providing a more holistic care. In other settings, for example in pharmaceutical research, comorbidity might often be the more useful term to use.


title: Comorbidity

text: In psychiatry, psychology, and mental health counseling, comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. However, in psychiatric classification, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect current inability to supply a single diagnosis accounting for all symptoms. On the DSM Axis I, major depressive disorder is a very common comorbid disorder. The Axis II personality disorders are often criticized because their comorbidity rates are excessively high, approaching 60% in some cases. Critics assert this indicates these categories of mental illness are too imprecisely distinguished to be usefully valid for diagnostic purposes, impacting treatment and resource allocation. Symptom overlap is a key component against DSM classification and serves as a note towards redefining criteria in disorders that the root cause may not be understood thoroughly. Regardless of criticisms, it stands that, annually, up to 45% of mental health patients fit the criteria for a comorbid diagnosis. A comorbid diagnosis is associated with more severe symptomatic expression and greater chance of dismal prognosis. Certain diagnoses such as ADHD, autism, OCD, and mood disorders have higher rates of co-occurring or being prevalent in separate diagnoses. "Comorbidity in OCD is the rule rather than the exception" with OCD diagnoses facing a lifetime rate of 90%. With overlapping symptoms comes overlap in treatment as well, CBT for example is common for both ADHD and OCD with pediatric onset and can be effective for both in a comorbid diagnosis. OCD and eating disorders have a high rate of occurrence, it is estimated that 20-60% of patients with an eating disorder have OCD. More often, comorbidity complicates and can prevent treatment efficacy on a varying scale depending on the circumstances.


title: Comorbidity

text: The term 'comorbidity' was introduced in medicine by Feinstein (1970) to describe cases in which a 'distinct additional clinical entity' occurred before or during treatment for the 'index disease', the original or primary diagnosis. Since the terms were coined, meta studies have shown that criteria used to determine the index disease were flawed and subjective, and moreover, trying to identify an index disease as the cause of the others can be counterproductive to understanding and treating interdependent conditions. In response, 'multimorbidity' was introduced to describe concurrent conditions without relativity to or implied dependency on another disease, so that the complex interactions to emerge naturally under analysis of the system as a whole.


title: Comorbidity

text: Although the term 'comorbidity' has recently become very fashionable in psychiatry, its use to indicate the concomitance of two or more psychiatric diagnoses is said to be incorrect because in most cases it is unclear whether the concomitant diagnoses actually reflect the presence of distinct clinical entities or refer to multiple manifestations of a single clinical entity. It has been argued that because "'the use of imprecise language may lead to correspondingly imprecise thinking', this usage of the term 'comorbidity' should probably be avoided".


title: Comorbidity

text: Due to its artifactual nature, psychiatric comorbidity has been considered as a Kuhnian anomaly leading the DSM to a scientific crisis and a comprehensive review on the matter considers comorbidity as an epistemological challenge to modern psychiatry. The Hierarchical Taxonomy of Psychopathology is a leading alternative classification system that addresses these concerns about comorbidity.


title: Comorbidity

text: Widespread study of physical and mental pathology found its place in psychiatry. I. Jensen (1975), J.H. Boyd (1984), W.C. Sanderson (1990), Yuri Nuller (1993), D.L. Robins (1994), A. B. Smulevich (1997), C.R. Cloninger (2002) and other psychiatrists discovered a number of comorbid conditions in those with psychiatric disorders.


title: Comorbidity

text: The influence of comorbidity on the clinical progression of the primary (basic) physical disorder, effectiveness of the medicinal therapy and immediate and long-term prognosis of the patients was researched by physicians and scientists of various medical fields in many countries across the globe. These scientists and physicians included: M. H. Kaplan (1974), T. Pincus (1986), M. E. Charlson (1987), F. G. Schellevis (1993), H. C. Kraemer (1995), M. van den Akker (1996), A. Grimby (1997), S. Greenfield (1999), M. Fortin (2004) & A. Vanasse (2004), C. Hudon (2005), L. B. Lazebnik (2005), (2008), G. E. Caughey (2008), F. I. Belyalov (2009), L. A. Luchikhin (2010) and many others.


title: Comorbidity

text: Many centuries ago the doctors propagated the viability of a complex approach in the diagnosis of disease and the treatment of the patient, however, modern medicine, which boasts a wide range of diagnostic methods and a variety of therapeutic procedures, stresses specification. This brought up a question: How to wholly evaluate the state of a patient who has a number of diseases simultaneously, where to start from and which disease(s) require(s) primary and subsequent treatment? For many years this question stood out unanswered, until 1970, when a renowned American doctor epidemiologist and researcher, A.R. Feinstein, who had greatly influenced the methods of clinical diagnosis and particularly methods used in the field of clinical epidemiology, came out with the term of "comorbidity". The appearance of comorbidity was demonstrated by Feinstein using the example of patients physically affected by rheumatic fever, discovering the worst state of the patients, who simultaneously had multiple diseases. In due course of time after its discovery, comorbidity was distinguished as a separate scientific-research discipline in many branches of medicine.


title: Comorbidity

text: Presently there is no agreed-upon terminology of comorbidity. Some authors bring forward different meanings of comorbidity and multi-morbidity, defining the former, as the presence of a number of diseases in a patient, connected to each other through proven pathogenetic mechanisms and the latter, as the presence of a number of diseases in a patient, not having any connection to each other through any of the proven to date pathogenetic mechanisms. Others affirm that multi-morbidity is the combination of a number of chronic or acute diseases and clinical symptoms in a person and do not stress the similarities or differences in their pathogenesis. However the principle clarification of the term was given by H. C. Kraemer and M. van den Akker, determining comorbidity as the combination in a patient of 2 or more chronic diseases (disorders), pathogenetically related to each other or coexisting in a single patient independent of each disease's activity in the patient.


title: Comorbidity

text: Comorbidity is widespread among the patients admitted at multidiscipline hospitals. During the phase of initial medical help, the patients having multiple diseases simultaneously are a norm rather than an exception. Prevention and treatment of chronic diseases declared by the World Health Organization, as a priority project for the second decade of the 20th century, are meant to better the quality of the global population. This is the reason for an overall tendency of large-scale epidemiological researches in different medical fields, carried-out using serious statistical data. In most of the carried-out, randomized, clinical researches the authors study patients with single refined pathology, making comorbidity an exclusive criterion. This is why it is hard to relate researches, directed towards the evaluation of the combination of ones or the other separate disorders, to works regarding the sole research of comorbidity. The absence of a single scientific approach to the evaluation of comorbidity leads to omissions in clinical practice. It is hard not to notice the absence of comorbidity in the taxonomy (systematics) of disease, presented in ICD-10.


title: Comorbidity

text: All the fundamental researches of medical documentation, directed towards the study of the spread of comorbidity and influence of its structure, were conducted until the 1990s. The sources of information, used by the researchers and scientists, working on the matter of comorbidity, were case histories, hospital records of patients and other medical documentation, kept by family doctors, insurance companies and even in the archives of patients in old houses.


title: Comorbidity

text: The listed methods of obtaining medical information are mainly based on clinical experience and qualification of the physicians, carrying out clinically, instrumentally and laboratorially confirmed diagnosis. This is why despite their competence, they are highly subjective. No analysis of the results of postmortem of deceased patients was carried out for any of the comorbidity researches.


title: Comorbidity

text: "It is the duty of the doctor to carry out autopsy of the patients they treat", said once professor . Autopsy allows you to exactly determine the structure of comorbidity and the direct cause of death of each patient independent of his/her age, gender and gender specific characteristics. Statistical data of comorbid pathology, based on these sections, are mainly devoid of subjectivism.


title: Comorbidity

text: The analysis of a decade long Australian research based on the study of patients having 6 widespread chronic diseases demonstrated that nearly half of the elderly patients with arthritis also had hypertension, 20% had cardiac disorders and 14% had type 2 diabetes. More than 60% of asthmatic patients complained of concurrent arthritis, 20% complained of cardiac problems and 16% had type 2 diabetes.


title: Comorbidity

text: In patients with chronic kidney disease (renal insufficiency) the frequency of coronary heart disease is 22% higher and new coronary events 3.4 times higher compared to patients without kidney function disorders. Progression of CKD towards end stage renal disease requiring renal replacement therapy is accompanied by increasing prevalence of Coronary Heart Disease and sudden death from cardiac arrest.


title: Comorbidity

text: A Canadian research conducted upon 483 obesity patients, it was determined that spread of obesity related accompanying diseases was higher among females than males. The researchers discovered that nearly 75% of obesity patients had accompanying diseases, which mostly included dyslipidemia, hypertension and type 2 diabetes. Among the young obesity patients (from 18 to 29) more than two chronic diseases were found in 22% males and 43% females.


title: Comorbidity

text: Fibromyalgia is a condition which is comorbid with several others, including but not limited to; depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, rheumatoid arthritis, migraine, and panic disorder.


title: Comorbidity

text: The number of comorbid diseases increases with age. Comorbidity increases by 10% in ages up to 19 years, up to 80% in people of ages 80 and older. According to data by M. Fortin, based on the analysis of 980 case histories, taken from daily practice of a family doctor, the spread of comorbidity is from 69% in young patients, up to 93% among middle aged people and up to 98% patients of older age groups. At the same time the number of chronic diseases varies from 2.8 in young patients and 6.4 among older patients.


title: Comorbidity

text: According to Russian data, based on the study of more than three thousand postmortem reports (n=3239) of patients of physical pathologies, admitted at multidisciplinary hospitals for the treatment of chronic disorders (average age 67.8 ± 11.6 years), the frequency of comorbidity is 94.2%. Doctors mostly come across a combination of two to three disorders, but in rare cases (up to 2.7%) a single patient carried a combination of 6–8 diseases simultaneously.


title: Comorbidity

text: The fourteen-year research conducted on 883 patients of idiopathic thrombocytopenic purpura (Werlhof disease), conducted in Great Britain, shows that the given disease is related to a wide range of physical pathologies. In the comorbid structure of these patients, most frequently present are malignant neoplasms, locomotorium disorders, skin and genitourinary system disorders, as well as haemorrhagic complications and other autoimmune diseases, the risk of whose progression during the first five years of the primary disease exceeds the limit of 5%.


title: Comorbidity

text: In a research conducted on 196 larynx cancer patients, it was determined that the survival rate of patients at various stages of cancer differs depending upon the presence or absence of comorbidity. At the first stage of cancer the survival rate in the presence of comorbidity is 17% and in its absence it is 83%, in the second stage of cancer the rate of survivability is 14% and 76%, in the third stage it is 28% and 66% and in the fourth stage of cancer it is 0% and 50% respectively. Overall the survivability rate of comorbid larynx cancer patients is 59% lower than the survivability rate of patients without comorbidity.


title: Comorbidity

text: Except for therapists and general physicians, the problem of comorbidity is also often faced by specialists. Regretfully they seldom pay attention to the coexistence of a whole range of disorders in a single patient and mostly conduct the treatment of specific to their specialization diseases. In current practice urologists, gynecologists, ENT specialists, eye specialists, surgeons and other specialists all too often mention only the diseases related to "own" field of specialization, passing on the discovery of other accompanying pathologies "under the control" of other specialists. It has become an unspoken rule for any specialized department to carry out consultations of the therapist, who feels obliged to carry out symptomatic analysis of the patient, as well as to the form the diagnostic and therapeutic concept, taking in view the potential risks for the patient and his long-term prognosis.


title: Comorbidity

text: Based on the available clinical and scientific data it is possible to conclude that comorbidity has a range of undoubted properties, which characterize it as a heterogeneous and often encountered event, which enhances the seriousness of the condition and worsens the patient's prospects. The heterogeneous character of comorbidity is due to the wide range of reasons causing it.


title: Comorbidity

text: The factors responsible for the development of comorbidity can be chronic infections, inflammations, involutional and systematic metabolic changes, iatrogenesis, social status, ecology and genetic susceptibility.


title: Comorbidity

text: The division of comorbidity as per syndromal and nosological principles is mainly preliminary and inaccurate, however it allows us to understand that comorbidity can be connected to a singular cause or common mechanisms of pathogenesis of the conditions, which sometimes explains the similarity in their clinical aspects, which makes it difficult to differentiate between nosologies.


title: Comorbidity

text: There are a number of rules for the formulation of clinical diagnosis for comorbid patients, which must be followed by a practitioner. The main principle is to distinguish in diagnosis the primary and background diseases, as well as their complications and accompanying pathologies.


title: Comorbidity

text: Many tests attempt to standardize the "weight" or value of comorbid conditions, whether they are secondary or tertiary illnesses. Each test attempts to consolidate each individual comorbid condition into a single, predictive variable that measures mortality or other outcomes. Researchers have validated such tests because of their predictive value, but no one test is as yet recognized as a standard.


title: Comorbidity

text: The Charlson comorbidity index predicts the one-year mortality for a patient who may have a range of comorbid conditions, such as heart disease, AIDS, or cancer (a total of 22 conditions). Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Scores are summed to provide a total score to predict mortality. Many variations of the Charlson comorbidity index have been presented, including the Charlson/Deyo, Charlson/Romano, Charlson/Manitoba, and Charlson/D'Hoores comorbidity indices.


title: Comorbidity

text: For a physician, this score is helpful in deciding how aggressively to treat a condition. For example, a patient may have cancer with comorbid heart disease and diabetes. These comorbidities may be so severe that the costs and risks of cancer treatment would outweigh its short-term benefit.


title: Comorbidity

text: Since patients often do not know how severe their conditions are, nurses were originally supposed to review a patient's chart and determine whether a particular condition was present in order to calculate the index. Subsequent studies have adapted the comorbidity index into a questionnaire for patients.


title: Comorbidity

text: The Charlson index, especially the Charlson/Deyo, followed by the Elixhauser have been most commonly referred by the comparative studies of comorbidity and multimorbidity measures.


title: Comorbidity

text: The comorbidity–polypharmacy score (CPS) is a simple measure that consists of the sum of all known comorbid conditions and all associated medications. There is no specific matching between comorbid conditions and corresponding medications. Instead, the number of medications is assumed to be a reflection of the "intensity" of the associated comorbid conditions. This score has been tested and validated extensively in the trauma population, demonstrating good correlation with mortality, morbidity, triage, and hospital readmissions. Of interest, increasing levels of CPS were associated with significantly lower 90-day survival in the original study of the score in trauma population.


title: Comorbidity

text: The Elixhauser comorbidity measure was developed using administrative data from a statewide California inpatient database from all non-federal inpatient community hospital stays in California ("n" = 1,779,167). The Elixhauser comorbidity measure developed a list of 30 comorbidities relying on the ICD-9-CM coding manual. The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital changes, and mortality) differently among different patients groups. The comorbidities identified by the Elixhauser comorbidity measure are significantly associated with in-hospital mortality and include both acute and chronic conditions. van Walraven et al. have derived and validated an Elixhauser comorbidity index that summarizes disease burden and can discriminate for in-hospital mortality. In addition, a systematic review and comparative analysis shows that among various comorbidities indices, Elixhauser index is a better predictor of the risk especially beyond 30 days of hospitalization.


title: Comorbidity

text: Patients who are more seriously ill tend to require more hospital resources than patients who are less seriously ill, even though they are admitted to the hospital for the same reason. Recognizing this, the diagnosis-related group (DRG) manually splits certain DRGs based on the presence of secondary diagnoses for specific complications or comorbidities (CC). The same applies to Healthcare Resource Groups (HRGs) in the UK.


title: Comorbidity

text: Patient S., 73 years, called an ambulance because of a sudden pressing pain in the chest. It was known from the case history that the patient had CHD for many years. Such chest pains were experienced by her earlier as well, but they always disappeared after a few minutes of sublingual administration of organic nitrates. This time taking three tablets of nitroglycerine did not kill the pain. It was also known from the case history that the patient had twice had myocardial infarctions during the last ten years, as well as had an Acute Cerebrovascular Event with sinistral hemiplegia more than 15 years ago. Apart from that the patient had hypertension, type 2 diabetes with diabetic nephropathy, hysteromyoma, cholelithiasis, osteoporosis and varicose pedi-vein disease. It was also learned that the patient regularly takes a number of antihypertensive drugs, urinatives and oral antihyperglycemic remedies, as well as statins, antiplatelet and nootropics. In the past the patient had undergone cholecystectomy due to cholelithiasis more than 20 years ago, as well as the extraction of a cataract of the right eye 4 years ago. The patient was admitted to cardiac intensive care unit at a general hospital diagnosed for acute transmural myocardial infarction. During the check-up moderate azotemia, mild erythronormoblastic anemia, proteinuria and lowering of left vascular ejection fraction were also identified.


title: Comorbidity

text: Analyzing the comorbid state of patient S, 73 years of age, using the most used international comorbidity assessment scales, a doctor would come across totally different evaluation. The uncertainty of these results would somewhat complicate the doctors judgment about the factual level of severity of the patient's condition and would complicate the process of prescribing rational medicinal therapy for the identified disorders. Such problems are faced by doctors on everyday basis, despite all their knowledge about medical science. The main hurdle in the way of inducting comorbidity evaluation systems in broad based diagnostic-therapeutic process is their inconsistency and narrow focus. Despite the variety of methods of evaluation of comorbidity, the absence of a singular generally accepted method, devoid of the deficiencies of the available methods of its evaluation, causes disturbance. The absence of a unified instrument, developed on the basis of colossal international experience, as well as the methodology of its use does not allow comorbidity to become doctor "friendly". At the same time due to the inconsistency in approach to the analysis of comorbid state and absence of components of comorbidity in medical university courses, the practitioner is unclear about its prognostic effect, which makes the generally available systems of associated pathology evaluation unreasoned and therefore un-needed as well.


title: Comorbidity

text: The effect of comorbid pathologies on clinical implications, diagnosis, prognosis and therapy of many diseases is polyhedral and patient-specific. The interrelation of the disease, age and drug pathomorphism greatly affect the clinical presentation and progress of the primary nosology, character and severity of the complications, worsens the patient's life quality and limit or make difficult the remedial-diagnostic process. Comorbidity affects life prognosis and increases the chances of fatality. The presence of comorbid disorders increases bed days, disability, hinders rehabilitation, increases the number of complications after surgical procedures, and increases the chances of decline in aged people.


title: Comorbidity

text: The presence of comorbidity must be taken into account when selecting the algorithm of diagnosis and treatment plans for any given disease. It is important to enquire comorbid patients about the level of functional disorders and anatomic status of all the identified nosological forms (diseases). Whenever a new, as well as mildly notable symptom appears, it is necessary to conduct a deep examination to uncover its causes. It is also necessary to be remembered that comorbidity leads to polypragmasy (polypharmacy), i.e. simultaneous prescription of a large number of medicines, which renders impossible the control over the effectiveness of the therapy, increases monetary expenses and therefore reduces compliance. At the same time, polypragmasy, especially in aged patients, renders possible the sudden development of local and systematic, unwanted medicinal side-effects. These side-effects are not always considered by the doctors, because they are considered as the appearance of comorbidity and as a result become the reason for the prescription of even more drugs, sealing-in the vicious circle. Simultaneous treatment of multiple disorders requires strict consideration of compatibility of drugs and detailed adherence of rules of rational drug therapy, based on E. M. Tareev's principles, which state: "Each non-indicated drug is contraindicated" and B. E. Votchal said: "If the drug does not have any side-effects, one must think if there is any effect at all".


title: Comorbidity

text: A study of inpatient hospital data in the United States in 2011 showed that the presence of a major complication or comorbidity was associated with a great risk of intensive-care unit utilization, ranging from a negligible change for acute myocardial infarction with major complication or comorbidity to nearly nine times more likely for a major joint replacement with major complication or comorbidity.


title: The Frighteners

text: The Frighteners is a 1996 supernatural comedy horror film directed by Peter Jackson and co-written with Fran Walsh. The film stars Michael J. Fox, Trini Alvarado, Peter Dobson, John Astin, Dee Wallace Stone, Jeffrey Combs, R. Lee Ermey and Jake Busey. "The Frighteners" tells the story of Frank Bannister (Fox), an architect who practices necromancy, developing psychic abilities allowing him to see, hear, and communicate with ghosts after his wife's murder. He initially uses his new abilities to befriend ghosts, whom he sends to haunt people so that he can charge them handsome fees for "exorcising" the ghosts. However, the spirit of a mass murderer appears able to attack the living and the dead, posing as the ghost of the Grim Reaper, prompting Frank to investigate the supernatural presence.


title: The Frighteners

text: Jackson and Walsh conceived the idea for "The Frighteners" during the script-writing phase of "Heavenly Creatures". Executive producer Robert Zemeckis hired the duo to write the script, with the original intention of Zemeckis directing "The Frighteners" as a spin-off film of the television series, "Tales from the Crypt". With Jackson and Walsh's first draft submitted in January 1994, Zemeckis believed the film would be better off directed by Jackson, produced by Zemeckis and funded/distributed by Universal Studios. The visual effects were created by Jackson's Weta Digital, which had only been in existence for three years. This, plus the fact that "The Frighteners" required more digital effects shots than almost any movie made until that time, resulted in the eighteen-month period for effects work by Weta Digital being largely stressed.


title: The Frighteners

text: Despite a rushed post-production schedule, Universal was so impressed with Jackson's rough cut on "The Frighteners", the studio moved the theatrical release date up by three months. The film was not a box office success, but received generally positive reviews from critics. The film gained a cult following and is considered a cult classic on Jackson’s catalog.


title: The Frighteners

text: In 1990, architect Frank Bannister's wife, Debra, dies in a car accident. He abandons his profession and his unfinished "dream house" sits incomplete. Following the accident, Frank gained the power to see ghosts and he befriends three: 1970s street gangster Cyrus, 1950s nerd Stuart, and The Judge, a gunslinger from the Old West. The ghosts haunt houses so Frank can then "exorcise" them for a fee. Most locals consider him a con man.