question_text: what percentage of the us has a high school diploma

text: General attainment of degrees/diplomas[edit]

text:
Educational attainment in the United States (2014)[3]

Education
Age 25 and over
Age 25-29

High school diploma or GED
88.31%
0%

Some college
58.57%
64.31%

Associate and/or bachelor's degree
41.89%
44.08%

Bachelor's degree
31.96%
34.04%

Master's and/or doctorate and/or professional degree
11.77%
7.57%

Doctorate and/or professional degree
3.27%
1.70%

Doctorate
1.77%
0.89%

text: In 2003, over four-fifths (85 percent) of all adults 25 years or older reported they had completed at least high school or didn't complete high school but obtained a GED/high school equivalency certificate. Over one in four adults (27 percent) had attained at least a bachelor's degree. Both of these measures are all time highs. In 2003, the percentage of the adult population who had completed high school or had not completed high school but obtained a GED increased for the first time since 2000, when it was 84 percent. This increase follows a general trend that the Current Population Survey has shown since educational attainment was first measured in 1947.[2]

text: In 2015, among adults aged 65 and older, 84 percent had either completed high school or more education, or had failed to complete high school but obtained at least a GED certification, compared to 91 percent of adults aged 25 to 34 and 89 percent of adults aged 35 to 44 years or 45 to 64 years. In addition, 27 percent of the population aged 65 and older reported a bachelor's degree or more education compared to 36 percent of adults 25 to 34 years old and 32 percent of adults aged 45 to 64 years.[4]

text: Since 1983 the percentage of people either graduating from high school or failing to complete high school but getting a GED certification has increased from 85% to 88%. The greatest increases in educational attainment were documented in the 1950s, 60s and 70s. In the 1950s and much of the 1960s high school graduates constituted about 50% of those considered adults (25 and above). For young adults aged between 25 and 29, the percentage of either high school graduates or GED obtainers was roughly 50% in 1950 versus 90% today.[2]

text: Gender[edit]

text: For the past fifty years, there has been a gap in the educational achievement of males and females in the United States, but which gender has been disadvantaged has fluctuated over the years. In the 1970s and 1980s, data showed girls trailing behind boys in a variety of academic performance measures, specifically in test scores in math and science.[5]

text: Data in the last twenty years shows the general trend of girls outperforming boys in academic achievement in terms of class grades across all subjects and college graduation rates, but boys scoring higher on standardized tests and being better represented in the higher-paying and more prestigious STEM fields (science, technology, engineering, and math).[5]

text: Gender gap in literacy[edit]

text: Traditionally, girls have outperformed boys in reading and writing. Although this gap may be minimal in kindergarten, it grows as students continue their education. According to the 2004 National Reading Assessment measured by the US Department of Education, the gap between boys and girls, only slightly noticeable in 4th grade, left boys 14 points behind girls during their 12th grade year.[6] On the 2008 test, female students continued to have higher average reading scores than male students at all three ages. The gap between male and female 4th graders was 7 points in 2008. By 12th grade, there was an 11-point gap between males and females.[6]

text: On the 2002 National Writing Assessment, boys scored on average 17 points lower than girls in 4th grade. The average gap increased to 21 points by 8th grade and widened to 24 points by senior year in high school.[7] In the more recent 2007 National Assessment of Writing Skills, female students continued to score higher than male students, though margins closed slightly from previous assessments. The average score for female eighth-graders was 20 points higher than males, down 1 point from the 2002 score. For twelfth-graders, females outscored males by 18 points as opposed to 24 points in 2002.[8]

text: All of these assessments were conducted on a 100-point scale.[6][7][8]

text: Graduation rates[edit]

text: Overall, women have surpassed men in terms of completing secondary and post-secondary education with the gender gap almost completely reversed. In 2006, 10.3% of males and 8.3% of females dropped out of high school.[9] In 2005/2006, women earned 62% of associate degrees, 58% of bachelor's degrees, 60.0% of master's degrees, and 48.9% of Doctorates.[10]

text: According to recent data[when?], 55 percent of college students are females and 45 percent are males. From 1995 until 2005, the number of males enrolled in college increased by 18 percent, while the number of female students rose by 27 percent.[11] Males are enrolling in college in greater numbers than ever before, yet fewer than two-thirds of them are graduating with a bachelor's degree. The numbers of both men and women receiving a bachelor's degree have increased significantly, but the increasing rate of female college graduates exceeds the increasing rate for males.[12]

text: In 2007, the United States Census Bureau estimated that 18,423,000 males over the age of 18 held a bachelor's degree, while 20,501,000 females over the age 18 held one. In addition, fewer males held master's degrees: 6,472,000 males compared to 7,283,000 females. However, more men held professional and doctoral degrees than women. 2,033,000 males held professional degrees compared to 1,079,000, and 1,678,000 males had received a doctoral degree compared to 817,000 females.[13]

text: In 2015, the United States Census Bureau estimated that 36.1% of individuals between the ages of 25 to 34 had a bachelor's degree, with 36.3% in individuals aged 35 to 44, 32% in individuals 45 to 64, and 26.7% in individuals 65 and older.

text: In 2016/2017, women are projected to earn 64.2% of associate degrees, 59.9% of bachelor's degrees, 62.9% of master's degrees, and 55.5% of Doctorates.[14]

text: Ethnicity and race[edit]

text: While the educational attainment of all races increased during the 1990s, with the gap between African Americans and non-Hispanic whites decreasing, differences between the races remain, especially among those with a bachelor's degree or higher. Asian Americans had the highest educational attainment of any race, followed by whites who had a higher percentage of high school graduates but a lower percentage of college graduates. Persons identifying as Hispanic or Latino, without regard to race, had the lowest educational attainment. The gap was the largest between foreign-born Asian Americans, over half (50.1%) of whom had a bachelor's degree or higher and foreign-born Hispanics, 9.8% of whom had a four-year college degree.[2]

text: Hispanics and Latinos also trailed far behind in terms of graduating from high school; it was the only major group for which high school graduates constituted less than 80% of the population. This large inequality might partially be explained thorough the influx of uneducated foreign-born Hispanic Americans who had not been offered the chance to complete secondary education in their home country and who had not completed secondary education in the United States.

text: Overall nearly half (49.8%) of Asian Americans, nearly a third (30%) of non-Hispanic Whites, 17.3% of non-Hispanic Blacks, and just over a tenth (11.4%) of Hispanics or Latinos had a four-year college degree. The same differences decrease significantly at the high school level with 89.4% of non-Hispanic whites, 87.6% of Asian Americans, 80.0% of African Americans, and 57% of Hispanics or Latinos having graduated from high school.[2]

text: The Racial achievement gap in the United States refers to these educational disparities between minority students and Caucasian students. Evidence of the racial achievement gap remains present today because not all groups of students are advancing at the same rates. The racial achievement gap has many individual and economic implications and there have been many efforts in education reform to narrow this gap.

text: Foreign born and immigrants[edit]

text: A trend becomes visible when comparing the foreign-born to the native-born populace of some races. Foreign-born Asian, European, and African immigrants had a higher educational attainment in terms of having earned a four-year college degree than their native-born counterparts. According to the U.S census about 43.8 percent of African immigrants achieved the most college degrees, compared to 42.5 percent of Asian-Americans, 28.9 percent for immigrants from Europe, Russia and Canada and 23.1 percent of the U.S. population as a whole.[15][16][17]

text: The opposite is true on the high school level and among Hispanics, where the dramatically lower educational attainment of the foreign-born population decreased the educational attainment of the general Hispanophone populace, statistically.[2]

text:
The percentage of the foreign born with a high school diploma (67 percent) was dramatically lower than that of the native population (88 percent), but paradoxically, the percentage with a bachelor's degree was the same (27 percent)... At the bachelor's level, foreign born Blacks and non-Hispanic Whites fared better than their native counterparts. Foreign-born Hispanics, in contrast, had a smaller proportion with a bachelor's degree than the native population... The low educational attainment of foreign-born Hispanics, who compose more than 50 percent of the Hispanic population, contributes to the low attainment levels of the entire Hispanic population.
— US Census Bureau, 2003

text: Only among Hispanics and Latinos was the proportion of college graduates larger among the native born population. In the general population the proportion of persons with a bachelor's degree or higher was the same among the foreign-born and native-born population (27.2%). As stated above fewer foreign born Americans completed high school than native born Americans. Overall 87.5% of the native born population had graduated from high school, versus 67.2%. Among whites the difference was three percentage points, the same as for African Americans. Among Asian Americans the difference was five percentage points. It was thirty percentage points among Hispanics or Latinos.[2]

text: African immigrants have been the most highly educated group in the United States since the 1990s.[18][19] This phenomenon is related to the large "brain drain" in Africa.[20]

text: Income[edit]

text: Educational attainment is strongly correlated with income in the United States. Although the incomes of both men and women are associated with higher educational attainment (higher incomes for higher educational attainment), large income gaps linked to race and gender remained at each educational level. In 2003, average incomes ranged from $13,459 for a male high-school dropout to $90,761 for a male with an advanced degree. The most significant average income difference was between those who had some college education or an Associates degree and those who had a Bachelor's degree. While those with some college averaged $31,046, those with a bachelor's degree averaged $51,194, over $20,000 (64.9%) a year more.[2]

text: The second most dramatic difference in average income was between those with a Bachelor's degree with $51,940 and those with an advanced degree who made $72,824, roughly $21,000 (42.2%) more. The least significant difference was between those who had graduated from high school and those who had either some college or an Associates degree. Here the difference was a mere $3,766 or 13.8%. The difference between those with a high school diploma ($30,000) and those who did not complete high school ($18,826) was $8,454 or 45%. Overall, the income in the United States for all sexes, races and levels of educational attainment was $36,308 annually.[2]

text: Even though African immigrants have higher educational attainment rates than any other group, they were the hardest hit during the most recent recession beginning in 2007.[21][16][22][23][24] This shows that race and/or ethnicity may play a role in income levels and job selection.[22]

text:
Criteria
Overall
Less than 9th grade
High school drop-out
High school graduate
Some college
Associates degree
Bachelor's degree
Bachelor's degree or more
Master's degree
Professional degree
Doctorate degree

Median individual income
Male, age 25+
$33,517
$15,461
$18,990
$28,763
$35,073
$39,015
$50,916
$55,751
$61,698
$88,530
$73,853

Female, age 25+
$19,679
$9,296
$10,786
$15,962
$21,007
$24,808
$31,309
$35,125
$41,334
$48,536
$53,003

Median household income
$45,016
$18,787
$22,718
$36,835
$45,854
$51,970
$68,728
$73,446
$78,541
$100,000
$96,830

text: SOURCE: US Census Bureau, 2003[25][26]

text: The change in median personal and household income since 1991 also varied greatly with educational attainment. While both the overall median personal and household income increased since 1991, this increase did not take place on all levels of educational attainment. The overall income increased over the course of the 1990s, reaching its high in 1999, but has been decreasing ever since. In 1991 the median household income in the US was $40,873 in 2003 dollars, while the median household income in 2003 was $45,016. In 1999, however, the median household income was $46,236, 2.7% higher than today. While this trend held true for all levels of educational attainment the extent of chorinical fluctuations in income were greatly influenced by educational attainment.[25][26]

text: Overall the median household and personal income decreased for those with more than a 9th grade education but less than a four-year college degree since 1991. In other words, the median household income decreased for households and individuals at the high school drop-outs and graduate, some-college, and an Associates degree level. Income did, however, increase for those with a Bachelor's degree or more. The following table shows the median household income according to the educational attainment of the householder. All data is in 2003 dollars and only applies to householders whose householder is aged twenty-five or older. The highest and lowest points of the median household income are presented in bold face.[25][26]

text:
Year
Overall Median
Less than 9th grade
High school drop-out
High school graduate
Some college
Associates degree
Bachelor's degree
Bachelor's degree or more
Master's degree
Professional degree
Doctorate degree

1991
$40,873
$17,414
$23,096
$37,520
$46,296
$52,289
$64,150
$68,845
$72,669
$102,667
$92,614

1993
$40,324
$17,450
$22,523
$35,979
$44,153
$49,622
$64,537
$70,349
$75,645
$109,900
$93,712

1995
$42,235
$18,031
$21,933
$37,609
$44,537
$50,485
$63,357
$69,584
$77,865
$98,302
$95,899

1997
$43,648
$17,762
$22,688
$38,607
$45,734
$51,726
$67,487
$72,338
$77,850
$105,409
$99,699

1999
$46,236
$19,008
$23,977
$39,322
$48,588
$54,282
$70,925
$76,958
$82,097
$110,383
$107,217

2001
$45,300
$18,830
$24,162
$37,468
$47,605
$53,166
$69,796
$75,116
$81,993
$103,918
$96,442

2003
$45,016
$18,787
$22,718
$36,835
$45,854
$51,970
$68,728
$73,446
$78,541
$100,000
$96,830

Average
$43,376
$18,183
$23,013
$37,620
$46,109
$51,934
$66,997
$72,376
$78,094
$104,368
$94,487

text: SOURCE: US Census Bureau, 2003 Yellow indicates the year with the lowest median income while green indicates the year with the highest reported median income.[25]

text: Among the races, educational attainment retains its dramatic effect on average income which varies significantly at each educational level. European Americans (White Americans) had the highest average income at every level of educational attainment. However, the proportion of those having college degrees is greater among Asian Americans than among non-Hispanic whites, and the overall highest average income is found among Asians. All races except Whites ranked last on at least one level with African Americans ranking last on the non-high school, high school and advanced degree level.[2]

text: Asians were second highest on the college graduate level and had the highest overall income among the general population. They also had the lowest average annual income for those with some college education or an Associates degree. Racial income difference were also significant at every level of educational attainment with the largest racial inequality being between European and African Americans who did not complete high school and those with advanced college degrees.[2]

text: Overall European Americans with an advanced degree had the highest average annual income with $74,122. Asian Americans had the second highest with $72,852. Hispanics and African Americans had the lowest annual incomes among those with advanced degrees averaging $67,679 and $59,944 annually. The largest racial inequity was between European Americans with a Bachelor's degree who made $53,185 and Hispanics who made $12,263 or 29.9% less with an average annual income of $40,949.[2]

text: Occupation[edit]

text: The educational attainment varied significantly among the different types of occupations. The highest occupational attainment was among those in the Professional and related fields followed by those Business, Management and financial related occupations. The professional/managerial fields were the only two occupational fields where college graduates with a Bachelor's degree or higher represented the majority. Among professional occupations, 99.1% of the population graduated from high school, 90.2% had some college education or an Associates degree and over two thirds, 68.2% had a Bachelor's degree or higher.[2]

text: Business and managerial occupations were second with 97.8% having graduated from high school, 79.5% having some college or an associates degree and just over half, 53.4% having a Bachelor's degree or higher. While nearly all employment fields feature a population where over 80% had graduated from high school with over a third having some college education or an Associates degree, the fields relating to agriculture, construction, manufacturing, and transportation did not. These, often described as blue collar, fields featured a labor force where less than a tenth of the population had a Bachelor's degree or higher, less than half had some college or an Associates, and less than 80% had graduated from high school.[2]

text: Overall the least educated occupational field was agriculture, ranking last on all educational levels. Here 55.4% had graduated from high school, roughly one fifth (20.8%) had some college education or an Associates degree and 6.8% had a Bachelor's degree or higher. While the largest occupational field, that consisting of professionals and relating occupations was also the largest field, the fields with lower educational attainment combined were larger than the professional and managerial fields combined. Overall 38.02% were employed in the professional and managerial fields while 61.89% were employed in the other white and blue collar fields were those with a bachelor's degree or higher constituted less than a third of the work force.[2]

text: Geography[edit]

text: Educational attainment among the population aged 25 and above varied rather slightly with geography region. The population of the Northeastern United States, which had the smallest population of any region with thirty-six million residents, had the highest percentage of high-school and college graduates. The western United States had the highest percentage of those with some college or an Associates degree and ranked second for college graduates. The South which had by far the largest population with roughly sixty-six million people had the lowest educational attainment at every level.[2]

text: The proportion of high school graduates was the largest in the Midwest while the proportion of those with some college or an Associates degree was the second and that of those with a Bachelor's degree or higher was the third largest of any region.

text: Social class and education[edit]

text: Educational attainment is one of the primary indicators of social class in the United States.[27] While the American social class system is a vaguely defined concept with many contradicting theories,[28][29] educational attainment emerges as one of the top assessments of social class. Not only is a high educational attainment a status symbol by itself, but it is also very closely related to the other two main indicators of social class: occupation and income. A graduate degree and the roughly seven to eight years of post-secondary education serve as the main requirement for entering the "professions" and becoming part of the professional middle class.[27]

text: Education is a major key in becoming a more privileged member of the American middle class.[27][29] Overall, educational attainment is the main entrance barrier into more privileged parts of the middle class as it is not only of high value but is also the requirement for becoming a professional and earning the corresponding income.[27] This corresponding income is typically significantly higher than that of someone without this higher level of educational attainment in the United States. Exceptions include some entrepreneurs who can rank anywhere in the class system but are usually not referred to as professional middle class unless they are of the professions.

text: In the United States, it is also important to differentiate between the statistical middle class, often defined as consisting of those who are neither rich nor poor, and the professional middle class. Recent research has shown that not only is the statistical middle of society (those with income roughly 80% to 120% of the national median or members of the mid-quintile) no longer able to afford the lifestyle indicative of the middle class,[30] but there also seems to be a widening income gap in between those who may be described as being middle class.

text: Education is not only the main requirement for becoming a member of the professional middle class, it is also key to a comfortable lifestyle and economic security.[27] Those in the statistical middle may have to fear lay-offs and cost-cutting downsizing as well as out-sourcing, while some of those in the professional middle class are less subject to economic fluctuations and are more likely to enjoy upper-middle range incomes even in the face of recessions. Increasingly however even the professional middle class is facing lay-offs and job elimination due to downsizing and replacement of full-time workers with part-time workers—this is particularly evident in colleges and universities where, by 2009, half of the faculty were part-time; another 25% were full-time but with short-term contracts, thus showing that advanced education is not necessarily associated with high salaries and economic stability.[31]

text:
Academic class models

Dennis Gilbert, 2002
William Thompson & Joseph Hickey, 2005
Leonard Beeghley, 2004

Class
Typical characteristics
Class
Typical characteristics
Class
Typical characteristics

Capitalist class (1%)
Top-level executives, high-rung politicians, heirs. Ivy League education common.
Upper class (1%)
Top-level executives, celebrities, heirs; income of $500,000+ common. Ivy league education common.
The super-rich (0.9%)
Multi-millionaires whose incomes commonly exceed $350,000; includes celebrities and powerful executives/politicians. Ivy League education common.

Upper middle class[1] (15%)
Highly-educated (often with graduate degrees), most commonly salaried, professionals and middle management with large work autonomy.
Upper middle class[1] (15%)
Highly-educated (often with graduate degrees) professionals & managers with household incomes varying from the high 5-figure range to commonly above $100,000.
The rich (5%)
Households with net worth of $1 million or more; largely in the form of home equity. Generally have college degrees.

Middle class (plurality/
majority?; ca. 46%)
College-educated workers with considerably higher-than-average incomes and compensation; a man making $57,000 and a woman making $40,000 may be typical.

Lower middle class (30%)
Semi-professionals and craftsmen with a roughly average standard of living. Most have some college education and are white-collar.
Lower middle class (32%)
Semi-professionals and craftsmen with some work autonomy; household incomes commonly range from $35,000 to $75,000. Typically, some college education.

Working class (30%)
Clerical and most blue-collar workers whose work is highly routinized. Standard of living varies depending on number of income earners, but is commonly just adequate. High school education.

Working class (32%)
Clerical, pink- and blue-collar workers with often low job security; common household incomes range from $16,000 to $30,000. High school education.
Working class
(ca. 40–45%)
Blue-collar workers and those whose jobs are highly routinized with low economic security; a man making $40,000 and a woman making $26,000 may be typical. High school education.

Working poor (13%)
Service, low-rung clerical and some blue-collar workers. High economic insecurity and risk of poverty. Some high school education.

Lower class (ca. 14–20%)
Those who occupy poorly-paid positions or rely on government transfers. Some high school education.

Underclass (12%)
Those with limited or no participation in the labor force. Reliant on government transfers. Some high school education.
The poor (ca. 12%)
Those living below the poverty line with limited to no participation in the labor force; a household income of $18,000 may be typical. Some high school education.

References: Gilbert, D. (2002) The American Class Structure: In An Age of Growing Inequality. Belmont, CA: Wadsworth, ISBN 0534541100. (see also Gilbert Model);

Thompson, W. & Hickey, J. (2005). Society in Focus. Boston, MA: Pearson, Allyn & Bacon; Beeghley, L. (2004). The Structure of Social Stratification in the United States. Boston, MA: Pearson, Allyn & Bacon.

1 The upper middle class may also be referred to as "Professional class" Ehrenreich, B. (1989). The Inner Life of the Middle Class. NY, NY: Harper-Collins.

text: Educational attainment in social theory[edit]

text: Bourdieu and cultural capital[edit]

text: Many scholars have studied educational attainment in the US as a form of social reproduction and stratification. In 1977, Pierre Bourdieu presented the idea that education leads to social reproduction and a stratified society by honoring the cultural capital of elite classes. Students who possess the valued cultural capital, according to Bourdieu, are rewarded with high academic achievement.[32]

text: When elite class members enter the workforce, they are channeled into high paying jobs and powerful positions within society, while those who did not achieve the same level of academic success fall into subordinate occupations and status levels. By rewarding the desired cultural capital with high academic achievement, upper classes are able and prepared to reach higher levels of educational attainment. Members of the working class, on the other hand, are not rewarded for their cultural capital in schools, and are instead socialized for working class jobs.

text: Lareau and concerted cultivation[edit]

text: Annette Lareau also addresses the factors that lead to social stratification in educational attainment. Lareau's idea of concerted cultivation refers to an active involvement of parents in a child's learning and development experiences by creating and controlling organized activities for their children. According to Lareau, middle-class parents engage in concerted cultivation to teach their children, while lower- and working-class parents do not. Laureau further explains that schools firmly encourage and expect parents to use concerted cultivation as a child-rearing strategy.[33]

text: The child-rearing practices of lower- and working-class families thus do not comply with the standards of educational institutions. As a result, lower- and working-class students develop a sense of "distance, distrust, and constraint" in educational institutions, while children of middle-class families gain a sense of entitlement. These differences in child-rearing practices lead to children of lower- and working-class families to lack the necessary life skills that the children of the middle class possess, further isolating them from educational opportunities. In the United States, education attainment typically is viewed as a sign of social status.

text: Collins and credentialism[edit]

text: Randall Collins contributed the idea of credentialism to the study of class-based differences in educational attainment. Collins maintains that public schools are socializing institutions that teach and reward middle-class values of competition and achievement. In this view, elites are selectively separated from other students and placed into prestigious schools and colleges, where they are trained to hold positions of power.[34]

text: By teaching middle-class culture through the public education system, the elite class ensures a monopoly over positions of power, while others acquire the credentials to compete in a subordinate job market and economy. In this way, schools of medicine, law, and elite institutions have remained closed to members of lower classes.


document_title: British West Africa

question_text: british colonial rule in west africa started in the year

root

text: British West Africa

text: Historical jurisdiction[edit]

text: British West Africa, or the British West African Settlements, constituted during two periods (17 October 1821, until its first dissolution on 13 January 1850, and again 19 February 1866, until its final demise on 24 November 1888) an administrative entity under a governor-in-chief (comparable in rank to a Governor-general), an office vested in the governor of Sierra Leone (at Freetown).[citation needed]

tag: p

text: The other colonies originally included in the jurisdiction were the Gambia and the British Gold Coast (modern Ghana). Also western Nigeria, eastern Nigeria and northern Nigeria.

text: Social and cultural development[edit]

text: British West Africa's present makeup includes Ghana, Sierra Leone, Gambia, Western Nigeria, Eastern Nigeria and Northern Nigeria. Each of these countries and areas are a post-colonial period, or what the Ghanaian writer Kwame Appiah dubs neo-colonialism.

text: British West Africa's development was solely based on modernisation, and autonomous educational systems were the first step to modernising indigenous culture. Cultures and interests of indigenous peoples were ignored. A new social order, as well as European influences within schools and local traditions, helped mould British West Africa's culture. Significant was the British West African colonial school curriculum. Local elites developed, with new values and philosophies, who changed the overall cultural development.

text: In terms of social issues with British West Africa; sex and race usually conflicted each other. (Carina E. Ray called it the "White Wife Problem"). During British West Africa's history, interracial relations were frowned upon, and couples might be discriminated against. Black men were often accused of taking the jobs of white British men (mostly port workers) jobs as well as stealing their wives. White women were seen as immoral traitors who put their own selfish sexual desires over the good of their nation. There were even certain policies that deported the wives of these relationships back to Britain and denied them access to any of these colonies.[citation needed]

text: Economic development[edit]

text: Colonial banks might develop monopolies to control competition, at the expense of British West African citizens. There were only two major banks that operated in British West Africa: Barclays and the Bank of British West Africa. They had major economic and financial influence in British West Africa from about 1916 to 1960. From a dependency theory view point, these banks took advantage through price fixing and certain unfair regulations.

text: Coverage of West African economics by historians, mostly British, has left a legacy of controversy. Three historians, in particular, were accused by Adu Boahen for inaccurate reportage, mainly of Gold Coast and Ghana: William Walton Claridge, in A History of the Gold Coast and Ashanti (1915, reprint by Frank Cass in 1964); William Ernest Frank Ward in History of the Gold Coast (1940, published 1948, as A History of Ghana in 1958); and John Donnelly Fage in Ghana, An Historical Interpretation.

text: Economic development was mostly attributed to each region's agricultural developments. Development of the financial markets through colonial banking often disadvantaged the colonies as producers of commodities.

text: Aftermath[edit]

text: Even after its final dissolution, a single currency, the British West African pound, was in effect throughout the region—including Nigeria—from 1907 to 1962.

text: Nigeria gained independence in 1960. Sierra Leone was self-governing by 1958 and gained independence in 1961. Gambia gained independence in 1965. In 1954, the British Gold Coast was allowed by Britain to self-govern and in 1957, the Gold Coast was given independence from Britain, under the name Ghana.


document_title: US Airways Flight 1549

question_text: where is the plane that crashed in the hudson

text: US Airways Flight 1549

text: Route, aircraft, crew and passengers[edit]

text: On January 15, 2009, US Airways Flight 1549[b] with callsign 'CACTUS 1549' was scheduled to fly from New York City's LaGuardia Airport (LGA) to Charlotte Douglas (CLT), with direct onward service to Seattle–Tacoma International Airport in Washington State. The aircraft was an Airbus A320-214 powered by two GE Aviation/Snecma-designed CFM56-5B4/P turbofan engines.[9][c]

text: The pilot in command was 57-year-old Chesley B. "Sully" Sullenberger, a former fighter pilot who had been an airline pilot since leaving the United States Air Force in 1980. At the time, he had logged 19,663 total flight hours, including 4,765 in an A320; he was also a glider pilot and expert on aviation safety.[13][14][15] First officer Jeffrey B. Skiles, 49,[14][16][17] had accrued 15,643 career flight hours, but this was his first Airbus A320 assignment since qualifying to fly it.[18] There were 150 passengers and three flight attendants aboard.[1][19]

text: Accident[edit]

text: Takeoff and bird strike[edit]

text:
New York TRACON audio

Air traffic control audio from about time of bird strike until ditching (3:10 long)

Problems playing this file? See media help.

tag: table

text: The flight was cleared for takeoff to the northeast from LaGuardia's Runway 4 at 3:24:56 pm Eastern Standard Time (20:24:56 UTC). With Skiles in control, the crew made its first report after becoming airborne at 3:25:51 as being at 700 feet (210 m) and climbing.[20]

text: The weather at 2:51 p.m. was 10 miles visibility with broken clouds at 3,700 feet, wind 8 knots from 290°; an hour later it was few clouds at 4,200 feet, wind 9 knots from 310°.[21] At 3:26:37 Sullenberger remarked to Skiles: "What a view of the Hudson today."[22]

text: At 3:27:11 the plane struck a flock of Canada geese at an altitude of 2,818 feet (859 m) about 4.5 miles (7.2 km) north-northwest of LaGuardia. The pilots' view was filled with the large birds;[23][24] passengers and crew heard very loud bangs and saw flames from the engines, followed by silence and an odor of fuel.[25][26][27]

text: Realizing that both engines had shut down, Sullenberger took control while Skiles worked the checklist for engine restart.[d][2] The aircraft slowed but continued to climb for a further nineteen seconds, reaching about 3,060 feet (930 m) at an airspeed of about 185 knots (343 km/h; 213 mph), then began a glide descent, accelerating to 210 knots (390 km/h; 240 mph) at 3:28:10 as it descended through 1,650 feet (500 m).

text: At 3:27:33, Sullenberger radioed a Mayday call to New York Terminal Radar Approach Control (TRACON):[29][30] "... this is Cactus 1539 [sic – correct call sign was Cactus 1549], hit birds. We've lost thrust on both engines. We're turning back towards LaGuardia".[22] Air traffic controller Patrick Harten[31] told LaGuardia's tower to hold all departures, and directed Sullenberger back to Runway 13.[30] Sullenberger responded, "Unable".[30]

text: Sullenberger asked if they could attempt to land in New Jersey, mentioning Teterboro Airport;[30][32][33] controllers obtained permission for a landing on Teterboro's Runway 1.[33] Sullenberger responded: "We can't do it ... We're gonna be in the Hudson".[32] The aircraft passed less than 900 feet (270 m) above the George Washington Bridge.[34] Sullenberger commanded over the cabin address system, "Brace for impact",[34] and the flight attendants relayed the command to passengers.[35] Meanwhile, air traffic controllers asked the Coast Guard to caution vessels in the Hudson and ask them to prepare to assist with rescue.[citation needed]

text: Ditching and evacuation[edit]

text: About ninety seconds later, at 3:31 pm, the plane made an unpowered ditching, descending southwards at about 125 knots (140 mph; 230 km/h) into the middle of the North River section of the Hudson tidal estuary, at 40°46′10″N 74°00′17″W / 40.7695°N 74.0046°W / 40.7695; -74.0046[36] roughly opposite West 50th Street (near the Intrepid Sea, Air & Space Museum) in Manhattan and Port Imperial in Weehawken, New Jersey. Flight attendants compared the ditching to a "hard landing" with "one impact, no bounce, then a gradual deceleration."[32] The ebb tide then began to take the plane southward.[37]

text: Sullenberger opened the cockpit door and ordered evacuation. The crew began evacuating the passengers through the four overwing window exits and into an inflatable slide/raft deployed from the front right passenger door (the front left slide failed to operate, so the manual inflation handle was pulled). A panicked passenger opened a rear door, which a flight attendant was unable to reseal.[38] Water was also entering a hole in the fuselage and through cargo doors that had come open,[39] so as the water rose the attendant urged passengers to move forward by climbing over seats.[e] One passenger was in a wheelchair.[41][42] Finally, Sullenberger walked the cabin twice to confirm it was empty.[43][44][45]

text: The air and water temperatures were about 19 °F (−7 °C) and 41 °F (5 °C) respectively.[21] Some evacuees waited for rescue knee-deep in water on the partially submerged slides, some wearing life-vests. Others stood on the wings or, fearing an explosion, swam away from the plane.[38] One passenger, after helping with the evacuation, found the wing so crowded that he jumped into the river and swam to a boat.[46][32][47]

text: Rescue[edit]

text: Sullenberger had ditched near boats to facilitate rescue.[20][43] NY Waterway ferries Thomas Jefferson and then Governor Thomas H. Kean both arrived within minutes[48][49] and began taking people aboard using a Jason's cradle. Sullenberger advised the ferry crews to rescue those on the wings first, as they were in more jeopardy than those on the slides, which detached to become life rafts.[34] As the plane drifted, passengers on one slide, fearing that the boat would crush them, shouted for it to steer away.[50] The last person was taken from the plane at 3:55 pm.[51]

text: About 140 New York City firefighters responded to nearby docks,[52][53][54] as did police, helicopters, and various vessels and divers.[52] Other agencies provided medical help on the Weehawken side of the river, where most passengers were taken.[55]

text: Aftermath[edit]

text: There were five serious injuries,[2] including a deep laceration in flight attendant Doreen Welsh's leg.[32][56] Seventy-eight people were treated, mostly for minor injuries[57] and hypothermia,[58] twenty-four passengers and two rescuers treated at hospitals,[59] with two passengers kept overnight. One passenger now wears glasses because of jet fuel damaging his eyes.[46] No pets were being carried on the flight.[60]

text: Each passenger later received a letter of apology, $5,000 in compensation for lost baggage (and $5,000 more if they could demonstrate larger losses) and refund of the ticket price.[61][62] In May 2009 they received any belongings that had been recovered. In addition, they reported offers of $10,000 each in return for agreeing not to sue US Airways.[63]

text: Many passengers and rescuers later experienced post-traumatic stress symptoms such as sleeplessness, flashbacks, and panic attacks; some began an email support group.[64] Patrick Harten, the controller who had worked the flight, said that "the hardest, most traumatic part of the entire event was when it was over", and that he was "gripped by raw moments of shock and grief".[65]

text: In an effort to prevent similar accidents, officials captured and gassed 1,235 Canada geese at 17 locations across New York City in mid-2009 and coated 1,739 goose eggs with oil to smother the developing goslings.[66]

text: Investigation[edit]

text: The partially submerged plane was moored to a pier near the World Financial Center in Lower Manhattan, roughly 4 miles (6 km) downstream from the ditching location.[35] The left engine, detached by the ditching, was recovered from the riverbed.[67] On January 17 the aircraft was barged[68][69] to New Jersey.[70]

text: The initial National Transportation Safety Board (NTSB) evaluation that the plane had lost thrust after a bird strike[71][72][73] was confirmed by analysis of the cockpit voice and flight data recorders.[74]

text: It was soon reported that a few days earlier the plane had experienced a less severe compressor stall, and its passengers had been told an emergency landing might be required,[75][76] but the affected engine was restarted. The NTSB later reported that a faulty temperature sensor had been the cause, and that the engine had not been damaged in that incident.[77]

text: On January 21, the NTSB found evidence of soft-body damage in the right engine along with organic debris including a feather.[78][79] The left engine also evidenced soft body impact, with: "dents on both the spinner and inlet lip of the engine cowling. Five booster inlet guide vanes are fractured and eight outlet guide vanes are missing." Both engines, missing large portions of their housings,[80] were sent to the manufacturer for examination.[81] On January 31, the plane was moved to Kearny, New Jersey. The bird remains[77][82] were later identified by DNA testing to be Canada geese, which typically weigh more than engines are designed to withstand ingesting.[77]

text: Because the plane was assembled in France[83] the European Aviation Safety Agency (the European counterpart of the FAA) and the Bureau d'Enquêtes et d'Analyses pour la Sécurité de l'Aviation Civile (the French counterpart of the NTSB) joined the investigation, with technical assistance from Airbus Industrie and GE Aviation/Snecma, respectively the manufacturers of the airframe and the engines.[84][85]

text: The NTSB used flight simulators to test the possibility that the flight could have returned safely to LaGuardia or diverted to Teterboro; only seven of the thirteen simulated returns to La Guardia succeeded, and only one of the two to Teterboro.[86] Furthermore, the NTSB report called these simulations unrealistic: "The immediate turn made by the pilots during the simulations did not reflect or account for real-world considerations." A further simulation, conducted with the pilot delayed by 35 seconds, crashed.[87] In testimony before the NTSB, Sullenberger maintained that there had been no time to bring the plane to any airport, and that attempting to do so would likely have killed those onboard and more on the ground.[88]

text: The Board ultimately ruled that Sullenberger had made the correct decision,[88] reasoning that the checklist for dual-engine failure is designed for higher altitudes, when pilots have more time to deal with the situation, and that while simulations showed that the plane might have just barely made it back to LaGuardia, those scenarios assumed an instant decision to do so, with no time allowed for assessing the situation.[89][90]

text: The NTSB concluded its investigation on May 4, 2010, identifying the probable cause as "the ingestion of large birds into each engine, which resulted in an almost total loss of thrust in both engines."[87] The final report credited the outcome to four factors: good decision-making and teamwork by the cockpit crew (including decisions to immediately turn on the APU and to ditch in the Hudson); the fact that the A320 is certified for extended overwater operation (and hence carried life vests and additional raft/slides) even though not required for that route; the performance of the flight crew during the evacuation; and the proximity of working vessels to the ditching site. Contributing factors were good visibility and a fast response from the ferry operators and emergency responders. The report also makes a range of recommendations to improve safety in such situations.[2]

text: Author and pilot William Langewiesche asserted that insufficient credit was given to the A320's fly-by-wire design, by which the pilot uses a side-stick to make control inputs to the flight control computers. The computers then impose adjustments and limits of their own to keep the plane stable, which the pilot cannot override even in an emergency. This design allowed the pilots of Flight 1549 to concentrate on engine restart and deciding the course, without the burden of manually adjusting the glidepath to reduce the plane's rate of descent.[51] Sullenberger said that these computer-imposed limits also prevented him from achieving the optimum landing flare for the ditching, which would have softened the impact.[91]

text: In 2010, the damaged plane (excluding its engines)[92] was acquired for the Carolinas Aviation Museum in Charlotte, North Carolina,[93] which held a reception on June 11 to commemorate the arrival in Charlotte of the plane's body, with Sullenberger as keynote speaker and the passengers invited.[94][95][96][97]

text: Crew awards and honors[edit]

text:
The reactions of all members of the crew, the split second decision making and the handling of this emergency and evacuation was "text book" and an example to us all. To have safely executed this emergency ditching and evacuation, with the loss of no lives, is a heroic and unique aviation achievement.

—Guild of Air Pilots and Air Navigators citation

tag: div

text: An NTSB board member called the ditching "the most successful ... in aviation history. These people knew what they were supposed to do and they did it and as a result, no lives were lost."[98]

text: The crew, especially Sullenberger, was praised, notably by New York City Mayor Michael Bloomberg and New York State Governor David Paterson, who said: "We had a Miracle on 34th Street. I believe now we have had a Miracle on the Hudson."[57][99][100] U.S. President George W. Bush said he was "inspired by the skill and heroism of the flight crew," and praised the emergency responders and volunteers.[101] President-elect Barack Obama said that everyone was proud of Sullenberger's "heroic and graceful job in landing the damaged aircraft." He thanked the crew, whom he invited to his inauguration five days later.[102][103]

text: The Guild of Air Pilots and Air Navigators awarded the crew a Master's Medal on January 22, 2009; this is awarded only rarely, for outstanding aviation achievements at the discretion of the Master of the Guild.[8] New York City Mayor Michael Bloomberg presented the crew with the Keys to the City, and Sullenberger with a replacement copy of a library book lost on the flight, Sidney Dekker's Just Culture: Balancing Safety and Accountability.[104] Rescuers received Certificates of Honor.[105]

text: The crew received a standing ovation at the Super Bowl XLIII on February 1, 2009,[106] and Sullenberger threw out the first pitch at the 2009 Major League Baseball season for the San Francisco Giants. His Giants' jersey was inscribed with the name "Sully" and the number 155 – the count of people aboard the plane.[107]

text: On July 28, passengers Dave Sanderson and Barry Leonard organized a thank you luncheon for emergency responders from Hudson County, New Jersey, on the shores of Palisades Medical Center in North Bergen, New Jersey, where 57 passengers had been brought following their rescue. Present were members of the U.S. Coast Guard, North Hudson Regional Fire and Rescue, NY Waterway Ferries, the American Red Cross, Weehawken Volunteer First Aid, the Weehawken Police Department, West New York E.M.S., North Bergen E.M.S., the Hudson County Office of Emergency Management, the New Jersey E.M.S. Task Force, the Guttenberg Police Department, McCabe Ambulance, the Harrison Police Department, and doctors and nurses who treated survivors.[108][109]

text: Sullenberger was named Grand Marshal for the 2010 Tournament of Roses Parade in Pasadena, California.

text: In August 2010, Jeppesen issued an approach plate titled "Hudson Miracle APCH," dedicated to the five crew of Flight 1549 and annotated "Presented with Pride and Gratitude from your friends at Jeppesen."[110]

text: Sullenberger retired on March 3, 2010, after thirty years with US Airways and its predecessor, Pacific Southwest Airlines. At the end of his final flight he was reunited with Skiles and a number of the passengers from Flight 1549.[111]

text: Media and popular culture[edit]

text: The accident was recorded by several closed-circuit television cameras. Various television reports and documentaries produced soon afterwards contained extensive video of the ditching and rescue, and recorded interviews with the aircrew, passengers, rescuers, and other key participants. These included:

text:
On February 8, 2009, the CBS program 60 Minutes broadcast three segments that included interviews with the aircrew as well as their reunion with passengers. The program aired again on July 5, 2009.

"Flight 1549: A Routine Takeoff Turns Ugly"[112]
"Flight 1549: Saving 155 Souls In Minutes"[113]
"Flight 1549: An Emotional Reunion"[114]

On February 19, 2009, Channel 4 in the United Kingdom aired a documentary entitled The Miracle of the Hudson Plane Crash included personal accounts from passengers, rescuers, and witnesses.[50]
On February 21, 2009, KGO-TV in San Francisco broadcast an interview in the "Face to Face" series. Dan Ashley talked to Captain and Mrs. Sullenberger about their experiences during and since the accident.[115]
On March 4, 2009, the Discovery Channel broadcast a one-hour documentary entitled Hudson Plane Crash – What Really Happened, with computer-generated imagery (CGI) animations of the flight, and interviews with passengers, crew, witnesses, rescuers, and aviation safety experts.[116]
On January 10, 2010, TLC aired a documentary entitled Brace For Impact, aired again on April 14 in Australia as Brace For Impact: Inside The Hudson Plane Crash.[117]
In March 2011, Ric Elias, a front-row passenger shared his experience during a TED Conference.[118]
Beginning in June 2011, the University of North Carolina School of Filmmaking and Process Pictures, LLC worked with the Carolinas Aviation Museum to produce a documentary, which also looked at the impact of the incident on society.[119][120]

tag: ul

text: The crash was featured in the Discovery Channel (Canada) / National Geographic TV series Mayday on the episode Hudson Splash Down.[121] It was also recreated in a National Geographic Channel TV special titled "Miracle Landing on the Hudson,"[122] and in the United Kingdom for a Channel 5 special in 2011.[123]

text: Garrison Keillor honored the entire flight crew by writing a song and performing it on his show, A Prairie Home Companion.[124]

text: The ditching is referenced in the song "A Real Hero" by College and Electric Youth, best known from the 2011 movie Drive. The lyrics of the second verse describe the water landing and the survival of the passengers and crew, as well alluding to the freezing river.[125]

text: Sullenberger's memoir, Highest Duty: My Search for What Really Matters was adapted into a feature film Sully: Miracle on the Hudson, directed by Clint Eastwood,[126] with Tom Hanks as Sullenberger and Aaron Eckhart as co-pilot Jeff Skiles.[127] It was released by Warner Bros. on September 9, 2016.[128]


document_title: A Million Ways to Die in the West

question_text: ewan mcgregor a million ways to die in the west cameo

text: A Million Ways to Die in the West

text: Plot[edit]

text: In 1882, in the town of Old Stump, Arizona, a cowardly sheep farmer named Albert Stark (Seth MacFarlane) is dumped by his girlfriend Louise (Amanda Seyfried) as a result of his withdrawal from a gunfight. He prepares to leave for San Francisco, believing that the frontier offers nothing for him. Meanwhile, infamous outlaw Clinch Leatherwood (Liam Neeson) robs and kills an old prospector (Matt Clark) for a gold nugget. He orders his right-hand man Lewis (Evan Jones) to escort his wife Anna (Charlize Theron) to Old Stump to lie low while he continues his banditry. Lewis and Anna arrive in Old Stump under the guise of two siblings intending to build a farm, but Lewis is arrested after shooting the Pastor's (John Aylward) son (Dylan Kenin) in a saloon. During the ensuing fight, Albert saves Anna from being crushed to death by two of the brawlers, and the two become close friends. They attend a county fair where Louise's new boyfriend, the haughty Foy (Neil Patrick Harris), challenges Albert to a shooting contest. Albert is defeated, but Anna steps in and defeats Foy. Foy mocks Albert, who angrily challenges Foy to a duel in a week's time. Anna then spends the week teaching Albert how to shoot.

text: During a barn dance the night before the duel, Anna slips Foy a Mickey. After leaving the dance, Albert and Anna kiss before heading home. Upon breaking out of jail and murdering the sheriff, Lewis witnesses the kiss and reports it to Clinch. On the day of the duel, Foy arrives late and goes into convulsions from the laxative he had unknowingly drunk. Albert, who has decided that Louise is not worth fighting for, once again forfeits the duel. He retires to the saloon, but Clinch arrives and demands to know who kissed his wife. When no one comes forward, Clinch shoots a nearby cowboy (Ryan Reynolds). He reveals that Anna is his wife and threatens to continue killing unless his wife's lover duels him at noon the next day. Clinch later forces Anna to reveal Albert's name and then prepares to have sex with her, but she knocks him unconscious and escapes.

text: Anna returns to Albert's farm, where he angrily shouts at her for lying to him. Clinch pursues Anna to the farm; Albert helps her escape, then escapes himself. While fleeing, he is captured by a tribe of Apache Indians, who threaten to burn him alive. The Indians spare him when he reveals that he can speak their language. They give him a bowl of peyote, which sends him flashing back to his birth and through painful events of his childhood before making him realize that he loves Anna. Meanwhile, Clinch recaptures Anna in town, in front of Edward's (Giovanni Ribisi) house. Albert returns to Old Stump and confronts Clinch. He wounds Clinch with a bullet poisoned with rattlesnake venom before his own gun is shot out of his hand, but he manages to stall until Clinch fatally succumbs to the poison. Louise attempts to win back Albert, but he rejects her and instead happily enters a relationship with Anna. Albert also receives a bounty for killing Clinch and uses the money to buy more sheep.

text: Later at the Fair, the proprietor of a racially charged shooting game called "Runaway Slave" asks who would like to take a shot. Django (Jamie Foxx) steps up and shoots the man while commenting that "people die at the fair".

text: Cast[edit]

text:
Seth Macfarlane as Albert Stark, a sheepherder.
Mike Salazar as 6-year-old Albert
Charlize Theron as Anna Barnes-Leatherwood,[4] Clinch Leatherwood's wife who befriends Albert.
Liam Neeson as Clinch Leatherwood,[5] an infamous outlaw and Anna's husband.
Giovanni Ribisi as Edward,[5] Albert's best friend and Ruth's boyfriend
Neil Patrick Harris as Foy,[6] an Old Stump inhabitant and Louise's current boyfriend.
Sarah Silverman as Ruth, Edward's girlfriend and a prostitute.
Amanda Seyfried as Louise,[7] Albert's ex-girlfriend.
Christopher Hagen as George Stark, Albert's cantankerous father.
Wes Studi as Cochise[8]
Rex Linn as Sheriff/Narrator[7]
Alex Borstein as Millie, a madam at a local brothel which Ruth works at.
Ralph Garman as Dan
John Aylward as Pastor Wilson
Amick Byram as Marcus Thornton
Evan Jones as Lewis, an outlaw and Clinch Leatherwood's right-hand man.
Dylan Kenin as Pastor's Son, the son of a pastor who is killed by Lewis in the bar.

text: Cameos[edit]

text:
Jamie Foxx (uncredited) as Django Freeman,[9] he appears where he shoots the owner of the "Runaway Slave" game. The scene featuring him was added after audiences in test screenings reacted poorly to the shooting gallery at the fair which features cartoon images of black slaves as targets.
Ryan Reynolds (uncredited) as cowboy killed in bar
Tait Fletcher as Cowboy #1[10]
Gilbert Gottfried as Abraham Lincoln,[11] he was seen during Albert's drug trip.
Mike Henry as smiling man in photograph
Dennis Haskins as snake oil salesman
John Michael Higgins as Dandy #1
Christopher Lloyd as Doc Brown[12]
Bill Maher as comic[13]
Ewan McGregor as a cowboy who laughed with Foy at Albert's expense at the fair.
Alec Sulkin as guy at fair
Rupert Boneham as guy in bar fight
Kaley Cuoco (uncredited, unrated version only) as a woman that Albert tries to pick up in a store.
Patrick Stewart (uncredited voice) as a sheep with long legs that was seen in Albert's drug trip.

text: Production[edit]

text: Development[edit]

text: A Million Ways to Die in the West originated as an inside joke between MacFarlane and co-writers Sulkin and Wild,[14] while they were watching Hang 'Em High.[15] The joke evolved into "riffing on the idea of how dull, depressing, and dangerous it must have been to live in the Wild West."[14] MacFarlane, a lifelong fan of westerns, began researching the topic, using Jeff Guinn's nonfiction novel, The Last Gunfight: The Real Story of the Shootout at the O.K. Corral — And How It Changed the American West as an "invaluable resource," and basis for many of the ways of dying in the film.[14] Various aspects of the film were inspired by real westerns. The decision to make Albert a sheep herder was inspired by Montana (1950) and his average, non-confrontational demeanor by 3:10 to Yuma (1957).[16] Other westerns that inspired MacFarlane and the crew during writing included Oklahoma! (1955), The Man Who Shot Liberty Valance (1962), and El Dorado (1966).[16] The film was first announced on December 3, 2012, marking MacFarlane's second foray into live-action directing, after 2012's Ted.[17]

text: Casting[edit]

text:
On January 30, 2013, it was announced that Charlize Theron had joined the film.[18] Theron later revealed that she "begged" for her role, as she wanted the opportunity to work in comedy.[19] On February 11, it was announced Amanda Seyfried had joined the film.[20] On March 6, it was announced Liam Neeson and Giovanni Ribisi had joined the film.[21] Neeson, who nearly always suppresses his Irish accent when acting, agreed to play the part of Clinch only on the condition that he could use his Irish accent. In an interview on The Tonight Show Starring Jimmy Fallon, Neeson remarked that he made this demand because an episode of MacFarlane's Family Guy had previously made a joke out of the juxtaposition of Neeson playing a cowboy with an Irish accent.[22]
On March 18, it was announced that Sarah Silverman was cast to play a prostitute in the film.[23] On May 10, it was announced that the film would be co-financed by Media Rights Capital and Fuzzy Door Productions, along with Bluegrass Films and distributed by Universal Studios.[24] On May 11, 2013, it was announced that Neil Patrick Harris had joined the film.[25] On May 29, 2013, MacFarlane announced that Bill Maher had joined the cast.[13] On February 21, 2014, he announced that Gilbert Gottfried had also joined the cast.[11]

text: Filming[edit]

text: Principal photography began on May 6, 2013.[26][27] Filming locations included various areas in and around Albuquerque, New Mexico,[28] also including the Santa Fe Studio in Santa Fe.[29] Principal photography ended on August 9, 2013.[30] The film shoot was difficult, as the cast and crew navigated rough weather: "everything from hailstorms to blistering heat to arctic winds and torrential rainstorms."[14]

text: Soundtrack[edit]

text:
A Million Ways to Die in the WestSoundtrack album by Joel McNeelyReleased
May 27, 2014Recorded
2014Genre
Film scoreLength
41:20Label
Back Lot MusicJoel McNeely film scores chronology

The Pirate Fairy(2014)

A Million Ways to Die in the West(2014)

Home(2015)

text: The score was composed by Joel McNeely. The soundtrack was released by Back Lot Music on May 27, 2014.[31] The theme song "A Million Ways to Die" is performed by Alan Jackson. It was released as a single on April 29, 2014.[32] A portion of the Back to the Future theme by Alan Silvestri is used during Christopher Lloyd's cameo.[10]

text: All music composed by Joel McNeely, except as noted.

text: No.TitleLength1."A Million Ways to Die" (performed by Alan Jackson)2:272."Main Title"2:333."Missing Louise"2:084."Old Stump"0:455."Saloon Brawl"1:506."Rattlesnake Ridge"1:287."People Die at the Fair"2:118."The Shooting Lesson"2:169."The Barn Dance"2:2910."If You’ve Only Got a Moustache" (composed by Stephen Foster, performed by Amick Byram)1:3111."Anna and Albert"4:1912."Clinch Hunts Albert"3:4113."Racing the Train"2:2114."Captured by Cochise"2:0715."Albert Takes a Trip"2:2416."The Showdown"2:2017."Sheep to the Horizon"2:0018."End Title Suite"2:30Total length:41:20

text: Release[edit]

text: On May 16, 2014, the film had its world premiere at the Regency Village Theater in Los Angeles.[33][34] The film was later released nationwide on May 30, 2014.[35] The film was produced by Media Rights Capital, Fuzzy Door Productions, and Bluegrass Films and distributed by Universal Pictures.[36][37]

text: Marketing[edit]

text: On January 27, 2014, MacFarlane announced that he wrote a companion novel based on the film's script, which was released on March 4, 2014.[38][39] An audio-book version was also made available, narrated by Jonathan Frakes.[40] MacFarlane wrote the book on weekends during shooting for the film, partially due to boredom.[14]

text: Box office[edit]

text: A Million Ways to Die in the West grossed $43.1 million in North America and $43.3 million in other territories, for a worldwide total of $86.4 million, against its $40 million budget.[3]

text: The film grossed $16.8 million in its opening weekend, finishing in third place at the box office behind fellow newcomer Maleficent and the previous weekend's opener X-Men: Days of Future Past.[3] This was below expectations of $26 million.[41] In its second weekend, the film dropped to number five, grossing an additional $7.3 million.[42] In its third weekend, the film dropped to number eight, grossing $3.2 million.[43] In its fourth weekend, the film dropped to number 11, grossing $1.6 million.[44]

text: Home media[edit]

text: A Million Ways to Die in the West was released via DVD and Blu-ray on October 7, 2014.[45] The Blu-ray release contains an unrated version (135 minutes), along with the original theatrical cut (116 minutes). In the United States, the film has grossed $8,336,420 from DVD sales and $6,739,162 from Blu-ray sales, making a total of $15,075,582.[46]

text: Reception[edit]

text: Critical response[edit]

text: A Million Ways to Die in the West received mixed reviews from critics.[47][48] Review aggregation website Rotten Tomatoes gave the film a 33% rating based on 192 reviews, with an average score of 4.9/10. The site's consensus states, "While it offers a few laughs and boasts a talented cast, Seth MacFarlane's overlong, aimless A Million Ways to Die in the West is a disappointingly scattershot affair."[49] Another review aggregation website, Metacritic, gave a score of 44 out of 100, based on reviews from 43 critics, indicating "mixed or average reviews".[47] Audiences surveyed by CinemaScore gave the film an average grade of "B" on an A+ to F scale; opening weekend demographics were 55% male and 72% over 25 years of age.[50]

text: Claudia Puig's review in USA Today was largely positive, writing, "A Western with a contemporary sensibility and dialogue that sounds markedly modern, A Million Ways to Die in the West is quintessential MacFarlane, at once silly and witty, juvenile and clever."[51] Stephen Holden's review in The New York Times was mainly neutral, calling the film "a live-action spinoff of [Family Guy], with different characters."[52] "While the whole thing feels weirdly miscalculated to me, A Million Ways to Die in the West tweaks the formula just enough, delivers a few laughs and keeps the guest stars coming," wrote Salon columnist Andrew O'Hehir.[53] Rafer Guzman of Newsday found the film amusing, calling it "another example of MacFarlane's ability to mix poop jokes with romance, foul language with sweet sentiment, offensive humor with boyish charm."[54]

text: Scott Mendelson of Forbes commended MacFarlane's decision to make an unconventional western comedy, but summarized the film as "just ambitious enough for that to be genuinely disappointing."[55] Michael O'Sullivan at The Washington Post was mixed, deeming the film a "broad, wildly hit-or-miss satire," remarking that he found few of the jokes in the film funny.[56] "Spiritually, it's closer to a mid-range crowd-pleaser such as City Slickers than Blazing Saddles, too enamoured of genre convention to reach for the comic dynamite," wrote Mike McCahill at The Guardian.[57]

text: Much of the film's criticism was directed towards its writing, running time, and MacFarlane's debut live-action performance. Michael Phillips of the Chicago Tribune criticized MacFarlane's acting and direction as: "A failure of craft. He can't direct action, or even handle scenery well. He can't set up a visual joke properly without resorting to head-butting and bone-crunching, and he doesn't know how, or when, to move his camera. He's not good enough as a romantic lead to anchor a picture."[58] Richard Corliss of Time called the film a "sagebrush comedy whose visual grandeur and appealing actors get polluted by some astonishingly lazy writing."[59] Scott Foundas of Variety found the film "overlong and uninspired," criticizing the film's "lazy writing," and MacFarlane's "surprisingly bland" comic performance.[60]

text: Rene Rodriguez of the Miami Herald gave the film one star, commenting, "There are enough laughs scattered throughout A Million Ways to Die in the West that while you're watching it, the movie seems like a passable comedy. By the time you get home, though, you can barely remember the jokes."[61] John DeFore of The Hollywood Reporter criticized the film's running time: "Though the film is hardly laugh-free, its uneven jokes appear to have breezed through a very forgiving editing process."[62] Joe Morgenstern of The Wall Street Journal too found the film's length "exhausting," noting, "Some of it sputters, settling for smiles instead of laughs, and much of it flounders while the slapdash script searches [...] for ever more common denominators in toilet humor."[63]

text: Accolades[edit]

text:
Award

Date of ceremony

Category

Recipients

Result

Ref

People's Choice Award

January 7, 2015

Favorite Comedic Movie Actress

Charlize Theron

Nominated

[64]

International Film Music Critics Association Award

February 19, 2015

Best Original Score for a Comedy Film

Joel McNeely

Nominated

[65]

Golden Raspberry Awards

February 21, 2015

Worst Actor

Seth MacFarlane

Nominated

[66]

Worst Actress

Charlize Theron

Nominated

Worst Director

Seth MacFarlane

Nominated

Worst Screen Combo

Seth MacFarlane and Charlize Theron

Nominated


document_title: Emergency contraception

question_text: when did plan b become available over the counter

text: Emergency contraception

text: Emergency contraceptive pills[edit]

text: Emergency contraceptive pills (ECPs) (sometimes referred to as emergency hormonal contraception, EHC) may contain higher doses of the same hormones (estrogens, progestins, or both) found in regular combined oral contraceptive pills. Taken after unprotected sexual intercourse or contraceptive failure, such higher doses may prevent pregnancy from occurring.[5]

text: Types[edit]

text: Three types of emergency contraceptive pills are available: combined estrogen and progestin pills, progestin-only (levonorgestrel, LNG) pills, and antiprogestin (ulipristal acetate or mifepristone) pills.[6] Progestin-only and antiprogestin pills are available as dedicated (specifically packaged for use as) emergency contraceptive pills.[6][7] Combined estrogen and progestin pills are no longer available as dedicated emergency contraceptive pills, but certain regular combined oral contraceptive pills may be used as emergency contraceptive pills.[6]

text: Progestin-only emergency contraceptive pills contain levonorgestrel, either as a single tablet or as a split dose of two tablets taken 12 hours apart, effective up to 72 hours after intercourse.[6] Progestin-only ECPs are sold under many different brand names.[8][9][10] Progestin-only ECPs are available over-the-counter (OTC) in several countries (e.g. Bangladesh, Bulgaria, Canada, Cyprus, Czech Republic, Denmark, Estonia, India, Netherlands, Norway, Portugal, Romania, Slovakia, South Africa, Sweden, United States), from a pharmacist without a prescription, and available with a prescription in some other countries.[8][9][10]

text: The antiprogestin ulipristal acetate is available as a micronized emergency contraceptive tablet, effective up to 120 hours after intercourse.[6][7] Ulipristal acetate ECPs developed by HRA Pharma are available by prescription in over 50 countries under the brand names ellaOne, ella (marketed by Watson Pharmaceuticals in the United States), Duprisal 30, Ulipristal 30, and UPRIS.[8][9][10][11]

text: The antiprogestin mifepristone (also known as RU-486) is available in five countries as a low-dose or mid-dose emergency contraceptive tablet, effective up to 120 hours after intercourse.[6][7] Low-dose mifepristone ECPs are available by prescription in Armenia, Russia, Ukraine, and Vietnam and from a pharmacist without a prescription in China.[8][9] Mid-dose mifepristone ECPs are available by prescription in China and Vietnam.[8][9]

text: Combined estrogen (ethinylestradiol) and progestin (levonorgestrel or norgestrel) pills used to be available as dedicated emergency contraceptive pills under several brand names: Schering PC4, Tetragynon, Neoprimavlar, and Preven (in the United States) but were withdrawn after more effective dedicated progestin-only (levonorgestrel) emergency contraceptive pills with fewer side effects became available.[6] If other more effective dedicated emergency contraceptive pills (levonorgestrel, ulipristal acetate, or mifepristone) are not available, specific combinations of regular combined oral contraceptive pills can be taken in split doses 12 hours apart (the Yuzpe regimen), effective up to 72 hours after intercourse.[6] The U.S. Food and Drug Administration (FDA) approved this off-label use of certain brands of regular combined oral contraceptive pills in 1997.[5] As of 2014, there are 26 brands of regular combined oral contraceptive pills containing levonorgestrel or norgestrel available in the United States that can be used in the emergency contraceptive Yuzpe regimen.[6]

text: Effectiveness[edit]

text: Ulipristal acetate, and mid-dose mifepristone is more effective than levonorgestrel, which is more effective than the Yupse method.[12]

text: The effectiveness of emergency contraception is expressed as a percentage reduction in pregnancy rate for a single use of EC. Using an example of "75% effective", the effectiveness calculation thus:

text: ... these numbers do not translate into a pregnancy rate of 25 percent. Rather, they mean that if 1,000 women have unprotected intercourse in the middle two weeks of their menstrual cycles, approximately 80 will become pregnant. Use of emergency contraceptive pills would reduce this number by 75 percent, to 20 women.[13]

text: The progestin-only regimen (using levonorgestrel) has an 89% effectiveness. As of 2006[update], the labeling on the U.S. brand Plan B explained this effectiveness rate by stating, "Seven out of every eight women who would have gotten pregnant will not become pregnant."[14]

text: In 1999, a meta-analysis of eight studies of the combined (Yuzpe) regimen concluded that the best point estimate of effectiveness was 74%.[15] A 2003 analysis of two of the largest combined (Yuzpe) regimen studies, using a different calculation method, found effectiveness estimates of 47% and 53%.[16]

text: For both the progestin-only and Yuzpe regimens, the effectiveness of emergency contraception is highest when taken within 12 hours of intercourse and declines over time.[17][18][19] The World Health Organization (WHO) suggested that reasonable effectiveness may continue for up to 120 hours (5 days) after intercourse.[20]

text: For 10 mg of mifepristone taken up to 120 hours (5 days) after intercourse, the combined estimate from three trials was an effectiveness of 83%.[21] A review found that a moderate dose of mifepristone is better than LNG or Yuzpe.[22]

text: HRA Pharma changed its packaging information for Norlevo (which has dosage and chemical makeup identical to many other EHCs) in November 2013 warning that the drug loses effectiveness in women who weigh more than 165 pounds and is completely ineffective for women who weigh over 176 pounds.[23][24]

text: Safety[edit]

text: The most common side effect reported by users of emergency contraceptive pills was nausea (50.5% of 979 Yuzpe regimen users and 23.1% of 977 levonorgestrel-only users in the 1998 WHO trial; 14.3% of 2,720 levonorgestrel-only users in the 2002 WHO trial); vomiting is much less common and unusual with levonorgestrel-only ECPs (18.8% of 979 Yuzpe regimen users and 5.6% of levonorgestrel-only users in the 1998 WHO trial; 1.4% of 2,720 levonorgestrel-only users in the 2002 WHO trial).[17][20][25] Anti-emetics are not routinely recommended with levonorgestrel-only ECPs.[25][26] If a woman vomits within 2 hours of taking a levonorgestrel-only ECP, she should take a further dose as soon as possible.[25][27]

text: Other common side effects (each reported by less than 20% of levonorgestrel-only users in both the 1998 and 2002 WHO trials) were abdominal pain, fatigue, headache, dizziness, and breast tenderness.[17][20][25] Side effects usually do not occur for more than a few days after treatment, and they generally resolve within 24 hours.[6]

text: Temporary disruption of the menstrual cycle is also commonly experienced. If taken before ovulation, the high doses of progestogen in levonorgestrel treatments may induce progestogen withdrawal bleeding a few days after the pills are taken. One study found that about half of women who used levonorgestrel ECPs experienced bleeding within 7 days of taking the pills.[28] If levonorgestrel is taken after ovulation, it may increase the length of the luteal phase, thus delaying menstruation by a few days.[29] Mifepristone, if taken before ovulation, may delay ovulation by 3–4 days[30] (delayed ovulation may result in a delayed menstruation). These disruptions only occur in the cycle in which ECPs were taken; subsequent cycle length is not significantly affected.[28] If a woman's menstrual period is delayed by two weeks or more, it is advised that she take a pregnancy test.[31] (Earlier testing may not give accurate results.)

text: Existing pregnancy is not a contraindication in terms of safety, as there is no known harm to the woman, the course of her pregnancy, or the fetus if progestin-only or combined emergency contraception pills are accidentally used, but EC is not indicated for a woman with a known or suspected pregnancy because it is not effective in women who are already pregnant.[6][32][33][31][34][35][36][37][38]

text: The World Health Organization (WHO) lists no medical condition for which the risks of emergency contraceptive pills outweigh the benefits.[35] The American Academy of Pediatrics (AAP) and experts on emergency contraception have concluded that progestin-only ECPs may be preferable to combined ECPs containing estrogen in women with a history of blood clots, stroke, or migraine.[6][32][33]

text: There are no medical conditions in which progestin-only ECPs are contraindicated.[6][32][33][31][34][35][36] Current venous thromboembolism, current or past history of breast cancer, inflammatory bowel disease, and acute intermittent porphyria are conditions where the advantages of using emergency contraceptive pills generally outweigh the theoretical or proven risks.[36]

text: ECPs, like all other contraceptives, reduce the absolute risk of ectopic pregnancy by preventing pregnancies and there is no increase in the relative risk of ectopic pregnancy in women who become pregnant after using progestin-only ECPs.[6][39][40]

text: Interactions[edit]

text: The herbal preparation of St John's wort and some enzyme-inducing drugs (e.g. anticonvulsants or rifampicin) may reduce the effectiveness of ECP, and a larger dose may be required.[25][41]

text: Intrauterine device[edit]

text: An alternative to emergency contraceptive pills is the copper-T intrauterine device (IUD) which can be used up to 5 days after unprotected intercourse to prevent pregnancy. Insertion of an IUD is more effective than use of Emergency Contraceptive Pills - pregnancy rates when used as emergency contraception are the same as with normal IUD use. IUDs may be left in place following the subsequent menstruation to provide ongoing contraception (3–10 years depending upon type).[42]

text: As regular contraception[edit]

text: One brand of levonorgestrel pills was marketed as an ongoing method of postcoital contraception.[43] However, there are serious drawbacks to such use of postcoital high-dose progestin-only oral contraceptive pills, especially if they are not used according to their package directions, but are instead used according to the package directions of emergency contraceptive pills:

text:
Due to the increasing severity of side effects with frequent use, Postinor is only recommended for women who have intercourse four or fewer times per month.[43][44]
If not used according to their package directions, but instead used according to the directions of levonorgestrel emergency contraceptive pills (up to 72 hours after intercourse), they would be estimated to have a "perfect-use" (when not used according to their package directions but used as directed on the package directions for levonorgestrel emergency contraception pills) pregnancy rate of 20% per year when used as the sole means of contraception (as compared to a 40% annual pregnancy rate for the Yuzpe regimen).[45] These failure rates would be higher than those of almost all other birth control methods, including the rhythm method and withdrawal.[46]
Like all hormonal methods, postcoital high-dose progestin-only oral contraceptive pills do not protect against sexually transmitted infections.[47]

text: ECPs are generally recommended for backup or "emergency" use, rather than as the primary means of contraception. They are intended for use when other means of contraception have failed—for example, if a woman has forgotten to take a birth control pill or when a condom is torn during sex.[45]

text: Relationship to high risk sex and abortion[edit]

text: The current (December 2012) American Academy of Pediatrics (AAP) Policy Statement on Emergency Contraception says: "Despite multiple studies showing no increased risk behavior and evidence that hormonal emergency contraception will not disrupt an established pregnancy, public and medical discourse reflects that personal values of physicians and pharmacists continue to affect emergency-contraception access, particularly for adolescents."[48]

text: The latest (December 2013) review by emergency contraception experts Trussell and Raymond says: "Published evidence would seem to demonstrate convincingly that making ECPs more widely available does not increase risk-taking or adversely affect regular contraceptive use". . . ."However, reanalysis of one of the randomized trials suggests that easier access to ECPs may have increased the frequency of coital acts with the potential to lead to pregnancy."[6] and notes that four randomized controlled trials have found that advanced provision of emergency contraceptive pills did not increase rates of sexually transmitted infections or sexual risk taking.[49][50][51][52] Trussell and Raymond noted that after one of the four studies had been reanalysed later, the data did show higher sexual risk-taking,[6] specifically substituting in some cases emergency contraceptives for contraceptives such as condoms that are more effective.

text: In France, Sweden, and Britain—where Yuzpe-regimen EC had been available by prescription for more than a decade and progestin-only EC has been available without a prescription for 8, 6, and 2 years respectively—the abortion rate was stable or higher during that time period.[53] Another study concluded that distribution of free, advance supplies of EC to large numbers of women in Scotland did not reduce abortion rates.[54] A randomized controlled trial of 2000 women in China compared women with advance access to EC to women without access, and noted that the pregnancy rate was the same between the two groups. The study observed that "...providing EC in advance increases use, but there is no direct evidence that it reduces unintended pregnancy" and concluded that EC may not lower abortion rates.[55]

text: In September 2006, emergency contraception expert Anna Glasier wrote a BMJ editorial entitled "Emergency Contraception. Is it worth all the fuss?" that said in closing: "So is emergency contraception worth the fuss? If you are a woman who has had unprotected sex then of course it is, because emergency contraception will prevent pregnancy in some women some of the time—and if you don’t want to get pregnant anything is better than nothing. If you are the CMAJ’s editor or FDA commissioner then yes, because scientific freedom is worth the fight. If you are looking for an intervention that will reduce abortion rates, emergency contraception may not be the solution, and perhaps you should concentrate most on encouraging people to use contraception before or during sex, not after it."[56]

text: EC and sexual assault[edit]

text: Before EC was used in the general population or defined as "emergency contraception," it was used, beginning in the 1960s and 70s, specifically for women who had been sexually assaulted.[57][58] Pregnancy rates among rape victims of child-bearing age are around 5%; in the U.S., about half of rape victims who become pregnant have abortions.[59] Although EC is commonly used as an option for victims of sexual assault, some researchers believe such use is a public health measure that is not sufficiently widespread.[60]

text: Mechanism of action[edit]

text: The primary mechanism of action of progestogen-only emergency contraceptive pills is to prevent fertilization by inhibition of ovulation.[3][25][39][61][62][63] The best available evidence is that they do not have any post-fertilization effects such as the prevention of implantation.[3][25][39][61][62][63] The U.S. FDA-approved labels and European EMA-approved labels (except for HRA Pharma's NorLevo) levonorgestrel emergency contraceptive pills (based on labels for regular oral contraceptive pills) say they may cause endometrial changes that discourage implantation.[64][65][66] Daily use of regular oral contraceptive pills can alter the endometrium (although this has not been proven to interfere with implantation), but the isolated use of a levonorgestrel emergency contraceptive pill does not have time to alter the endometrium.[64] In March 2011, the International Federation of Gynecology and Obstetrics (FIGO) issued a statement that: "review of the evidence suggests that LNG [levonorgestreol] ECPs cannot prevent implantation of a fertilized egg. Language on implantation should not be included in LNG ECP product labeling."[64][67] In June 2012, a New York Times editorial called on the FDA to remove from the label the unsupported suggestion that levonorgestrel emergency contraceptive pills inhibit implantation.[68] In November 2013, the European Medicines Agency (EMA) approved a change to the label for HRA Pharma's NorLevo saying it cannot prevent implantation of a fertilized egg.[69]

text: Progestogen-only emergency contraceptive does not appear to affect the function of the Fallopian tubes or increase the rate of ectopic pregnancies.[70]

text: The primary mechanism of action of progesterone receptor modulator emergency contraceptive pills like low-dose and mid-dose mifepristone and ulipristal acetate is to prevent fertilization by inhibition or delay of ovulation.[3][25][61][62][63][71] One clinical study found that post-ovulatory administration of ulipristal acetate altered the endometrium, but whether the changes would inhibit implantation is unknown.[3][72] The European EMA-approved labels for ulipristal acetate emergency contraceptive pills do not mention an effect on implantation, but the U.S. FDA-approved label says: "alterations to the endometrium that may affect implantation may also contribute to efficacy."[64][73][74]

text: The primary mechanism of action of copper-releasing intrauterine devices (IUDs) as emergency contraceptives is to prevent fertilization because of copper toxicity to sperm and ova.[3][25] The very high effectiveness of copper-releasing IUDs as emergency contraceptives implies that they must also prevent some pregnancies by post-fertilization effects such as prevention of implantation.[3][25][61]

text: History[edit]

text: In 1966, gynecologist John McLean Morris and biologist Gertrude Van Wagenen at the Yale School of Medicine reported the successful use of oral high-dose estrogen pills as post-coital contraceptives in women and rhesus macaque monkeys, respectively.[75][76] A few different drugs were studied, with a focus on high-dose estrogens, and it was originally hoped that postcoital contraception would prove viable as an ongoing contraceptive method.[77]

text: The first widely used methods were five-day treatments with high-dose estrogens, using diethylstilbestrol (DES) in the US and ethinylestradiol in the Netherlands by Dr. Haspels.[78][79]

text: In the early 1970s, the Yuzpe regimen was developed by A. Albert Yuzpe in 1974;[80] progestin-only postcoital contraception was investigated (1975);[81] and the copper IUD was first studied for use as emergency contraception (1975).[82] Danazol was tested in the early 1980s in the hopes that it would have fewer side effects than Yuzpe, but was found to be ineffective.[83]

text: The Yuzpe regimen became the standard course of treatment for postcoital contraception in many countries in the 1980s. The first prescription-only combined estrogen-progestin dedicated product, Schering PC4 (ethinylestradiol and norgestrel), was approved in the UK in January 1984 and first marketed in October 1984.[84] Schering introduced a second prescription-only combined product, Tetragynon (ethinylestradiol and levonorgestrel) in Germany in 1985.[1] By 1997, Schering AG dedicated prescription-only combined products had been approved in only 9 countries: the UK (Schering PC4), New Zealand (Schering PC4), South Africa (E-Gen-C), Germany (Tetragynon), Switzerland (Tetragynon), Denmark (Tetragynon), Norway (Tetragynon), Sweden (Tetragynon) and Finland (Neoprimavlar); and had been withdrawn from marketing in New Zealand in 1997 to prevent it being sold over-the-counter.[2] [3][permanent dead link] [4] Regular combined oral contraceptive pills (which were less expensive and more widely available) were more commonly used for the Yuzpe regimen even in countries where dedicated products were available.[85]

text: Over time, interest in progestin-only treatments increased. The Special Program on Human Reproduction (HRP), an international organization whose members include the World Bank and World Health Organization, "played a pioneering role in emergency contraception" by "confirming the effectiveness of levonorgestrel."[86] After the WHO conducted a large trial comparing Yuzpe and levonorgestrel in 1998,[87][88] combined estrogen-progestin products were gradually withdrawn from some markets (Preven in the United States discontinued May 2004, Schering PC4 in the UK discontinued October 2001, and Tetragynon in France) in favor of progestin-only EC, although prescription-only dedicated Yuzpe regimen products are still available in some countries.

text: In 2002, China became the first country in which mifepristone was registered for use as EC.

text: Calculating effectiveness[edit]

text: Early studies of emergency contraceptives did not attempt to calculate a failure rate; they simply reported the number of women who became pregnant after using an emergency contraceptive. Since 1980, clinical trials of emergency contraception have first calculated probable pregnancies in the study group if no treatment were given. The effectiveness is calculated by dividing observed pregnancies by the estimated number of pregnancies without treatment.[89]

text: Placebo-controlled trials that could give a precise measure of the pregnancy rate without treatment would be unethical, so the effectiveness percentage is based on estimated pregnancy rates. These are currently estimated using variants of the calendar method.[90] Women with irregular cycles for any reason (including recent hormone use such as oral contraceptives and breastfeeding) must be excluded from such calculations. Even for women included in the calculation, the limitations of calendar methods of fertility determination have long been recognized. In their February 2014 emergency review article, Trussell and Raymond note:

text: Calculation of effectiveness, and particularly the denominator of the fraction, involves many assumptions that are difficult to validate...The risk of pregnancy for women requesting ECPs appears to be lower than assumed in the estimates of ECP efficacy, which are consequently likely to be overestimates. Yet, precise estimates of efficacy may not be highly relevant to many women who have had unprotected intercourse, since ECPs are often the only available treatment.[6]

text: In 1999, hormonal assay was suggested as a more accurate method of estimating fertility for EC studies.[91]

text: United States[edit]

text: DES[edit]

text:
In 1971, a New England Journal of Medicine editorial calling attention to previously published studies on the use of DES as a postcoital contraceptive at Yale University, and a large study published in JAMA on the use of DES as a postcoital contraceptive at the University of Michigan, led to off-label use of DES as a postcoital contraceptive becoming prevalent at many university health services.[92][93]
In May 1973, in an attempt to restrict off-label use of DES as a postcoital contraceptive to emergency situations such as rape, a FDA Drug Bulletin was sent to all U.S. physicians and pharmacists that said the FDA had approved, under restricted conditions, postcoital contraceptive use of DES.[94] (In February 1975, the FDA Commissioner testified that the only error in the May 1973 FDA Drug Bulletin was that the FDA had not approved postcoital contraceptive use of DES.)[95]
In September 1973, the FDA published a proposed rule specifying patient labeling and special packaging requirements for any manufacturer seeking FDA approval to market DES as a postcoital contraceptive, inviting manufacturers to submit abbreviated new drug applications (ANDAs) for that indication, and notifying manufacturers that the FDA intended to order the withdrawal of DES 25 mg tablets (which were being used off-label as postcoital contraceptives).[96][97][97][98]
In late 1973, Eli Lilly, the largest U.S. manufacturer of DES, discontinued its DES 25 mg tablets and in March 1974 sent a letter to all U.S. physicians and pharmacists telling them it did not recommend use of DES as a postcoital contraceptive.[95]
Only one pharmaceutical company, Tablicaps, Inc., a small manufacturer of generic drugs, ever submitted (in January 1974) an ANDA for use of DES as an emergency postcoital contraceptive, and the FDA never approved it.[95][99]
In February 1975, the FDA said it had not yet approved DES as a postcoital contraceptive, but would after March 8, 1975 permit marketing of DES for that indication in emergency situations such as rape or incest if a manufacturer obtained an approved ANDA that provided patient labeling and special packaging as set out in a FDA final rule published in February 1975.[100] To discourage off-label use of DES as a postcoital contraceptive, in February 1975 the FDA ordered DES 25 mg (and higher) tablets removed from the market and ordered the labeling of lower doses (5 mg and lower) of DES still approved for other indications be changed to state: "THIS DRUG PRODUCT SHOULD NOT BE USED AS A POSTCOITAL CONTRACEPTIVE" in block capital letters on the first line of the physician prescribing information package insert and in a prominent and conspicuous location of the container and carton label.[97][101]
In March 1978, a FDA Drug Bulletin was sent to all U.S. physicians and pharmacists which said: "FDA has not yet given approval for any manufacturer to market DES as a postcoital contraceptive. The Agency, however, will approve this indication for emergency situations such as rape or incest if a manufacturer provides patient labeling and special packaging. To discourage 'morning after' use of DES without patient labeling, FDA has removed from the market the 25 mg tablets of DES, formerly used for this purpose."[102]
In the 1980s, off-label use of the Yuzpe regimen superseded off-label use of DES for postcoital contraception.[99][103][104]

DES is no longer commercially available in the U.S.; Eli Lilly, the last U.S. manufacturer, ceased production in spring 1997.[105]

text: Preven[edit]

text:
On February 25, 1997, the FDA posted a notice in the Federal Register saying it had concluded that the Yuzpe regimen was safe and effective for off-label use as postcoital EC, was prepared to accept NDAs for COCPs labeled as ECPs, and listed 6 then available COCPs (there are now 22) that could be used as ECPs.[5]
On September 1, 1998, the FDA approved the prescription Yuzpe regimen Preven Emergency Contraception Kit (which contained a urine pregnancy test and 4 COCPs).[106] Preven was discontinued in May 2004.[107]

text: Plan B[edit]

text:
On July 28, 1999, the FDA approved the prescription progestin-only Plan B (two 750 µg levonorgestrel pills) emergency contraceptive.[108]
On August 24, 2006, the FDA approved nonprescription behind-the-counter access to Plan B from pharmacies staffed by a licensed pharmacist for women 18 or older; a prescription-only form of Plan B was made available for younger females aged 17 and younger.[109]
On November 6, 2006, Barr Pharmaceuticals announced that its subsidiary, Duramed Pharmaceuticals, had initiated shipment of dual-label Plan B OTC/Rx and it would be available in pharmacies across the U.S. by mid-November 2006.[110]
On March 23, 2009, a US judge ordered the FDA to allow 17-year-olds to acquire Plan B without a prescription.[111] This now changes the August 24, 2006 ruling and Plan B is now available "behind the counter" for men and women. There is a prescription method available for girls under 17.
On April 30, 2013, the FDA approved (with three-year marketing exclusivity) Teva Pharmaceutical Industries Plan B One-Step for sale without a prescription to anyone age 15 or over who can show proof of age such as a driver's license, birth certificate, or passport to a drug store retail clerk.[112] Generic one-pill levonorgestrel emergency contraceptives and all two-pill levonorgestrel emergency contraceptives will remain restricted to sale from a pharmacist—without a prescription to anyone age 17 or over who can show proof of age.[112]
On June 10, 2013, the Obama administration ceased trying to block the over-the-counter availability the pill for all women and girls. With this reversal it means that any woman or girl will be able to purchase the Plan B One-Step without a prescription.[113]

text: Availability[edit]