title: Joss Whedon

text: In 2013, Whedon said that he is a workaholic. This arose during the time that followed the completion of "Much Ado About Nothing", which was made in the span of a two-week vacation from "The Avengers", and after making the pilot for "Agents of S.H.I.E.L.D." amidst the pre-production for "Avengers: Age of Ultron". "It is actually a problem. Sometimes it's adorable ... and sometimes it's not ... Not to get all dark and weird, but it is something I need to address." He has been a member of the Academy of Motion Picture Arts and Sciences in its Writers' branch since 2017.


title: Joss Whedon

text: In 1995, Whedon married Kai Cole, an architect, producer and co-founder of Bellwether Pictures. They have two children together. Whedon and Cole separated in 2012 and divorced in 2016. In 2017, Cole claimed that Whedon had repeatedly been unfaithful to her and that he "does not practice what he preaches" in regard to feminism.


title: Joss Whedon

text: Whedon has identified himself as an atheist. In an interview with "The A.V. Club" Whedon elaborated on his nonbelief in gods.


title: Joss Whedon

text: Whedon has identified as an absurdist and existentialist. A committed humanist, Whedon was presented with the Outstanding Lifetime Achievement Award in Cultural Humanism by the Humanist Chaplaincy at Harvard University in 2009. He has spoken about existentialism, explaining in detail how it, and more specifically Jean-Paul Sartre's "Nausea", was used as a basis for the "Firefly" episode "Objects in Space". He called it "the most important book" he ever read, and said it was given to him right after he saw Steven Spielberg's "Close Encounters of the Third Kind", whose impact, he recalls, had made him an existentialist.


title: Joss Whedon

text: In July 2012, at the San Diego Comic-Con International, in response to one woman who noted the anti-corporate themes in many of his films and asked him to give his economic philosophy in 30 seconds or less, Whedon spoke out against capitalism, saying that America is "turning into Tsarist Russia".


title: Joss Whedon

text: Endorsing Barack Obama in the 2012 United States presidential election, Whedon satirically equated Mitt Romney's future as president with a zombie apocalypse, quipping, "Romney is ready to make the deep rollbacks in health care, education, social services and reproductive rights that will guarantee poverty, unemployment, overpopulation, disease, rioting—all crucial elements in creating a nightmare zombie wasteland."


title: Joss Whedon

text: In 2015, Whedon signed a petition as part of a political campaign calling for Elizabeth Warren to run for President of the United States.


title: Joss Whedon

text: In January 2017, after actress Nicole Kidman publicly suggested that America should accept that Donald Trump is president, Whedon tweeted a photograph of plastic puppet Lady Penelope Creighton-Ward alongside an image of Kidman, an action some interpreted as mocking and objectifying Kidman's physical appearance. That same month, Whedon also received criticism for reportedly comparing Ivanka Trump to a dog and for wishing that Paul Ryan would be raped to death by a rhinoceros. Referring to Ivanka's husband Jared Kushner and Trump, he tweeted: "He's a Voldemort in training, & unlike the Pekingese he married under, can play the long game." Whedon stated that he had been referring to Donald Trump. In April 2017, Whedon took a shot at Republicans by criticizing the physical appearance of teenage cancer survivors who were visiting then–Speaker of the House Paul Ryan. He later apologized on Twitter.


title: Warner Bros. Discovery

text: Warner Bros. Discovery, Inc. (WBD) is an American multinational mass media and entertainment conglomerate headquartered at 230 Park Avenue South in New York City. It was formed after the spin-off of WarnerMedia by AT&T, and its merger with Discovery, Inc. on April 22, 2021.


title: Warner Bros. Discovery

text: The company's properties are divided into nine business units, including the flagship Warner Bros. film and television studios, comic book publisher DC Entertainment, Home Box Office, Inc. (which includes HBO), U.S. Networks (which includes the majority of the ad-supported cable networks of its predecessors, including Discovery, Scripps Networks, Turner Broadcasting, and Warner), CNN, Sports (which includes Motor Trend Group, AT&T SportsNet, TNT Sports, and Eurosport, among others), Global Streaming & Interactive Entertainment (which includes the Discovery+ and HBO Max streaming services, and video game publisher Warner Bros. Interactive Entertainment), and International Networks. It also holds a minority stake in The CW and a majority stake in the Food Network (including its spin-off network Cooking Channel), all of which are alongside Nexstar Media Group, and the former alongside Paramount Global.


title: Warner Bros. Discovery

text: Warner Bros., Turner Broadcasting System, Scripps Networks Interactive and Discovery, Inc. have conjoined histories over the years. Warner Bros. was founded in 1923 by four brothers, Harry, Albert, Sam, and Jack Warner, the company established itself as a leader in the American film industry before diversifying into animation, television, and video games and is one of the "Big Five" major American film studios, as well as a member of the Motion Picture Association (MPA). In 1965, Turner Broadcasting System was founded by Ted Turner and based in Atlanta, Georgia. A year later, Kinney National Company came into existence and its media division became Warner Communications before merging with Time Inc. in 1990 to become Time Warner. During its time as Warner Communications, the company made a number of further acquisitions.


title: Warner Bros. Discovery

text: In 1979, Warner formed a joint venture with credit card company American Express called Warner-Amex Satellite Entertainment. This company owned such cable channels as MTV, Nickelodeon, The Movie Channel, and VH1 (which was launched in 1985 on the channel space left by Turner's Cable Music Channel). Warner bought out American Express's half in 1984 and sold the venture a year later to the original iteration of Viacom, which renamed it MTV Networks (now known as Paramount Media Networks). In 1982, Warner purchased Popular Library from CBS Publications.


title: Warner Bros. Discovery

text: Meanwhile, Cable Education Network was founded in 1985 and was renamed to Discovery Communications in 1994. Scripps Networks Interactive was founded in 2008 spun off from E. W. Scripps Company's cable division.


title: Warner Bros. Discovery

text: On October 10, 1996, Time Warner acquired the Turner Broadcasting System; but the company later merged with AOL to form AOL Time Warner in 2001 and reverted back to Time Warner name in 2003. Time Warner spun off its cable division (later known as Spectrum owned by Charter Communications) and AOL (now owned by Yahoo! Inc.) in 2009 and Time, Inc. was spun out in 2013, which was later acquired by Meredith Corporation in January 2018 and is now known as Dotdash Meredith. Discovery Communications acquired Scripps Networks Interactive in March 2018 and was renamed to Discovery, Inc. while AT&T acquired Time Warner that June. In March 2019, AT&T dissolved the Turner Broadcasting System as part of its reorganization of its media assets.


title: Warner Bros. Discovery

text: On May 16, 2021, Bloomberg News reported that AT&T was considering an offer to divest equity interest in their media subsidiary WarnerMedia (the former Time Warner, which AT&T acquired in 2018 for just over $85 billion in an attempt to become a vertically integrated media conglomerate), and have it merge with Discovery, Inc. to form a new publicly traded company. AT&T and Discovery officially confirmed the agreement the next day; the merger would be structured as a Reverse Morris Trust, with AT&T shareholders holding a 71% interest in the new company's stock and appointing seven board members, and Discovery shareholders holding a 29% interest and appointing six board members. AT&T would receive US$43 billion in cash and debt from the divestment. The merger was expected to be completed in mid-2022.


title: Warner Bros. Discovery

text: The new company would be led by Discovery's current CEO, David Zaslav; WarnerMedia's CEO Jason Kilar's position in the new company was uncertain. Zaslav stated that the two companies would spend a combined US$20 billion annually on content (outpacing even Netflix). The company will aim to expand their streaming services, which includes WarnerMedia's HBO Max, to reach 400 million global subscribers. It was stated that the company would aim to achieve $3 billion in cost savings via synergies within two years.


title: Warner Bros. Discovery

text: On June 1, 2021, it was announced that the merged company would be known as Warner Bros. Discovery, and an interim wordmark was unveiled with the tagline "The stuff that dreams are made of"—a quote from the 1941 Warner Bros. film "The Maltese Falcon". Zaslav explained that the company aimed to be the "most innovative, exciting and fun place to tell stories in the world", and would combine Warner Bros.' "fabled hundred-year legacy of creative, authentic storytelling and taking bold risks to bring the most amazing stories to life" with Discovery's "integrity, innovation and inspiration."


title: Warner Bros. Discovery

text: In an SEC filing on November 18, 2021, Discovery Inc. revealed that talks with AT&T had fallen through, in April 2021, due to disagreements over the ownership of the new company between AT&T and Discovery shareholders, and the amount of debt transferred to Discovery when they merged with WarnerMedia, before talks resumed on May 17, 2021.


title: Warner Bros. Discovery

text: In November 2021, during an earnings call, Discovery Streaming CEO JB Perrette discussed possible options for its Discovery+ streaming service post-merger, including bundling the service with HBO Max and eventually merging them under a single platform with a mixture of both companies' technologies. He also noted that WBD may prioritize launching Discovery+ and HBO Max as a unified platform in markets where Discovery+ has yet to launch, such as another parts of the Asia-Pacific. On March 14, 2022, Discovery CFO Gunnar Wiedenfels—who would assume the same position post-merger—confirmed that such a transition was a long-term goal.


title: Warner Bros. Discovery

text: On December 22, 2021, the transaction was approved by the European Commission. On January 5, 2022, "The Wall Street Journal" reported that WarnerMedia and Paramount Global (at the time named ViacomCBS) were exploring a possible sale of either a majority stake or all of The CW, and that Nexstar Media Group (which became The CW's largest affiliate group when it acquired former WB co-owner Tribune Broadcasting in 2019) was considered a leading bidder. The news led to speculation that, should a sale take place, new ownership could steer the network in a new direction, transforming The CW from a young adult-oriented network into one that featured more unscripted and even national news programming. However, reports also indicated that WarnerMedia and ViacomCBS could include a contractual commitment that would require any new owner to buy new programming from those companies, allowing them to reap some continual revenue through the network. Network president/CEO Mark Pedowitz confirmed talks of a potential sale in a memo to CW staffers, but added that "It's too early to speculate what might happen" and that the network "must continue to do what we do best."


title: Warner Bros. Discovery

text: On January 26, 2022, AT&T CEO John Stankey stated that the merger was expected to close sometime during the second quarter of 2022. On February 1, 2022, it was reported that AT&T had finalized the structure of the merger: WarnerMedia would be spun off pro rata to AT&T's shareholders, and then merge into Discovery Inc. to form the new company. The transaction was approved by the Brazilian antitrust regulator Cade on February 7, followed by the United States Department of Justice on February 9. On March 11, 2022, the merger was approved by Discovery's shareholders. Due to the structure of the merger, it did not require separate approval from AT&T shareholders.


title: Warner Bros. Discovery

text: In an SEC filing on March 25, 2022, AT&T stated that two-way trading of WBD stock with that of AT&T would begin on April 4, 2022, and that a special dividend would be issued the next day to give AT&T shareholders a 0.24 share in WBD for each share of AT&T common stock they hold. The merger was officially completed on April 8, 2022, with trading beginning on the Nasdaq on April 11. At this time the company unveiled its final logo, designed by Chermayeff & Geismar & Haviv, which features a rendition of Warner Bros.' long-time shield logo.


title: Warner Bros. Discovery

text: The combined company retained several top executives from WarnerMedia, including film and television heads Toby Emmerich and Channing Dungey, and HBO and HBO Max chief content officer Casey Bloys. Most of the company's top executive roles are filled by their Discovery counterparts, including Gunnar Wiedenfels as CFO, JB Perrette as president and CEO of global streaming and interactive, and Discovery's chief lifestyle brands officer Kathleen Finch—whose role has been expanded to cover most of the combined company's U.S. linear networks, besides CNN (which was taken over by Chris Licht, replacing the outgoing Jeff Zucker), Magnolia Network (which reports to Bloys, after having previously reported directly to Zaslav under Discovery), and the Turner Sports unit (which would be overseen by the newly-formed Warner Bros. Discovery Sports division).


title: Warner Bros. Discovery

text: In an introductory town hall featuring Oprah Winfrey as host, Zaslav stated that the combined company would need to have "one culture" that "starts with people feeling safe, people feeling valued for who they are", as opposed what he described as a culture of internal competition between WarnerMedia's businesses. He also expected that "investment avoidance" via the consolidation of redundant business units (such as streaming) and staff would be one of the main ways that the company would achieve its promised $3 billion in cost savings. On April 21, 2022, Licht and Perrette announced the shutdown of CNN's streaming service CNN+, which had only launched two weeks prior to the completion of the merger; the new leadership considered it to be incompatible with their goal of a unified streaming service for all WBD properties.


title: Warner Bros. Discovery

text: In an investors' call on April 26 (concurrent with the first quarter earnings reports for Discovery Inc., its last prior to the merger), Zaslav contrasted the company's streaming businesses with those of Netflix (whose stock saw a decline after a quarterly loss in subscribers), describing Warner Bros. Discovery as being a "far more balanced and competitive company" that would "invest at scale smartly" and not "overspend" on growth and that its streaming businesses would complement its linear television. He stated that HBO Max had "meaningful subscriber churn", and that the planned merger of it with Discovery+ would help to reduce it by offering a broader array of content. It was reported that the company had also suspended scripted development at TBS and TNT, in order to evaluate their strategies moving forward. The following day, Zaslav purchased approximately $1 million worth of WBD stock.


title: Warner Bros. Discovery

text: On May 11, 2022, Warner Bros. Discovery eliminated several executive positions carried over from WarnerMedia, including Kids, Young Adults and Classics head Tom Ascheim, and general manager of TBS, TNT, and TruTV head Brett Weitz. These networks will be overseen by Finch as head of U.S. Networks, while the studios under the Kids, Young Adults and Classics division was moved under Warner Bros. Television. The same day, it announced an agreement with British telecom company BT Group for it to contribute its BT Sport channels into a 50/50 joint venture with its UK Eurosport channels, and eventually merge them. On June 9, WBD named former Discovery and Univision executive Luis Silberwasser as chairman of Sports.


title: Warner Bros. Discovery

text: In July 2022, Warner Bros. Pictures head Toby Emmerich announced that he would step down and establish a new studio, which will be funded by and have an exclusive, five-year distribution deal with Warner Bros. Pictures. Warner Bros. Pictures was then divided into three business units with their own leadership: former MGM executives Michael De Luca and Pamela Abdy became the co-chairs of Warner Bros. Pictures and New Line Cinema, and will temporarily oversee the DC Films and Warner Animation Group units until new executives are hired for the positions. Alan Horn also rejoined Warner Bros. as a consultant.


title: Warner Bros. Discovery

text: WBD delivered its second-quarter earnings report—its first since the merger—on August 4, 2022. Ahead of the report, the company performed multiple cuts to HBO Max throughout July and early-August, including cutting new programming development in much of Europe, live-action children's programming development, and direct-to-streaming films—leading to the notable August 3 cancellations of the nearly-completed films "Batgirl" and "" as tax write-offs, and the quiet removals of multiple HBO Max original films from the platform and its upcoming releases.


title: Warner Bros. Discovery

text: In the second quarter of 2022, WBD took $9.8 billion in revenue and a net loss of $2.2 billion pro forma, primarily from integration and restructuring expenses. The company took $825 million in write-offs on "content impairments and development". The company confirmed cuts to children's programming development, and abandoned the production of direct-to-streaming films for HBO Max—with Zaslav arguing that they lacked economic value and impact in comparison to theatrical releases. WBD renewed its contracts with Bloys and other key HBO executives, with Zaslav praising his performance as chief content officer. Zaslav stated that a "10-year plan" was in development for DC Films, modeled after those of Marvel Studios, while Perrette stated that the planned merger of Discovery+ and HBO Max would occur by summer 2023 in the United States, with other markets to follow.


title: Warner Bros. Discovery

text: HBO subsequently faced a reorganization on August 15 to dismantle most of HBO Max's autonomous units, with HBO Max's head of comedy Suzanna Makkos now reporting to HBO's head of comedy Amy Gravitt, and layoffs within HBO Max's non-scripted, live-action family entertainment, international originals, and casting units, as well as HBO's acquisitions unit. HBO Max also continued to remove and cancel some of its lesser-viewed original programming, particularly family-oriented and animated series.


title: Warner Bros. Discovery

text: In September 2022, WBD became the subject of a proposed class-action lawsuit by one of its shareholders, alleging that WarnerMedia was overinvesting in streaming content "without sufficient concern for return on investments", and had overstated the number of HBO Max subscribers by at least 10 million by counting inactivated subscriptions bundled with AT&T services—thus misleading investors in violation of the Securities Act. It also alleged that Discovery executives failed to warn investors that WarnerMedia's prospectus contained misleading statements.


title: Warner Bros. Discovery

text: On September 28 during a company town hall, Zaslav addressed speculation that WBD was pursuing a possible sale as early as 2024, stating that they were "absolutely not for sale", and "have everything we need to be successful." On October 11, Warner Bros. Television Group laid off 82 employees and eliminated 43 vacant positions as part of a restructuring that primarily impacts their unscripted and animation units. The restructuring saw the consolidation of Warner Horizon and Telepictures' creative operations, and the consolidation of Cartoon Network Studios' and Warner Bros. Animation's development and production teams (with the two studios remaining separate labels with their own distinct output).


title: Warner Bros. Discovery

text: In October 2022, it was announced that filmmaker James Gunn and producer Peter Safran would serve as the co-CEO and co-chairmen of DC Films which will be rebranded as DC Studios moving forward. The duo has signed a four-year deal that will oversee the production of films, television, and animation under the DC label. The pair will report directly to Zaslav, while also working alongside but independently with other members of the studio. Gunn will oversee creative development on DC projects, while Safran will oversee the business aspect. During an earnings report in November 2022, it was announced that the launch of WBD's streaming service had been moved up to spring 2023. In early-December 2022, it was reported by CNBC via inside sources that the unified platform was being developed under the codename "BEAM", and that multiple names were being considered—including simply "Max".


title: Warner Bros. Discovery

text: Former Discovery shareholder Advance Publications holds a 8.16% stake in WBD's stock. The Vanguard Group (6.79%) and BlackRock (4.74%) also hold stakes.


title: Kashmir

text: Kashmir () is the northernmost geographical region of the Indian subcontinent. Until the mid-19th century, the term "Kashmir" denoted only the Kashmir Valley between the Great Himalayas and the Pir Panjal Range. Today, the term encompasses a larger area that includes the Indian-administered territories of Jammu and Kashmir and Ladakh, the Pakistani-administered territories of Azad Kashmir and Gilgit-Baltistan, and the Chinese-administered territories of Aksai Chin and the Trans-Karakoram Tract.


title: Kashmir

text: In 1820 the Sikh Empire, under Ranjit Singh, annexed Kashmir. In 1846, after the Sikh defeat in the First Anglo-Sikh War, and upon the purchase of the region from the British under the Treaty of Amritsar, the Raja of Jammu, Gulab Singh, became the new ruler of Kashmir. The rule of his descendants, under the "paramountcy" (or tutelage) of the British Crown, lasted until the Partition of India in 1947, when the former princely state of the British Indian Empire became a disputed territory, now administered by three countries: India, Pakistan, and China.


title: Kashmir

text: The word "Kashmir" is thought to have been derived from Sanskrit and was referred to as "". A popular local etymology of "Kashmira" is that it is land desiccated from water.


title: Kashmir

text: An alternative etymology derives the name from the name of the Vedic sage Kashyapa who is believed to have settled people in this land. Accordingly, "Kashmir" would be derived from either "kashyapa-mir" (Kashyapa's Lake) or "kashyapa-meru" (Kashyapa's Mountain).


title: Kashmir

text: The word has been referenced to in a Hindu scripture mantra worshipping the Hindu goddess Sharada and is mentioned to have resided in the land of "kashmira", or which might have been a reference to the Sharada Peeth.


title: Kashmir

text: The Ancient Greeks called the region "Kasperia", which has been identified with "Kaspapyros" of Hecataeus of Miletus (apud Stephanus of Byzantium) and "Kaspatyros" of Herodotus (3.102, 4.44). Kashmir is also believed to be the country meant by Ptolemy's "Kaspeiria". The earliest text which directly mentions the name "Kashmir" is in "Ashtadhyayi" written by the Sanskrit grammarian Pāṇini during the 5th century BC. Pāṇini called the people of Kashmir "Kashmirikas". Some other early references to Kashmir can also be found in Mahabharata in Sabha Parva and in puranas like Matsya Purana, Vayu Purana, Padma Purana and Vishnu Purana and Vishnudharmottara Purana.


title: Kashmir

text: Huientsang, the Buddhist scholar and Chinese traveller, called Kashmir "kia-shi-milo", while some other Chinese accounts referred to Kashmir as "ki-pin" (or Chipin or Jipin) and "ache-pin".


title: Kashmir

text: "Cashmeer" is an archaic spelling of modern Kashmir, and in some countries it is still spelled this way. Kashmir is called "Cachemire" in French, "Cachemira" in Spanish, "Caxemira" in Portuguese, "Caixmir" in Catalan, "Casmiria" in Latin, "Cașmir" in Romanian, and "Cashmir" in Occitan.


title: Kashmir

text: The Government of India and Indian sources, refer to the territory under Pakistan control "Pakistan-occupied Kashmir" ("POK"). The Government of Pakistan and Pakistani sources refer to the portion of Kashmir administered by India as "Indian-occupied Kashmir" ("IOK") or "Indian-held Kashmir" (IHK);


title: Kashmir

text: The terms "Indian-administered Kashmir" and "Pakistani-administered Kashmir" are often used by neutral sources for the parts of the Kashmir region controlled by each country.


title: Kashmir

text: In the first half of the first millennium, the Kashmir region became an important centre of Hinduism and later of Buddhism. During the 7th-14th centuries, the region was ruled by a series of Hindu dynasties, and Kashmir Shaivism arose. In 1339, Shah Mir became the first Muslim ruler of Kashmir, inaugurating the "Salatin-i-Kashmir" or Shah Mir dynasty. The region was part of the Mughal Empire from 1586 to 1751, and thereafter, until 1820, of the Afghan Durrani Empire.


title: Kashmir

text: In 1819, the Kashmir Valley passed from the control of the Durrani Empire of Afghanistan to the conquering armies of the Sikhs under Ranjit Singh of the Punjab. As the Kashmiris had suffered under the Afghans, they initially welcomed the new Sikh rulers. However, the Sikh governors turned out to be hard taskmasters, and Sikh rule was generally considered oppressive. Kashmir had also now begun to attract European visitors, several of whom wrote of the abject poverty of the vast Muslim peasantry and of the exorbitant taxes under the Sikhs. High taxes forced many Kashmiri peasants to migrate to the plains of the Punjab. Kashmir became the second highest revenue earner for the Sikh Empire. During this time Kashmir shawls became known worldwide, attracting many buyers, especially in the West.


title: Kashmir

text: The state of Jammu, which had been on the ascendant after the decline of the Mughal Empire, came under the sway of the Sikhs in 1770. Further in 1808, it was fully conquered by Maharaja Ranjit Singh. Gulab Singh, then a youngster in the House of Jammu, enrolled in the Sikh troops and, by distinguishing himself in campaigns, gradually rose in power and influence. In 1822, he was anointed as the Raja of Jammu. Along with his able general Zorawar Singh Kahluria, he conquered and subdued Rajouri (1821), Kishtwar (1821), Suru valley and Kargil (1835), Ladakh (1834–1840), and Baltistan (1840), thereby surrounding the Kashmir Valley. He became a wealthy and influential noble in the Sikh court.


title: Kashmir

text: Gulab Singh contrived to hold himself aloof till the battle of Sobraon (1846), when he appeared as a useful mediator and the trusted advisor of Sir Henry Lawrence. Two treaties were concluded. By the first the State of Lahore (i.e. West Punjab) handed over to the British, as equivalent for one crore indemnity, the hill countries between the rivers Beas and Indus; by the second the British made over to Gulab Singh for 75 lakhs all the hilly or mountainous country situated to the east of the Indus and the west of the Ravi i.e. the Vale of Kashmir.


title: Kashmir

text: Drafted by a treaty and a bill of sale, and constituted between 1820 and 1858, the Princely State of Kashmir and Jammu (as it was first called) combined disparate regions, religions, and ethnicities: to the east, Ladakh was ethnically and culturally Tibetan and its inhabitants practised Buddhism; to the south, Jammu had a mixed population of Hindus, Muslims and Sikhs; in the heavily populated central Kashmir valley, the population was overwhelmingly Sunni Muslim, however, there was also a small but influential Hindu minority, the Kashmiri brahmins or pandits; to the northeast, sparsely populated Baltistan had a population ethnically related to Ladakh, but which practised Shia Islam; to the north, also sparsely populated, Gilgit Agency, was an area of diverse, mostly "Shiʻa" groups; and, to the west, Punch was Muslim, but of different ethnicity than the Kashmir valley. After the Indian Rebellion of 1857, in which Kashmir sided with the British, and the subsequent assumption of direct rule by Great Britain, the princely state of Kashmir came under the suzerainty of the British Crown.


title: Kashmir

text: In the British census of India of 1941, Kashmir registered a Muslim majority population of 77%, a Hindu population of 20% and a sparse population of Buddhists and Sikhs comprising the remaining 3%. That same year, Prem Nath Bazaz, a Kashmiri Pandit journalist wrote: "The poverty of the Muslim masses is appalling. ... Most are landless laborers, working as serfs for absentee [Hindu] landlords ... Almost the whole brunt of official corruption is borne by the Muslim masses." Under the Hindu rule, Muslims faced hefty taxation, discrimination in the legal system and were forced into labor without any wages. Conditions in the princely state caused a significant migration of people from the Kashmir Valley to Punjab of British India. For almost a century until the census, a small Hindu elite had ruled over a vast and impoverished Muslim peasantry. Driven into docility by chronic indebtedness to landlords and moneylenders, having no education besides, nor awareness of rights, the Muslim peasants had no political representation until the 1930s.


title: Kashmir

text: Ranbir Singh's grandson Hari Singh, who had ascended the throne of Kashmir in 1925, was the reigning monarch in 1947 at the conclusion of British rule of the subcontinent and the subsequent partition of the British Indian Empire into the newly independent Dominion of India and the Dominion of Pakistan. According to Burton Stein's "History of India", Kashmir was neither as large nor as old an independent state as Hyderabad; it had been created rather off-handedly by the British after the first defeat of the Sikhs in 1846, as a reward to a former official who had sided with the British. The Himalayan kingdom was connected to India through a district of the Punjab, but its population was 77 per cent Muslim and it shared a boundary with Pakistan. Hence, it was anticipated that the maharaja would accede to Pakistan when the British paramountcy ended on 14–15 August. When he hesitated to do this, Pakistan launched a guerrilla onslaught meant to frighten its ruler into submission. Instead the Maharaja appealed to Mountbatten for assistance, and the governor-general agreed on the condition that the ruler accede to India. Indian soldiers entered Kashmir and drove the Pakistani-sponsored irregulars from all but a small section of the state. The United Nations was then invited to mediate the quarrel. The UN mission insisted that the opinion of Kashmiris must be ascertained, while India insisted that no referendum could occur until all of the state had been cleared of irregulars.


title: Kashmir

text: In the last days of 1948, a ceasefire was agreed under UN auspices. However, since the plebiscite demanded by the UN was never conducted, relations between India and Pakistan soured, and eventually led to two more wars over Kashmir in 1965 and 1999.


title: Kashmir

text: India has control of about half the area of the former princely state of Jammu and Kashmir, which comprises Jammu and Kashmir and Ladakh, while Pakistan controls a third of the region, divided into two provinces, Azad Kashmir and Gilgit-Baltistan. Jammu and Kashmir and Ladakh are administered by India as union territories. They formed a single State until 5 August 2019, when the state was bifurcated and its limited autonomy was revoked.


title: Kashmir

text: Although there was a clear Muslim majority in Kashmir before the 1947 partition and its economic, cultural, and geographic contiguity with the Muslim-majority area of the Punjab (in Pakistan) could be convincingly demonstrated, the political developments during and after the partition resulted in a division of the region. Pakistan was left with territory that, although basically Muslim in character, was sparsely populated, relatively inaccessible, and economically underdeveloped. The largest Muslim group, situated in the Valley of Kashmir and estimated to number more than half the population of the entire region, lay in Indian-administered territory, with its former outlets via the Jhelum valley route blocked.


title: Kashmir

text: The eastern region of the former princely state of Kashmir is also involved in a boundary dispute that began in the late 19th century and continues into the 21st. Although some boundary agreements were signed between Great Britain, Afghanistan and Russia over the northern borders of Kashmir, China never accepted these agreements, and China's official position has not changed following the communist revolution of 1949 that established the People's Republic of China. By the mid-1950s the Chinese army had entered the north-east portion of Ladakh.


title: Kashmir

text: By 1956–57 they had completed a military road through the Aksai Chin area to provide better communication between Xinjiang and western Tibet. India's belated discovery of this road led to border clashes between the two countries that culminated in the Sino-Indian War of October 1962.


title: Kashmir

text: The region is divided amongst three countries in a territorial dispute: Pakistan controls the northwest portion (Northern Areas and Kashmir), India controls the central and southern portion (Jammu and Kashmir) and Ladakh, and the People's Republic of China controls the northeastern portion (Aksai Chin and the Trans-Karakoram Tract). India controls the majority of the Siachen Glacier area, including the Saltoro Ridge passes, whilst Pakistan controls the lower territory just southwest of the Saltoro Ridge. India controls of the disputed territory, Pakistan controls , and the People's Republic of China controls the remaining .


title: Kashmir

text: Jammu and Azad Kashmir lie south and west of the Pir Panjal range, and are under Indian and Pakistani control respectively. These are populous regions. Gilgit-Baltistan, formerly known as the "Northern Areas", is a group of territories in the extreme north, bordered by the Karakoram, the western Himalayas, the Pamir, and the Hindu Kush ranges. With its administrative centre in the town of Gilgit, the Northern Areas cover an area of and have an estimated population approaching 1 million (10 lakhs).


title: Kashmir

text: Ladakh is between the Kunlun mountain range in the north and the main Great Himalayas to the south. Capital towns of the region are Leh and Kargil. It is under Indian administration and was part of the state of Jammu and Kashmir until 2019. It is one of the most sparsely populated regions in the area and is mainly inhabited by people of Indo-Aryan and Tibetan descent. Aksai Chin is a vast high-altitude desert of salt that reaches altitudes up to . Geographically part of the Tibetan Plateau, Aksai Chin is referred to as the Soda Plain. The region is almost uninhabited, and has no permanent settlements.


title: Kashmir

text: Though this regions are in practice administered by their respective claimants, neither India nor Pakistan has formally recognised the accession of the areas claimed by the other. India claims those areas, including the area "ceded" to China by Pakistan in the Trans-Karakoram Tract in 1963, are a part of its territory, while Pakistan claims the entire region excluding Aksai Chin and Trans-Karakoram Tract. The two countries have fought several declared wars over the territory. The Indo-Pakistani War of 1947 established the rough boundaries of today, with Pakistan holding roughly one-third of Kashmir, and India one-half, with a dividing line of control established by the United Nations. The Indo-Pakistani War of 1965 resulted in a stalemate and a UN-negotiated ceasefire.


title: Kashmir

text: The Kashmir region lies between latitudes 32° and 36° N, and longitudes 74° and 80° E. It has an area of . It is bordered to the north and east by China (Xinjiang and Tibet), to the northwest by Afghanistan (Wakhan Corridor), to the west by Pakistan (Khyber Pakhtunkhwa and Punjab) and to the south by India (Himachal Pradesh and Punjab).


title: Kashmir

text: The topography of Kashmir is mostly mountainous. It is traversed mainly by the Western Himalayas. The Himalayas terminate in the western boundary of Kashmir at Nanga Parbat. Kashmir is traversed by three rivers namely Indus, Jehlum and Chenab. These river basins divide the region into three valleys separated by high mountain ranges. The Indus valley forms the north and north-eastern portion of the region which include bare and desolate areas of Baltistan and Ladakh. The upper portion of the Jhelum valley forms the proper Vale of Kashmir surrounded by high mountain ranges. The Chenab valley forms the southern portion of the Kashmir region with its denuded hills towards the south. It includes almost the whole of the Jammu province. High altitude lakes are frequent at high elevations. Lower down in the Vale of Kashmir there are many freshwater lakes and large areas of swamplands which include Wular Lake, Dal Lake and Hokersar near Srinagar.


title: Kashmir

text: To the north and northeast, beyond the Great Himalayas, the region is traversed by the Karakoram mountains. To the northwest lies the Hindu Kush mountain range. The upper Indus River separates the Himalayas from the Karakoram. The Karakoram is the most heavily glaciated part of the world outside the polar regions. The Siachen Glacier at and the Biafo Glacier at rank as the world's second and third longest glaciers outside the polar regions. Karakoram has four eight-thousander mountain peaks with K2, the second highest peak in the world at .


title: Kashmir

text: The Indus River system forms the drainage basin of the Kashmir region. The river enters the region in Ladakh at its southeastern corner from the Tibetan Plateau, and flows northwest to run a course through the entire Ladakh and Gilgit-Baltistan. Almost all the rivers originating in these region are part of the Indus river system. After reaching the end of the Greaty Himalayan range, the Indus turns a corner and flows southwest into the Punjab plains. The Jhelum and Chenab rivers also follow a course roughly parallel to this, and join the Indus river in southern Punjab plains in Pakistan.


title: Kashmir

text: The geographical features of the Kashmir region differ considerably from one part to another. The lowest part of the region consists of the plains of Jammu at the southwestern corner, which continue into the plains of Punjab at an elevation of below 1000 feet. Mountains begin at 2000 feet, then raising to 3000–4000 feet in the "Outer Hills", a rugged country with ridges and long narrow valleys. Next within the tract lie the Middle Mountains which are 8000–10,000 feet in height with ramifying valleys. Adjacent to these hills are the lofty Great Himalayan ranges (14000–15000 feet) which divide the drainage of the Chenab and Jehlum from that of the Indus. Beyond this range lies a wide tract of mountainous country of 17000–22000 feet in Ladakh and Baltistan.


title: Kashmir

text: Kashmir has a different climate for every region owing to the great variation of the level of the altitude. The temperatures ranges from the tropical heat of the Punjab summer to the intensity of the cold which keeps the perpetual snow on the mountains. Jammu Division, excluding the upper parts of the Chenab Valley, features a humid subtropical climate. The Vale of Kashmir has a moderate climate. The Astore Valley and some parts of Gilgit-Baltistan features a semi-Tibetan climate. While as the other parts of Gilgit-Baltistan and Ladakh have Tibetan climate which is considered as almost rainless climate.


title: Kashmir

text: The southwestern Kashmir which includes much of the Jammu province and Muzaffarabad falls within the reach of Indian monsoon. The Pir Panjal Range acts as an effective barrier and blocks these monsoon tracts in reaching the main Kashmir Valley and the Himalayan slopes. These areas of the region receive much of the precipitation from the wind currents of the Arabian Sea. The Himalayan slope and the Pir Panjal witness greatest snow melting from March until June. These variations in snow melting and rainfall have led to destructive inundations of the main valley. One instance of such Kashmir flood of a larger proportion is recorded in the 12th-century book "Rajatarangini". A single cloudburst in July 1935 caused the upper Jehlum river level to rise 11 feet. The 2014 Kashmir floods inundated the Kashmir city of Srinagar and submerged hundreds of other villages.


title: Kashmir

text: Kashmir has a recorded forest area of along with some national parks and reserves. The forests vary according to the climatic conditions and the altitude. Kashmir forests range from the tropical deciduous forests in the foothills of Jammu and Muzafarabad, to the temperate forests throughout the Vale of Kashmir and to the alpine grasslands and high altitude meadows in Gilgit-Baltistan and Ladakh.


title: Kashmir

text: The Kashmir region has four well defined zones of vegetation in the tree growth, due to the difference in elevation. The tropical forests up to 1500 m, are known as the Phulai ("Acacia modesta") and Olive (Olea cuspid ata) Zone. There occur semi-deciduous species of "Shorea robusta", "Acacia catechu", "Dalbergia sissoo", "Albizia lebbeck", "Garuga pinnata", "Terminalia bellirica" and "T. tomentosa" and "Pinus roxburghii" are found at higher elevations. The temperate zone between (1,500–3,500 m) is referred as the Chir Pine (Finns longifolia). This zone is dominated by oaks ("Quercus" spp.) and "Rhododendron" spp. The Blue Pine (Finns excelsa) Zone with "Cedrus deodara", "Abies pindrow" and "Picea smithiana" occur at elevations between 2,800 and 3,500 m. The Birch (Betula utilis) Zone has Herbaceous genera of Anemone, Geranium, Iris, Lloydia, Potentilla and Primula interspersed with dry dwarf alpine scrubs of Berberis, Cotoneaster, Juniperus and Rhododendron are prevalent in alpine grasslands at 3,500 m and above.


title: Kashmir

text: Kashmir is referred as a beauty spot of the medicinal and herbaceous flora in the Himalayas. There are hundreds of different species of wild flowers recorded in the alpine meadows of the region. The botanical garden and the tulip gardens of Srinagar built in the Zabarwans grow 300 breeds of flora and 60 varieties of tulips respectively. The later is considered as the largest Tulip Garden of Asia.


title: Kashmir

text: Kashmir region is home to rare species of animals, many of which are protected by sanctuaries and reserves. The Dachigam National Park in the Valley holds the last viable population of Kashmir stag "(Hangul)" and the largest population of black bear in Asia. In Gilgit-Baltistan the Deosai National Park is designated to protect the largest population of Himalayan brown bears in the western Himalayas. Snow leopards are found in high density In the Hemis National Park in Ladakh. The region is home to musk deer, markhor, leopard cat, jungle cat, red fox, jackal, Himalayan wolf, serow, Himalayan yellow-throated marten, long-tailed marmot, Indian porcupine, Himalayan mouse-hare, langur and Himalayan weasel. At least 711 bird species are recorded in the valley alone with 31 classified as globally threatened species.


title: Kashmir

text: In the 1901 Census of the British Indian Empire, the population of the princely state of Kashmir and Jammu was 2,905,578. Of these, 2,154,695 (74.16%) were Muslims, 689,073 (23.72%) Hindus, 25,828 (0.89%) Sikhs, and 35,047 (1.21%) Buddhists (implying 935 (0.032%) others).


title: Kashmir

text: The Hindus were found mainly in Jammu, where they constituted a little less than 60% of the population. In the Kashmir Valley, the Hindus represented "524 in every 10,000 of the population ("i.e." 5.24%), and in the frontier "wazarats" of Ladhakh and Gilgit only 94 out of every 10,000 persons (0.94%)." In the same Census of 1901, in the Kashmir Valley, the total population was recorded to be 1,157,394, of which the Muslim population was 1,083,766, or 93.6% and the Hindu population 60,641. Among the Hindus of Jammu province, who numbered 626,177 (or 90.87% of the Hindu population of the princely state), the most important castes recorded in the census were "Brahmans (186,000), the Rajputs (167,000), the Khattris (48,000) and the Thakkars (93,000)."


title: Kashmir

text: In the 1911 Census of the British Indian Empire, the total population of Kashmir and Jammu had increased to 3,158,126. Of these, 2,398,320 (75.94%) were Muslims, 696,830 (22.06%) Hindus, 31,658 (1%) Sikhs, and 36,512 (1.16%) Buddhists. In the last census of British India in 1941, the total population of Kashmir and Jammu (which as a result of the Second World War, was estimated from the 1931 census) was 3,945,000. Of these, the total Muslim population was 2,997,000 (75.97%), the Hindu population was 808,000 (20.48%), and the Sikh 55,000 (1.39%).


title: Kashmir

text: The Kashmiri Pandits, the only Hindus of the Kashmir valley, who had stably constituted approximately 4 to 5% of the population of the valley during Dogra rule (1846–1947), and 20% of whom had left the Kashmir valley by 1950, began to leave in much greater numbers in the 1990s. According to a number of authors, approximately 100,000 of the total Kashmiri Pandit population of 140,000 left the valley during that decade. Other authors have suggested a higher figure for the exodus, ranging from the entire population of over 150, to 190 thousand (1.5 to 190,000) of a total Pandit population of 200 thousand (200,000), to a number as high as 300 thousand (300,000).


title: Kashmir

text: People in Jammu speak Hindi, Punjabi and Dogri, the Kashmir Valley speaks Kashmiri and the sparsely inhabited Ladakh speaks Tibetan and Balti.


title: Kashmir

text: The population of Indian-administered union territories of Jammu and Kashmir and Ladakh combined is 12,541,302 and Pakistani-administered territory of Azad Kashmir is 4,045,366, and Gilgit-Baltistan is 1,492,924.


title: Kashmir

text: Kashmir's economy is centred around agriculture. Traditionally the staple crop of the valley was rice, which formed the chief food of the people. In addition, Indian corn, wheat, barley and oats were also grown. Given its temperate climate, it is suited for crops like asparagus, artichoke, seakale, broad beans, scarletrunners, beetroot, cauliflower and cabbage. Fruit trees are common in the valley, and the cultivated orchards yield pears, apples, peaches, and cherries. The chief trees are deodar, firs and pines, chenar or plane, maple, birch and walnut, apple, cherry.


title: Kashmir

text: Historically, Kashmir became known worldwide when Cashmere wool was exported to other regions and nations (exports have ceased due to decreased abundance of the cashmere goat and increased competition from China). Kashmiris are well adept at knitting and making Pashmina shawls, silk carpets, rugs, kurtas, and pottery. Saffron, too, is grown in Kashmir. Srinagar is known for its silver-work, papier-mâché, wood-carving, and the weaving of silk. The economy was badly damaged by the 2005 Kashmir earthquake which, as of 8 October 2005, resulted in over 70,000 deaths in the Pakistani-administered territory of Azad Kashmir and around 1,500 deaths in the Indian-administered territory of Jammu and Kashmir.


title: Kashmir

text: Transport is predominantly by air or road vehicles in the region. Kashmir has a long modern railway line that started in October 2009, and was last extended in 2013 and connects Baramulla, in the western part of Kashmir, to Srinagar and Banihal. It is expected to link Kashmir to the rest of India after the construction of the railway line from Katra to Banihal is completed.


title: Kashmir

text: Irish poet Thomas Moore's 1817 romantic poem "Lalla Rookh" is credited with having made Kashmir (spelt "Cashmere" in the poem) "a household term in Anglophone societies", conveying the idea that it was a kind of paradise (an old idea going back to Hindu and Buddhist texts in Sanskrit).


title: Diazepam

text: Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, and restless legs syndrome. It may also be used to cause memory loss during certain medical procedures. It can be taken by mouth, inserted into the rectum, injected into muscle, injected into a vein or used as a nasal spray. When given into a vein, effects begin in one to five minutes and last up to an hour. By mouth, effects begin after 15 to 60 minutes.


title: Diazepam

text: Common side-effects include sleepiness and trouble with coordination. Serious side effects are rare. They include increased risk of suicide, decreased breathing, and an increased risk of seizures if used too frequently in those with epilepsy. Occasionally, excitement or agitation may occur. Long-term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction. Abrupt stopping after long-term use can be potentially dangerous. After stopping, cognitive problems may persist for six months or longer. It is not recommended during pregnancy or breastfeeding. Its mechanism of action works by increasing the effect of the neurotransmitter "gamma"-aminobutyric acid (GABA).


title: Diazepam

text: Diazepam was patented in 1959 by Hoffmann-La Roche. It has been one of the most frequently prescribed medications in the world since its launch in 1963. In the United States it was the best-selling medication between 1968 and 1982, selling more than 2billion tablets in 1978 alone. In 2020, it was the 128th most-commonly prescribed medication in the United States, with more than 4million prescriptions. In 1985 the patent ended, and there are now more than 500 brands available on the market. It is on the World Health Organization's List of Essential Medicines.


title: Diazepam

text: Diazepam is mainly used to treat anxiety, insomnia, panic attacks and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis, or amnesia before certain medical procedures (e.g., endoscopy). In 2020, it was approved for use in the United States as a nasal spray to interrupt seizure activity in people with epilepsy. Diazepam is the most commonly used benzodiazepine for "tapering" benzodiazepine dependence due to the drug's comparatively long half-life, allowing for more efficient dose reduction. Benzodiazepines have a relatively low toxicity in overdose.


title: Diazepam

text: Used in treatment of organophosphate poisoning and reduces the risk of seizure induced brain and cardiac damage.


title: Diazepam

text: Dosages should be determined on an individual basis, depending on the condition being treated, severity of symptoms, patient body weight, and any other conditions the person may have.


title: Diazepam

text: Intravenous diazepam or lorazepam are first-line treatments for status epilepticus. However, intravenous lorazepam has advantages over intravenous diazepam, including a higher rate of terminating seizures and a more prolonged anticonvulsant effect. Diazepam gel was better than placebo gel in reducing the risk of non-cessation of seizures. Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within six to 12 months of treatment, effectively rendering it useless for that purpose.


title: Diazepam

text: The anticonvulsant effects of diazepam can help in the treatment of seizures due to a drug overdose or chemical toxicity as a result of exposure to sarin, VX, or soman (or other organophosphate poisons), lindane, chloroquine, physostigmine, or pyrethroids.


title: Diazepam

text: Diazepam is sometimes used intermittently for the prevention of febrile seizures that may occur in children under five years of age. Recurrence rates are reduced, but side effects are common so the decision to treat febrile seizures (which are benign in nature) with medication should use this as part of the evaluation. Long-term use of diazepam for the management of epilepsy is not recommended; however, a subgroup of individuals with treatment-resistant epilepsy benefit from long-term benzodiazepines, and for such individuals, clorazepate has been recommended due to its slower onset of tolerance to the anticonvulsant effects.


title: Diazepam

text: Because of its relatively long duration of action, and evidence of safety and efficacy, diazepam is preferred over other benzodiazepines for treatment of persons experiencing moderate to severe alcohol withdrawal. An exception to this is when a medication is required intramuscular in which case either lorazepam or midazolam is recommended.


title: Diazepam

text: Diazepam is used for the emergency treatment of eclampsia, when IV magnesium sulfate and blood-pressure control measures have failed. Benzodiazepines do not have any pain-relieving properties themselves, and are generally recommended to avoid in individuals with pain. However, benzodiazepines such as diazepam can be used for their muscle-relaxant properties to alleviate pain caused by muscle spasms and various dystonias, including blepharospasm. Tolerance often develops to the muscle relaxant effects of benzodiazepines such as diazepam. Baclofen is sometimes used as an alternative to diazepam.


title: Diazepam

text: Diazepam is marketed in over 500 brands throughout the world. It is supplied in oral, injectable, inhalation, and rectal forms.


title: Diazepam

text: The United States military employs a specialized diazepam preparation known as Convulsive Antidote, Nerve Agent (CANA), which contains diazepam. One CANA kit is typically issued to service-members, along with three Mark I NAAK kits, when operating in circumstances where chemical weapons in the form of nerve agents are considered a potential hazard. Both of these kits deliver drugs using autoinjectors. They are intended for use in "buddy-aid" or "self-aid" administration of the drugs in the field prior to decontamination and delivery of the patient to definitive medical care.


title: Diazepam

text: Adverse effects of benzodiazepines such as diazepam include anterograde amnesia, confusion (especially pronounced in higher doses) and sedation. The elderly are more prone to adverse effects of diazepam, such as confusion, amnesia, ataxia, and hangover effects, as well as falls. Long-term use of benzodiazepines such as diazepam is associated with drug tolerance, benzodiazepine dependence, and benzodiazepine withdrawal syndrome. Like other benzodiazepines, diazepam can impair short-term memory and learning of new information. While benzodiazepine drugs such as diazepam can cause anterograde amnesia, they do not cause retrograde amnesia; information learned before using benzodiazepines is not impaired. Tolerance to the cognitively impairing effects of benzodiazepines does not tend to develop with long-term use, and the elderly are more sensitive to them. Additionally, after cessation of benzodiazepines, cognitive deficits may persist for at least six months; it is unclear whether these impairments take longer than six months to abate or if they are permanent. Benzodiazepines may also cause or worsen depression. Infusions or repeated intravenous injections of diazepam when managing seizures, for example, may lead to drug toxicity, including respiratory depression, sedation and hypotension. Drug tolerance may also develop to infusions of diazepam if it is given for longer than 24 hours. Sedatives and sleeping pills, including diazepam, have been associated with an increased risk of death.


title: Diazepam

text: In September 2020, the U.S. Food and Drug Administration (FDA) required the boxed warning be updated for all benzodiazepine medicines to describe the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions consistently across all the medicines in the class.


title: Diazepam

text: Less commonly, paradoxical side effects can occur, including nervousness, irritability, excitement, worsening of seizures, insomnia, muscle cramps, changes in libido, and in some cases, rage and violence. These adverse reactions are more likely to occur in children, the elderly, and individuals with a history of a substance use disorder, such as an alcohol use disorder, or a history of aggressive behavior. In some people, diazepam may increase the propensity toward self-harming behaviors and, in extreme cases, may provoke suicidal tendencies or acts. Very rarely dystonia can occur.


title: Diazepam

text: Diazepam may impair the ability to drive vehicles or operate machinery. The impairment is worsened by consumption of alcohol, because both act as central nervous system depressants.


title: Diazepam

text: During the course of therapy, tolerance to the sedative effects usually develops, but not to the anxiolytic and myorelaxant effects.


title: Diazepam

text: Patients with severe attacks of apnea during sleep may experience respiratory depression (hypoventilation), leading to respiratory arrest and death.


title: Diazepam

text: Diazepam in doses of 5 mg or more causes significant deterioration in alertness performance combined with increased feelings of sleepiness.


title: Diazepam

text: Diazepam, as with other benzodiazepine drugs, can cause tolerance, physical dependence, substance use disorder, and benzodiazepine withdrawal syndrome. Withdrawal from diazepam or other benzodiazepines often leads to withdrawal symptoms similar to those seen during barbiturate or alcohol withdrawal. The higher the dose and the longer the drug is taken, the greater the risk of experiencing unpleasant withdrawal symptoms.


title: Diazepam

text: Withdrawal symptoms can occur from standard dosages and also after short-term use, and can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis. Withdrawal symptoms can sometimes resemble pre-existing conditions and be misdiagnosed. Diazepam may produce less intense withdrawal symptoms due to its long elimination half-life.


title: Diazepam

text: Benzodiazepine treatment should be discontinued as soon as possible by a slow and gradual dose reduction regimen. Tolerance develops to the therapeutic effects of benzodiazepines; for example tolerance occurs to the anticonvulsant effects and as a result benzodiazepines are not generally recommended for the long-term management of epilepsy. Dose increases may overcome the effects of tolerance, but tolerance may then develop to the higher dose and adverse effects may increase. The mechanism of tolerance to benzodiazepines includes uncoupling of receptor sites, alterations in gene expression, down-regulation of receptor sites, and desensitisation of receptor sites to the effect of GABA. About one-third of individuals who take benzodiazepines for longer than four weeks become dependent and experience withdrawal syndrome on cessation.


title: Diazepam

text: Differences in rates of withdrawal (50–100%) vary depending on the patient sample. For example, a random sample of long-term benzodiazepine users typically finds around 50% experience few or no withdrawal symptoms, with the other 50% experiencing notable withdrawal symptoms. Certain select patient groups show a higher rate of notable withdrawal symptoms, up to 100%.


title: Diazepam

text: Rebound anxiety, more severe than baseline anxiety, is also a common withdrawal symptom when discontinuing diazepam or other benzodiazepines. Diazepam is therefore only recommended for short-term therapy at the lowest possible dose owing to risks of severe withdrawal problems from low doses even after gradual reduction. The risk of pharmacological dependence on diazepam is significant, and patients experience symptoms of benzodiazepine withdrawal syndrome if it is taken for six weeks or longer. In humans, tolerance to the anticonvulsant effects of diazepam occurs frequently.


title: Diazepam

text: Improper or excessive use of diazepam can lead to dependence. At a particularly high risk for diazepam misuse, substance use disorder or dependence are:


title: Diazepam

text: Patients from the aforementioned groups should be monitored very closely during therapy for signs of abuse and development of dependence. Therapy should be discontinued if any of these signs are noted, although if dependence has developed, therapy must still be discontinued gradually to avoid severe withdrawal symptoms. Long-term therapy in such instances is not recommended.


title: Diazepam

text: People suspected of being dependent on benzodiazepine drugs should be very gradually tapered off the drug. Withdrawals can be life-threatening, particularly when excessive doses have been taken for extended periods of time. Equal prudence should be used whether dependence has occurred in therapeutic or recreational contexts.


title: Diazepam

text: Diazepam is a good choice for tapering for those using high doses of other benzodiazepines since it has a long half-life thus withdrawal symptoms are tolerable. The process is very slow (usually from 14 to 28 weeks) but is considered safe when done appropriately.


title: Diazepam

text: An individual who has consumed too much diazepam typically displays one or more of these symptoms in a period of approximately four hours immediately following a suspected overdose:


title: Diazepam

text: Although not usually fatal when taken alone, a diazepam overdose is considered a medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of diazepam (or any other benzodiazepine) is flumazenil (Anexate). This drug is only used in cases with severe respiratory depression or cardiovascular complications. Because flumazenil is a short-acting drug, and the effects of diazepam can last for days, several doses of flumazenil may be necessary. Artificial respiration and stabilization of cardiovascular functions may also be necessary. Though not routinely indicated, activated charcoal can be used for decontamination of the stomach following a diazepam overdose. Emesis is contraindicated. Dialysis is minimally effective. Hypotension may be treated with levarterenol or metaraminol.


title: Diazepam

text: The oral (lethal dose in 50% of the population) of diazepam is 720mg/kg in mice and 1240mg/kg in rats. D. J. Greenblatt and colleagues reported in 1978 on two patients who had taken 500 and 2000mg of diazepam, respectively, went into moderately-deep comas, and were discharged within 48 hours without having experienced any important complications, in spite of having high concentrations of diazepam and its metabolites desmethyldiazepam, oxazepam, and temazepam, according to samples taken in the hospital and as follow-up.


title: Diazepam

text: If diazepam is administered concomitantly with other drugs, attention should be paid to the possible pharmacological interactions. Particular care should be taken with drugs that potentiate the effects of diazepam, such as barbiturates, phenothiazines, opioids, and antidepressants.


title: Diazepam

text: Diazepam does not increase or decrease hepatic enzyme activity, and does not alter the metabolism of other compounds. No evidence would suggest diazepam alters its own metabolism with chronic administration.


title: Diazepam

text: Agents with an effect on hepatic cytochrome P450 pathways or conjugation can alter the rate of diazepam metabolism. These interactions would be expected to be most significant with long-term diazepam therapy, and their clinical significance is variable.


title: Diazepam

text: Diazepam is a long-acting "classical" benzodiazepine. Other classical benzodiazepines include chlordiazepoxide, clonazepam, lorazepam, oxazepam, nitrazepam, temazepam, flurazepam, bromazepam, and clorazepate. Diazepam has anticonvulsant properties. Benzodiazepines act via micromolar benzodiazepine binding sites as calcium channel blockers and significantly inhibit depolarization-sensitive calcium uptake in rat nerve cell preparations.


title: Diazepam

text: Diazepam inhibits acetylcholine release in mouse hippocampal synaptosomes. This has been found by measuring sodium-dependent high-affinity choline uptake in mouse brain cells "in vitro", after pretreatment of the mice with diazepam "in vivo". This may play a role in explaining diazepam's anticonvulsant properties.


title: Diazepam

text: Diazepam binds with high affinity to glial cells in animal cell cultures. Diazepam at high doses has been found to decrease histamine turnover in mouse brain via diazepam's action at the benzodiazepine-GABA receptor complex. Diazepam also decreases prolactin release in rats.


title: Diazepam

text: Benzodiazepines are positive allosteric modulators of the GABA type A receptors (GABA). The GABA receptors are ligand-gated chloride-selective ion channels that are activated by GABA, the major inhibitory neurotransmitter in the brain. Binding of benzodiazepines to this receptor complex promotes the binding of GABA, which in turn increases the total conduction of chloride ions across the neuronal cell membrane. This increased chloride ion influx hyperpolarizes the neuron's membrane potential. As a result, the difference between resting potential and threshold potential is increased and firing is less likely. As a result, the arousal of the cortical and limbic systems in the central nervous system is reduced.


title: Diazepam

text: The GABA receptor is a heteromer composed of five subunits, the most common ones being two αs, two βs, and one γ (α2β2γ). For each subunit, many subtypes exist (α1–6, β1–3, and γ1–3). GABA receptors containing the α1 subunit mediate the sedative, the anterograde amnesic, and partly the anticonvulsive effects of diazepam. GABA receptors containing α2 mediate the anxiolytic actions and to a large degree the myorelaxant effects. GABA receptors containing α3 and α5 also contribute to benzodiazepines myorelaxant actions, whereas GABA receptors comprising the α5 subunit were shown to modulate the temporal and spatial memory effects of benzodiazepines. Diazepam is not the only drug to target these GABA receptors. Drugs such as flumazenil also bind to GABA to induce their effects.


title: Diazepam

text: Diazepam appears to act on areas of the limbic system, thalamus, and hypothalamus, inducing anxiolytic effects. Benzodiazepine drugs including diazepam increase the inhibitory processes in the cerebral cortex.


title: Diazepam

text: The anticonvulsant properties of diazepam and other benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems limited by benzodiazepines' effect of slowing recovery of sodium channels from inactivation.


title: Diazepam

text: The muscle relaxant properties of diazepam are produced via inhibition of polysynaptic pathways in the spinal cord.


title: Diazepam

text: Diazepam can be administered orally, intravenously (must be diluted, as it is painful and damaging to veins), intramuscularly (IM), or as a suppository.


title: Diazepam

text: The onset of action is one to five minutes for IV administration and 15–30 minutes for IM administration. The duration of diazepam's peak pharmacological effects is 15 minutes to one hour for both routes of administration. The half-life of diazepam in general is 30–56 hours. Peak plasma levels occur between 30 and 90 minutes after oral administration and between 30 and 60 minutes after intramuscular administration; after rectal administration, peak plasma levels occur after 10 to 45 minutes. Diazepam is highly protein-bound, with 96 to 99% of the absorbed drug being protein-bound. The distribution half-life of diazepam is two to 13 minutes.


title: Diazepam

text: Diazepam is highly lipid-soluble, and is widely distributed throughout the body after administration. It easily crosses both the blood–brain barrier and the placenta, and is excreted into breast milk. After absorption, diazepam is redistributed into muscle and adipose tissue. Continual daily doses of diazepam quickly build to a high concentration in the body (mainly in adipose tissue), far in excess of the actual dose for any given day.


title: Diazepam

text: Diazepam is stored preferentially in some organs, including the heart. Absorption by any administered route and the risk of accumulation is significantly increased in the neonate, and withdrawal of diazepam during pregnancy and breast feeding is clinically justified.


title: Diazepam

text: Diazepam undergoes oxidative metabolism by demethylation (CYP 2C9, 2C19, 2B6, 3A4, and 3A5), hydroxylation (CYP 3A4 and 2C19) and glucuronidation in the liver as part of the cytochrome P450 enzyme system. It has several pharmacologically active metabolites. The main active metabolite of diazepam is desmethyldiazepam (also known as nordazepam or nordiazepam). Its other active metabolites include the minor active metabolites temazepam and oxazepam. These metabolites are conjugated with glucuronide, and are excreted primarily in the urine. Because of these active metabolites, the serum values of diazepam alone are not useful in predicting the effects of the drug. Diazepam has a biphasic half-life of about one to three days, and two to seven days for the active metabolite desmethyldiazepam. Most of the drug is metabolized; very little diazepam is excreted unchanged. The elimination half-life of diazepam and also the active metabolite desmethyldiazepam increases significantly in the elderly, which may result in prolonged action, as well as accumulation of the drug during repeated administration.


title: Diazepam

text: Diazepam is a 1,4-benzodiazepine. Diazepam occurs as solid white or yellow crystals with a melting point of 131.5 to 134.5 °C. It is odorless, and has a slightly bitter taste. The British Pharmacopoeia lists it as being very slightly soluble in water, soluble in alcohol, and freely soluble in chloroform. The United States Pharmacopoeia lists diazepam as soluble 1 in 16 ethyl alcohol, 1 in 2 of chloroform, 1 in 39 ether, and practically insoluble in water. The pH of diazepam is neutral (i.e., pH = 7). Due to additives such as benzoic acid/benzoate in the injectable form. (Plumb's, 6th edition page 372) Diazepam has a shelf life of five years for oral tablets and three years for IV/IM solutions.


title: Diazepam

text: Diazepam should be stored at room temperature (15–30 °C). The solution for parenteral injection should be protected from light and kept from freezing. The oral forms should be stored in air-tight containers and protected from light.


title: Diazepam

text: Diazepam can absorb into plastics, so liquid preparations should not be kept in plastic bottles or syringes, etc. As such, it can leach into the plastic bags and tubing used for intravenous infusions. Absorption appears to depend on several factors, such as temperature, concentration, flow rates, and tube length. Diazepam should not be administered if a precipitate has formed and does not dissolve.


title: Diazepam

text: Diazepam may be quantified in blood or plasma to confirm a diagnosis of poisoning in hospitalized patients, provide evidence in an impaired driving arrest, or to assist in a medicolegal death investigation. Blood or plasma diazepam concentrations are usually in a range of 0.1–1.0 mg/L in persons receiving the drug therapeutically. Most commercial immunoassays for the benzodiazepine class of drugs cross-react with diazepam, but confirmation and quantitation are usually performed using chromatographic techniques.


title: Diazepam

text: Diazepam was the second benzodiazepine invented by Leo Sternbach of Hoffmann-La Roche at the company's Nutley, New Jersey, facility following chlordiazepoxide (Librium), which was approved for use in 1960. Released in 1963 as an improved version of Librium, diazepam became incredibly popular, helping Roche to become a pharmaceutical industry giant. It is 2.5 times more potent than its predecessor, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.


title: Diazepam

text: The benzodiazepines gained popularity among medical professionals as an improvement over barbiturates, which have a comparatively narrow therapeutic index, and are far more sedative at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or opioids). Benzodiazepine drugs such as diazepam initially had widespread public support, but with time the view changed to one of growing criticism and calls for restrictions on their prescription.


title: Diazepam

text: Marketed by Roche using an advertising campaign conceived by the William Douglas McAdams Agency under the leadership of Arthur Sackler, diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak annual sales in 1978 of 2.3 billion tablets. Diazepam, along with oxazepam, nitrazepam and temazepam, represents 82% of the benzodiazepine market in Australia. While psychiatrists continue to prescribe diazepam for the short-term relief of anxiety, neurology has taken the lead in prescribing diazepam for the palliative treatment of certain types of epilepsy and spastic activity, for example, forms of paresis. It is also the first line of defense for a rare disorder called stiff-person syndrome.


title: Diazepam

text: Diazepam is a medication with a high risk of misuse and can cause drug dependence. Urgent action by national governments has been recommended to improve prescribing patterns of benzodiazepines such as diazepam. A single dose of diazepam modulates the dopamine system in similar ways to how morphine and alcohol modulate the dopaminergic pathways.


title: Diazepam

text: Diazepam has been shown to be able to substitute for the behavioral effects of barbiturates in a primate study.


title: Diazepam

text: Diazepam drug misuse can occur either through recreational misuse where the drug is taken to achieve a high or when the drug is continued long term against medical advice.


title: Diazepam

text: Sometimes, it is used by stimulant users to "come down" and sleep and to help control the urge to binge. These users often escalate dosage from 2 to 25 times the therapeutic dose of 5 to 10 mg.


title: Diazepam

text: A large-scale study in the US, conducted by SAMHSA, using data from 2011, determined benzodiazepines were present in 28.7% of emergency department visits involving nonmedical use of pharmaceuticals. In this regard, benzodiazepines are second only to opiates, the study found in 39.2% of visits. About 29.3% of drug-related suicide attempts involve benzodiazepines, making them the most frequently represented class in drug-related suicide attempts. Males misuse benzodiazepines as commonly as females.


title: Diazepam

text: Diazepam was detected in 26% of cases of people suspected of driving under the influence of drugs in Sweden, and its active metabolite nordazepam was detected in 28% of cases. Other benzodiazepines and zolpidem and zopiclone also were found in high numbers. Many drivers had blood levels far exceeding the therapeutic dose range, suggesting a high degree of potential for misuse for benzodiazepines, zolpidem, and zopiclone. In Northern Ireland, in cases where drugs were detected in samples from impaired drivers who were not impaired by alcohol, benzodiazepines were found in 87% of cases. Diazepam was the most commonly detected benzodiazepine.


title: Diazepam

text: Classified as a controled drug, listed under Schedule IV, Part I (CD Benz POM) of the Misuse of Drugs Regulations 2001, allowing possession with a valid prescription. The Misuse of Drugs Act 1971 makes it illegal to possess the drug without a prescription, and for such purposes it is classified as a Class C drug.


title: Diazepam

text: Classified as a prescription-drug, or in high dosage as a restricted drug ("Betäubungsmittelgesetz, Anlage III").


title: Diazepam

text: Diazepam is a Schedule-4-substance under the Poisons Standard (June 2018). A schedule-4-drug is outlined in the Poisons Act 1964 as, "Substances, the use or supply of which should be by or on the order of persons permitted by State or Territory legislation to prescribe and should be available from a pharmacist on prescription".


title: Diazepam

text: The states of California and Florida offer diazepam to condemned inmates as a pre-execution sedative as part of their lethal injection program, although the state of California has not executed a prisoner since 2006. In August 2018, Nebraska used diazepam as part of the drug combination used to execute Carey Dean Moore, the first death row inmate executed in Nebraska in over 21 years.


title: Diazepam

text: Diazepam is used as a short-term sedative and anxiolytic for cats and dogs, sometimes used as an appetite stimulant. It can also be used to stop seizures in dogs and cats.


title: Harold Shipman

text: Harold Frederick Shipman (14 January 1946 – 13 January 2004), known by the public as Doctor Death and to acquaintances as Fred Shipman, was an English general practitioner and serial killer. He is considered to be one of the most prolific serial killers in modern history, with an estimated 250 victims. On 31 January 2000, Shipman was found guilty of murdering 15 patients under his care. He was sentenced to life imprisonment with a whole life order. Shipman died by suicide, hanging himself in his cell at HM Prison Wakefield, West Yorkshire, on 13 January 2004, the day before his 58th birthday.


title: Harold Shipman

text: "The Shipman Inquiry", a two-year-long investigation of all deaths certified by Shipman, chaired by Dame Janet Smith, examined Shipman's crimes. It revealed Shipman targeted vulnerable elderly people who trusted him as he was their doctor. He killed his victims either by a fatal dose of drugs or prescribing them an abnormal amount.


title: Harold Shipman

text: Shipman is the only British doctor to date to have been convicted of murdering his patients, although other doctors have been acquitted of similar crimes or convicted of lesser charges.


title: Harold Shipman

text: Shipman was born on 14 January 1946 on the Bestwood Estate, a council estate, in Nottingham, the second of the three children of Harold Frederick Shipman (12 May 1914 – 5 January 1985), a lorry driver, and Vera Brittan (23 December 1919 – 21 June 1963). His working-class parents were devout Methodists. When growing up, Shipman was an accomplished rugby player in youth leagues.


title: Harold Shipman

text: Shipman passed his eleven-plus in 1957, moving to High Pavement Grammar School, Nottingham, which he left in 1964. He excelled as a distance runner, and in his final year at school served as vice-captain of the athletics team. Shipman was particularly close to his mother, who died of lung cancer when he was aged seventeen. Her death came in a manner similar to what later became Shipman's own "modus operandi": in the later stages of her disease, she had morphine administered at home by a doctor. Shipman witnessed his mother's pain subside, despite her terminal condition, until her death on 21 June 1963. On 5 November 1966, he married Primrose May Oxtoby; the couple had four children.


title: Harold Shipman

text: Shipman studied medicine at Leeds School of Medicine, University of Leeds, graduating in 1970. He began working at Pontefract General Infirmary in Pontefract, West Riding of Yorkshire, and in 1974 took his first position as a general practitioner (GP) at the Abraham Ormerod Medical Centre in Todmorden. The following year, Shipman was caught forging prescriptions of pethidine for his own use. He was fined £600 and briefly attended a drug rehabilitation clinic in York. He became a GP at the Donneybrook Medical Centre in Hyde, Greater Manchester, in 1977.


title: Harold Shipman

text: Shipman continued working as a GP in Hyde throughout the 1980s and established his own surgery at 21 Market Street in 1993, becoming a respected member of the community. In 1983, he was interviewed in an edition of the Granada Television documentary "World in Action" on how the mentally ill should be treated in the community. A year after his conviction, the interview was re-broadcast on "Tonight with Trevor McDonald".


title: Harold Shipman

text: In March 1998, Linda Reynolds of the Brooke Surgery in Hyde expressed concerns to John Pollard, the coroner for the South Manchester District, about the high death rate among Shipman's patients. In particular, she was concerned about the large number of cremation forms for elderly women that he had needed countersigned. Police were unable to find sufficient evidence to bring charges and closed the investigation on 17 April. "The Shipman Inquiry" later blamed Greater Manchester Police for assigning inexperienced officers to the case. After the investigation was closed, Shipman killed three more people. A few months later, in August, taxi driver John Shaw told the police that he suspected Shipman of murdering 21 patients. Shaw became suspicious as many of the elderly customers he took to the hospital, who seemed to be in good health, died in Shipman's care.


title: Harold Shipman

text: Shipman's last victim was Kathleen Grundy, a former mayor of Hyde who was found dead at her home on 24 June 1998. He was the last person to see her alive; he later signed her death certificate, recording the cause of death as old age. Grundy's daughter, solicitor Angela Woodruff, became concerned when fellow solicitor Brian Burgess informed her that a will had been made, apparently by her mother, with doubts about its authenticity. The will excluded Woodruff and her children, but left £386,000 to Shipman. At Burgess' urging, Woodruff went to the police, who began an investigation. Grundy's body was exhumed and found to contain traces of diamorphine (heroin), often used for pain control in terminal cancer patients. Shipman claimed that Grundy had been an addict and showed them comments he had written to that effect in his computerised medical journal; however, police examination of his computer showed that the entries were written after her death.


title: Harold Shipman

text: Shipman was arrested on 7 September 1998, and was found to own a Brother typewriter of the type used to make the forged will. "Prescription for Murder", a 2000 book by journalists Brian Whittle and Jean Ritchie, suggested that Shipman forged the will either because he wanted to be caught, because his life was out of control, or because he planned to retire at 55 and leave the UK.


title: Harold Shipman

text: The police investigated other deaths Shipman had certified and investigated fifteen specimen cases. They discovered a pattern of his administering lethal doses of diamorphine, signing patients' death certificates, and then falsifying medical records to indicate that they had been in poor health.


title: Harold Shipman

text: In 2003, David Spiegelhalter "et al." suggested that "statistical monitoring could have led to an alarm being raised at the end of 1996, when there were 67 excess deaths in females aged over 65 years, compared with 119 by 1998."


title: Harold Shipman

text: Shipman's trial began at Preston Crown Court on 5 October 1999. He was charged with the murders of 15 women by lethal injections of diamorphine, all between 1995 and 1998:


title: Harold Shipman

text: Shipman's legal representatives tried unsuccessfully to have the Grundy case tried separately from the others, as a motive was shown by the alleged forgery of Grundy's will.


title: Harold Shipman

text: On 31 January 2000, after six days of deliberation, the jury found Shipman guilty of 15 counts of murder and one count of forgery. Mr Justice Forbes subsequently sentenced Shipman to life imprisonment on all 15 counts of murder, with a recommendation that he be subject to a whole life tariff, to be served concurrently with a sentence of four years for forging Grundy's will. On 11 February, 11 days after his conviction, Shipman was struck off the medical register by the General Medical Council (GMC). Two years later, Home Secretary David Blunkett confirmed the judge's whole life tariff, just months before British government ministers lost their power to set minimum terms for prisoners. While authorities could have brought many additional charges, they concluded that a fair hearing would be impossible in view of the enormous publicity surrounding the original trial. Furthermore, the 15 life sentences already imposed rendered further litigation unnecessary. Shipman became friends with fellow serial killer Peter Moore while in prison.


title: Harold Shipman

text: Shipman denied his guilt, disputing the scientific evidence against him. He never made any public statements about his actions. Shipman's wife, Primrose, maintained that he was not guilty, even after his conviction.


title: Harold Shipman

text: Shipman is the only doctor in the history of British medicine found guilty of murdering his patients. John Bodkin Adams was charged in 1957 with murdering a single patient, amid rumours he had killed dozens more over a 10-year period and "possibly provided the role model for Shipman"; however, he was acquitted and no further charges were pursued. Historian Pamela Cullen has argued that because of Adams' acquittal, there was no impetus to examine asserted flaws in the British legal system until the Shipman case.


title: Harold Shipman

text: Shipman hanged himself in his cell at HM Prison Wakefield at 6:20 a.m. on 13 January 2004, the eve of his 58th birthday. He was pronounced dead at 8:10 a.m. A statement from Her Majesty's Prison Service indicated that he had hanged himself from the window bars of his cell using his bed sheets. After Shipman's death, his body was taken to the mortuary at the Medico Legal Centre for a post-mortem examination. West Yorkshire Coroner David Hinchliff eventually released the body to his family after an inquest was opened and adjourned shortly after.


title: Harold Shipman

text: Some of the victims' families said they felt "cheated", as Shipman's suicide meant they would never have the satisfaction of a confession, nor answers as to why he committed his crimes. Home Secretary David Blunkett admitted that celebration was tempting: "You wake up and you receive a call telling you Shipman has topped himself and you think, is it too early to open a bottle? And then you discover that everybody's very upset that he's done it."


title: Harold Shipman

text: Shipman's death divided national newspapers, with the "Daily Mirror" branding him a "cold coward" and condemning the Prison Service for allowing his suicide to happen. However, "The Sun" ran a celebratory front-page headline; "Ship Ship hooray!" "The Independent" called for the inquiry into Shipman's suicide to look more widely at the state of UK prisons as well as the welfare of inmates. In "The Guardian", an article by General Sir David Ramsbotham, who had formerly served as Her Majesty's Chief Inspector of Prisons, suggested that whole life sentencing be replaced by indefinite sentencing, for this would at least give prisoners the hope of eventual release and reduce the risk of their ending their own lives by suicide, as well as making their management easier for prison officials.


title: Harold Shipman

text: Shipman's motive for suicide was never established, though he reportedly told his probation officer that he was considering suicide to assure his wife's financial security after he was stripped of his National Health Service pension.


title: Harold Shipman

text: Primrose Shipman received a full NHS pension; she would not have been entitled to it if Shipman had lived past the age of sixty. Additionally, there was evidence that Primrose, who had consistently protested Shipman's innocence despite the overwhelming evidence, had begun to suspect his guilt. Shipman refused to take part in courses which would have encouraged acknowledgement of his crimes, leading to a temporary removal of privileges, including the opportunity to telephone his wife. During this period, according to Shipman's cellmate, he received a letter from Primrose exhorting him to, "Tell me everything, no matter what." A 2005 inquiry found that Shipman's suicide "could not have been predicted or prevented," but that procedures should nonetheless be re-examined.


title: Harold Shipman

text: After Shipman's body was released to his family, it remained in Sheffield for more than a year despite multiple false reports about his funeral. His widow was advised by police against burying her husband in case the grave was attacked. Shipman was eventually cremated on 19 March 2005 at Hutcliffe Wood Crematorium. The cremation took place outside normal working hours to maintain secrecy and was attended only by Primrose and the couple's four children.


title: Harold Shipman

text: In January 2001, Chris Gregg, a senior West Yorkshire Police detective, was selected to lead an investigation into 22 of the West Yorkshire deaths. Following this, "The Shipman Inquiry", submitted in July 2002, concluded that he had killed at least 218 of his patients between 1975 and 1998, during which time he practised in Todmorden (1974–1975) and Hyde (1977–1998). Dame Janet Smith, the judge who submitted the report, admitted that many more deaths of a suspicious nature could not be definitively ascribed to Shipman. Most of his victims were elderly women in good health.


title: Harold Shipman

text: In her sixth and final report, issued on 24 January 2005, Smith reported that she believed that Shipman had killed three patients, and she had serious suspicions about four further deaths, including that of a four-year-old girl, during the early stage of his medical career at Pontefract General Infirmary. In total, 459 people died while under his care between 1971 and 1998, but it is uncertain how many of those were murder victims, as he was often the only doctor to certify a death. Smith's estimate of Shipman's total victim count over that 27-year period was 250.


title: Harold Shipman

text: The GMC charged six doctors, who signed cremation forms for Shipman's victims, with misconduct, claiming they should have noticed the pattern between Shipman's home visits and his patients' deaths. All these doctors were found not guilty. In October 2005, a similar hearing was held against two doctors who worked at Tameside General Hospital in 1994, who failed to detect that Shipman had deliberately administered a "grossly excessive" dose of morphine. "The Shipman Inquiry" recommended changes to the structure of the GMC.


title: Harold Shipman

text: In 2005, it came to light that Shipman may have stolen jewellery from his victims. In 1998, police had seized over £10,000 worth of jewellery they found in his garage. In March 2005, when Primrose asked for its return, police wrote to the families of Shipman's victims asking them to identify the jewellery. Unidentified items were handed to the Assets Recovery Agency in May. The investigation ended in August. Authorities returned 66 pieces to Primrose and auctioned 33 pieces that she confirmed were not hers. Proceeds of the auction went to Tameside Victim Support. The only piece returned to a murdered patient's family was a platinum diamond ring, for which the family provided a photograph as proof of ownership.


title: Harold Shipman

text: A memorial garden to Shipman's victims, called the Garden of Tranquillity, opened in Hyde Park, Hyde, on 30 July 2005. As of early 2009, families of over 200 of the victims of Shipman were still seeking compensation for the loss of their relatives. In September 2009, letters Shipman wrote in prison to friends were to be sold at auction, but following complaints from victims' relatives and the media, the sale was withdrawn.


title: Harold Shipman

text: The Shipman case, and a series of recommendations in the "Shipman Inquiry" report, led to changes to standard medical procedures in the UK (now referred to as the "Shipman effect"). Many doctors reported changes in their dispensing practices, and a reluctance to risk over-prescribing pain medication may have led to under-prescribing. Death certification practices were altered as well. Perhaps the largest change was the movement from single-doctor general practices to multiple-doctor general practices. This was not a direct recommendation, but rather because the report stated that there was not enough safeguarding and monitoring of doctors' decisions.


title: Harold Shipman

text: The forms needed for a cremation in England and Wales have had their questions altered as a direct result of the Shipman case. For example, the person(s) organising the funeral must answer, "Do you know or suspect that the death of the person who has died was violent or unnatural? Do you consider that there should be any further examination of the remains of the person who has died?"


title: Harold Shipman

text: "Harold and Fred (They Make Ladies Dead)" was a cartoon strip in a 2001 issue of "Viz" comic, also featuring serial killer Fred West. Some relatives of Shipman's victims voiced anger at the cartoon.


title: Harold Shipman

text: "", an ITV television dramatisation of the case, was broadcast in 2002; it starred James Bolam in the title role.


title: Harold Shipman

text: A documentary also titled "Harold Shipman: Doctor Death", with new witness testimony about the serial killer, was shown by ITV as part of its "Crime & Punishment" strand on 26 April 2018. The programme was criticised as offering "little new insight".


title: Harold Shipman

text: A play titled "Beyond Belief – Scenes from the Shipman Inquiry", written by Dennis Woolf and directed by Chris Honer was performed at the Library Theatre, Manchester, from 20 October to 22 November 2004. The script of the play comprised edited verbatim extracts from the Shipman Inquiry, spoken by actors playing the witnesses and lawyers at the inquiry. This provided a "stark narrative" that focused on personal tragedies.


title: Harold Shipman

text: A BBC drama-documentary, entitled "Harold Shipman" and starring Ian Brooker in the title role, was broadcast in April 2014.


title: Harold Shipman

text: "The Shipman Files: A Very British Crime Story", a three-part documentary by Chris Wilson, was broadcast on BBC Two on three consecutive nights between 28 and 30 September 2020, and focussed on Shipman's victims and how he went undetected for so long.


title: Harold Shipman

text: Podcast episode "Catching a Killer Doctor" from the "Cautionary Tales with Tim Harford" podcast series features the story of Harold Shipman and how it could have been detected much earlier with good statistical models.


title: Harold Shipman

text: The 2005 song "What About Us?" by British band the Fall makes explicit reference to the Shipman killings ("There was a man going round all the time/He was dishing out drugs/He was a doctor/Dishing out morphine to old ladies"), and the name Shipman is sung as backing vocals during the choruses.


title: Harold Shipman

text: Shipman was a member of the Conservative Party and was mentioned in the 2022 Wakefield by-election when Conservative candidate Nadeem Ahmed highlighted his local connections, following Shipman's suicide in Wakefield prison, claiming that voters should "trust Tories like they do GPs after Harold Shipman".


title: Unsimulated sex

text: In the film industry, unsimulated sex is the presentation of sex scenes in which actors genuinely perform the depicted sex acts, rather than simulating them. Although it is ubiquitous in films intended as pornographic, it is very uncommon in other films. At one time in the United States, such scenes were restricted by law and self-imposed industry standards such as the Motion Picture Production Code. Films showing explicit sexual activity were confined to privately distributed underground films, such as stag films or "porn loops". In the 1960s, social attitudes about sex began to shift, and sexually explicit films were decriminalized in many countries.


title: Unsimulated sex

text: With movies such as "Blue Movie" by Andy Warhol, mainstream movies began pushing boundaries in terms of what was presented on screen. Notable examples include two of the eight "Bedside"-films and the six "Zodiac"-films from the 1970s, all of which were produced in Denmark and had many pornographic sex scenes, but were nevertheless considered mainstream films, all having mainstream casts and crews, and premiering in mainstream cinemas. The last of these films, "Agent 69 Jensen i Skyttens tegn", was made in 1978. From the end of the 1970s until the late 1990s it was rare to see hardcore scenes in mainstream cinema, but this changed with the success of Lars von Trier's "The Idiots" (1998), which heralded a wave of art-house films with explicit content, such as "Romance" (1999), "Baise-moi" (2000), "Intimacy" (2001), Vincent Gallo's "The Brown Bunny" (2003), and Michael Winterbottom's "9 Songs" (2004). Some simulated sex scenes are sufficiently realistic that critics mistakenly believe that they are real, such as the cunnilingus scene in the 2006 film "Red Road".


title: Unsimulated sex

text: In an interview after the release of his film "Love" (2015), when asked why audiences want to see realistic portrayals of sex, Gaspar Noé suggested it's really about power structures: "In most societies whether they're western or not, people want to control the sexual behaviour or to organise it in a precise context. Sex is like a danger zone. Sometimes class barriers fall down and it scares a lot of people. It's about states controlling their systems, like religion."


title: Unsimulated sex

text: James Franco has cited "aesthetics and personal reasons" for why he worked on "Interior. Leather Bar." (2013):


title: Unsimulated sex

text: A few directors have openly discussed or written about the technical problems inherent in filming of actual sexual acts, particularly with actors or actresses who have never performed such acts on film. In an interview with "BlackBook", Gaspar Noé acknowledges that it is difficult for several reasons: an actor may not be able to get or maintain an erection in the presence of even a small crew, or on camera; either of the participants may have a current partner. "So I've decided that the best way to show real sex is to cast two single people who used to be a couple."