title: Zimbabwean dollar

text: The Zimbabwean dollar was introduced in 1980 to directly replace the Rhodesian dollar (which had been introduced in 1970) at par (1:1), at a similar value to the US dollar. In the 20th century the dollar functioned as a normal currency, but in the early 21st century hyperinflation in Zimbabwe reduced the Zimbabwean dollar to one of the lowest valued currency units in the world. It was redenominated three times (in 2006, 2008 and 2009), with denominations up to a $100 trillion banknote issued. The final redenomination produced the "fourth dollar" (ZWL), which was worth 10 ZWD (first dollars).


title: Zimbabwean dollar

text: Use of the Zimbabwean dollar as an official currency was effectively abandoned on 12 April 2009. It was demonetised in 2015, with outstanding accounts able to be reimbursed until 30 April 2016. In place of the Zimbabwean dollar, currencies including the South African rand, Botswana pula, pound sterling, Indian rupee, euro, Japanese yen, Australian dollar, Chinese yuan, and the United States dollar were used.


title: Zimbabwean dollar

text: On 24 June 2019, the Reserve Bank of Zimbabwe abolished the multiple-currency system and replaced it with a new Zimbabwe dollar (the RTGS Dollar), which was the only official currency in the country between June 2019 and March 2020, after which multiple foreign currencies were allowed again.


title: Zimbabwean dollar

text: The Zimbabwean dollar's predecessor, the Rhodesian dollar, was essentially equal to half of the value of the pound sterling at the time of its adoption (during the decimalisation of 1970). A similar practice was used in other Commonwealth countries such as South Africa, Australia, and New Zealand. The selection of the name was motivated by the fact that the reduced value of the new unit correlated more closely to the value of the US dollar than to the pound sterling.


title: Zimbabwean dollar

text: The main illustration on the obverse of all of the banknotes was the Chiremba Balancing Rocks in Epworth, Harare, which were used as a metaphor demonstrating the importance of balancing development and the preservation of the fragile environment. The reverse side of dollar notes often illustrated the culture or landmarks of Zimbabwe.


title: Zimbabwean dollar

text: The first Zimbabwean dollar was introduced in 1980 and replaced the Rhodesian dollar at par. The initial ISO 4217 code was "ZWD". At the time of its introduction, the Zimbabwean dollar was worth more than the US dollar in the official exchange market, with 1 ZWD = , although this did not reflect the actual purchasing power it held. As a result, in both the official and parallel markets, the currency's value eroded rapidly over the years, and by July 2006, the parallel market value of the Zimbabwean dollar fell to one millionth of a pound sterling (Z$1,000,000 = £1).


title: Zimbabwean dollar

text: In October 2005, the current Governor of the Reserve Bank of Zimbabwe at the time, Dr. Gideon Gono, announced that Zimbabwe would have a new currency the following year, and new banknotes and coins would be produced. However, in June 2006, it was decreed that, for a new currency to be viable, Zimbabwe had to first achieve macro-economic stability. Instead, in August 2006, the first dollar was redenominated to the second dollar at the rate of 1000 first dollars to 1 second dollar (1000:1). At the same time, the currency was devalued against the US dollar, from 101000 first dollars (101 once revalued) to 250 second dollars, a decrease of about 60% (see exchange rate history table below). ISO originally assigned a new currency code of "ZWN" to this redenominated currency, but the Reserve Bank of Zimbabwe could not deal with a currency change, so the currency code remained 'ZWD'. The revaluation campaign, which Gideon Gono named "Operation Sunrise", was completed on 21 August 2006. It was estimated that some ten trillion old Zimbabwe dollars (22% of the money supply) were not redeemed during this period.


title: Zimbabwean dollar

text: The following year, on 2 February 2007, the RBZ revealed that a new (third) dollar would be released. However, with inflation still exceeding 1000%, the banknotes were kept in storage. During the same month, the Reserve Bank of Zimbabwe declared inflation illegal, outlawing any raise in prices on certain commodities between 1 March and 30 June 2007. Officials arrested executives of some Zimbabwean companies for increasing prices on their products, and economists reported that "chaos had started to reign and people in the public sector became frantic". On 6 September 2007, the Zimbabwe dollar was devalued again by 92%, creating an official exchange rate of to , although the black market exchange rate was estimated to be to .


title: Zimbabwean dollar

text: As an official exchange rate became more unreliable, the WM/Reuters company introduced a notional exchange rate (ISO ZWN) which was based on Purchasing Power Parity utilising the dual listing of companies on the Harare (ZH) and London Stock exchanges (LN).


title: Zimbabwean dollar

text: On 30 July 2008, the dollar was redenominated and given a new currency code of "ZWR". After 1 August 2008, 10 billion ZWN were worth 1 ZWR. Coins valued at , and and banknotes worth , , , , and were issued in ZWR. Due to frequent cash shortages and the apparently worthless Zimbabwean dollar, foreign currency was effectively legalised as a de facto currency on 13 September 2008 via a special program. This program officially allowed a number of retailers to accept foreign money. This reflected the reality of the dollarisation of the economy, with many shop keepers refusing to accept Zimbabwe dollars and requesting US dollars or South African rand instead. Despite redenomination, the RBZ was forced to print banknotes of ever higher values to keep up with surging inflation, with ten zeros reappearing by the end of 2008. While worthless at the time, these 100 trillion dollar notes subsequently became popular with collectors.


title: Zimbabwean dollar

text: On 2 February 2009, the RBZ announced that a further 12 zeros were to be taken off the currency, with 1,000,000,000,000 third Zimbabwean dollars being exchanged for 1 new fourth dollar. New banknotes were introduced with face values of , , , , , and . The banknotes of the fourth dollar circulated alongside the third dollar, which remained legal tender until 30 June 2009. The new ISO currency code was ZWL.


title: Zimbabwean dollar

text: Despite the introduction of the fourth dollar, the problems were not eliminated, and the economy continued to be almost completely dollarised. In his first budget, the Zimbabwe finance minister, Tendai Biti, stated "the death of the Zimbabwe dollar is a reality we have to live with. Since October 2008 our national currency has become moribund". In late January 2009, acting Finance Minister Patrick Chinamasa announced that all Zimbabweans would be allowed to conduct business with any currency, as a response to the hyperinflation crisis. On 12 April 2009, media outlets reported that economic planning minister Elton Mangoma had announced the suspension of the local currency "for at least a year", effectively terminating the fourth dollar.


title: Zimbabwean dollar

text: All four issues of the Zimbabwean dollar experienced high rates of inflation, although it was not until the early 2000s that Zimbabwe started to experience totally unsustainable hyperinflation.


title: Zimbabwean dollar

text: On 13 July 2007, the Zimbabwean government said that it had temporarily stopped publishing (official) inflation figures, a move that observers said was meant to draw attention away from "runaway inflation which has come to symbolise the country's unprecedented economic meltdown". In 2008, the inflation rate accelerated dramatically, from a rate in January of over 100,000% to an estimated rate of over 1,000,000% by May, and nearly 250,000,000% in July. As predicted by the quantity theory of money, this hyperinflation was linked to the Reserve Bank of Zimbabwe's choice to increase the money supply.


title: Zimbabwean dollar

text: The Reserve Bank of Zimbabwe responded to the dwindling value of the dollar by repeatedly arranging the printing of further banknotes, often at great expense from overseas suppliers.


title: Zimbabwean dollar

text: On 1 March 2008 "The Sunday Times" reported that it had obtained documents showing that the Munich company Giesecke & Devrient (G&D) was receiving more than €500,000 (£381,562) a week for delivering bank notes to the value of Z$170 trillion a week. By late 2008, inflation had risen so high that automated teller machines for one major bank gave a "data overflow error" and stopped customers' attempts to withdraw money with so many zeros.


title: Zimbabwean dollar

text: It was reported that on 1 July 2008 the company's management board decided to cease delivering banknote paper to the Reserve Bank of Zimbabwe with immediate effect. The decision was in response to an "official request" from the German government and calls for international sanctions by the European Union and the United Nations.


title: Zimbabwean dollar

text: The use of foreign currencies was legalised in January 2009, causing general consumer prices to stabilise again after years of hyperinflation and price speculation. The move led to a sharp drop in the usage of the Zimbabwean dollar, as hyperinflation rendered even the highest denominations worthless. The Zimbabwean dollar was effectively abandoned as an official currency on 12 April 2009, when the Economic Planning Minister Elton Mangoma confirmed the suspension of the national currency for at least a year.


title: Zimbabwean dollar

text: On 29 January 2014, the Zimbabwe central bank announced that the US dollar, South African rand, Botswana pula, pound sterling, Euro, Australian dollar, Chinese yuan (renminbi), Indian rupee, and Japanese yen would all be accepted as legal currency within the country.


title: Zimbabwean dollar

text: In June 2015, the Reserve Bank of Zimbabwe began to formally demonetise the Zimbabwean dollar, reducing its value steadily to zero in order to complete a switch to the US dollar by the end of September 2015. The Zimbabwean government stated that it would credit 5 US dollars to domestic bank accounts with balances of up to 175 quadrillion Zimbabwean dollars, and that it would exchange Zimbabwean dollars for US dollars at a rate of US$1 to 35 quadrillion Zimbabwean dollars to accounts with balances above 175 quadrillion Zimbabwean dollars. This move was meant to stabilise the economy and establish a credible nominal anchor under low inflation conditions. The exercise brought closure to the outstanding issue on the Zimbabwe dollar, further confirming the government's position that the local unit will not return anytime soon. The Government has maintained that the return of the Zimbabwe dollar will only be considered when key economic fundamentals, such as productivity in key sectors, have been achieved.


title: Zimbabwean dollar

text: Similar to the Iraqi dinar scam, some promoters claim that a future "revalue" (RV) event will cause Zimbabwe dollar notes to regain some nonzero fraction of their original value.


title: Zimbabwean dollar

text: In 1980, coins were introduced in denominations of 1, 5, 10, 20, 50 cents, and 1 dollar. The 1 cent coin was struck in bronze, with the others struck in cupro-nickel. In 1989, bronze-plated steel replaced bronze. A 2-dollar coin was introduced in 1997. In 2001, nickel-plated steel replaced cupro-nickel in the 10, 20 and 50 cents and 1 dollar coins, and a bimetallic 5-dollar coin was introduced. The Reserve Bank of Zimbabwe announced plans for new and coins in June 2005, although these were never actually struck.


title: Zimbabwean dollar

text: In its 2014 mid-term monetary policy statement, the Reserve Bank of Zimbabwe (RBZ) said it would import special coins, known as Zimbabwean bond coins, to ease a shortage of change in the economy. Like the original 1980 coins, these special coins would be denominated in 1, 5, 10, 20, and 50 cents, but would have values at par with US cents. There would also be South African rand coins of 10, 20, 50 cents, 1, 2, 5 rands. The RBZ's statement did not specify when or where these coins would be imported from, but a later report on 26 November 2014 clarified that over $40 million worth of these coins were expected to be delivered within the next week from Pretoria. On 18 December 2014, the 1, 5, 10, and 25 US cent denominations were released into circulation. The 50 US cent denomination followed in March 2015. A 1 dollar bond coin was released in November 2016.


title: Zimbabwean dollar

text: The banknotes of the Zimbabwean dollar were issued by the Reserve Bank of Zimbabwe from 1980 to 2009. Up to 2003, regular banknotes were issued, but as hyperinflation developed from 2003, the Reserve Bank issued short-lived emergency traveller's cheques.


title: Zimbabwean dollar

text: This table shows a condensed history of the foreign exchange rate of the Zimbabwean Dollars to one US Dollar:


title: Zimbabwean dollar

text: † Due to the December 2007 banknote shortage, funds transferred via Electronic Funds Transfer Systems (EFTS) bore a premium rate of about , while the cash transaction rate varied around .‡ Exchange rate was 20,000,000 for large amounts.


title: Zimbabwean dollar

text: The third dollar rates above are OMIR. The cash rate differs significantly to the above rates. The table below is the cash rate of the third dollar history:


title: Zimbabwean dollar

text: The first dollar (ZWD) devalued from 0.6788 R$ to in 1978 to roughly half a million per US$ in 2006, when the currency was revalued.


title: Zimbabwean dollar

text: In the first redenomination of 1 August 2006, 1000 ZWD were exchanged for 1 second dollar (ZWN). The second dollar started off with an official rate of 250 and a parallel rate of 550 to the . By July 2008 the exchange rate with US$ had reached (parallel rate) 500 billion to 1 , leading to a second redenomination.


title: Zimbabwean dollar

text: In the final months before Zimbabwe's central bank reforms of 30 April 2008, virtually all popular currency conversion resources relied upon the official rate of 30,000 ZWD to US$1 for published figures, in spite of the vast differences between that and free market rates. By 23 May 2008, Bloomberg and Oanda began publishing floating rates based on Zimbabwe's formally regulated domestic bank market, while Yahoo Finance started using the updated official rate in July, albeit with a decimal point shift of 6 places. Those reported rates generally reflected the Official Rate as shown in the above table. They soon began to differ, in overvaluation of the Zimbabwean dollar, increasingly substantially in comparison to less regulated markets such as offshore markets or paper cash freely traded on the streets of Harare, reflected above as Parallel Rates.


title: Zimbabwean dollar

text: On 1 August 2008, a second redenomination was conducted, in which 10,000,000,000 2nd dollars (ZWN) became 1 3rd dollar (ZWR). On 3 October 2008, the Reserve Bank of Zimbabwe temporarily suspended the Real Time Gross Settlement (RTGS) system, halting electronic parallel market transfers, but it was reinstated on 13 November 2008.


title: Zimbabwean dollar

text: On 2 February 2009, a third redenomination took place, in which the RBZ removed 12 zeros from the currency, with 1,000,000,000,000 (third, ZWR) Zimbabwe dollars being exchanged for 1 new (fourth, ZWL) dollar. Therefore, the fourth dollar (ZWL) is equivalent to 10,000,000,000,000,000,000,000,000, or 1×10 or 10 septillion first dollars (ZWD) (or 1 trillion third dollars). Although the dollar was abandoned on 12 April 2009, exchange rates were maintained at intervals for some months.


title: Zimbabwean dollar

text: On 4 June 2015, it was announced that the Reserve Bank of Zimbabwe would exchange some of the old banknotes for US dollars.


title: Zimbabwean dollar

text: Shortly after the Zimbabwean dollar was discontinued, they were purchased as curiosities, or in quantity as novelty gifts, for example to financial advisers' clients to show why they should invest in diverse assets instead of cash, which loses its value over the long term. Later they were purchased as an investment, to sell to collectors, for a very much better rate of return than most investments. In 2022 various denominations were sold on eBay at prices exceeding £100.


title: The Outlaws (2017 film)

text: The Outlaws () is a 2017 South Korean crime action film, written and directed by Kang Yoon-sung, starring Ma Dong-seok and Yoon Kye-sang. It was released on October 3, 2017. Set in 2007, the film revolves around Detective Ma Seok-do, who tries to control the gang-wars between Chinese-Korean gangs while also dealing with a ruthless loan shark named Jang-Chen.


title: The Outlaws (2017 film)

text: "The Outlaws" is the first film of "Crime City" series. The first sequel, "The Roundup" was released in 2022 and the second sequel, "" is in production.


title: The Outlaws (2017 film)

text: "The Outlaws" follows a turf war that grows between a local gang that runs Garibong-dong in Guro District, Seoul and the Heuksapa gang from Yanbian, The police are called in to attempt to bring peace to the neighborhood. Jang Chen is a bloodthirsty leader of the Chinese mainland gang "Black Dragon", who works as a loan shark in a seedy Chinatown area of Seoul. He's backed up by his henchmen Wei Sung-Rak and Yang-Tae. Jang Chen is beyond brutal in his methods to collect money. Ma Suk-Do is a detective in the Chinatown area of Seoul, who along with his Captain Jeon Il-man tries to keep the peace, while two Chinese-Korean gangs dubbed "Venom Gang" headed by and Ahn Sung-Tae and "Cobra Gang" headed by Jang-I-Soo as they battle over the turf in the neighborhood.


title: The Outlaws (2017 film)

text: Jang Chen, along with Sung-Rak and Yang-Tae makes their move to take over Chinatown and destroy the "Venom Gang" and kill Sung-Tae where they take over Jang-I-Soo's casino. Enraged, Jang-I-Soo attacks the casino. Sung-Rak and Yung-Tae fight with Jang-I-Soo and his henchmen, but are interrupted by Ma, who arrest Sung-Rak while Yang-Tae escapes and informs Jang-Chen. Ma and Jeon learn about Jang Chen's crimes where they plan to arrest him. The next day, Jang Chen, along with Yang-Tae attacks Jang-I-soo and his henchmen where he, along with Yang-Tae kill them at Jang-I-Soo's mother's birthday bash. Meanwhile, Jang Chen's location is informed by the hotelier to CEO Hwang (When Jang Chen and his henchmen had killed their men in the hotel), who along with his henchmen arrive and tries to kill Jang Chen, but Jang Chen manages to escape and the hotelier is later killed by Jang Chen and learns Hwang's involvement.


title: The Outlaws (2017 film)

text: Ma seeks the help of Chinatown colony members for help to catch the Chinese moneylenders. They accept and start taking photos of the moneylenders and the people. Ma and his fellow police officers arrest all of them, including Yang-Tae. One of the police officer named Kang Hong-seok gets caught by Jang Chen and is about to run a car over him, but Ma saves him by crashing into Jang Chen's car. Jang Chen escapes and Ma chases after him but loses sight of him after a while. Jang Chen reaches the airport to fly away to China where he leaves for the restroom. Ma arrives at the restroom and a combat ensues between them. Ma manages to knock down Jang Chen and leaves him handcuffed in the restroom. The gang leaders are arrested and Jeon is congratulated by the commissioner where Ma and his team celebrate for solving the case. Just then, Ma is called by the commissioner to investigate another case.


title: The Outlaws (2017 film)

text: "The Outlaws" opened in South Korea on October 3, 2017. By October 23, it grossed from more than 5 million admissions. One month after it was released, the film marked 6.05 million admissions, with gross. By December 1, the film had reached 6.87 million admissions with a gross of , making it the 3rd highest-grossing domestic film of the year in South Korea and the third best-selling R-rated Korean film of all time.


title: The Outlaws (2017 film)

text: A sequel of the film titled as "The Roundup" directed by Lee Sang-yong was released on May 18, 2022. Ma Dong-seok, Choi Gwi-hwa, Park Ji-hwan, Heo Dong-won, and Ha Jun reprised their roles. The film became the highest-grossing film of the year surpassing 10 million ticket sales on the 25th day since its release. It also became the 3rd highest-grossing film and 9th most viewed film in South Korean cinema history.


title: The Outlaws (2017 film)

text: The production of a second sequel under title "" is currently in progress with a target release in 2023.


title: The Outlaws (2017 film)

text: The film is remade in Indian Hindi-language version in the name of "Radhe" directed by Prabhu Deva. It was released on 13 May 2021 to negative reviews.


title: Heart rate

text: Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excrete carbon dioxide, but is also modulated by numerous factors, including, but not limited to, genetics, physical fitness, stress or psychological status, diet, drugs, hormonal status, environment, and disease/illness as well as the interaction between and among these factors. It is usually equal or close to the pulse measured at any peripheral point.


title: Heart rate

text: The American Heart Association states the normal resting adult human heart rate is 60–100 bpm. Tachycardia is a high heart rate, defined as above 100 bpm at rest. Bradycardia is a low heart rate, defined as below 60 bpm at rest. When a human sleeps, a heartbeat with rates around 40–50 bpm is common and is considered normal. When the heart is not beating in a regular pattern, this is referred to as an arrhythmia. Abnormalities of heart rate sometimes indicate disease.


title: Heart rate

text: While "heart rhythm" is regulated entirely by the sinoatrial node under normal conditions, "heart rate" is regulated by sympathetic and parasympathetic input to the sinoatrial node. The accelerans nerve provides sympathetic input to the heart by releasing norepinephrine onto the cells of the sinoatrial node (SA node), and the vagus nerve provides parasympathetic input to the heart by releasing acetylcholine onto sinoatrial node cells. Therefore, stimulation of the accelerans nerve increases heart rate, while stimulation of the vagus nerve decreases it.


title: Heart rate

text: As water and blood are incompressible fluids, one of the physiological ways to deliver more blood to an organ is to increase heart rate. Normal resting heart rates range from 60 to 100 bpm. Bradycardia is defined as a resting heart rate below 60 bpm. However, heart rates from 50 to 60 bpm are common among healthy people and do not necessarily require special attention. Tachycardia is defined as a resting heart rate above 100 bpm, though persistent rest rates between 80 and 100 bpm, mainly if they are present during sleep, may be signs of hyperthyroidism or anemia (see below).


title: Heart rate

text: There are many ways in which the heart rate speeds up or slows down. Most involve stimulant-like endorphins and hormones being released in the brain, some of which are those that are 'forced'/'enticed' out by the ingestion and processing of drugs such as cocaine or atropine.


title: Heart rate

text: This section discusses target heart rates for healthy persons, which would be inappropriately high for most persons with coronary artery disease.


title: Heart rate

text: The heart rate is rhythmically generated by the sinoatrial node. It is also influenced by central factors through sympathetic and parasympathetic nerves. Nervous influence over the heart rate is centralized within the two paired cardiovascular centres of the medulla oblongata. The cardioaccelerator regions stimulate activity via sympathetic stimulation of the cardioaccelerator nerves, and the cardioinhibitory centers decrease heart activity via parasympathetic stimulation as one component of the vagus nerve. During rest, both centers provide slight stimulation to the heart, contributing to autonomic tone. This is a similar concept to tone in skeletal muscles. Normally, vagal stimulation predominates as, left unregulated, the SA node would initiate a sinus rhythm of approximately 100 bpm.


title: Heart rate

text: Both sympathetic and parasympathetic stimuli flow through the paired cardiac plexus near the base of the heart. The cardioaccelerator center also sends additional fibers, forming the cardiac nerves via sympathetic ganglia (the cervical ganglia plus superior thoracic ganglia T1–T4) to both the SA and AV nodes, plus additional fibers to the atria and ventricles. The ventricles are more richly innervated by sympathetic fibers than parasympathetic fibers. Sympathetic stimulation causes the release of the neurotransmitter norepinephrine (also known as noradrenaline) at the neuromuscular junction of the cardiac nerves. This shortens the repolarization period, thus speeding the rate of depolarization and contraction, which results in an increased heartrate. It opens chemical or ligand-gated sodium and calcium ion channels, allowing an influx of positively charged ions.


title: Heart rate

text: Norepinephrine binds to the beta–1 receptor. High blood pressure medications are used to block these receptors and so reduce the heart rate.


title: Heart rate

text: Parasympathetic stimulation originates from the cardioinhibitory region of the brain with impulses traveling via the vagus nerve (cranial nerve X). The vagus nerve sends branches to both the SA and AV nodes, and to portions of both the atria and ventricles. Parasympathetic stimulation releases the neurotransmitter acetylcholine (ACh) at the neuromuscular junction. ACh slows HR by opening chemical- or ligand-gated potassium ion channels to slow the rate of spontaneous depolarization, which extends repolarization and increases the time before the next spontaneous depolarization occurs. Without any nervous stimulation, the SA node would establish a sinus rhythm of approximately 100 bpm. Since resting rates are considerably less than this, it becomes evident that parasympathetic stimulation normally slows HR. This is similar to an individual driving a car with one foot on the brake pedal. To speed up, one need merely remove one's foot from the brake and let the engine increase speed. In the case of the heart, decreasing parasympathetic stimulation decreases the release of ACh, which allows HR to increase up to approximately 100 bpm. Any increases beyond this rate would require sympathetic stimulation.


title: Heart rate

text: The cardiovascular centres receive input from a series of visceral receptors with impulses traveling through visceral sensory fibers within the vagus and sympathetic nerves via the cardiac plexus. Among these receptors are various proprioreceptors, baroreceptors, and chemoreceptors, plus stimuli from the limbic system which normally enable the precise regulation of heart function, via cardiac reflexes. Increased physical activity results in increased rates of firing by various proprioreceptors located in muscles, joint capsules, and tendons. The cardiovascular centres monitor these increased rates of firing, suppressing parasympathetic stimulation or increasing sympathetic stimulation as needed in order to increase blood flow.


title: Heart rate

text: Similarly, baroreceptors are stretch receptors located in the aortic sinus, carotid bodies, the venae cavae, and other locations, including pulmonary vessels and the right side of the heart itself. Rates of firing from the baroreceptors represent blood pressure, level of physical activity, and the relative distribution of blood. The cardiac centers monitor baroreceptor firing to maintain cardiac homeostasis, a mechanism called the baroreceptor reflex. With increased pressure and stretch, the rate of baroreceptor firing increases, and the cardiac centers decrease sympathetic stimulation and increase parasympathetic stimulation. As pressure and stretch decrease, the rate of baroreceptor firing decreases, and the cardiac centers increase sympathetic stimulation and decrease parasympathetic stimulation.


title: Heart rate

text: There is a similar reflex, called the atrial reflex or Bainbridge reflex, associated with varying rates of blood flow to the atria. Increased venous return stretches the walls of the atria where specialized baroreceptors are located. However, as the atrial baroreceptors increase their rate of firing and as they stretch due to the increased blood pressure, the cardiac center responds by increasing sympathetic stimulation and inhibiting parasympathetic stimulation to increase HR. The opposite is also true.


title: Heart rate

text: Increased metabolic byproducts associated with increased activity, such as carbon dioxide, hydrogen ions, and lactic acid, plus falling oxygen levels, are detected by a suite of chemoreceptors innervated by the glossopharyngeal and vagus nerves. These chemoreceptors provide feedback to the cardiovascular centers about the need for increased or decreased blood flow, based on the relative levels of these substances.


title: Heart rate

text: The limbic system can also significantly impact HR related to emotional state. During periods of stress, it is not unusual to identify higher than normal HRs, often accompanied by a surge in the stress hormone cortisol. Individuals experiencing extreme anxiety may manifest panic attacks with symptoms that resemble those of heart attacks. These events are typically transient and treatable. Meditation techniques have been developed to ease anxiety and have been shown to lower HR effectively. Doing simple deep and slow breathing exercises with one's eyes closed can also significantly reduce this anxiety and HR.


title: Heart rate

text: Using a combination of autorhythmicity and innervation, the cardiovascular center is able to provide relatively precise control over the heart rate, but other factors can impact on this. These include hormones, notably epinephrine, norepinephrine, and thyroid hormones; levels of various ions including calcium, potassium, and sodium; body temperature; hypoxia; and pH balance.


title: Heart rate

text: The catecholamines, epinephrine and norepinephrine, secreted by the adrenal medulla form one component of the extended fight-or-flight mechanism. The other component is sympathetic stimulation. Epinephrine and norepinephrine have similar effects: binding to the beta-1 adrenergic receptors, and opening sodium and calcium ion chemical- or ligand-gated channels. The rate of depolarization is increased by this additional influx of positively charged ions, so the threshold is reached more quickly and the period of repolarization is shortened. However, massive releases of these hormones coupled with sympathetic stimulation may actually lead to arrhythmias. There is no parasympathetic stimulation to the adrenal medulla.


title: Heart rate

text: In general, increased levels of the thyroid hormones (thyroxine(T4) and triiodothyronine (T3)), increase the heart rate; excessive levels can trigger tachycardia. The impact of thyroid hormones is typically of a much longer duration than that of the catecholamines. The physiologically active form of triiodothyronine, has been shown to directly enter cardiomyocytes and alter activity at the level of the genome. It also impacts the beta adrenergic response similar to epinephrine and norepinephrine.


title: Heart rate

text: Calcium ion levels have a great impact on heart rate and myocardial contractility: increased calcium levels cause an increase in both. High levels of calcium ions result in hypercalcemia and excessive levels can induce cardiac arrest. Drugs known as calcium channel blockers slow HR by binding to these channels and blocking or slowing the inward movement of calcium ions.


title: Heart rate

text: Caffeine and nicotine are both stimulants of the nervous system and of the cardiac centres causing an increased heart rate. Caffeine works by increasing the rates of depolarization at the SA node, whereas nicotine stimulates the activity of the sympathetic neurons that deliver impulses to the heart.


title: Heart rate

text: Both surprise and stress induce physiological response: elevate heart rate substantially. In a study conducted on 8 female and male student actors ages 18 to 25, their reaction to an unforeseen occurrence (the cause of stress) during a performance was observed in terms of heart rate. In the data collected, there was a noticeable trend between the location of actors (onstage and offstage) and their elevation in heart rate in response to stress; the actors present offstage reacted to the stressor immediately, demonstrated by their immediate elevation in heart rate the minute the unexpected event occurred, but the actors present onstage at the time of the stressor reacted in the following 5 minute period (demonstrated by their increasingly elevated heart rate). This trend regarding stress and heart rate is supported by previous studies; negative emotion/stimulus has a prolonged effect on heart rate in individuals who are directly impacted.


title: Heart rate

text: In regard to the characters present onstage, a reduced startle response has been associated with a passive defense, and the diminished initial heart rate response has been predicted to have a greater tendency to dissociation. Current evidence suggests that heart rate variability can be used as an accurate measure of psychological stress and may be used for an objective measurement of psychological stress.


title: Heart rate

text: The heart rate can be slowed by altered sodium and potassium levels, hypoxia, acidosis, alkalosis, and hypothermia. The relationship between electrolytes and HR is complex, but maintaining electrolyte balance is critical to the normal wave of depolarization. Of the two ions, potassium has the greater clinical significance. Initially, both hyponatremia (low sodium levels) and hypernatremia (high sodium levels) may lead to tachycardia. Severely high hypernatremia may lead to fibrillation, which may cause CO to cease. Severe hyponatremia leads to both bradycardia and other arrhythmias. Hypokalemia (low potassium levels) also leads to arrhythmias, whereas hyperkalemia (high potassium levels) causes the heart to become weak and flaccid, and ultimately to fail.


title: Heart rate

text: Heart muscle relies exclusively on aerobic metabolism for energy. Severe myocardial infarction (commonly called a heart attack) can lead to a decreasing heart rate, since metabolic reactions fueling heart contraction are restricted.


title: Heart rate

text: Acidosis is a condition in which excess hydrogen ions are present, and the patient's blood expresses a low pH value. Alkalosis is a condition in which there are too few hydrogen ions, and the patient's blood has an elevated pH. Normal blood pH falls in the range of 7.35–7.45, so a number lower than this range represents acidosis and a higher number represents alkalosis. Enzymes, being the regulators or catalysts of virtually all biochemical reactions – are sensitive to pH and will change shape slightly with values outside their normal range. These variations in pH and accompanying slight physical changes to the active site on the enzyme decrease the rate of formation of the enzyme-substrate complex, subsequently decreasing the rate of many enzymatic reactions, which can have complex effects on HR. Severe changes in pH will lead to denaturation of the enzyme.


title: Heart rate

text: The last variable is body temperature. Elevated body temperature is called hyperthermia, and suppressed body temperature is called hypothermia. Slight hyperthermia results in increasing HR and strength of contraction. Hypothermia slows the rate and strength of heart contractions. This distinct slowing of the heart is one component of the larger diving reflex that diverts blood to essential organs while submerged. If sufficiently chilled, the heart will stop beating, a technique that may be employed during open heart surgery. In this case, the patient's blood is normally diverted to an artificial heart-lung machine to maintain the body's blood supply and gas exchange until the surgery is complete, and sinus rhythm can be restored. Excessive hyperthermia and hypothermia will both result in death, as enzymes drive the body systems to cease normal function, beginning with the central nervous system.


title: Heart rate

text: A study shows that bottlenose dolphins can learn – apparently via instrumental conditioning – to rapidly and selectively slow down their heart rate during diving for conserving oxygen depending on external signals. In humans regulating heart rate by methods such as listening to music, meditation or a vagal maneuver takes longer and only lowers the rate to a much smaller extent.


title: Heart rate

text: Heart rate is not a stable value and it increases or decreases in response to the body's need in a way to maintain an equilibrium (basal metabolic rate) between requirement and delivery of oxygen and nutrients. The normal SA node firing rate is affected by autonomic nervous system activity: sympathetic stimulation increases and parasympathetic stimulation decreases the firing rate. A number of different metrics are used to describe heart rate.


title: Heart rate

text: The basal or resting heart rate (HR) is defined as the heart rate when a person is awake, in a neutrally temperate environment, and has not been subject to any recent exertion or stimulation, such as stress or surprise. The available evidence indicates that the normal range for resting heart rate is 50-90 beats per minute. This resting heart rate is often correlated with mortality. For example, all-cause mortality is increased by 1.22 (hazard ratio) when heart rate exceeds 90 beats per minute. The mortality rate of patients with myocardial infarction increased from 15% to 41% if their admission heart rate was greater than 90 beats per minute. ECG of 46,129 individuals with low risk for cardiovascular disease revealed that 96% had resting heart rates ranging from 48 to 98 beats per minute. Finally, in one study 98% of cardiologists suggested that as a desirable target range, 50 to 90 beats per minute is more appropriate than 60 to 100. The normal resting heart rate is based on the at-rest firing rate of the heart's sinoatrial node, where the faster pacemaker cells driving the self-generated rhythmic firing and responsible for the heart's autorhythmicity are located. For endurance athletes at the elite level, it is not unusual to have a resting heart rate between 33 and 50 bpm.


title: Heart rate

text: The "maximum heart rate" (HR) is the age-related highest number of beats per minute of the heart when reaching a point of exhaustion without severe problems through exercise stress.


title: Heart rate

text: It generally decreases with age. Since HR varies by individual, the most accurate way of measuring any single person's HR is via a cardiac stress test. In this test, a person is subjected to controlled physiologic stress (generally by treadmill or bicycle ergometer) while being monitored by an electrocardiogram (ECG). The intensity of exercise is periodically increased until certain changes in heart function are detected on the ECG monitor, at which point the subject is directed to stop. Typical duration of the test ranges ten to twenty minutes.


title: Heart rate

text: The theoretical maximum heart rate of a human is 300bpm, however there have been multiple cases where this theoretical upper limit has been exceeded. The fastest human ventricular conduction rate recorded to this day is a conducted tachyarrhythmia with ventricular rate of 480 beats per minute, which is comparable to the heart rate of a mouse.


title: Heart rate

text: Adults who are beginning a new exercise regimen are often advised to perform this test only in the presence of medical staff due to risks associated with high heart rates. For general purposes, a formula is often employed to estimate a person's maximum heart rate. However, these predictive formulas have been criticized as inaccurate because they generalized population-averages and usually focus on a person's age and do not even take normal resting pulse rate into consideration. It is well-established that there is a "poor relationship between maximal heart rate and age" and large standard deviations relative to predicted heart rates. ("see Limitations of Estimation Formulas").


title: Heart rate

text: Notwithstanding later research, the most widely cited formula for HR (which contains no reference to any standard deviation) is still:


title: Heart rate

text: Although attributed to various sources, it is widely thought to have been devised in 1970 by Dr. William Haskell and Dr. Samuel Fox. Inquiry into the history of this formula reveals that it was not developed from original research, but resulted from observation based on data from approximately 11 references consisting of published research or unpublished scientific compilations. It gained widespread use through being used by Polar Electro in its heart rate monitors, which Dr. Haskell has "laughed about", as the formula "was never supposed to be an absolute guide to rule people's training."


title: Heart rate

text: While it is the most common (and easy to remember and calculate), this particular formula is not considered by reputable health and fitness professionals to be a good predictor of HR. Despite the widespread publication of this formula, research spanning two decades reveals its large inherent error, S = 7–11 bpm. Consequently, the estimation calculated by   HR = 220 − age   has neither the accuracy nor the scientific merit for use in exercise physiology and related fields.


title: Heart rate

text: Yet, it is common practice to use 85% of the predicted HR (Haskel & Fox) to evaluate chronotropic response to exercise. An ongoing study has found that the 5th percentil of the study cohort maximal heart rate correlates much better with the 85% of predicted HR (Haskel & Fox) than the 5th percentil of the study cohort heart rate reserve to the 80% of the predicted heart rate reserve.


title: Heart rate

text: Their meta-analysis (of 351 prior studies involving 492 groups and 18,712 subjects) and laboratory study (of 514 healthy subjects) concluded that, using this equation, HRmax was very strongly correlated to age (r = −0.90). The regression equation that was obtained in the laboratory-based study (209 − 0.7 x age), was virtually identical to that of the meta-study. The results showed HRmax to be independent of gender and independent of wide variations in habitual physical activity levels. This study found a standard deviation of ~10 beats per minute for individuals of any age, meaning the HRmax formula given has an accuracy of ±20 beats per minute.


title: Heart rate

text: A 2002 study of 43 different formulas for HR (including that of Haskell and Fox – see above) published in the Journal of Exercise Psychology concluded that:


title: Heart rate

text: In 2007, researchers at the Oakland University analyzed maximum heart rates of 132 individuals recorded yearly over 25 years, and produced a linear equation very similar to the Tanaka formula, HR = 207 − (0.7 × age), and a nonlinear equation, HR = 192 − (0.007 × age). The linear equation had a confidence interval of ±5–8 bpm and the nonlinear equation had a tighter range of ±2–5 bpm


title: Heart rate

text: Research conducted at Northwestern University by Martha Gulati, et al., in 2010 suggested a maximum heart rate formula for women:


title: Heart rate

text: Based on measurements of 3320 healthy men and women aged between 19 and 89, and including the potential modifying effect of gender, body composition, and physical activity, Nes "et al" found:


title: Heart rate

text: This relationship was found to hold the substantially regardless of gender, physical activity status, maximal oxygen uptake, smoking, or body mass index. However, a standard error


title: Heart rate

text: of the estimate of 10.8 beats/min must be accounted for when applying the formula to clinical settings, and the researchers concluded that actual measurement via a maximal test may be preferable whenever possible.


title: Heart rate

text: Maximum heart rates vary significantly between individuals. Even within a single elite sports team, such as Olympic rowers in their 20s, maximum heart rates have been reported as varying from 160 to 220. Such a variation would equate to a 60 or 90 year age gap in the linear equations above, and would seem to indicate the extreme variation about these average figures.


title: Heart rate

text: Figures are generally considered averages, and depend greatly on individual physiology and fitness. For example, an endurance runner's rates will typically be lower due to the increased size of the heart required to support the exercise, while a sprinter's rates will be higher due to the improved response time and short duration. While each may have predicted heart rates of 180 (= 220 − age), these two people could have actual HR 20 beats apart (e.g., 170–190).


title: Heart rate

text: Further, note that individuals of the same age, the same training, in the same sport, on the same team, can have actual HR 60 bpm apart (160–220): the range is extremely broad, and some say "The heart rate is probably the least important variable in comparing athletes."


title: Heart rate

text: "Heart rate reserve" (HR) is the difference between a person's measured or predicted maximum heart rate and resting heart rate. Some methods of measurement of exercise intensity measure percentage of heart rate reserve. Additionally, as a person increases their cardiovascular fitness, their HR will drop, and the heart rate reserve will increase. Percentage of HR is statistically indistinguishable from percentage of VO reserve.


title: Heart rate

text: For healthy people, the "Target Heart Rate" (THR) or "Training Heart Rate Range" (THRR) is a desired range of heart rate reached during aerobic exercise which enables one's heart and lungs to receive the most benefit from a workout. This theoretical range varies based mostly on age; however, a person's physical condition, sex, and previous training also are used in the calculation.


title: Heart rate

text: The THR can be calculated as a range of 65–85% intensity, with intensity defined simply as percentage of HR. However, it is crucial to derive an accurate HR to ensure these calculations are meaningful.


title: Heart rate

text: The "Karvonen method" factors in resting heart rate (HR) to calculate target heart rate (THR), using a range of 50–85% intensity:


title: Heart rate

text: An alternative to the Karvonen method is the "Zoladz method", which is used to test an athlete's capabilities at specific heart rates. These are not intended to be used as exercise zones, although they are often used as such. The Zoladz test zones are derived by subtracting values from HR:


title: Heart rate

text: Heart rate recovery (HRR) is the reduction in heart rate at peak exercise and the rate as measured after a cool-down period of fixed duration. A greater reduction in heart rate after exercise during the reference period is associated with a higher level of cardiac fitness.


title: Heart rate

text: Heart rates assessed during treadmill stress test that do not drop by more than 12 bpm one minute after stopping exercise (if cool-down period after exercise) or by more than 18 bpm one minute after stopping exercise (if no cool-down period and supine position as soon as possible) are associated with an increased risk of death. People with an abnormal HRR defined as a decrease of 42 beats per minutes or less at two minutes post-exercise had a mortality rate 2.5 times greater than patients with a normal recovery. Another study reported a four-fold increase in mortality in subjects with an abnormal HRR defined as ≤12 bpm reduction one minute after the cessation of exercise. A study reported that a HRR of ≤22 bpm after two minutes "best identified high-risk patients". They also found that while HRR had significant prognostic value it had no diagnostic value.


title: Heart rate

text: The heartbeat of a human embryo begins at approximately 21 days after conception, or five weeks after the last normal menstrual period (LMP), which is the date normally used to date pregnancy in the medical community. The electrical depolarizations that trigger cardiac myocytes to contract arise spontaneously within the myocyte itself. The heartbeat is initiated in the pacemaker regions and spreads to the rest of the heart through a conduction pathway. Pacemaker cells develop in the primitive atrium and the sinus venosus to form the sinoatrial node and the atrioventricular node respectively. Conductive cells develop the bundle of His and carry the depolarization into the lower heart.


title: Heart rate

text: The human heart begins beating at a rate near the mother's, about 75–80 beats per minute (bpm). The embryonic heart rate then accelerates linearly for the first month of beating, peaking at 165–185 bpm during the early 7th week, (early 9th week after the LMP). This acceleration is approximately 3.3 bpm per day, or about 10 bpm every three days, an increase of 100 bpm in the first month.


title: Heart rate

text: After peaking at about 9.2 weeks after the LMP, it decelerates to about 150 bpm (+/-25 bpm) during the 15th week after the LMP. After the 15th week the deceleration slows reaching an average rate of about 145 (+/-25 bpm) bpm at term. The regression formula which describes this acceleration before the embryo reaches 25 mm in crown-rump length or 9.2 LMP weeks is:


title: Heart rate

text: Heart rate is measured by finding the pulse of the heart. This pulse rate can be found at any point on the body where the artery's pulsation is transmitted to the surface by pressuring it with the index and middle fingers; often it is compressed against an underlying structure like bone. The thumb should not be used for measuring another person's heart rate, as its strong pulse may interfere with the correct perception of the target pulse.


title: Heart rate

text: The radial artery is the easiest to use to check the heart rate. However, in emergency situations the most reliable arteries to measure heart rate are carotid arteries. This is important mainly in patients with atrial fibrillation, in whom heart beats are irregular and stroke volume is largely different from one beat to another. In those beats following a shorter diastolic interval left ventricle does not fill properly, stroke volume is lower and pulse wave is not strong enough to be detected by palpation on a distal artery like the radial artery. It can be detected, however, by doppler.


title: Heart rate

text: A more precise method of determining heart rate involves the use of an electrocardiograph, or ECG (also abbreviated EKG). An ECG generates a pattern based on electrical activity of the heart, which closely follows heart function. Continuous ECG monitoring is routinely done in many clinical settings, especially in critical care medicine. On the ECG, instantaneous heart rate is calculated using the R wave-to-R wave (RR) interval and multiplying/dividing in order to derive heart rate in heartbeats/min. Multiple methods exist:


title: Heart rate

text: Heart rate monitors allow measurements to be taken continuously and can be used during exercise when manual measurement would be difficult or impossible (such as when the hands are being used). Various commercial heart rate monitors are also available. Some monitors, used during sport, consist of a chest strap with electrodes. The signal is transmitted to a wrist receiver for display.


title: Heart rate

text: Pulse oximetry of the finger and laser Doppler imaging of the eye fundus are often used in the clinics. Those techniques can assess the heart rate by measuring the delay between pulses.


title: Heart rate

text: Tachycardia is a resting heart rate more than 100 beats per minute. This number can vary as smaller people and children have faster heart rates than average adults.


title: Heart rate

text: Bradycardia was defined as a heart rate less than 60 beats per minute when textbooks asserted that the normal range for heart rates was 60–100 bpm. The normal range has since been revised in textbooks to 50–90 bpm for a human at total rest. Setting a lower threshold for bradycardia prevents misclassification of fit individuals as having a pathologic heart rate. The normal heart rate number can vary as children and adolescents tend to have faster heart rates than average adults. Bradycardia may be associated with medical conditions such as hypothyroidism.


title: Heart rate

text: Trained athletes tend to have slow resting heart rates, and resting bradycardia in athletes should not be considered abnormal if the individual has no symptoms associated with it. For example, Miguel Indurain, a Spanish cyclist and five time Tour de France winner, had a resting heart rate of 28 beats per minute, one of the lowest ever recorded in a healthy human. Daniel Green achieved the world record for the slowest heartbeat in a healthy human with a heart rate of just 26 bpm in 2014.


title: Heart rate

text: Arrhythmias are abnormalities of the heart rate and rhythm (sometimes felt as palpitations). They can be divided into two broad categories: fast and slow heart rates. Some cause few or minimal symptoms. Others produce more serious symptoms of lightheadedness, dizziness and fainting.


title: Heart rate

text: A number of investigations indicate that faster resting heart rate has emerged as a new risk factor for mortality in homeothermic mammals, particularly cardiovascular mortality in human beings. Faster heart rate may accompany increased production of inflammation molecules and increased production of reactive oxygen species in cardiovascular system, in addition to increased mechanical stress to the heart. There is a correlation between increased resting rate and cardiovascular risk. This is not seen to be "using an allotment of heart beats" but rather an increased risk to the system from the increased rate.


title: Heart rate

text: An Australian-led international study of patients with cardiovascular disease has shown that heart beat rate is a key indicator for the risk of heart attack. The study, published in "The Lancet" (September 2008) studied 11,000 people, across 33 countries, who were being treated for heart problems. Those patients whose heart rate was above 70 beats per minute had significantly higher incidence of heart attacks, hospital admissions and the need for surgery. Higher heart rate is thought to be correlated with an increase in heart attack and about a 46 percent increase in hospitalizations for non-fatal or fatal heart attack.


title: Heart rate

text: Other studies have shown that a high resting heart rate is associated with an increase in cardiovascular and all-cause mortality in the general population and in patients with chronic diseases. A faster resting heart rate is associated with shorter life expectancy and is considered a strong risk factor for heart disease and heart failure, independent of level of physical fitness. Specifically, a resting heart rate above 65 beats per minute has been shown to have a strong independent effect on premature mortality; every 10 beats per minute increase in resting heart rate has been shown to be associated with a 10–20% increase in risk of death. In one study, men with no evidence of heart disease and a resting heart rate of more than 90 beats per minute had a five times higher risk of sudden cardiac death. Similarly, another study found that men with resting heart rates of over 90 beats per minute had an almost two-fold increase in risk for cardiovascular disease mortality; in women it was associated with a three-fold increase.


title: Heart rate

text: Given these data, heart rate should be considered in the assessment of cardiovascular risk, even in apparently healthy individuals. Heart rate has many advantages as a clinical parameter: It is inexpensive and quick to measure and is easily understandable. Although the accepted limits of heart rate are between 60 and 100 beats per minute, this was based for convenience on the scale of the squares on electrocardiogram paper; a better definition of normal sinus heart rate may be between 50 and 90 beats per minute.


title: Heart rate

text: Standard textbooks of physiology and medicine mention that heart rate (HR) is readily calculated from the ECG as follows: HR = 1000*60/RR interval in milliseconds, HR = 60/RR interval in seconds, or HR = 300/number of large squares between successive R waves. In each case, the authors are actually referring to instantaneous HR, which is the number of times the heart would beat if successive RR intervals were constant.


title: Heart rate

text: Lifestyle and pharmacological regimens may be beneficial to those with high resting heart rates. Exercise is one possible measure to take when an individual's heart rate is higher than 80 beats per minute. Diet has also been found to be beneficial in lowering resting heart rate: In studies of resting heart rate and risk of death and cardiac complications on patients with type 2 diabetes, legumes were found to lower resting heart rate. This is thought to occur because in addition to the direct beneficial effects of legumes, they also displace animal proteins in the diet, which are higher in saturated fat and cholesterol. Another nutrient is omega-3 long chain polyunsaturated fatty acids (omega-3 fatty acid or LC-PUFA). In a meta-analysis with a total of 51 randomized controlled trials (RCTs) involvingy 3,000 participants, the supplement mildly but significantly reduced heart rate (-2.23 bpm; 95% CI: -3.07, -1.40 bpm). When docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were compared, modest heart rate reduction was observed in trials that supplemented with DHA (-2.47 bpm; 95% CI: -3.47, -1.46 bpm), but not in those received EPA.


title: Heart rate

text: A very slow heart rate (bradycardia) may be associated with heart block. It may also arise from autonomous nervous system impairment.


title: Val Demings

text: Valdez Venita Demings (née Butler; born March 12, 1957) is an American politician and former police officer serving as the U.S. representative from since 2017. The district covers most of the western half of Orlando and includes much of the area around Orlando's resort parks. It includes many of Orlando's western suburbs, including Apopka and Winter Garden. From 2007 to 2011, Demings was chief of the Orlando Police Department, its first female chief, capping a 27-year career with the department. She has also been first lady of Orange County, Florida, since December 4, 2018, when her husband Jerry Demings was sworn in as the mayor.


title: Val Demings

text: Demings was the Democratic nominee to represent Florida's 10th congressional district in Congress in both 2012 and 2016. After losing in 2012 to Republican incumbent Daniel Webster, she won in 2016 after the State Supreme Court mandated redistricting statewide.


title: Val Demings

text: On January 15, 2020, House Speaker Nancy Pelosi selected Demings to serve as a House impeachment manager in the first Senate trial of President Donald Trump. In early August 2020, Demings was said to be one of the top contenders to be Joe Biden's vice-presidential running mate in the 2020 United States presidential election, along with Kamala Harris and Susan Rice. She was the Democratic nominee in the 2022 United States Senate election in Florida, losing to Republican incumbent Marco Rubio.


title: Val Demings

text: Valdez Venita Butler was born on March 12, 1957, one of seven children born to a poor family; her father worked as a janitor, her mother as a maid. They lived in Mandarin, a neighborhood in Jacksonville, Florida. She attended segregated schools in the 1960s and graduated from Wolfson High School in 1975.


title: Val Demings

text: Demings became interested in a career in law enforcement after serving in the "school patrol" at Dupont Junior High School. She attended Florida State University, graduating with a degree in criminology in 1979. In 1996, Demings earned a master's degree in public administration from Webster University Orlando.


title: Val Demings

text: After graduating from college, Demings worked as a state social worker in Jacksonville for 18 months.


title: Val Demings

text: In 1983, Demings applied for a job with the Orlando Police Department (OPD); her first assignment was on patrol on Orlando's west side. Demings was appointed chief of the Orlando Police Department in 2007, becoming the first woman to lead the department. From 2007 to 2011, she oversaw a 40% decrease in violent crime.


title: Val Demings

text: According to a 2015 article in "The Atlantic", the Orlando Police Department "has a long record of excessive-force allegations, and a lack of transparency on the subject, dating back at least as far as Demings's time as chief." A 2008 "Orlando Weekly" exposé described the Orlando Police Department as "a place where rogue cops operate with impunity, and there's nothing anybody who finds himself at the wrong end of their short fuse can do about it." Demings responded with an op-ed in the "Orlando Sentinel", writing, "Looking for a negative story in a police department is like looking for a prayer at church", adding, "It won't take long to find one." In the same op-ed, she cast doubt on video evidence that conflicts with officers' statements in excessive force cases, writing, "a few seconds (even of video) rarely capture the entire set of circumstances."


title: Val Demings

text: In 2009, she had her firearm, a Sig Sauer P226R, stolen from her department vehicle while parked at her home; she was issued a written censure. The firearm has not been recovered.


title: Val Demings

text: Demings retired from her position as chief of OPD effective June 1, 2011, after serving with the OPD for 27 years.


title: Val Demings

text: Demings was the Democratic nominee for the United States House of Representatives in Florida's 10th congressional district in the 2012 elections. She faced freshman Republican Daniel Webster in a district that had been made slightly more Republican than its predecessor in 2010. Demings narrowly lost, taking 48% of the vote to Webster's 51%.


title: Val Demings

text: Democrats attempted to recruit Demings to run against Webster again in 2014. She decided to run for mayor of Orange County, Florida, against Teresa Jacobs, instead, but dropped out of the mayoral race on May 20, 2014.


title: Val Demings

text: In 2015, Demings announced her candidacy for the 10th district seat after a court-ordered redistricting made the 10th significantly more Democratic ahead of the 2016 elections. Webster concluded the new 10th was unwinnable, and ran for reelection in the nearby 11th district.


title: Val Demings

text: Demings won the Democratic nomination on August 30 and the general election in November with 65% of the vote. She is the third Democrat to win this Orlando-based district since its creation in 1973 (it was numbered as the 5th from 1973 to 1993, the 8th from 1993 to 2013, and has been the 10th since 2013).


title: Val Demings

text: On May 21, 2020, Demings confirmed she was on "the shortlist" to be Joe Biden's vice presidential nominee for the 2020 presidential election. She said she would accept the role if offered. Some critics, including Black Lives Matter activists, criticized her record as Orlando police chief. Kamala Harris was announced as Biden's running mate on August 11, 2020. In November 2020, Demings was named a candidate for United States Secretary of Homeland Security in the Biden administration.


title: Val Demings

text: Demings was sworn in on January 3, 2017. She is a member of the New Democrat Coalition and the Congressional Black Caucus.


title: Val Demings

text: In June 2021, Demings announced her candidacy for the Democratic nomination in Florida's 2022 U.S. Senate election. The incumbent U.S. Senator, Republican Marco Rubio, ran for reelection in 2022. In March 2022, PolitiFact reported that Demings falsely claimed that Rubio supported tax hikes. She lost to Rubio in the November 8, 2022, general election.


title: Val Demings

text: Demings received a 100% voting score from NARAL Pro-Choice America for 2017, 2018, and 2019. She received a 100% rating from Planned Parenthood Action Fund for 2020. She has an F rating from the anti-abortion Susan B. Anthony List.


title: Val Demings

text: Demings received a 97% lifetime rating from the League of Conservation Voters based on scores from 2017 to 2021.


title: Val Demings

text: Demings has said that she seeks to keep firearms out of the hands of "people who seek to do harm", saying that the gun control legislation she supports "isn’t about taking guns away from responsible, law-abiding people." She supported the Gun Violence Restraining Order Act of 2017, which would have provided a lawful method of temporarily confiscating firearms from people deemed to be a threat to themselves or others. Of the act, Demings said, "We must do what we can to make sure law enforcement has the tools it needs to more effectively perform the ever more challenging job of keeping us a safe nation. The Gun Violence Restraining Order Act is a major step to doing just that." After the Stoneman Douglas High School shooting in 2018, Demings opposed arming teachers, calling the idea "ridiculous" and saying it would "only shift the responsibility from lawmakers to others. It shifts the pain, the hurt, and the guilt to school staff who will find themselves outskilled and outgunned in active shooter situations."


title: Val Demings

text: Demings has an "F" rating from the National Rifle Association (NRA). She has accused the NRA of "hijacking" conversations after mass shootings in the United States to make them about the Second Amendment.


title: Val Demings

text: In June 2019 Demings released a congressional report on insulin prices, criticizing manufacturers for raising prices well beyond manufacturing costs, and said it was "inexcusable that American families are dying for the sake of corporate profit."


title: Val Demings

text: On December 18, 2019, Demings voted for both articles of impeachment against President Donald Trump. She was selected as one of seven House impeachment managers who presented the impeachment case against Trump during his trial before the United States Senate.


title: Val Demings

text: On January 13, 2021, Demings voted for the single article of impeachment in the second impeachment of President Donald Trump.


title: Val Demings

text: Citing the unusually contested 2021 United States Electoral College vote count and the 2021 storming of the United States Capitol, Demings joined Representative Cori Bush in sponsoring House Resolution 25 on January 11, 2021, seeking to expel the 138 Republican U.S. Representatives who voted to object to the electoral college certification.


title: Val Demings

text: Demings's husband, Jerry Demings, is mayor of Orange County, Florida, and the former Orange County Sheriff. He served as the chief of the Orlando Police Department, the first African American to do so, from 1999 to 2002. The two met on patrol in the OPD; they married in 1988 and have three children.


title: 2S1 Gvozdika

text: The 2S1 "Gvozdika" (, "Carnation") is a Soviet self-propelled howitzer based on the MT-LBu multi-purpose chassis, mounting a 122 mm 2A18 howitzer. "2S1" is its GRAU designation. An alternative Russian designation is SAU-122 but in the Russian Army it is commonly known as "Gvozdika". The 2S1 is fully amphibious with very little preparation, and once afloat is propelled by its tracks. A variety of track widths are available to allow the 2S1 to operate in snow or swamp conditions. It is NBC protected and has infrared night-vision capability.


title: 2S1 Gvozdika

text: The 2S1 has seven road wheels on each side; the running gear can be fitted with different widths of track to match terrain. The interior is separated into a driver's compartment on the left, an engine compartment on the right and a fighting compartment to the rear. Within the fighting compartment the commander sits on the left, the loader on the right and the gunner to the front. The all-welded turret is located above the fighting compartment. The 2S1 uses a 122 mm howitzer based on the towed D-30 howitzer. The gun is equipped with a power rammer, a double-baffle muzzle brake and a fume extractor. It is capable of firing HE (high explosive), leaflet, HE/RAP, armor-piercing HE, flechette and chemical rounds.


title: 2S1 Gvozdika

text: The first prototype was ready in 1958. The 2S1 entered service with the Soviet Army in the early 1970s and was first seen in public at a Polish Army parade in 1974. The vehicle was deployed in large numbers (72 per tank division, 36 per motorized rifle division). It was designated the M1974 by the U.S. Army and manufactured in Soviet, Polish and Bulgarian state factories.


title: 2S1 Gvozdika

text: The 2S1 Gvozdika (as well as other related vehicles such as the MT-LB and Opal) were produced in Poland by Huta Stalowa Wola under the name 2S1 Goździk.


title: Classical language

text: A classical language is any language with an independent literary tradition and a large and ancient body of written literature. Classical languages are typically dead languages, or show a high degree of diglossia, as the spoken varieties of the language diverge further away from the classical written language over time.


title: Classical language

text: In the context of traditional European classical studies, the "classical languages" refer to Greek and Latin, which were the literary languages of the Mediterranean world in classical antiquity.


title: Classical language

text: Greek was the language of Homer and of classical Athenian, Hellenistic and Byzantine historians, playwrights, and philosophers. It has contributed many words to the vocabulary of English and many other European languages, and has been a standard subject of study in Western educational institutions since the Renaissance. Latinized forms of Ancient Greek roots are used in many of the scientific names of species and in other scientific terminology. Koine Greek, which served as a lingua franca in the Eastern Roman Empire, remains in use today as a sacred language in some Eastern Orthodox churches.


title: Classical language

text: Latin became the lingua franca of the early Roman Empire and later of the Western Roman Empire. Despite the decline of the Western Roman Empire, the Latin language continued to flourish in the very different social and economic environment of the Middle Ages, not least because it became the official language of the Roman Catholic Church. In Western and Central Europe and in parts of northern Africa, Latin retained its elevated status as the main vehicle of communication for the learned classes throughout the Middle Ages and subsequently; witness especially the Renaissance and Baroque periods. This language was not supplanted for scientific purposes until the 18th century, and for formal descriptions in zoology as well as botany it survived to the later 20th century. The modern international binomial nomenclature holds to this day: taxonomists assign a Latin or Latinized name as the scientific name of each species.


title: Classical language

text: In terms of worldwide cultural importance, Edward Sapir in his book "Language" would extend the list to include Chinese, Arabic, and Sanskrit:


title: Classical language

text: When we realize that an educated Japanese can hardly frame a single literary sentence without the use of Chinese resources, that to this day Siamese and Burmese and Cambodgian bear the unmistakable imprint of the Sanskrit and Pali that came in with Hindu Buddhism centuries ago, or that whether we argue for or against the teaching of Latin and Greek [in schools,] our argument is sure to be studded with words that have come to us from Rome and Athens, we get some indication of what early Chinese culture and Buddhism, and classical Mediterranean civilization have meant in the world's history. There are just five languages that have had an overwhelming significance as carriers of culture. They are classical Chinese, Sanskrit, Arabic, Greek, and Latin. In comparison with these, even such culturally important languages as Hebrew and French sink into a secondary position.


title: Classical language

text: In this sense, a classical language is a language that has a broad influence over an extended period of time, even after it is no longer a colloquial mother tongue in its original form. If one language uses roots from another language to coin words (in the way that many European languages use Greek and Latin roots to devise new words such as "telephone", etc.), this is an indication that the second language is a classical language.


title: Classical language

text: The following languages are generally taken to have a "classical" stage. Such a stage is limited in time and is considered "classical" if it comes to be regarded as a literary "golden age" retrospectively. Thus, Classical Greek is the language of 5th to 4th century BC Athens and, as such, only a small subset of the varieties of the Greek language as a whole. A "classical" period usually corresponds to a flowering of literature following an "archaic" period, such as Classical Latin succeeding Old Latin, Classical Sumerian succeeding Archaic Sumerian, Classical Sanskrit succeeding Vedic Sanskrit, Classical Persian succeeding Old Persian. This is partly a matter of terminology, and for example Old Chinese is taken to include rather than precede Classical Chinese. In some cases, such as those of Persian and Tamil, the "classical" stage corresponds to the earliest attested literary variant.


title: Twenty-second Amendment to the United States Constitution

text: The Twenty-second Amendment (Amendment XXII) to the United States Constitution limits the number of times a person is eligible for election to the office of President of the United States to two, and sets additional eligibility conditions for presidents who succeed to the unexpired terms of their predecessors. Congress approved the Twenty-second Amendment on March 21, 1947, and submitted it to the state legislatures for ratification. That process was completed on February 27, 1951, when the requisite 36 of the 48 states had ratified the amendment (neither Alaska nor Hawaii had yet been admitted as states), and its provisions came into force on that date.


text: The amendment prohibits anyone who has been elected president twice from being elected again. Under the amendment, someone who fills an unexpired presidential term lasting more than two years is also prohibited from being elected president more than once. Scholars debate whether the amendment prohibits affected individuals from succeeding to the presidency under any circumstances or whether it applies only to presidential elections. Until the amendment's ratification, the president had not been subject to term limits, but both George Washington and Thomas Jefferson (the first and third presidents) decided not to serve a third term, establishing the two-term tradition. In the 1940 and 1944 presidential elections, Franklin D. Roosevelt became the only president to win third and fourth terms, giving rise to concerns about a president serving unlimited terms.


text: The Twenty-second Amendment was a reaction to Franklin D. Roosevelt's election to an unprecedented four terms as president, but presidential term limits had long been debated in American politics. Delegates to the Constitutional Convention of 1787 considered the issue extensively (alongside broader questions, such as who would elect the president, and the president's role). Many, including Alexander Hamilton and James Madison, supported lifetime tenure for presidents, while others favored fixed terms. Virginia's George Mason denounced the life-tenure proposal as tantamount to elective monarchy. An early draft of the U.S. Constitution provided that the president was restricted to one seven-year term. Ultimately, the Framers approved four-year terms with no restriction on how many times a person could be elected president.


text: Though dismissed by the Constitutional Convention, term limits for U.S. presidents were contemplated during the presidencies of George Washington and Thomas Jefferson. As his second term entered its final year in 1796, Washington was exhausted from years of public service, and his health had begun to decline. He was also bothered by his political opponents' unrelenting attacks, which had escalated after the signing of the Jay Treaty, and believed he had accomplished his major goals as president. For these reasons, he decided not to run for a third term, a decision he announced to the nation in his September 1796 "Farewell Address". Eleven years later, as Thomas Jefferson neared the halfway point of his second term, he wrote,


text: Since Washington made his historic announcement, numerous academics and public figures have looked at his decision to retire after two terms, and have, according to political scientist Bruce Peabody, "argued he had established a "two-term tradition" that served as a vital check against any one person, or the presidency as a whole, accumulating too much power". Various amendments aimed at changing informal precedent to constitutional law were proposed in Congress in the early to mid-19th century, but none passed. Three of the next four presidents after Jefferson—James Madison, James Monroe, and Andrew Jackson—served two terms, and each adhered to the two-term principle; Martin Van Buren was the only president between Jackson and Abraham Lincoln to be nominated for a second term, though he lost the 1840 election and so served only one term. At the outset of the Civil War the seceding States drafted the Constitution of the Confederate States of America, which in most respects resembled the United States Constitution, but limited the president to a single six-year term.


text: In spite of the strong two-term tradition, a few presidents before Roosevelt attempted to secure a third term. Following Ulysses S. Grant's reelection in 1872, there were serious discussions within Republican political circles about the possibility of his running again in 1876. But interest in a third term for Grant evaporated in the light of negative public opinion and opposition from members of Congress, and Grant left the presidency in 1877 after two terms. Even so, as the 1880 election approached, he sought nomination for a (non-consecutive) third term at the 1880 Republican National Convention, but narrowly lost to James Garfield, who won the 1880 election.


text: Theodore Roosevelt succeeded to the presidency on September 14, 1901, following William McKinley's assassination ( days into his second term), and was handily elected to a full term in 1904. He declined to seek a third (second full) term in 1908, but did run again in the election of 1912, losing to Woodrow Wilson. Wilson himself, despite his ill health following a serious stroke, aspired to a third term. Many of his advisers tried to convince him that his health precluded another campaign, but Wilson nonetheless asked that his name be placed in nomination for the presidency at the 1920 Democratic National Convention. Democratic Party leaders were unwilling to support Wilson, and the nomination went to James M. Cox, who lost to Warren G. Harding. Wilson again contemplated running for a (nonconsecutive) third term in 1924, devising a strategy for his comeback, but again lacked any support; he died in February of that year.


text: Franklin Roosevelt spent the months leading up to the 1940 Democratic National Convention refusing to say whether he would seek a third term. His vice president, John Nance Garner, along with Postmaster General James Farley, announced their candidacies for the Democratic nomination. When the convention came, Roosevelt sent a message to the convention saying he would run only if drafted, saying delegates were free to vote for whomever they pleased. This message was interpreted to mean he was willing to be drafted, and he was renominated on the convention's first ballot. Roosevelt won a decisive victory over Republican Wendell Willkie, becoming the first (and to date only) president to exceed eight years in office. His decision to seek a third term dominated the election campaign. Willkie ran against the open-ended presidential tenure, while Democrats cited the war in Europe as a reason for breaking with precedent.


text: Four years later, Roosevelt faced Republican Thomas E. Dewey in the 1944 election. Near the end of the campaign, Dewey announced his support of a constitutional amendment to limit presidents to two terms. According to Dewey, "four terms, or sixteen years (a direct reference to the president's tenure in office four years hence), is the most dangerous threat to our freedom ever proposed." He also discreetly raised the issue of the president's age. Roosevelt exuded enough energy and charisma to retain voters' confidence and was elected to a fourth term.


text: While he quelled rumors of poor health during the campaign, Roosevelt's health was deteriorating. On April 12, 1945, only days after his fourth inauguration, he suffered a cerebral hemorrhage and , to be succeeded by Vice President Harry Truman. In the midterm elections months later, Republicans took control of the House and the Senate. As many of them had campaigned on the issue of presidential tenure, declaring their support for a constitutional amendment that would limit how long a person could serve as president, the issue was given priority in the 80th Congress when it convened in January 1947.


text: The House of Representatives took quick action, approving a proposed constitutional amendment (House Joint Resolution 27) setting a limit of two four-year terms for future presidents. Introduced by Earl C. Michener, the measure passed 285–121, with support from 47 Democrats, on February 6, 1947. Meanwhile, the Senate developed its own proposed amendment, which initially differed from the House proposal by requiring that the amendment be submitted to state ratifying conventions for ratification, rather than to the state legislatures, and by prohibiting any person who had served more than 365 days in each of two terms from further presidential service. Both these provisions were removed when the full Senate took up the bill, but a new provision was, however, added. Put forward by Robert A. Taft, it clarified procedures governing the number of times a vice president who succeeded to the presidency might be elected to office. The amended proposal was passed 59–23, with 16 Democrats in favor, on March 12.


text: On March 21, the House agreed to the Senate's revisions and approved the resolution to amend the Constitution. Afterward, the amendment imposing term limitations on future presidents was submitted to the states for ratification. The ratification process was completed on February 27, 1951, after it was sent to the states.


text: Conversely, two states—Oklahoma and Massachusetts—rejected the amendment, while five (Arizona, Kentucky, Rhode Island, Washington, and West Virginia) took no action.


text: Because of the grandfather clause in Section 1, the amendment did not apply to Harry S. Truman, the incumbent president at the time it was submitted to the states by the Congress. Without this full exemption, Truman would not have been eligible to run again in 1952. He had served nearly all of Franklin Roosevelt's unexpired 1945–1949 term and had been elected to a full four-year term beginning in 1949. But with his job approval rating at around 27%, and after a poor performance in the 1952 New Hampshire primary, Truman chose not to seek his party's nomination. Since becoming operative in 1951, the amendment has been applicable to six presidents who have been elected twice: Dwight D. Eisenhower, Richard Nixon, Ronald Reagan, Bill Clinton, George W. Bush, and Barack Obama.


text: As worded, the focus of the 22nd Amendment is on limiting individuals from being elected to the presidency more than twice. Questions have been raised about the amendment's meaning and application, especially in relation to the 12th Amendment, ratified in 1804, which states, "no person constitutionally ineligible to the office of President shall be eligible to that of Vice-President of the United States." While the 12th Amendment stipulates that the constitutional qualifications of age, citizenship, and residency apply to the president and vice president, it is unclear whether someone who is ineligible to be elected president due to term limits could be elected vice president. Because of the ambiguity, a two-term former president could possibly be elected vice president and then succeed to the presidency as a result of the incumbent's death, resignation, or removal from office, or succeed to the presidency from another stated office in the presidential line of succession.


text: Some argue that the 22nd Amendment and 12th Amendment bar any two-term president from later serving as vice president as well as from succeeding to the presidency from any point in the presidential line of succession. Others contend that the original intent of the 12th Amendment concerns qualification for service (age, residence, and citizenship), while the 22nd Amendment concerns qualifications for election, and thus a former two-term president is still eligible to serve as vice president. Neither amendment restricts the number of times someone can be elected to the vice presidency and then succeed to the presidency to serve out the balance of the term, although the person could be prohibited from running for election to an additional term.


text: The practical applicability of this distinction has not been tested, as no twice-elected president has ever been nominated for the vice presidency. While Hillary Clinton once suggested she considered former President Bill Clinton as her running mate, the constitutional question remains unresolved.


text: Over the years, several presidents have voiced their antipathy toward the amendment. After leaving office, Harry Truman described the amendment as stupid and one of the worst amendments of the Constitution with the exception of the Prohibition Amendment. A few days before leaving office in January 1989, President Ronald Reagan said he would push for a repeal of the 22nd Amendment because he thought it infringed on people’s democratic rights. In a November 2000 interview with "Rolling Stone", President Bill Clinton suggested that the 22nd Amendment should be altered to limit presidents to two consecutive terms but then allow non-consecutive terms, because of longer life expectancies. Donald Trump questioned presidential term limits on multiple occasions while in office, and in public remarks talked about serving beyond the limits of the 22nd Amendment. During an April 2019 White House event for the Wounded Warrior Project, he suggested he would remain president for 10 to 14 years.


text: The first efforts in Congress to repeal the 22nd Amendment were undertaken in 1956, five years after the amendment's ratification. Over the next 50 years, 54 joint resolutions seeking to repeal the two-term presidential election limit were introduced. Between 1997 and 2013, José E. Serrano, Democratic representative for New York, introduced nine resolutions (one per Congress, all unsuccessful) to repeal the amendment. Repeal has also been supported by Representatives Barney Frank and David Dreier and Senators Mitch McConnell and Harry Reid.


title: Jay Roach

text: Mathew Jay Roach (born June 14, 1957) is an American filmmaker. He is best known for directing the "Austin Powers" film series, "Meet the Parents", "Dinner for Schmucks", "The Campaign", "Trumbo", and "Bombshell".


title: Jay Roach

text: Roach also earned critical acclaim for directing and producing the political drama films "Recount", "Game Change", and "All the Way". He produced these films under his Everyman Pictures banner. For his work, he has received four Primetime Emmy Awards from six nominations.


title: Jay Roach

text: Roach was born and raised in Albuquerque, New Mexico, where his father was a military worker. He graduated from Eldorado High School in 1975. He received a BA in economics from Stanford University in 1980 and later earned a Master of Fine Arts in film production from the University of Southern California in 1986.


title: Jay Roach

text: Roach made his directorial debut with the 1990 comedy film "Zoo Radio". He received recognition for the commercially successful spy comedy film "" (1997), starring Mike Myers as the title character. He returned to direct the sequels "" (1999) and "Austin Powers in Goldmember" (2002).


title: Jay Roach

text: Roach also directed the sports comedy-drama film "Mystery, Alaska", which was released in October 1999. He continued to direct critically and commercially successful comedies, including "Meet the Parents" (2000) and its sequel "Meet the Fockers" (2004), "Dinner for Schmucks" (2010), and "The Campaign" (2012). Roach expanded into other genres, directing the biographical period drama "Trumbo" (2015) and the biographical drama "Bombshell" (2019), which earned multiple Academy Award nominations.


title: Jay Roach

text: Roach earned critical acclaim for directing multiple HBO political drama films. He directed "Recount" (2008), which earned him two Primetime Emmy Awards for Outstanding Directing for a Limited Series, Movie, or Dramatic Special and Outstanding Television Movie, in addition to the Directors Guild of America Award for Outstanding Directing – Miniseries or TV Film. He then directed "Game Change", about the 2008 McCain/Palin campaign, which premiered March 2012 as one of the most watched films in HBO history. The film earned him additional Primetime Emmy Awards in the same categories as well as the Golden Globe Award for Best Miniseries or Television Film and a Peabody Award. He also directed "All the Way", which premiered in May 2016 and earned Roach two more Primetime Emmy Award nominations in the same categories.


title: Jay Roach

text: Roach is married to musician and actress Susanna Hoffs of The Bangles, with whom he has two sons. Roach was raised a Southern Baptist and converted to Judaism before marrying Hoffs.


title: Trichotillomania

text: Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen.


title: Trichotillomania

text: The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look.


title: Trichotillomania

text: Treatment is typically with cognitive behavioral therapy. The medication clomipramine may also be helpful, as will keeping fingernails clipped. Trichotillomania is estimated to affect one to four percent of people. Trichotillomania most commonly begins in childhood or adolescence. Women are affected about 10 times more often than men. The name was created by François Henri Hallopeau in 1889, from the Greek ; (meaning 'hair'), along with ; (meaning 'to pull'), and ; "mania" (meaning 'madness').


title: Trichotillomania

text: Trichotillomania is usually confined to one or two sites, but can involve multiple sites. The scalp is the most common pulling site, followed by the eyebrows, eyelashes, face, arms, and legs. Some less common areas include the pubic area, underarms, beard, and chest. The classic presentation is the "Friar Tuck" form of vertex and crown alopecia. Children are less likely to pull from areas other than the scalp.


title: Trichotillomania

text: People with trichotillomania often pull only one hair at a time and these hair-pulling episodes can last for hours at a time. Some individuals may experience more satisfaction after pulling an anagen phase hair with the gel-like inner root sheath still surrounding the base of the hair. Trichotillomania can go into remission-like states where the individual may not experience the urge to "pull" for days, weeks, months, or even years.


title: Trichotillomania

text: Individuals with trichotillomania exhibit hair of differing lengths; some are broken hairs with blunt ends, some new growth with tapered ends, some broken mid-shaft, or some uneven stubble. Scaling on the scalp is not present, overall hair density is normal, and a hair pull test is negative (the hair does not pull out easily). Hair is often pulled out leaving an unusual shape. Individuals with trichotillomania may be secretive or shameful of the hair pulling behavior.


title: Trichotillomania

text: An additional psychological effect can be low self-esteem, often associated with being shunned by peers and the fear of socializing, due to appearance and negative attention they may receive. Some people with trichotillomania wear hats, wigs, false eyelashes, eyebrow pencil, or style their hair in an effort to avoid such attention. There seems to be a strong stress-related component. In low-stress environments, some exhibit no symptoms (known as "pulling") whatsoever. This "pulling" often resumes upon leaving this environment. Some individuals with trichotillomania may feel they are the only person with this problem due to low rates of reporting.


title: Trichotillomania

text: For some people, trichotillomania is a mild problem, merely a frustration. But for many, embarrassment about hair pulling causes isolation and results in a great deal of emotional distress, placing them at risk for a co-occurring psychiatric disorder, such as a mood or anxiety disorder. Hair pulling can lead to tension and strained relationships with family members and friends. Family members may need professional help in coping with this problem.


title: Trichotillomania

text: Other medical complications include infection, permanent loss of hair, repetitive stress injury, carpal tunnel syndrome, and gastrointestinal obstruction as a result of trichophagia. In trichophagia, people with trichotillomania also ingest the hair that they pull; in extreme (and rare) cases this can lead to a hair ball (trichobezoar). Rapunzel syndrome, an extreme form of trichobezoar in which the "tail" of the hair ball extends into the intestines, can be fatal if misdiagnosed.


title: Trichotillomania

text: Environment is a large factor which affects hair pulling. Sedentary activities such as being in a relaxed environment are conducive to hair pulling. A common example of a sedentary activity promoting hair pulling is lying in a bed while trying to rest or fall asleep. An extreme example of automatic trichotillomania is found when some patients have been observed to pull their hair out while asleep. This is called sleep-isolated trichotillomania.


title: Trichotillomania

text: Anxiety, depression and obsessive–compulsive disorder are more frequently encountered in people with trichotillomania. Trichotillomania has a high overlap with post traumatic stress disorder, and some cases of trichotillomania may be triggered by stress. Another school of thought emphasizes hair pulling as addictive or negatively reinforcing, as it is associated with rising tension beforehand and relief afterward. A neurocognitive model — the notion that the basal ganglia play a role in habit formation and that the frontal lobes are critical for normally suppressing or inhibiting such habits — sees trichotillomania as a habit disorder.


title: Trichotillomania

text: Abnormalities in the caudate nucleus are noted in OCD, but there is no evidence to support that these abnormalities can also be linked to trichotillomania. One study has shown that individuals with trichotillomania have decreased cerebellar volume. These findings suggest some differences between OCD and trichotillomania. There is a lack of structural MRI studies on trichotillomania. In several MRI studies that have been conducted, it has been found that people with trichotillomania have more gray matter in their brains than those who do not have the disorder.


title: Trichotillomania

text: It is likely that multiple genes confer vulnerability to trichotillomania. One study identified mutations in the SLITRK1 gene.


title: Trichotillomania

text: Patients may be ashamed or actively attempt to disguise their symptoms. This can make diagnosis difficult as symptoms are not always immediately obvious, or have been deliberately hidden to avoid disclosure. If the patient admits to hair pulling, diagnosis is not difficult; if patients deny hair pulling, a differential diagnosis must be pursued. The differential diagnosis will include evaluation for alopecia areata, iron deficiency, hypothyroidism, tinea capitis, traction alopecia, alopecia mucinosa, thallium poisoning, and loose anagen syndrome. In trichotillomania, a hair pull test is negative.


title: Trichotillomania

text: A biopsy can be performed and may be helpful; it reveals traumatized hair follicles with perifollicular hemorrhage, fragmented hair in the dermis, empty follicles, and deformed hair shafts. Multiple catagen hairs are typically seen. An alternative technique to biopsy, particularly for children, is to shave a part of the involved area and observe for regrowth of normal hairs.


title: Trichotillomania

text: Trichotillomania is defined as a self-induced and recurrent loss of hair. It includes the criterion of an increasing sense of tension before pulling the hair and gratification or relief when pulling the hair. However, some people with trichotillomania do not endorse the inclusion of "rising tension and subsequent pleasure, gratification, or relief" as part of the criteria because many individuals with trichotillomania may not realize they are pulling their hair, and patients presenting for diagnosis may deny the criteria for tension prior to hair pulling or a sense of gratification after hair is pulled.