title: Huntington, West Virginia

text: One such project has been the Paul Ambrose Trail for Health (PATH). This is a growing, bicycle and pedestrian trail system in the City of Huntington. It is designed to create interconnected loops around each of the neighborhood parks that would create recreational opportunities and an alternative means of transportation around the city. The namesake, Dr. Paul Ambrose, was a promising young physician who was killed at the Pentagon in the terrorist attacks on September 11, 2001. Dr. Ambrose was dedicated to family health and preventive medicine to fight obesity and the trail system is a way for his efforts to have a lasting effect in Huntington.


title: Huntington, West Virginia

text: The Rahall Transportation Institute Foundation, in association with the City of Huntington and various community members, has designed this trail system to incorporate many of Huntington's amenities and workplaces to allow the citizens of Huntington an alternative means of transportation.


title: Huntington, West Virginia

text: Memorial Park is at 1301 Memorial Boulevard. It contains a walking trail, a small playground, a picnic shelter, and a small restroom. It formerly included a large swimming pool that featured two slides, but was abandoned and demolished in 2006. The two-mile (3 km) walking trail merges with the one-mile (1.6 km) trail around the main Ritter Park at 8th Street & North Blvd.


title: Huntington, West Virginia

text: Huntington's Veterans Memorial Arch is a historic memorial arch in Memorial Park. It was built between 1924 and 1929 by the Cabell County War Memorial Association as a memorial to the dead and to those who served the county in World War I. It is built of gray Indiana limestone on a gray granite base. It measures high, wide, and deep. It features Classical Revival style bas-relief carvings. The structure was rededicated in 1980. It is the only triumphal style arch in West Virginia. It was listed on the National Register of Historic Places in 1981.


title: Huntington, West Virginia

text: Harveytown Park is one of the newest parks in the Harveytown district. It currently features six picnic tables, one of which is handicap accessible, an electrical outlet, a grill, water fountain, and restrooms. Construction on Phase I of the new park began on October 28, 2003. The financing and co-ordination was a joint effort between the city of Huntington, HUD CDBG funds, and the Greater Huntington Park and Recreation District. During Phase I, the initial park site was cleared and prepared, underground utilities were installed, a main entrance and parking lot was constructed, and the picnic shelter was installed. The shelter was unique in that it was both aesthetically pleasing and functional. Possible expansion plans include a skateboard facility, bicycle trails and tennis courts.


title: Huntington, West Virginia

text: Camp Mad Anthony Wayne is on Spring Valley Drive. Named for "Mad" Anthony Wayne, a frontier army general, it contains vast open grounds, swings and sliding boards, hiking trails, a disc golf course, numerous picnic tables, an open campfire circle, and a lodge. The facility sleeps 28 and contains a bathroom and shower facilities. It is host to two large wood-fired fireplaces. Part of the park was listed on the National Register of Historic Places in 2002. The eight historic buildings are the camp lodge building (1931), four nearly identical gable roofed, stone, rustic vernacular cottages dated to 1942; a gable-roofed, stone, rustic vernacular caretaker's house and two associated outbuildings, dated to 1944. The lodge is a gable-roofed, brick, rustic vernacular building.


title: Huntington, West Virginia

text: Camden Park is a amusement park near Huntington. It is a traditional park home to over 30 rides and attractions. The park features two of the three remaining roller coasters built by National Amusement Devices. The Big Dipper, a wooden roller coaster constructed in 1958, features the original Century Flyer cars complete with headlights and detail work. The coaster is classified as an ACE Coaster Classic by the American Coaster Enthusiasts. The park's second coaster, the Lil' Dipper was completed in 1961 and is also an ACE Coaster Classic. The park is also home to several entertainment events which take place throughout the year: Children's Festival, Hot Summer Nights Concert Series, Coca-Cola Days, and Halloween Spooktacular.


title: Huntington, West Virginia

text: Camden Park was originally built in 1903 at the western terminus of the trolley line (then owned by the Camden Interstate Railway Company) to encourage ridership. Camden Park is now owned by the Boylin Family. This is the second generation of Boylins owning and operating West Virginia's only amusement park. J. P. Boylin transformed Camden Park from a carousel to an amusement park in 1950. By the late 19th century almost every large town in America had streetcars and many had parks to boost weekend and holiday traffic. Originally developed as a picnic area by the Camden Interstate Railway in 1903 Camden Park has survived into the 21st century as a thriving traditional amusement park. Over the years Camden Park has been the setting for baseball games, tens of thousands of picnics, fairs, marathon dances, roller derbies, flagpole sitting, a swimming pool, a zoo, plus numerous attractions and rides.


title: Huntington, West Virginia

text: Beech Fork State Park is in Cabell County and Wayne County, West Virginia, roughly south of downtown Huntington. The park is on the tailwater shores of Beech Fork Lake, a flood control impoundment of the U.S. Army Corps of Engineers on the Beech Fork of Twelvepole Creek. Since its development in the mid 1970s, Beech Fork State Park has proved to be a popular recreation spot for the residents of nearby Barboursville and Huntington, as well as those living in the surrounding region. The park is about south of the Hal Greer exit (Exit 11) of Interstate 64. Access to the park is also available from Exits 8, 15, and 20 of I-64. The Beech Fork Lake Dam and Marina are about a 20-mile (40 minute) drive from the park.


title: Huntington, West Virginia

text: Beech Fork State Park is home to Beech Fork Lake, a reservoir near Lavalette in Wayne County, West Virginia. Beech Fork Lake is also partly located in neighboring Cabell County. Millers Fork and Stowers Branch join Beech Fork with their own river valleys contributing to the majority of the lake surface of Beech Fork Lake. These streams are tributaries of Twelvepole Creek.


title: Huntington, West Virginia

text: Beech Fork Lake as a flood control impoundment was authorized by the Flood Control Act of October 23, 1962 and was constructed by the U.S. Army Corps of Engineers in the mid-1970s. The lake was completed and dedicated in May 1978.


title: Huntington, West Virginia

text: Known in agrarian times as the "Bean Capital of the World" because of its abundant harvests, remote Beech Fork and its fertile farms had by the mid-20th century devolved into a "Tobacco Road" cut off from the opportunities of modern development. Some tombstones in the Park's Bowen Cemetery date to the 18th century; and family names adorning Civil War graves can be seen on roadside mailboxes even today. Government appropriation of private land for the lake caused rancor among locals with historic land holdings. The Beech Fork strain of Adkins family (appropriately known as "Beech Fork Adkinses") was largely driven out to the Huntington metropolitan area. So numerous were these displaced persons that townsfolk joked about an "Adkins factory" at Beech Fork which mass-produced persons of the surname. It has also been said that in the last days, "the Jews will go back to Palestine and the Adkinses will go back to Beech Fork."


title: Huntington, West Virginia

text: Huntington's sports scene is dominated by Marshall University athletics and Huntington Prep basketball.


title: Huntington, West Virginia

text: Marshall's sports teams are known as the "Thundering Herd". The school colors are kelly green and white. Marshall participates in FBS for football as a member of The Sun Belt Conference. The name Thundering Herd came from a Zane Grey novel released in 1925, and a silent movie of the same name two years later. Marshall teams were originally known as the Indians, and the green-white colors came in 1903, replacing black and blue. "The Herald-Dispatch" sports editor Carl "Duke" Ridgley tagged the team with the Thundering Herd name, but many other nicknames were suggested over the next thirty years, including Boogercats, Big Green, Green Gobblers, Rams, Judges and others. In 1965, students, alums and faculty settled on Thundering Herd in a vote, and Big Green was given to the athletic department's fund-raising wing.


title: Huntington, West Virginia

text: Sports at the school include women's softball, swimming and diving, tennis, volleyball, and track and field; men's football, baseball; and teams for both genders in basketball, cross country, golf, and soccer. Marshall also fields club teams, not affiliated with the MU Athletic Department, in rugby union for both women and men, men's and women's lacrosse, and an equestrian team that competes in the Intercollegiate Horse Show Association.


title: Huntington, West Virginia

text: In 2012, Huntington Prep was ranked as one of the top ten basketball teams in the nation and had the top high school player in the class of 2013, Andrew Wiggins. As of 2012, all students were considered NCAA Division I prospects and recruited by some of the top programs in the country. Huntington Prep is housed within St. Joseph Central Catholic High School, a religious school. The students are regular St. Joseph's students and must abide to the rules and regulations of the high school. Practice is held in the Recreation Center at Marshall University, with "home" games played at local high schools, the Cam Henderson Center, and formerly at the now demolished Veterans Memorial Fieldhouse.


title: Huntington, West Virginia

text: The team's nickname is the "Express" which is a derivative of the nickname of the former Huntington High School, "Pony Express", and the city's railroad heritage. (The current Huntington High is a consolidation of the original Huntington High and Huntington East High School, and took East's nickname of "Highlanders".) The school colors are Carolina blue and yellow. None of the players are from West Virginia, as Coach Rob Fulford does not want to take West Virginia players away from their local teams. Instead, all the players are recruited and attend St. Joseph's. Because of this, the school is excluded from playing West Virginia teams by the West Virginia Secondary School Activities Commission, which is the state's high school sanctioning body.


title: Huntington, West Virginia

text: The Mountain Health Arena was formerly the home of the River Cities LocoMotives (2001) and the Huntington Hammer (2011–2012), both members of the Ultimate Indoor Football League, and the Huntington Heroes indoor football team in the American Indoor Football League (2006–2008).


title: Huntington, West Virginia

text: Huntington has a long history of baseball clubs, starting with the Huntington Blue Sox (1911–1916). Other clubs include: the Huntington Boosters (1931–1933, 1937 & 1939), the Huntington Red Birds (1934–1936), the Huntington Bees (1938), the Huntington Aces (1940–1941), the Huntington Jewels (1942), and the Huntington Cubs (1990–1994). The Huntington Cubs played in the Appalachian League, and were affiliated with the Chicago Cubs. Their home stadium was at St. Cloud Commons.


title: Huntington, West Virginia

text: Huntington was also home to the Huntington Stars (1939–1941), the Huntington Hornets (1956–1957), and the Huntington Blizzard (1993–2000) ice hockey teams. The Blizzard played at the Mountain Health Arena, the Hornets played at the Veterans Memorial Fieldhouse, and the Stars played at the former Iceland Arena. Marshall University has a club ice hockey team.


title: Huntington, West Virginia

text: Huntington is home to the Jewel City Roller Girls, a women's roller derby team that was founded in 2010.


title: Huntington, West Virginia

text: Huntington has one of West Virginia's largest daily circulating newspapers, "The Herald-Dispatch", with an average weekday circulation of just over 25,000.) The paper is locally owned by HD Media Co. LLC. Huntingtonnews.net has been online since 2000 and is a local Independent news source owned by Matthew Pinson.


title: Huntington, West Virginia

text: "The Parthenon," Marshall University's independent student newspaper has a weekly print circulation of 6,000 and is distributed around Marshall's campus.


title: Huntington, West Virginia

text: Note - all stations listed serve both Huntington and Charleston, as both cities comprise a single TV market


title: Huntington, West Virginia

text: The residents of Huntington are served by the Cabell and Wayne County School Systems, which include Huntington High School, Cabell Midland High School, Spring Valley High School, Cabell County Career Technology Center, five middle schools, and 19 elementary schools. Private schools include the St. Joseph Catholic School (a regionally accredited, parochial school), Grace Christian School (a regionally accredited, evangelical school), and Covenant School.


title: Huntington, West Virginia

text: Huntington is home to colleges and universities including Marshall University and one of its graduate schools, the Joan C. Edwards School of Medicine, the Robert C. Byrd Institute for Advanced Manufacturing, Mountwest Community & Technical College, the Huntington Junior College, St. Mary's Medical Center's School of Medical Imaging, School of Nursing, and School of Respiratory Care, as well as the Tri-State Institute of Pharmaceutical Sciences.


title: Huntington, West Virginia

text: The Cabell County Public Library system operates a main branch downtown and seven branches in neighboring towns.


title: Huntington, West Virginia

text: The roads of Huntington, West Virginia include one major interstate, Interstate 64; two U.S. highways, U.S. Route 60 and U.S. Route 52; 6 state routes; and numerous major thoroughfares. Huntington utilizes a grid-like street pattern featuring several wide boulevard-style avenues that run east and west. Most notable of these are Third and Fifth Avenues. The city has a numbered street naming system, with avenues running east and west (parallel to the Ohio River) and streets running north and south. The city is divided into an "East End" and a "West End" by First Street. Streets west of First Street carry as "West" indicator after the street name (i.e. "Fourteenth Street West"). The street plan was originally laid out by Andrew J. Enslow, a professional contractor, making Huntington one of the first professionally planned cities in America.


title: Huntington, West Virginia

text: WV 101 is an unsigned highway which runs for less than a mile, connecting Third Avenue (US 60) with Rotary Park. Until 1990, this was an alignment of US 60.


title: Huntington, West Virginia

text: WV 106 enters the Huntington neighborhood of Guyandotte, via the East End Bridge from Proctorville. The highway crosses WV Route 2, and immediately terminates at U.S. Route 60, across the 3rd and 5th avenue split.


title: Huntington, West Virginia

text: WV 152's northern terminus is just shy of the city at Interstate 64. Continuing north changes to WV 527.


title: Huntington, West Virginia

text: WV 527 crosses south into Huntington from Chesapeake, Ohio, via the Robert C. Byrd Bridge. WV 527 then travels through downtown as 5th Street and exits the city at Interstate 64, which serves as the highway's southern terminus. Continuing south will lead into WV 152.


title: Huntington, West Virginia

text: The city has connections over the Ohio River to Proctorville, Ohio via the East Huntington Bridge, and to Chesapeake, Ohio via the Robert C. Byrd Bridge and the West Huntington Bridge.


title: Huntington, West Virginia

text: The Robert C. Byrd Bridge is a continuous truss automobile bridge that crosses the Ohio River between Huntington, West Virginia and Chesapeake, Ohio. The crossing was constructed to replace an old, narrow two lane structure that was demolished after 69 years of service in a spectacular implosion on July 17, 1995. The previous bridge, opened in 1926, was Huntington's first bridge across the Ohio River and was designed in a gothic style, complete with four two-ton spires that rested on top of each peak. The ground breaking ceremonies for the four-lane bridge was held on April 30, 1991.


title: Huntington, West Virginia

text: The old 6th Street Bridge closed in the summer of 1993 to allow for the construction of the ramps and approaches in West Virginia and Ohio. The new bridge was named the Robert C. Byrd Bridge under an executive order from former Governor Gaston Caperton to honor the U.S. senator from West Virginia who is credited with obtaining the funding for the project that was completed on November 6, 1994. The $32.6 million bridge was constructed with $1.4 coming from Ohio, $5.6 coming from West Virginia, and $25.3 in federal funds. The famous spires, which once adorned the top of the former span, were saved. One is currently on display outside of the Chesapeake city hall at the intersection of State Route 7 and the Robert C. Byrd Bridge. Two others are installed along 9th Street between 3rd and 5th Avenues.


title: Huntington, West Virginia

text: The East Huntington Bridge (officially the "Frank Gatski Memorial Bridge", also called the "East End Bridge" or the "31st Street Bridge") is a cable-stayed bridge crossing the Ohio River at Huntington, West Virginia. It carries WV 106 on the West Virginia approach and OH 775 on the Ohio approach. The history of the span dates to the early 1970s when possible routings for a future Ohio River span were being discussed. To conform to the Huntington city comprehensive plan, the alignment preferred by the city was one that connected to Interstate 64 outside of the city boundaries. Many favored a plan about one mile (1.6 km) north of the city along WV 2.


title: Huntington, West Virginia

text: Work began on the bridge in 1983 and was completed in August 1985 at a cost of $38 million. The designer of the bridge was Arvid Grant and Associated of Olympia, Washington and was the first bridge of its type in West Virginia. It was only the second of its kind in the United States since it utilized concrete instead of steel for its construction. It was built as a FHWA demonstration project. The Ohio River span and approach ramps on both sides of the river completed was what was known as Phase I. Future plans involved tolling the bridge and connecting it to U.S. Route 60 four blocks east The bridge was renamed for Marshall University's first member of the Pro Football Hall of Fame, Frank "Gunner" Gatski, during halftime of the Marshall-UTEP Football game on November 18, 2006.


title: Huntington, West Virginia

text: Since its founding as the western terminus of the C&O Railroad, Huntington has served as a major break of bulk point between rail traffic and the Ohio River/Mississippi River watershed. The Huntington Division is still the largest in the CSX Transportation network. A large portion of the division's revenue comes from hauling coal out of the coalfields of West Virginia and Eastern Kentucky. Much of the coal is brought to the Port of Huntington-Tristate by train to be transported by river barges to industrial centers in other parts of the United States.


title: Huntington, West Virginia

text: Huntington is in the company's Southern Region and is the largest of ten operating divisions on the network. The division comprises the former railroads Chesapeake and Ohio (C&O); Baltimore and Ohio (B&O); Western Maryland (WM); Louisville and Nashville (L&N); and the Clinchfield. It serves the states of Kentucky, Tennessee, Virginia, West Virginia and Ohio. CSX's Huntington Division main office is in the historical former C&O passenger station in downtown Huntington. The building is home to the division's top managers, a centralized yardmasters and train dispatchers center, a freight car light repair shop and a locomotive heavy repair facility in the city.


title: Huntington, West Virginia

text: The city was once a major hub for passenger rail service, but it now accounts for a significantly smaller portion of rail traffic than in the early decades of the 20th century.


title: Huntington, West Virginia

text: The Amtrak station is on the "Cardinal" line running three days a week (Wednesday, Friday, Sunday) between New York City and Chicago via Washington, D.C., Charlottesville, Virginia, Cincinnati, and Indianapolis. The station at 1050 8th Avenue contains a waiting room and ticket office, as well as a platform on the south side of the east-west tracks, a small parking lot, and a small building in between.


title: Huntington, West Virginia

text: The Amtrak station is six blocks south and two blocks west of the Tri-State Transit Authority Transit Center, where most TTA bus routes and Greyhound Buses stop. For closer connections, riders can take advantage of TTA Routes 2, 4, 5, 6, 10, which pass only two blocks away at 4th Avenue.


title: Huntington, West Virginia

text: Those connections are not always practical under the current "Cardinal" schedule. The passengers arriving on the eastbound train, arriving from Chicago about 7:15 a.m. can easily transfer to any route that serves the Transit Center. But few bus routes are running after the westbound train departs around 9:50 p.m. Except for the few PM routes, most TTA routes stop running hours before the westbound train arrives, limiting options for any passengers who are either boarding or disembarking from the train.


title: Huntington, West Virginia

text: Tri-State Transit Authority (TTA) provides fixed-route bus service throughout Huntington and the surrounding area. Its buses range, on the West Virginia side from 19th Street West in Huntington to Milton, West Virginia, about to the east. On the Ohio side, the buses range from downtown Ironton to the Huntington suburb of Proctorville, Ohio, which is also a range of about . Interchange buses provide links between Huntington and Chesapeake, Ohio, and between Ironton and Ashland, Kentucky, where transfers are available to the Ashland Bus System. However the system does not interchange between the TTA and the City of Ashland Bus Service in Ceredo, West Virginia.


title: Huntington, West Virginia

text: The TTA also was involved in a joint venture with the Charleston, West Virginia-based Kanawha Valley Regional Transportation Authority bus system called Intelligent Transit which linked downtown Huntington to Charleston via bus. All bus routes began and ended at the old Greyhound Bus Depot in downtown Huntington, which is now known as the TTA Center. The service from Huntington to Charleston ceased in 2015. TTA bus services operate on Monday to Saturday between 6:00 a.m. and 11:15 p.m.


title: Huntington, West Virginia

text: The Port of Huntington-Tristate is the largest inland port in the United States in terms of total tonnage and ton-miles. This is due in large part to the coal traffic from the railroads and the petroleum products produced by the Marathon Petroleum oil refinery in nearby Catlettsburg, Kentucky that use the Port of Huntington/Tri-State to load their products onto barges.


title: Huntington, West Virginia

text: The public Tri-State Airport, southwest of the city, has two runways. Commercial air service is provided by Allegiant Air and American Eagle.


title: Farooq Abdullah

text: Farooq Abdullah (born 21 October 1937) is an Indian politician who was Ex. President of Jammu & Kashmir National Conference. He has served as the Chief Minister of Jammu and Kashmir on several occasions since 1982, and as the union minister for New and Renewable Energy between 2009 and 2014. He is the son of the 1st elected Chief Minister of Jammu and Kashmir Sheikh Abdullah, and father of former Chief Minister of Jammu and Kashmir Omar Abdullah.


title: Farooq Abdullah

text: Farooq Abdullah was born to the veteran statesman and National Conference leader Sheikh Abdullah and Begum Akbar Jehan Abdullah. He studied at Tyndale Biscoe School, and subsequently received his MBBS degree from SMS Medical College, Jaipur. He subsequently travelled to the UK to practice medicine.


title: Farooq Abdullah

text: He is married to Molly, a nurse of British origin. They have a son, Omar, and three daughters, Safia, Hinna, and Sara. Their son Omar Abdullah is also involved in state and national politics, who was a member of the Lok Sabha and was the chief minister of Jammu and Kashmir. Sara is married to Congress politician Sachin Pilot


title: Farooq Abdullah

text: Abdullah was elected to the Lok Sabha unopposed from Srinagar Lok Sabha constituency in the 1980 General Election.


title: Farooq Abdullah

text: Abdullah was a novice in the political arena of Jammu and Kashmir when he was appointed president of the National Conference in August 1981. His main qualification was that he was the son of Sheikh Abdullah. After his father's death in 1982, Farooq Abdullah became the chief minister of the state. In 1984, a faction of the National conference led by his brother-in-law Ghulam Mohammad Shah broke away, leading to the collapse of his government and his dismissal. Shah subsequently became the Chief Minister with the support of the Congress.


title: Farooq Abdullah

text: In 1986, G.M. Shah's government was dismissed after the communal 1986 Kashmir riots in South Kashmir, and a new National Conference–Congress government was sworn in with Abdullah as the chief minister, after the Rajiv-Farooq accord.


title: Farooq Abdullah

text: A new election was held in 1987 and the National Conference–Congress alliance won the election amid allegations of fraud. This period saw a rise in militancy in the state, with the return of trained militants in J&K and incidents that included the kidnapping of the daughter of the Union Home Minister Mufti Mohammad Sayeed. The period also witnessed the genocide and displacement of Kashmiri Pandits from the valley. Subsequently, Farooq Abdullah resigned in protest after Jagmohan was appointed the governor,


title: Farooq Abdullah

text: After returning to India, and winning the Legislative Assembly elections in 1996, Abdullah was once again sworn in as chief minister of the state, his fifth time. His government lasted for a full six-year term. In 1999, the National Conference joined the Atal Bihari Vajpayee led National Democratic Alliance, and his son Omar Abdullah was subsequently appointed a union minister of state.


title: Farooq Abdullah

text: In the 2002 Legislative Assembly elections, Omar Abdullah was chosen to lead the National Conference, while Farooq Abdullah intended to continue his political career at the Central level. The National Conference lost the election and a coalition government headed by Mufti Mohammad Sayeed took office.On that year Former Prime Minister Atal Bihari Vajpayee in 2002 promised to make Abdullah the vice president, but later reneged on his promise.


title: Farooq Abdullah

text: Farooq Abdullah was subsequently elected to the Rajya Sabha in 2002 from Jammu and Kashmir and re-elected in 2009. He resigned from the Rajya Sabha in May 2009 and won a seat in the Lok Sabha from Srinagar. Abdullah joined the United Progressive Alliance government as a Cabinet Minister of New and Renewable Energy.


title: Farooq Abdullah

text: Abdullah contested the Srinagar Lok Sabha seat again in the 2014 General Election, but was defeated by the People's Democratic Party candidate Tariq Hameed Karra. In 2017, Tariq Hameed Karra resigned from the position, leading to a by-election for the Srinagar parliamentary seat. Abdullah got 48,555 votes and defeated PDP candidate Nazir Ahmed Khan by 10,700 votes.


title: Farooq Abdullah

text: On 16 September 2019, Abdullah became the first mainstream politician to be detained under the Public Safety Act. Prior to this, Abdullah was under house arrest since the scrapping of Article 370 of the Constitution of India. He was released from house detention under the PSA after seven and a half months on 13 March 2020.


title: Farooq Abdullah

text: In 2022, before the election of the President of India, Mamata Bannerjee along with several other opposition leaders had proposed Abdullah's name as the Opposition's candidate. But Abdullah declined the offer stating that he wanted to remain in active politics for more years and was concentrated in the Kashmir Union Territory issue.


title: Ronan the Accuser

text: Ronan the Accuser is a fictional character appearing in American comic books published by Marvel Comics. Ronan was created by writer Stan Lee and artist Jack Kirby and he first appeared in "Fantastic Four" #65 (August 1967). He is the Supreme Accuser of the Kree Empire, the militaristic government of the fictional alien race known as the Kree, and is commonly depicted as an adversary of superhero teams such as the Fantastic Four, the Avengers, and the Guardians of the Galaxy. In later years, the character was depicted as a more noble and heroic figure as a member of various superhero groups such as the Starforce, United Front and Annihilators. He was married to the Inhuman Crystal, a princess of the Inhuman Royal Family.


title: Ronan the Accuser

text: The character has been substantially adapted from the comics into various media, including several animated television series and video games. Lee Pace portrayed the character in the Marvel Cinematic Universe (MCU) films "Guardians of the Galaxy" (2014) and "Captain Marvel" (2019).


title: Ronan the Accuser

text: Ronan was created by writer Stan Lee and artist Jack Kirby. He first appeared in "Fantastic Four" #65 (August 1967).


title: Ronan the Accuser

text: The character returned sporadically in "Captain Marvel", and played an important role in the "Kree-Skrull War" storyline in "The Avengers" #88–97. After appearances in "Ms. Marvel" #19 and "Silver Surfer" vol. 3, Ronan returned in the "Galactic Storm" crossover in 1992.


title: Ronan the Accuser

text: Ronan subsequently appeared in "Fantastic Four" vol. 3 #13–14 and "Iron Man" vol. 3 #14, before having a major role in the "Maximum Security" crossover in Jan 2001.


title: Ronan the Accuser

text: During the 2006 "Annihilation" storyline, Ronan received a four-issue eponymous miniseries written by Simon Furman, and a leading role in "Annihilation" #1–6. He appeared in the sequels, "" #1–6 and "Annihilation Conquest: Wraith" #1–4 in 2007.


title: Ronan the Accuser

text: After being seen during the "Secret Invasion: War of Kings" one-shot, the character was used in "War of Kings" #1–6 (2009) and "Realm of Kings: Inhumans" #1–4. Following appearances in "The Thanos Imperative" #1–6 (2010), Ronan joined the titular team in "Annihilators" #1–4 (2011) and "Annihilators: Earthfall" #1–4 (Sept 2011–Dec 2011).


title: Ronan the Accuser

text: Ronan was born on the planet Hala, the capital of the Kree Empire in the Greater Magellanic Cloud. Ronan later joined the Accuser Corps, who are the Kree equivalent of military governors and jurists, and his rise through their ranks was extraordinary; he eventually became the third-most powerful being in the Kree Empire. The Supreme Intelligence ultimately appointed him "Supreme Accuser of the Kree Empire". He is known simply as "Ronan "the" Accuser".


title: Ronan the Accuser

text: On his first mission, Ronan is sent to Earth to investigate the destruction of a robotic Kree Sentry at the hands of the Fantastic Four. The team defeats Ronan, which prompts a Kree expedition to spy on and assess Earth. Captain Mar-Vell is a member of the team, and he interacts with Ronan frequently during his mission.


title: Ronan the Accuser

text: Ronan secretly plans with Zarek to overthrow the Kree leader, the Supreme Intelligence, believing the Empire should not be ruled by a non-humanoid entity. But Ronan is paralyzed by the psionic powers of Rick Jones, and control of the Kree Empire reverts to the Supreme Intelligence.


title: Ronan the Accuser

text: Ronan is subsequently mentally dominated by the Supreme Intelligence, and battles Mar-Vell on multiple occasions. Ronan later regains his sanity and returns to his former position as Supreme Accuser. During the second Kree-Skrull war, Ronan executes a Skrull duplicate of the Silver Surfer.


title: Ronan the Accuser

text: When Earth becomes a prison planet, Ronan serves as its warden. The Supreme Intelligence then plans to subvert the galactic council and use Ego the Living Planet as a weapon. Although Ronan is able to elevate his power by tapping into Ego's own energy, Mister Fantastic, Iron Man, Giant-Man and Bruce Banner manage to create a machine that transfers Ego's essence into Quasar. The weakened Ronan is defeated and captured by the U.S. Agent.


title: Ronan the Accuser

text: When Ronan is falsely accused of treason by Tana Nile, he discovers he has been framed by a highly placed member of a Kree house. After defending the Kree Empire against the Annihilation Wave, Ronan clears his name and kills his betrayer, although not before he lobotomizes the Supreme Intelligence. In an act of mercy, Ronan kills the Supreme Intelligence and becomes ruler of the Kree Empire.


title: Ronan the Accuser

text: When the Inhumans seek aid from the Kree against the Skrull's Secret Invasion, Ronan agrees on the condition that the Inhuman princess, Crystal, marries him. On their wedding day, Ronan is severely beaten by the Shi'ar Imperial Guard and hospitalized. He does not fully recover until after the War of Kings is over.


title: Ronan the Accuser

text: During the war with the cancerverse, Ronan is a member of Nova's main attack force. In an effort to prevent further conflict, Ronan joins the Annihilators, who protect Galador from the Dire Wraiths and oppose the Universal Church of Truth's attempt to revive the Magus.


title: Ronan the Accuser

text: Ronan is soon separated from his wife under the orders of Black Bolt, as part of a truce made between Black Bolt and the Supreme Intelligence to ensure peace between Inhumans and the Kree Empire. Crystal and Ronan are deeply saddened by this decision, as their arranged marriage had eventually become a stronger relationship.


title: Ronan the Accuser

text: In the "Infinity" storyline, Ronan the Accuser and the Supreme Intelligence appeared as members of the Galactic Council. Ronan later fights Thanos' minion Black Dwarf of the Black Order, and kills him.


title: Ronan the Accuser

text: Ronan the Accuser steals The Black Vortex from the cosmically powered X-Men, and, against the Supreme Intelligence's orders, submits to the Vortex and receives cosmic powers. Mister Knife later steals the Vortex and destroys Hala and the Supreme Intelligence. Ronan and the imperial fleet survive, but the last remaining seed of the Supreme Intelligence was stolen from the Collector by Star-Lord's half-sister Victoria.


title: Ronan the Accuser

text: Ronan wanders the ruins of Hala alone while remembering the names of the Kree that fell in battle when he came into conflict with Noh-Varr and the Inhumans except for Crystal. Thanks to Crystal's reasoning, Ronan blames himself for disobeying the Supreme Intelligence's orders. After freeing his captive, Ronan witnesses Noh-Varr planting the seed of his reality's Plex Intelligence into the remains of the Supreme Intelligence. Even though Hala has a new leader, Ronan still blames himself for what happened to the planet.


title: Ronan the Accuser

text: In the pages of "Death of the Inhumans," Karnak confronts the unnamed Kree commander of a Kree contingency that was sent away to explore and chart the outer reaches of the Universe. After generations away they finally returned to Hala, only to find it in ruins. The Kree commander also reveals that they eliminated Ronan, exile those loyal to him and decided use the Inhumans as part of their plans to rebuild Hala and bring a new dawn to the Kree Empire. However, Black Bolt eventually found out that the Kree commander had lied to Karnak about Ronan's fate. The Kree actually captured him and the Kree soldiers loyal to him and made gruesome experiments on them. Now merely a cyborg, Ronan begged Black Bolt to end his misery as he apologized for all the pain he caused to the Inhumans to which he complies by whispering "You are forgiven."


title: Ronan the Accuser

text: As a Kree warrior in peak physical condition, Ronan possesses his species' unique physiology and is thus resistant to poisons, toxins, and diseases. He has superhuman physical attributes which are all further enhanced by his exoskeleton body-armor. Ronan's armor, which contains multiple scanners, can also create fields of invisibility, and his gauntlets can discharge cosmic energy bolts or generate sufficient coldness to place certain lifeforms into a state of suspended animation. In addition, Ronan possesses a brilliant strategic mind; his high intellect allowed him to rise to one of the highest positions in the Kree Empire. He also has extensive knowledge in all matters pertaining to Kree law and is well-versed in the use of his species' highly advanced technology.


title: Ronan the Accuser

text: Ronan's primary weapon is a warhammer-like Accuser Cosmi-Rod called the "Universal Weapon". At its wielder's will, the device can absorb and fire cosmic energy, manipulate matter, generate force-fields, control gravity, and create "time-motion displacement fields". It also allows for interstellar teleportation, hyperspatial passages and flight. As a highly trained Kree soldier, Ronan is extremely proficient in the use of this weapon in both close- and long-ranged confrontations. Even without his war hammer, Ronan has proven a formidable hand-to-hand combatant.


title: Ronan the Accuser

text: The Ultimate version of Ronan the Accuser is the son of Thanos, and is a part of his empire. He is ultimately defeated by the Thing.


title: Ronan the Accuser

text: In the series "Hunger", another version of Ronan called Ro-Nan is married to Esa-La and have a son named Dra-ta. He leads an army of Kree warriors in a battle against the Chitauri, when both alien races encounter the entity Gah Lak Tus during battle. Ro-Nan is killed in "Hunger" #3.


title: Extramarital sex

text: Extramarital sex occurs when a married person engages in sexual activity with someone other than their spouse.


title: Extramarital sex

text: Where extramarital sexual relations do not breach a sexual norm, it may be referred to as consensual "non-monogamy" (see also "polyamory").


title: Extramarital sex

text: Where extramarital sexual relations do breach a sexual norm, it may be referred to as "adultery" or "non-monogamy" (sexual acts between a married person and a person other than the spouse), "fornication" (sexual acts between unmarried people), "philandery", or "infidelity". These terms imply moral or religious consequences, whether in civil law or religious law.


title: Extramarital sex

text: American researcher Alfred Kinsey found in his 1950-era studies that 50% of American males and 26% of females had extramarital sex. Depending on studies, it was estimated that 26–50% of men and 21–38% of women, or 22.7% of men and 11.6% of women had extramarital sex. Other authors say that between 20% and 25% of Americans had sex with someone other than their spouse. Durex's Global Sex Survey (2005) found that 44% of adults worldwide reported having had one-night extramarital sex and 22% had an affair. According to a 2004 United States survey, 16% of married partners have had extramarital sex, nearly twice as many men as women, while an additional 30% have fantasized about extramarital sex. According to a 2015 study by Durex and Match.com, Thailand and Denmark were the most adulterous countries based on the percentage of adults who admitted having an affair. A 2016 study by the Institute for Family Studies in the US found that black Protestants had a higher rate of extramarital sex than Catholics.


title: Extramarital sex

text: A 2018 US study found that 53.5% of Americans who admitted having extramarital sex did so with someone they knew well, such as a close friend. About 29.4% were with someone who's somewhat well-known, such as a neighbor, co-worker or long-term acquaintance, and the rest were with casual acquaintances. The study also found some gender differences, such as that men are more likely than women to hold more favorable attitudes about extramarital sex, and that among those who reported having extramarital sex in the past year, about 12% of men had paid for sex (or to have received payment for sex) compared to 1% for women.


title: Extramarital sex

text: Engagement in extramarital sex has been associated with individuals who have a higher libido (sex drive) than their partner.


title: Extramarital sex

text: Christianity teaches that extramarital sex is immoral and sin. Scriptural foundations for this teaching are passages like (KJV):


title: Extramarital sex

text: In Christian marriage, husband and wife publicly promise fidelity to each other until death. Adultery contradicts this promise.


title: Extramarital sex

text: Traditional interpretations of Islamic law (or Sharia) prescribe severe punishments for "zina", or extramarital sex, by both men and women. Premarital sex could be punished by up to 100 lashes, while adultery is punishable by stoning. The act of sexual penetration must, however, be attested by at least four male Muslim witnesses of good character, the accused has a right to testify in court, the suspect's word or testimony is required to hold the most weight in the eyes of the judge(s), punishments are reserved to the legal authorities and the law states that false accusations are to be punished severely. The former regulations also make some Muslims believe, that the process's goal was to eventually abolish the physical penalties relating to acts of fornication and adultery that were already present within many societies around the world when Islamic teachings first arose. According to this view, the principles are so rigorous in their search for evidence, that they create the near impossibility of being able to reach a verdict that goes against the suspect in any manner.


title: Extramarital sex

text: The Torah prescribes the death penalty through stoning for adultery, which is defined as having sex with a woman who is married to another man. Two witnesses of good character had to testify in court for the case to be even considered by the judges.


title: Extramarital sex

text: Israelite and historic Jewish society was polygynous (one man could have many wives), so the marital status of the man was irrelevant. If a woman, however, is unmarried, a sexual relationship, though highly immoral and sinful from the religion's point of view, is not considered to be adultery, and therefore not punishable by death, but by lashing.


title: Extramarital sex

text: Any physical punishments for any sins were in effect at the times of Judges and the Holy Temple. Now, any physical punishment is prohibited by Judaism—as no proper judicial process can be provided until the Holy Temple is rebuilt by the Messiah.


title: Extramarital sex

text: Extramarital sex is legal in most jurisdictions, but laws against adultery are more common. In the United States, for example, Virginia prosecuted John Bushey for adultery in 2004. Other states allow jilted spouses to sue their ex-partners' lovers for alienation of affections.


title: Extramarital sex

text: Extramarital sex is illegal in some Muslim-majority countries, including Saudi Arabia, Pakistan, Afghanistan, Iran, Kuwait, Maldives, Morocco, Oman, Mauritania, United Arab Emirates, Qatar, Sudan, and Yemen. Indonesia banned extramarital sex in December 2022, but regulations may take up to three years to come into effect.


title: Siberian Traps

text: The Siberian Traps () is a large region of volcanic rock, known as a large igneous province, in Siberia, Russia. The massive eruptive event that formed the traps is one of the largest known volcanic events in the last years.


title: Siberian Traps

text: The eruptions continued for roughly two million years and spanned the Permian–Triassic boundary, or P–T boundary, which occurred around 251.9 million years ago. The Siberian Traps are believed to be the primary cause of the Permian–Triassic extinction event, the most severe extinction event in the geologic record.


title: Siberian Traps

text: Large volumes of basaltic lava covered a large expanse of Siberia in a flood basalt event. Today, the area is covered by about of basaltic rock, with a volume of around .


title: Siberian Traps

text: The term "trap" has been used in geology since 1785–1795 for such rock formations. It is derived from the Swedish word for stairs ("trappa") and refers to the step-like hills forming the landscape of the region.


title: Siberian Traps

text: The source of the Siberian Traps basaltic rock has been attributed to a mantle plume, which rose until it reached the bottom of the Earth's crust, producing volcanic eruptions through the Siberian Craton. It has been suggested that, as the Earth's lithospheric plates moved over the mantle plume (the Iceland plume), the plume produced the Siberian Traps in the Permian and Triassic periods, after earlier producing the Viluy Traps to the east, and later going on to produce volcanic activity on the floor of the Arctic Ocean in the Jurassic and Cretaceous, and then generating volcanic activity in Iceland. Other plate tectonic causes have also been suggested. Another possible cause may be the impact that formed the Wilkes Land crater in Antarctica, which is estimated to have occurred around the same time and been nearly antipodal to the traps.


title: Siberian Traps

text: The main source of rock in this formation is basalt, but both mafic and felsic rocks are present, so this formation is officially called a Flood Basalt Province. The inclusion of mafic and felsic rock indicates multiple other eruptions that occurred and coincided with the one-million-year-long set of eruptions that created the majority of the basaltic layers. The traps are divided into sections based on their chemical, stratigraphical, and petrographical composition.


title: Siberian Traps

text: The Siberian traps are underlain by the Tungus Syneclise, a large sedimentary basin containing thick sequences of Early-Mid Paleozoic aged carbonate and evaporite deposits, as well as Carboniferous-Permian aged coal bearing clastic rocks. When heated, such as by igneous intrusions, these rocks are capable of emitting large amounts of toxic and greenhouse gases.


title: Siberian Traps

text: One of the major questions is whether the Siberian Traps were directly responsible for the Permian–Triassic mass extinction event that occurred 250 million years ago, or if they were themselves caused by some other, larger event, such as an asteroid impact. A recent hypothesis put forward is that the volcanism triggered the growth of "Methanosarcina", a microbe that then emitted large amounts of methane into Earth's atmosphere, ultimately altering the Earth's carbon cycle based on observations such as a significant increase of inorganic carbon reservoirs in marine environments.


title: Siberian Traps

text: This extinction event, also colloquially called the Great Dying, affected all life on Earth, and is estimated to have led to the extinction of about 81% of all marine species and 70% of terrestrial vertebrate species living at the time. Some of the disastrous events that affected the Earth continued to repeat themselves five to six million years after the initial extinction occurred. Over time a small portion of the life that survived the extinction was able to repopulate and expand starting with low trophic levels (local communities) until the higher trophic levels (large habitats) were able to be re-established. Calculations of sea water temperature from "δ"O measurements indicate that at the peak of the extinction, the Earth underwent lethally hot global warming, in which equatorial ocean temperatures exceeded . It took roughly eight to nine million years for any diverse ecosystem to be re-established; however, new classes of animals were established after the extinction that did not exist beforehand.


title: Siberian Traps

text: Palaeontological evidence further indicates that the global distribution of tetrapods vanished, with very rare exceptions in the region of Pangaea that is today Utah, between latitudes bounded by approximately 40°S to 30°N. The tetrapod gap of equatorial Pangaea coincides with an end-Permian to Middle Triassic global "coal gap" that indicates the loss of peat swamps. Peat formation, a product of high plant productivity, was reestablished only in the Anisian stage of the Triassic, and even then only in high southern latitudes, although gymnosperm forests appeared earlier (in the Early Spathian), but again only in northern and southern higher latitudes. In equatorial Pangaea, the establishment of conifer-dominated forests was not until the end of the Spathian, and the first coals at these latitudes did not appear until the Carnian, around 15 million years after their end-Permian disappearance. These signals suggest equatorial temperatures exceeded their thermal tolerance for many marine vertebrates at least during two thermal maxima, whereas terrestrial equatorial temperatures were sufficiently severe to suppress plant and animal abundance during most of the Early Triassic.


title: Siberian Traps

text: The volcanism that occurred in the Siberian Traps resulted in copious amounts of magma being ejected from the Earth's crust—leaving permanent traces of rock from the same time period of the mass extinction that can be examined today. More specifically, zircon is found in some of the volcanic rocks. To further the accuracy of the age of the zircon, several varying aged pieces of zircon were organized into a timeline based on when they crystallized. The CA-TIMS technique, a chemical abrasion age-dating technique that eliminates variability in accuracy due to lead depletion in zircon over time, was then used to accurately determine the age of the zircons found in the Siberian Traps. Eliminating the variability due to lead, the CA-TIMS age-dating technique allowed uranium within the zircon to be the centre focus in linking the volcanism in the Siberian Traps that resulted in high amounts of magmatic material with the Permian–Triassic mass extinction.


title: Siberian Traps

text: To further the connection with the Permian–Triassic extinction event, other disastrous events occurred around the same time period, such as sea level changes, meteor impacts and volcanism. Specifically focusing on volcanism, rock samples from the Siberian Traps and other southern regions were obtained and compared. Basalts and gabbro samples from several southern regions close to and from the Siberian Traps were dated based on argon isotope 40 and argon isotope 39 age-dating methods. Feldspar and biotite was specifically used to focus on the samples' age and duration of the presence of magma from the volcanic event in the Siberian Traps. The majority of the basalt and gabbro samples dated to 250 million years ago, covered a surface area of five million square kilometres on the Siberian Traps and occurred within a short period of time with rapid rock solidification/cooling. Studies confirmed that samples of gabbro and basalt from the same time period of the Permian–Triassic event from the other southern regions also matched the age of samples within the Siberian Traps. This confirms the assumption of the linkage between the age of volcanic rocks within the Siberian Traps, along with rock samples from other southern regions to the Permian–Triassic mass extinction event.


title: Siberian Traps

text: The giant Norilsk-Talnakh nickel–copper–palladium deposit formed within the magma conduits in the most complete part of the Siberian Traps. It has been linked to the Permian–Triassic extinction event, which occurred approximately 251.4 million years ago, based on large amounts of nickel and other elements found in rock beds that were laid down after the extinction occurred. The method used to correlate the extinction event with the surplus amount of nickel located in the Siberian Traps compares the timeline of the magmatism within the traps and the timeline of the extinction itself. Before the linkage between magmatism and the extinction event was discovered, it was hypothesized that the mass extinction and volcanism occurred at the same time due to the linkages in rock composition.


title: Clostridioides difficile infection

text: "Clostridioides difficile" infection is spread by bacterial spores found within feces. Surfaces may become contaminated with the spores with further spread occurring via the hands of healthcare workers. Risk factors for infection include antibiotic or proton pump inhibitor use, hospitalization, other health problems, and older age. Diagnosis is by stool culture or testing for the bacteria's DNA or toxins. If a person tests positive but has no symptoms, the condition is known as "C. difficile" colonization rather than an infection.


title: Clostridioides difficile infection

text: Prevention efforts include terminal room cleaning in hospitals, limiting antibiotic use, and handwashing campaigns in hospitals. Alcohol based hand sanitizer does not appear effective. Discontinuation of antibiotics may result in resolution of symptoms within three days in about 20% of those infected. The antibiotics metronidazole, vancomycin or fidaxomicin, will cure the infection. Retesting after treatment, as long as the symptoms have resolved, is not recommended, as a person may often remain colonized. Recurrences have been reported in up to 25% of people. Some tentative evidence indicates fecal microbiota transplantation and probiotics may decrease the risk of recurrence.


title: Clostridioides difficile infection

text: "C. difficile" infections occur in all areas of the world. About 453,000 cases occurred in the United States in 2011, resulting in 29,000 deaths. Global rates of disease increased between 2001 and 2016. "C. difficile" infections occur more often in women than men. The bacterium was discovered in 1935 and found to be disease-causing in 1978. In the United States, healthcare-associated infections increase the cost of care by US$1.5 billion each year. Although "C. difficile" is a common healthcare-associated infection, at most 30% of infections are transmitted within hospitals. The majority of infections are acquired outside of hospitals, where medications and a recent history of diarrheal illnesses (e.g. laxative abuse or food poisoning due to Salmonellosis) are thought to drive the risk of colonization.


title: Clostridioides difficile infection

text: Signs and symptoms of CDI range from mild diarrhea to severe life-threatening inflammation of the colon.


title: Clostridioides difficile infection

text: In adults, a clinical prediction rule found the best signs to be significant diarrhea ("new onset of more than three partially formed or watery stools per 24-hour period"), recent antibiotic exposure, abdominal pain, fever (up to 40.5 °C or 105 °F), and a distinctive foul odor to the stool resembling horse manure. In a hospital population, prior antibiotic treatment plus diarrhea or abdominal pain had a sensitivity of 86% and a specificity of 45%. In this study with a prevalence of positive cytotoxin assays of 14%, the positive predictive value was 18% and the negative predictive value was 94%.


title: Clostridioides difficile infection

text: In children, the most prevalent symptom of a CDI is watery diarrhea with at least three bowel movements a day for two or more days, which may be accompanied by fever, loss of appetite, nausea, and/or abdominal pain. Those with a severe infection also may develop serious inflammation of the colon and have little or no diarrhea.


title: Clostridioides difficile infection

text: Clostridia are anaerobic motile bacteria, ubiquitous in nature, and especially prevalent in soil. Under the microscope, they appear as long, irregular (often drumstick- or spindle-shaped) cells with a bulge at their terminal ends. Under gram staining, "C. difficile" cells are gram-positive and show optimum growth on blood agar at human body temperatures in the absence of oxygen. When stressed, the bacteria produce spores that are able to tolerate extreme conditions that the active bacteria cannot tolerate.


title: Clostridioides difficile infection

text: "C. difficile" may colonize the human colon without symptom; approximately 2–5% of the adult population are carriers, although it varies considerably with demographics. The risk of colonization has been linked to a history of unrelated diarrheal illnesses (e.g. laxative abuse and food poisoning due to Salmonellosis or Vibrio cholerae infection).


title: Clostridioides difficile infection

text: Pathogenic "C. difficile" strains produce multiple toxins. The most well-characterized are enterotoxin ("Clostridium difficile" toxin A) and cytotoxin ("Clostridium difficile" toxin B), both of which may produce diarrhea and inflammation in infected people, although their relative contributions have been debated. Toxins A and B are glucosyltransferases that target and inactivate the Rho family of GTPases. Toxin B (cytotoxin) induces actin depolymerization by a mechanism correlated with a decrease in the ADP-ribosylation of the low molecular mass GTP-binding Rho proteins. Another toxin, binary toxin, also has been described, but its role in disease is not fully understood.


title: Clostridioides difficile infection

text: Antibiotic treatment of CDIs may be difficult, due both to antibiotic resistance and physiological factors of the bacteria (spore formation, protective effects of the pseudomembrane). The emergence of a new and highly toxic strain of "C. difficile" that is resistant to fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin, said to be causing geographically dispersed outbreaks in North America, was reported in 2005. The U.S. Centers for Disease Control and Prevention in Atlanta warned of the emergence of an epidemic strain with increased virulence, antibiotic resistance, or both.


title: Clostridioides difficile infection

text: "C. difficile" is transmitted from person to person by the fecal-oral route. The organism forms heat-resistant spores that are not killed by alcohol-based hand cleansers or routine surface cleaning. Thus, these spores survive in clinical environments for long periods. Because of this, the bacteria may be cultured from almost any surface. Once spores are ingested, their acid-resistance allows them to pass through the stomach unscathed. Upon exposure to bile acids, they germinate and multiply into vegetative cells in the colon. People without a history of gastrointestinal disturbances due to antibiotic use or diarrheal illness are less likely to become colonized by "C. difficile".


title: Clostridioides difficile infection

text: In 2005, molecular analysis led to the identification of the "C. difficile" strain type characterized as group BI by restriction endonuclease analysis, as North American pulse-field-type NAP1 by pulsed-field gel electrophoresis and as ribotype 027; the differing terminology reflects the predominant techniques used for epidemiological typing. This strain is referred to as "C. difficile" BI/NAP1/027.


title: Clostridioides difficile infection

text: "C. difficile" colitis is associated most strongly with the use of these antibiotics: fluoroquinolones, cephalosporins, and clindamycin.


title: Clostridioides difficile infection

text: Some research suggests the routine use of antibiotics in the raising of livestock is contributing to outbreaks of bacterial infections such as "C. difficile".


title: Clostridioides difficile infection

text: People are most often infected in hospitals, nursing homes, or other medical institutions, although infection outside medical settings is increasing. Individuals can develop the infection if they touch objects or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Healthcare workers could possibly spread the bacteria or contaminate surfaces through hand contact. The rate of "C. difficile" acquisition is estimated to be 13% in those with hospital stays of up to two weeks, and 50% with stays longer than four weeks.


title: Clostridioides difficile infection

text: Long-term hospitalization or residence in a nursing home within the previous year are independent risk factors for increased colonization.


title: Clostridioides difficile infection

text: Increasing rates of community-acquired CDI are associated with the use of medication to suppress gastric acid production: H2-receptor antagonists increased the risk 1.5-fold, and proton pump inhibitors by 1.7 with once-daily use and 2.4 with more than once-daily use. Increased risk in recurrent CDI is also found with gastric acid repression use in observational studies, with a rate of 22.1%, compared to patients without gastric acid repression has a rate of 17.3% of recurrent CDI.


title: Clostridioides difficile infection

text: People with a recent history of diarrheal illness are at increased risk of becoming colonized by "C. difficile" when exposed to spores, including laxative abuse and gastrointestinal pathogens. Disturbances that increase intestinal motility are thought to transiently elevate the concentration of available dietary sugars, allowing "C. difficile" to proliferate and gain a foothold in the gut. Although not all colonization events lead to disease, asymptomatic carriers remain colonized for years at a time. During this time, the abundance of "C. difficile" varies considerably day-to-day, causing periods of increased shedding that could substantially contribute to community-acquired infection rates.


title: Clostridioides difficile infection

text: As a result of suppression of healthy bacteria, via a loss of bacterial food source, prolonged use of an elemental diet increases the risk of developing "C. difficile" infection. Low serum albumin levels is a risk factor for the development of "C. difficile" infection and when infected for severe disease. The protective effects of serum albumin may be related to the capability of this protein to bind "C. difficile" toxin A and toxin B, thus impairing entry into enterocytes.


title: Clostridioides difficile infection

text: Chronic kidney disease (CKD) has been identified as a risk factor in the development of a "C. difficile" infection. Patients with CKD have a higher risk of both initial and recurring infection, as well as a higher chance of severe infection, than those without CKD.


title: Clostridioides difficile infection

text: The use of systemic antibiotics, including broad-spectrum penicillins/cephalosporins, fluoroquinolones, and clindamycin, causes the normal microbiota of the bowel to be altered. In particular, when the antibiotic kills off other competing bacteria in the intestine, any bacteria remaining will have less competition for space and nutrients. The net effect is to permit more extensive growth than normal of certain bacteria. "C. difficile" is one such type of bacterium. In addition to proliferating in the bowel, "C. difficile" also produces toxins. Without either toxin A or toxin B, "C. difficile" may colonize the gut, but is unlikely to cause pseudomembranous colitis. The colitis associated with severe infection is part of an inflammatory reaction, with the "pseudomembrane" formed by a viscous collection of inflammatory cells, fibrin, and necrotic cells.


title: Clostridioides difficile infection

text: Prior to the advent of tests to detect "C. difficile" toxins, the diagnosis most often was made by colonoscopy or sigmoidoscopy. The appearance of "pseudomembranes" on the mucosa of the colon or rectum is highly suggestive, but not diagnostic of the condition. The pseudomembranes are composed of an exudate made of inflammatory debris, white blood cells. Although colonoscopy and sigmoidoscopy are still employed, now stool testing for the presence of "C. difficile" toxins is frequently the first-line diagnostic approach. Usually, only two toxins are tested for—toxin A and toxin B—but the organism produces several others. This test is not 100% accurate, with a considerable false-negative rate even with repeat testing.


title: Clostridioides difficile infection

text: CDI may be classified in non-severe CDI, severe CDI and fulminant CDI depending on creatinine and white blood count parameters.


title: Clostridioides difficile infection

text: "C. difficile" toxins have a cytopathic effect in cell culture, and neutralization of any effect observed with specific antisera is the practical gold standard for studies investigating new CDI diagnostic techniques. Toxigenic culture, in which organisms are cultured on selective media and tested for toxin production, remains the gold standard and is the most sensitive and specific test, although it is slow and labor-intensive.


title: Clostridioides difficile infection

text: Assessment of the A and B toxins by enzyme-linked immunosorbent assay (ELISA) for toxin A or B (or both) has a sensitivity of 63–99% and a specificity of 93–100%.


title: Clostridioides difficile infection

text: Previously, experts recommended sending as many as three stool samples to rule out disease if initial tests are negative, but evidence suggests repeated testing during the same episode of diarrhea is of limited value and should be discouraged. "C. difficile" toxin should clear from the stool of somebody previously infected if treatment is effective. Many hospitals only test for the prevalent toxin A. Strains that express only the B toxin are now present in many hospitals, however, so testing for both toxins should occur. Not testing for both may contribute to a delay in obtaining laboratory results, which is often the cause of prolonged illness and poor outcomes.


title: Clostridioides difficile infection

text: Stool leukocyte measurements and stool lactoferrin levels also have been proposed as diagnostic tests, but may have limited diagnostic accuracy.


title: Clostridioides difficile infection

text: Testing of stool samples by real-time polymerase chain reaction is able to detect "C. difficile" about 93% of the time and when positive is incorrectly positive about 3% of the time. This is more accurate than cytotoxigenic culture or cell cytotoxicity assay. Another benefit is that the result can be achieved within three hours. Drawbacks include a higher cost and the fact that the test only looks for the gene for the toxin and not the toxin itself. The latter means that if the test is used without confirmation, overdiagnosis may occur. Repeat testing may be misleading, and testing specimens more than once every seven days in people without new symptoms is highly unlikely to yield useful information.


title: Clostridioides difficile infection

text: Self containment by housing people in private rooms is important to prevent the spread of "C. difficile". Contact precautions are an important part of preventing the spread of  C. difficile. C. difficile does not often occur in people who are not taking antibiotics so limiting use of antibiotics decreases the risk.


title: Clostridioides difficile infection

text: The most effective method for preventing CDI is proper antibiotic prescribing. In the hospital setting, where CDI is most common, most people who develop CDI are exposed to antibiotics. Although proper antibiotic prescribing is highly recommended, about 50% is considered inappropriate. This is consistent whether in the hospital, clinic, community, or academic setting. A decrease in CDI by limiting antibiotics or by limiting unnecessary prescriptions in general, both in an outbreak and nonoutbreak setting has been demonstrated to be most strongly associated with reduced CDI. Further, reactions to medication may be severe: CDI infections were the most common contributor to adverse drug events seen in U.S. hospitals in 2011. In some regions of the UK, reduced used of fluoroquinolone antibiotics seems to lead to reduced rates of CDI.


title: Clostridioides difficile infection

text: Some evidence indicates probiotics may be useful to prevent infection and recurrence. Treatment with "Saccharomyces boulardii" in those who are not immunocompromised with "C. difficile" also may be useful. Initially, in 2010, the Infectious Diseases Society of America recommended against their use due to the risk of complications. Subsequent reviews, however, did not find an increase in adverse effects with treatment, and overall treatment appears safe and moderately effective in preventing Clostridium difficile-associated diarrhea.


title: Clostridioides difficile infection

text: One study in particular found that there does appear to be a "protective effect" of probiotics, specifically reducing the risk of antibiotic-associated diarrhea (AAD) by 51% in 3,631 outpatients, but it is important to note that the types of infections in the subjects were not specified. Yogurt, tablets, dietary supplements are just a few examples of probiotics available for people.


title: Clostridioides difficile infection

text: Rigorous infection protocols are required to minimize this risk of transmission. Infection control measures, such as wearing gloves and noncritical medical devices used for a single person with CDI, are effective at prevention. This works by limiting the spread of "C. difficile" in the hospital setting. In addition, washing with soap and water will wash away the spores from contaminated hands, but alcohol-based hand rubs are ineffective. These precautions should remain in place among those in hospital for at least 2 days after the diarrhea has stopped.


title: Clostridioides difficile infection

text: Bleach wipes containing 0.55% sodium hypochlorite have been shown to kill the spores and prevent transmission. Installing lidded toilets and closing the lid prior to flushing also reduces the risk of contamination.


title: Clostridioides difficile infection

text: Those who have CDIs should be in rooms with other people with CDIs or by themselves when in hospital.


title: Clostridioides difficile infection

text: Common hospital disinfectants are ineffective against "C. difficile" spores, and may promote spore formation, but various oxidants (e.g 1% sodium hypochlorite solution) rapidly destroy spores. Hydrogen peroxide vapor (HPV) systems used to sterilize a room after treatment is completed have been shown to reduce infection rates and to reduce risk of infection to others. The incidence of CDI was reduced by 53% or 42% through use of HPV. Ultraviolet cleaning devices, and housekeeping staff especially dedicated to disinfecting the rooms of people with "C. difficile" after discharge may be effective.


title: Clostridioides difficile infection

text: Carrying "C. difficile" without symptoms is common. Treatment in those without symptoms is controversial. In general, mild cases do not require specific treatment. Oral rehydration therapy is useful in treating dehydration associated with the diarrhea.


title: Clostridioides difficile infection

text: Several different antibiotics are used for "C. difficile", with the available agents being more or less equally effective.


title: Clostridioides difficile infection

text: Vancomycin or fidaxomicin by mouth are the typically recommended for mild, moderate, and severe infections. They are also the first-line treatment for pregnant women, especially since metronidazole may cause birth defects. Typical vancomycin 125mg is taken four times a day by mouth for 10 days. Fidaxomicin is taken at 200 mg twice daily for 10 days. It may also be given rectally if the person develops an ileus.


title: Clostridioides difficile infection

text: Fidaxomicin is tolerated as well as vancomycin, and may have a lower risk of recurrence. Fidaxomicin has been found to be as effective as vancomycin in those with mild to moderate disease, and it may be better than vancomycin in those with severe disease. Fidaxomicin may be used in those who have recurrent infections and have not responded to other antibiotics. Metronidazole (500 mg 3 times daily for 10 days) by mouth is recommended as an alternative treatment only for "C. difficile" infections when the affected person is allergic to first-line treatments, is unable to tolerate them, or has financial difficulties preventing them from accessing them. In fulminant disease vancomycin by mouth and intravenous metronidazole are commonly used together.


title: Clostridioides difficile infection

text: Medications used to slow or stop diarrhea, such as loperamide, may only be used after initiating the treatment.


title: Clostridioides difficile infection

text: Cholestyramine, an ion-exchange resin, is effective in binding both toxin A and B, slowing bowel motility, and helping prevent dehydration. Cholestyramine is recommended with vancomycin. A last-resort treatment in those who are immunosuppressed is intravenous immunoglobulin. Monoclonal antibodies against "C. difficile" toxin A and "C. difficile" toxin B are approved to prevent recurrence of "C. difficile" infection including bezlotoxumab.


title: Clostridioides difficile infection

text: Evidence to support the use of probiotics in the treatment of active disease is insufficient. Researchers have recently begun taking a mechanical approach to fecal-derived products. It is known that certain microbes with 7α-dehydroxylase activity can metabolize primary to secondary bile acids, which inhibit C. difficile. Thus, incorporating such microbes into therapeutic products such as probiotics may be protective, although more pre-clinical investigations are needed.


title: Clostridioides difficile infection

text: Fecal microbiota transplant, also known as a stool transplant, is roughly 85% to 90% effective in those for whom antibiotics have not worked. It involves infusion of the microbiota acquired from the feces of a healthy donor to reverse the bacterial imbalance responsible for the recurring nature of the infection. The procedure replenishes the normal colonic microbiota that had been wiped out by antibiotics, and re-establishes resistance to colonization by "Clostridioides difficile". Side effects, at least initially, are few.


title: Clostridioides difficile infection

text: In those with severe "C. difficile" colitis, colectomy may improve the outcomes. Specific criteria may be used to determine who will benefit most from surgery.


title: Clostridioides difficile infection

text: Recurrent CDI occurs in 20 to 30% of the patients, with increasing rates of recurrence with each subsequent episode. In clinical settings, it is virtually impossible to distinguish a recurrence that develops as a relapse of CDI with the same strain of "C. difficile" versus reinfection that is the result of a new strain.


title: Clostridioides difficile infection

text: Several treatment options exist for recurrent "C difficile" infection. For the first episode of recurrent "C difficile" infection, the 2017 IDSA guidelines recommend oral vancomycin at a dose of 125 mg four times daily for 10 days if metronidazole was used for the initial episode. If oral vancomycin was used for the initial episode, then a prolonged oral vancomycin pulse dose of 125 mg four times daily for 10-14 days followed by a taper (twice daily for one week, then every two to three days for 2-8 weeks) or fidaxomicin 200 mg twice daily for 10 days. For a second recurrent episode, the IDSA recommends options including the aforementioned oral vancomycin pulse dose followed by the prolonged taper; oral vancomycin 125 mg four times daily for 10 days followed by rifaximin 400 mg three times daily for 20 days; fidaxomicin 200 mg twice daily for 10 days, or a fecal microbiota transplant.


title: Clostridioides difficile infection

text: For patients with C. diff infections that fail to be resolved with traditional antibiotic regimens, fecal microbiome transplants boasts an average cure rate of >90%. In a review of 317 patients, it was shown to lead to resolution in 92% of the persistent and recurrent disease cases. It is clear that restoration of gut flora is paramount in the struggle against recurrent CDI. With effective antibiotic therapy, C. difficile can be reduced and natural colonization resistance can develop over time as the natural microbial community recovers. Reinfection or recurrence may occur before this process is complete. Fecal microbiota transplant may expedite this recovery by directly replacing the missing microbial community members. However, human-derived fecal matter is difficult to standardize and has multiple potential risks, including the transfer of infectious material and long-term consequences of inoculating the gut with a foreign fecal material. As a result, further research is necessary to study the long term effective outcomes of FMT.


title: Clostridioides difficile infection

text: After a first treatment with metronidazole or vancomycin, "C. difficile" recurs in about 20% of people. This increases to 40% and 60% with subsequent recurrences.


title: Clostridioides difficile infection

text: "C. difficile" diarrhea is estimated to occur in eight of 100,000 people each year. Among those who are admitted to hospital, it occurs in between four and eight people per 1,000. In 2011, it resulted in about half a million infections and 29,000 deaths in the United States.


title: Clostridioides difficile infection

text: Due in part to the emergence of a fluoroquinolone-resistant strain, "C. difficile"-related deaths increased 400% between 2000 and 2007 in the United States. According to the CDC, ""C. difficile" has become the most common microbial cause of healthcare-associated infections in U.S. hospitals and costs up to $4.8 billion each year in excess health care costs for acute care facilities alone."


title: Clostridioides difficile infection

text: Ivan C. Hall and Elizabeth O'Toole first named the bacterium "Bacillus difficilis" in 1935, choosing its specific epithet because it was resistant to early attempts at isolation and grew very slowly in culture. André Romain Prévot subsequently transferred it to the genus "Clostridium", which made its binomen "Clostridium difficile". Its combination was later changed to "Clostridiodes difficile" after being transferred to the new genus "Clostridioides".


title: Clostridioides difficile infection

text: Pseudomembranous colitis first was described as a complication of "C. difficile" infection in 1978, when a toxin was isolated from people with pseudomembranous colitis and Koch's postulates were met.


title: Clostridioides difficile infection

text: The genus name is from the Greek "klōstēr" (), "spindle", and the specific name is from Latin "difficile", neuter singular form of "difficilis" "difficult, obstinate", chosen in reference to fastidiousness upon culturing.


title: Clostridioides difficile infection

text: Regarding the pronunciation of the current and former genus assignments, "Clostridioides" is and "Clostridium" is . Both genera still have species assigned to them, but this species is now classified in the former. Via the norms of binomial nomenclature, it is understood that the former binomial name of this species is now an alias.


title: Clostridioides difficile infection

text: Regarding the specific name, is the traditional norm, reflecting how medical English usually pronounces naturalized New Latin words (which in turns largely reflects traditional English pronunciation of Latin), although a restored pronunciation of is also sometimes used (the classical Latin pronunciation is reconstructed as ). The specific name is also commonly pronounced , as though it were French, which from a prescriptive viewpoint is a "mispronunciation" but from a linguistically descriptive viewpoint cannot be described as erroneous because it is so widely used among health care professionals; it can be described as "the non-preferred variant" from the viewpoint of sticking most regularly to New Latin in binomial nomenclature, which is also a valid viewpoint, although New Latin specific names contain such a wide array of extra-Latin roots (including surnames and jocular references) that extra-Latin pronunciation is involved anyway (as seen, for example, with "Ba humbugi", "Spongiforma squarepantsii", and hundreds of others).


title: Tommy Douglas

text: Thomas Clement Douglas (20 October 1904 – 24 February 1986) was a Scottish-born Canadian politician who served as seventh premier of Saskatchewan from 1944 to 1961 and Leader of the New Democratic Party from 1961 to 1971. A Baptist minister, he was elected to the House of Commons of Canada in 1935 as a member of the Co-operative Commonwealth Federation (CCF). He left federal politics to become Leader of the Saskatchewan Co-operative Commonwealth Federation and then the seventh Premier of Saskatchewan. His government introduced the continent's first single-payer, universal health care program.


title: Tommy Douglas

text: After setting up Saskatchewan's universal healthcare program, Douglas stepped down and ran to lead the newly formed federal New Democratic Party (NDP), the successor party of the national CCF. He was elected as its first federal leader in 1961. Although Douglas never led the party to government, through much of his tenure the party held the balance of power in the House of Commons. He was noted as being the main opposition to the imposition of the "War Measures Act" during the 1970 October Crisis. He resigned as leader the next year, but remained as a Member of Parliament until 1979.


title: Tommy Douglas

text: Douglas was awarded many honorary degrees, and a foundation was named for him and his political mentor M. J. Coldwell in 1971. In 1981, he was invested into the Order of Canada, and he became a member of Canada's Privy Council in 1984, two years before his death. In 2004, a CBC Television program named Tommy Douglas "The Greatest Canadian", based on a Canada-wide, viewer-supported survey.


title: Tommy Douglas

text: Thomas Clement Douglas was born in 1904 in Camelon, Falkirk, Scotland, the son of Annie (née Clement) and Thomas Douglas, an iron moulder who fought in the Boer War. In 1910, his family emigrated to Canada, where they settled in Winnipeg. Shortly before he left Scotland, Douglas fell and injured his right knee. Osteomyelitis set in and he underwent a number of operations in Scotland in an attempt to cure the condition. Later in Winnipeg, the osteomyelitis flared up again, and Douglas was sent to hospital. Doctors there told his parents his leg would have to be amputated; however, a well-known orthopedic surgeon took interest and agreed to treat him for free if his parents allowed medical students to observe. After several operations, Douglas's leg was saved. This experience convinced him that health care should be free to all. Many years later, Douglas told an interviewer, "I felt that no boy should have to depend either for his leg or his life upon the ability of his parents to raise enough money to bring a first-class surgeon to his bedside."


title: Tommy Douglas

text: During World War I, the family went back to Glasgow. They returned to Winnipeg in late 1918, in time for Douglas to witness the Winnipeg general strike. From a rooftop vantage point on Main Street, he witnessed the police charging the strikers with clubs and guns, and a streetcar being overturned and set on fire. He also witnessed the RCMP shoot and kill one of the workers. This incident influenced Douglas later in life by cementing his commitment to protect fundamental freedoms in a Bill of Rights when he was premier of Saskatchewan.


title: Tommy Douglas

text: In 1920, at the age of 15, Douglas began amateur boxing at the One Big Union gym in Winnipeg. Weighing , he won the 1922 Lightweight Championship of Manitoba after a six-round fight. Douglas sustained a broken nose, a loss of some teeth, and a strained hand and thumb. He held the title the following year.


title: Tommy Douglas

text: In 1930, Douglas married Irma Dempsey, a music student at Brandon College. They had one daughter, actress Shirley Douglas, and they later adopted a second daughter, Joan, who became a nurse. Actor Kiefer Sutherland, son of daughter Shirley and actor Donald Sutherland, is his grandson.


title: Tommy Douglas

text: Douglas started elementary school in Winnipeg. He completed his elementary education after returning to Glasgow. He worked as a soap boy in a barber shop, rubbing lather into tough whiskers, then dropped out of high school at 13 after landing a job in a cork factory. The owner offered to pay Douglas's way through night school so that he could learn Portuguese and Spanish, languages that would enable him to become a cork buyer. However, the family returned to Winnipeg when the war ended and Douglas entered the printing trades. He served a five-year apprenticeship and worked as a Linotype operator finally acquiring his journeyman's papers, but decided to return to school to pursue his ambition to become an ordained minister.


title: Tommy Douglas

text: In 1924, the 19-year-old Douglas enrolled at Brandon College, a Baptist school affiliated with McMaster University, to finish high school and study theology. During his six years at the college, he was influenced by the Social Gospel movement, which combined Christian principles with social reform. Liberal-minded professors at Brandon encouraged students to question their fundamentalist religious beliefs. Christianity, they suggested, was just as concerned with the pursuit of social justice as it was with the struggle for individual salvation. Douglas took a course in socialism at Brandon and studied Greek philosophy. He came first in his class during his first three years, then competed for gold medals in his last three with a newly arrived student named Stanley Knowles. Both later became ministers of religion and prominent left-wing politicians. Douglas was extremely active in extracurricular activities. Among other things, he became a champion debater, wrote for the school newspaper and participated in student government winning election as Senior Stick, or president of the student body, in his final year.


title: Tommy Douglas

text: Douglas financed his education at Brandon College by conducting Sunday services at several rural churches for 15 dollars a week. A shortage of ordained clergy forced smaller congregations to rely on student ministers. Douglas reported later that he preached sermons advocating social reform and helping the poor: "[T]he Bible is like a bull fiddle ... you can play almost any tune you want on it." He added that his interest in social and economic questions led him to preach about "building a society and building institutions that would uplift mankind". He also earned money delivering entertaining monologues and poetry recitations at church suppers and service club meetings for five dollars a performance. During his second and third years at the college, he preached at a Presbyterian church in Carberry, Manitoba. There he met a farmer's daughter named Irma Dempsey who would later become his wife.


title: Tommy Douglas

text: Douglas graduated from Brandon College in 1930 and completed his Master of Arts degree in sociology at McMaster University in 1933. His thesis, "The Problems of the Subnormal Family", endorsed eugenics. The thesis proposed a system that would have required couples seeking to marry to be certified as mentally and morally fit. Those deemed to be "subnormal", because of low intelligence, moral laxity, or venereal disease would be sent to state farms or camps, while those judged to be mentally defective or incurably diseased would be sterilized.


title: Tommy Douglas

text: Douglas rarely mentioned his thesis later in his life, and his government never enacted eugenics policies, though two official reviews of Saskatchewan's mental health system recommended such a program when he became premier and minister of health. As premier, Douglas opposed the adoption of eugenics laws. By the time Douglas took office in 1944, many people questioned eugenics due to Nazi Germany's embrace of it in its effort to create a "master race". Instead, Douglas implemented vocational training for the mentally handicapped and therapy for those suffering from mental disorders.


title: Tommy Douglas

text: In the summer of 1931, Douglas continued his studies in sociology at the University of Chicago. He never completed his PhD thesis, but was deeply disturbed by his field work in the Depression-era "jungles" or hobo camps where about 75,000 transients sheltered in lean-tos venturing out by day to beg or to steal. Douglas interviewed men who once belonged to the American middle class—despondent bank clerks, lawyers and doctors. Douglas said later, "There were little soup kitchens run by the Salvation Army and the churches ... In the first half-hour they'd be cleaned out. After that there was nothing ... It was impossible to describe the hopelessness." Douglas was equally disturbed that members of the Socialist Party sat around quoting Marx and Lenin, waiting for a revolution while refusing to help the destitute. Douglas said: "That experience soured me with absolutists ... I've no patience with people who want to sit back and talk about a blueprint for society and do nothing about it."


title: Tommy Douglas

text: Two months after Douglas graduated from Brandon College, he married Irma Dempsey, and the two moved to the town of Weyburn, Saskatchewan, where he became an ordained minister at the Calvary Baptist Church. Irma was 19, while Douglas was 25. With the onset of the Depression, Douglas became a social activist and joined the new Co-operative Commonwealth Federation (CCF) political party. He was elected to the House of Commons of Canada in the 1935 federal election.


title: Tommy Douglas

text: During the September 1939 special House of Commons debate on entering the war, Douglas, who had visited Nazi Germany in 1936 and was disgusted by what he saw, supported going to war against Hitler. He was not a pacifist, unlike his party's leader, J. S. Woodsworth, and stated his reasons:


title: Tommy Douglas

text: Douglas and Coldwell's position was eventually adopted by the CCF National Council, but they also did not admonish Woodsworth's pacifist stand, and allowed him to put it forward in the House. Douglas assisted Woodsworth, during his leader's speech, by holding up the pages and turning them for him, even though he disagreed with him. Woodsworth had suffered a stroke earlier in the year and he needed someone to hold his notes, and Douglas still held him in very high regard, and dutifully assisted his leader.


title: Tommy Douglas

text: After the outbreak of World War II, Douglas enlisted in the wartime Canadian Army. He had volunteered for overseas service when a medical examination turned up his old leg problems. Douglas stayed in Canada and the Grenadiers headed for Hong Kong. If not for that ailment, he would likely have been with the regiment when its members were killed or captured at Hong Kong in December 1941.


title: Tommy Douglas

text: Despite being a federal Member of Parliament and not yet an MLA, Douglas was elected the leader of the Saskatchewan CCF in 1942 after successfully challenging the incumbent leader, George Hara Williams, but did not resign from the House of Commons until 1 June 1944. He led the CCF to power in the 15 June 1944 provincial election, winning 47 of 52 seats in the Legislative Assembly of Saskatchewan, and thus forming the first social democratic government in not only Canada, but all of North America. As premier, Douglas attended the coronation of Queen Elizabeth II in June 1953.


title: Tommy Douglas

text: Douglas and the Saskatchewan CCF then went on to win five straight majority victories in all subsequent Saskatchewan provincial elections up to 1960. Most of his government's pioneering innovations came about during its first term, including:


title: Tommy Douglas

text: Douglas was the first head of any government in Canada to call for a constitutional bill of rights. This he did at a federal-provincial conference in Quebec City in January 1950. No one in attendance at the conference supported him in this. Ten years later, Premier Jean Lesage of Quebec joined with Douglas at a First Ministers' Conference in July 1960 in advocating for a constitutional bill of rights. Thus, respectable momentum was given to the idea that finally came to fruition, on 17 April 1982, with the proclamation of the "Canadian Charter of Rights and Freedoms".


title: Tommy Douglas

text: Thanks to a booming postwar economy and the prudent financial management of provincial treasurer Clarence Fines, the Douglas government slowly paid off the huge public debt left by the previous Liberal government, and created a budget surplus for the Saskatchewan government. Coupled with a federal government promise in 1959 to give even more tax money for medical care, this paved the way for Douglas's most notable achievement, the introduction of universal health care legislation in 1961.


title: Tommy Douglas

text: Douglas's number one concern was the creation of Medicare. He introduced medical insurance reform in his first term, and gradually moved the province towards universal medicare near the end of his last term. In the summer of 1962, Saskatchewan became the centre of a hard-fought struggle between the provincial government, the North American medical establishment, and the province's physicians, who brought things to a halt with the 1962 Saskatchewan doctors' strike. The doctors believed their best interests were not being met and feared a significant loss of income as well as government interference in medical care decisions even though Douglas agreed that his government would pay the going rate for service that doctors charged. The medical establishment claimed that Douglas would import foreign doctors to make his plan work and used racist images to try to scare the public.


title: Tommy Douglas

text: Douglas is widely known as the father of Medicare, but the Saskatchewan universal program was finally launched by his successor, Woodrow Lloyd, in 1962. Douglas stepped down as premier and as a member of the legislature the previous year, to lead the newly formed federal successor to the CCF, the New Democratic Party of Canada (NDP).


title: Tommy Douglas

text: The success of the province's public health care program was not lost on the federal government. Another Saskatchewan politician, newly elected Prime Minister John Diefenbaker, decreed in 1958 that any province seeking to introduce a hospital plan would receive 50 cents on the dollar from the federal government. In 1962, Diefenbaker appointed Justice Emmett Hall—also of Saskatchewan, a noted jurist and Supreme Court Justice—to Chair a Royal Commission on the national health system—the Royal Commission on Health Services. In 1964, Justice Hall recommended a nationwide adoption of Saskatchewan's model of public health insurance. In 1966, the Liberal minority government of Lester B. Pearson created such a program, with the federal government paying 50% of the costs and the provinces the other half. The adoption of public health care across Canada ended up being the work of three men with diverse political ideals – Douglas of the CCF, Diefenbaker of the Progressive Conservatives, and Pearson of the Liberals.


title: Tommy Douglas

text: The 1958 Canadian general election was a disaster for the CCF; its caucus was reduced to eight, and party leader M. J. Coldwell lost his own seat. The CCF executive knew that their party was dying and needed radical change. The executive persuaded Coldwell to remain as leader, but the party also needed a leader in the House of Commons to replace him, because he obviously was no longer a Member of Parliament. The CCF parliamentary caucus chose Hazen Argue as its new leader in the House. During the lead-up to the 1960 CCF convention, Argue was pressing Coldwell to step down; this leadership challenge jeopardized plans for an orderly transition to the new party that was being planned by the CCF and the Canadian Labour Congress. CCF national president David Lewis – who succeeded Coldwell as president in 1958, when the national chairman and national president positions were merged – and the rest of the new party's organizers opposed Argue's manoeuvres and wanted Douglas to be the new party's first leader. To prevent their plans from being derailed, Lewis unsuccessfully attempted to persuade Argue not to force a vote at the convention on the question of the party's leadership, and there was a split between the parliamentary caucus and the party executive on the convention floor. Coldwell stepped down as leader, and Argue replaced him, becoming the party's final national leader.


title: Tommy Douglas

text: As far back as 1941, Coldwell wanted Douglas to succeed him in leading the National CCF (at that time, it was obvious that Coldwell would be assuming the national leadership in the near future). When the time came for the "New Party" to form, in 1961, Coldwell pressured Douglas to run for the leadership. Coldwell did not trust Argue, and many in the CCF leadership thought that he was already having secret meetings with the Liberals with a view to a party merger. Also, Coldwell and Douglas thought Lewis would not be a viable alternative to Argue because Lewis was not likely to defeat Argue; this was partly due to Lewis' lack of a parliamentary seat but also, and likely more importantly, because his role as party disciplinarian over the years had made him many enemies, enough to potentially prevent him from winning the leadership. Douglas, after much consultation with Coldwell, Lewis, and his caucus, decided in June 1961 to reluctantly contest the leadership of the New Party. He handily defeated Argue on 3 August 1961 at the first NDP leadership convention in Ottawa, and became the new party's first leader. Six months later, Argue crossed the floor and became a Liberal.


title: Tommy Douglas

text: Douglas resigned from provincial politics and sought election to the House of Commons in the riding of Regina City in 1962, but was defeated by Ken More. He was later elected in a by-election in the riding of Burnaby—Coquitlam, British Columbia.


title: Tommy Douglas

text: Re-elected as MP for that riding in the 1963 and 1965 elections, Douglas lost the redistricted seat of Burnaby—Seymour in the 1968 federal election. He won a seat again in a 1969 by-election in the riding of Nanaimo—Cowichan—The Islands, following the death of Colin Cameron in 1968, and represented it until his retirement from electoral politics in 1979.