document_title: Epidemiology

question_text: who is known as the father of epidemiology

question_tokens: who is known as the father of epidemiology

text: Epidemiology

text: Etymology[edit]

text: Epidemiology, literally meaning "the study of what is upon the people", is derived from Greek epi, meaning 'upon, among', demos, meaning 'people, district', and logos, meaning 'study, word, discourse', suggesting that it applies only to human populations. However, the term is widely used in studies of zoological populations (veterinary epidemiology), although the term "epizoology" is available, and it has also been applied to studies of plant populations (botanical or plant disease epidemiology).[2]

text: The distinction between "epidemic" and "endemic" was first drawn by Hippocrates,[3] to distinguish between diseases that are "visited upon" a population (epidemic) from those that "reside within" a population (endemic).[4] The term "epidemiology" appears to have first been used to describe the study of epidemics in 1802 by the Spanish physician Villalba in Epidemiología Española.[4] Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic.

text: The term epidemiology is now widely applied to cover the description and causation of not only epidemic disease, but of disease in general, and even many non-disease, health-related conditions, such as high blood pressure and obesity. Therefore, this epidemiology is based upon how the pattern of the disease cause changes in the function of everyone.

text: History[edit]

text: The Greek physician Hippocrates is known as the father of medicine,[5][6] sought a logic to sickness; he is the first person known to have examined the relationships between the occurrence of disease and environmental influences.[7] Hippocrates believed sickness of the human body to be caused by an imbalance of the four humors (air, fire, water and earth “atoms”). The cure to the sickness was to remove or add the humor in question to balance the body. This belief led to the application of bloodletting and dieting in medicine.[8] He coined the terms endemic (for diseases usually found in some places but not in others) and epidemic (for diseases that are seen at some times but not others).[9]

text: Modern era[edit]

text: In the middle of the 16th century, a doctor from Verona named Girolamo Fracastoro was the first to propose a theory that these very small, unseeable, particles that cause disease were alive. They were considered to be able to spread by air, multiply by themselves and to be destroyable by fire. In this way he refuted Galen's miasma theory (poison gas in sick people). In 1543 he wrote a book De contagione et contagiosis morbis, in which he was the first to promote personal and environmental hygiene to prevent disease. The development of a sufficiently powerful microscope by Antonie van Leeuwenhoek in 1675 provided visual evidence of living particles consistent with a germ theory of disease.

text: Wu Youke (1582–1652) developed the concept that some diseases were caused by transmissible agents, which he called liqi (pestilential factors). His book Wenyi Lun (Treatise on Acute Epidemic Febrile Diseases) can be regarded as the main etiological work that brought forward the concept, ultimately attributed to Westerners, of germs as a cause of epidemic diseases (source: http://baike.baidu.com/view/143117.htm). His concepts are still considered in current scientific research in relation to Traditional Chinese Medicine studies (see: http://apps.who.int/medicinedocs/en/d/Js6170e/4.html).

text: Another pioneer, Thomas Sydenham (1624–1689), was the first to distinguish the fevers of Londoners in the later 1600s. His theories on cures of fevers met with much resistance from traditional physicians at the time. He was not able to find the initial cause of the smallpox fever he researched and treated.[8]

text: John Graunt, a haberdasher and amateur statistician, published Natural and Political Observations ... upon the Bills of Mortality in 1662. In it, he analysed the mortality rolls in London before the Great Plague, presented one of the first life tables, and reported time trends for many diseases, new and old. He provided statistical evidence for many theories on disease, and also refuted some widespread ideas on them.

text: John Snow is famous for his investigations into the causes of the 19th century cholera epidemics, and is also known as the father of (modern) epidemiology.[10][11] He began with noticing the significantly higher death rates in two areas supplied by Southwark Company. His identification of the Broad Street pump as the cause of the Soho epidemic is considered the classic example of epidemiology. Snow used chlorine in an attempt to clean the water and removed the handle; this ended the outbreak. This has been perceived as a major event in the history of public health and regarded as the founding event of the science of epidemiology, having helped shape public health policies around the world.[12][13] However, Snow’s research and preventive measures to avoid further outbreaks were not fully accepted or put into practice until after his death.

text: Other pioneers include Danish physician Peter Anton Schleisner, who in 1849 related his work on the prevention of the epidemic of neonatal tetanus on the Vestmanna Islands in Iceland.[14][15] Another important pioneer was Hungarian physician Ignaz Semmelweis, who in 1847 brought down infant mortality at a Vienna hospital by instituting a disinfection procedure. His findings were published in 1850, but his work was ill-received by his colleagues, who discontinued the procedure. Disinfection did not become widely practiced until British surgeon Joseph Lister 'discovered' antiseptics in 1865 in light of the work of Louis Pasteur.

text: In the early 20th century, mathematical methods were introduced into epidemiology by Ronald Ross, Janet Lane-Claypon, Anderson Gray McKendrick, and others.[16][17][18][19]

text: Another breakthrough was the 1954 publication of the results of a British Doctors Study, led by Richard Doll and Austin Bradford Hill, which lent very strong statistical support to the link between tobacco smoking and lung cancer.

text: In the late 20th century, with advancement of biomedical sciences, a number of molecular markers in blood, other biospecimens and environment were identified as predictors of development or risk of a certain disease. Epidemiology research to examine the relationship between these biomarkers analyzed at the molecular level, and disease was broadly named “molecular epidemiology”. Specifically, "genetic epidemiology" has been used for epidemiology of germline genetic variation and disease. Genetic variation is typically determined using DNA from peripheral blood leukocytes. Since the 2000s, genome-wide association studies (GWAS) have been commonly performed to identify genetic risk factors for many diseases and health conditions.

text: While most molecular epidemiology studies are still using conventional disease diagnosis and classification systems, it is increasingly recognized that disease evolution represents inherently heterogeneous processes differing from person to person. Conceptually, each individual has a unique disease process different from any other individual (“the unique disease principle”),[20][21] considering uniqueness of the exposome (a totality of endogenous and exogenous / environmental exposures) and its unique influence on molecular pathologic process in each individual. Studies to examine the relationship between an exposure and molecular pathologic signature of disease (particularly cancer) became increasingly common throughout the 2000s. However, the use of molecular pathology in epidemiology posed unique challenges including lack of research guidelines and standardized statistical methodologies, and paucity of interdisciplinary experts and training programs.[22] Furthermore, the concept of disease heterogeneity appears to conflict with the long-standing premise in epidemiology that individuals with the same disease name have similar etiologies and disease processes. To resolve these issues and advance population health science in the era of molecular precision medicine, “molecular pathology” and “epidemiology” was integrated to create a new interdisciplinary field of “molecular pathological epidemiology” (MPE),[23][24] defined as “epidemiology of molecular pathology and heterogeneity of disease”. In MPE, investigators analyze the relationships between; (A) environmental, dietary, lifestyle and genetic factors; (B) alterations in cellular or extracellular molecules; and (C) evolution and progression of disease. A better understanding of heterogeneity of disease pathogenesis will further contribute to elucidate etiologies of disease. The MPE approach can be applied to not only neoplastic diseases but also non-neoplastic diseases.[25] The concept and paradigm of MPE have become widespread in the 2010s.[26][27][28][29][30][31][32]

text: Types of studies[edit]

text: Epidemiologists employ a range of study designs from the observational to experimental and generally categorized as descriptive, analytic (aiming to further examine known associations or hypothesized relationships), and experimental (a term often equated with clinical or community trials of treatments and other interventions). In observational studies, nature is allowed to “take its course," as epidemiologists observe from the sidelines. Conversely, in experimental studies, the epidemiologist is the one in control of all of the factors entering a certain case study.[33] Epidemiological studies are aimed, where possible, at revealing unbiased relationships between exposures such as alcohol or smoking, biological agents, stress, or chemicals to mortality or morbidity. The identification of causal relationships between these exposures and outcomes is an important aspect of epidemiology. Modern epidemiologists use informatics as a tool.

text: Observational studies have two components, descriptive and analytical. Descriptive observations pertain to the “who, what, where and when of health-related state occurrence”. However, analytical observations deal more with the ‘how’ of a health-related event.[33] Experimental epidemiology contains three case types: randomized controlled trials (often used for new medicine or drug testing), field trials (conducted on those at a high risk of conducting a disease), and community trials (research on social originating diseases).[33]

text: The term 'epidemiologic triad' is used to describe the intersection of Host, Agent, and Environment in analyzing an outbreak.

text: Case series[edit]

text: Case-series may refer to the qualitative study of the experience of a single patient, or small group of patients with a similar diagnosis, or to a statistical factor with the potential to produce illness with periods when they are unexposed.

text: The former type of study is purely descriptive and cannot be used to make inferences about the general population of patients with that disease. These types of studies, in which an astute clinician identifies an unusual feature of a disease or a patient's history, may lead to formulation of a new hypothesis. Using the data from the series, analytic studies could be done to investigate possible causal factors. These can include case control studies or prospective studies. A case control study would involve matching comparable controls without the disease to the cases in the series. A prospective study would involve following the case series over time to evaluate the disease's natural history.[34]

text: The latter type, more formally described as self-controlled case-series studies, divide individual patient follow-up time into exposed and unexposed periods and use fixed-effects Poisson regression processes to compare the incidence rate of a given outcome between exposed and unexposed periods. This technique has been extensively used in the study of adverse reactions to vaccination, and has been shown in some circumstances to provide statistical power comparable to that available in cohort studies.

text: Case-control studies[edit]

text: Case-control studies select subjects based on their disease status. It is a retrospective study. A group of individuals that are disease positive (the "case" group) is compared with a group of disease negative individuals (the "control" group). The control group should ideally come from the same population that gave rise to the cases. The case-control study looks back through time at potential exposures that both groups (cases and controls) may have encountered. A 2×2 table is constructed, displaying exposed cases (A), exposed controls (B), unexposed cases (C) and unexposed controls (D). The statistic generated to measure association is the odds ratio (OR), which is the ratio of the odds of exposure in the cases (A/C) to the odds of exposure in the controls (B/D), i.e. OR = (AD/BC).

text:
Cases
Controls

Exposed
A
B

Unexposed
C
D

text: If the OR is significantly greater than 1, then the conclusion is "those with the disease are more likely to have been exposed," whereas if it is close to 1 then the exposure and disease are not likely associated. If the OR is far less than one, then this suggests that the exposure is a protective factor in the causation of the disease. Case-control studies are usually faster and more cost effective than cohort studies, but are sensitive to bias (such as recall bias and selection bias). The main challenge is to identify the appropriate control group; the distribution of exposure among the control group should be representative of the distribution in the population that gave rise to the cases. This can be achieved by drawing a random sample from the original population at risk. This has as a consequence that the control group can contain people with the disease under study when the disease has a high attack rate in a population.

text: A major drawback for case control studies is that, in order to be considered to be statistically significant, the minimum number of cases required at the 95% confidence interval is related to the odds ratio by the equation:

text: where N is the ratio of cases to controls. As the odds ratio approached 1, approaches 0; rendering case control studies all but useless for low odds ratios. For instance, for an odds ratio of 1.5 and cases = controls, the table shown above would look like this:

text:
Cases
Controls

Exposed
103
84

Unexposed
84
103

text: For an odds ratio of 1.1:

text:
Cases
Controls

Exposed
1732
1652

Unexposed
1652
1732

text: Cohort studies[edit]

text: Cohort studies select subjects based on their exposure status. The study subjects should be at risk of the outcome under investigation at the beginning of the cohort study; this usually means that they should be disease free when the cohort study starts. The cohort is followed through time to assess their later outcome status. An example of a cohort study would be the investigation of a cohort of smokers and non-smokers over time to estimate the incidence of lung cancer. The same 2×2 table is constructed as with the case control study. However, the point estimate generated is the relative risk (RR), which is the probability of disease for a person in the exposed group, Pe = A / (A + B) over the probability of disease for a person in the unexposed group, Pu = C / (C + D), i.e. RR = Pe / Pu.

text:
.....
Case
Non-case
Total

Exposed
A
B
(A + B)

Unexposed
C
D
(C + D)

text: As with the OR, a RR greater than 1 shows association, where the conclusion can be read "those with the exposure were more likely to develop disease."

text: Prospective studies have many benefits over case control studies. The RR is a more powerful effect measure than the OR, as the OR is just an estimation of the RR, since true incidence cannot be calculated in a case control study where subjects are selected based on disease status. Temporality can be established in a prospective study, and confounders are more easily controlled for. However, they are more costly, and there is a greater chance of losing subjects to follow-up based on the long time period over which the cohort is followed.

text: Cohort studies also are limited by the same equation for number of cases as for cohort studies, but, if the base incidence rate in the study population is very low, the number of cases required is reduced by ½.

text: Outbreak investigation[edit]

text: Causal inference[edit]

text: Although epidemiology is sometimes viewed as a collection of statistical tools used to elucidate the associations of exposures to health outcomes, a deeper understanding of this science is that of discovering causal relationships.

text: "Correlation does not imply causation" is a common theme for much of the epidemiological literature. For epidemiologists, the key is in the term inference. Correlation is a necessary but not sufficient criteria for inference of causation. Epidemiologists use gathered data and a broad range of biomedical and psychosocial theories in an iterative way to generate or expand theory, to test hypotheses, and to make educated, informed assertions about which relationships are causal, and about exactly how they are causal.

text: Epidemiologists emphasize that the "one cause – one effect" understanding is a simplistic mis-belief.[citation needed] Most outcomes, whether disease or death, are caused by a chain or web consisting of many component causes.[35] Causes can be distinguished as necessary, sufficient or probabilistic conditions. If a necessary condition can be identified and controlled (e.g., antibodies to a disease agent, energy in an injury), the harmful outcome can be avoided (Robertson, 2015).

text: Bradford Hill criteria[edit]

text: In 1965, Austin Bradford Hill proposed a series of considerations to help assess evidence of causation,[36] which have come to be commonly known as the "Bradford Hill criteria". In contrast to the explicit intentions of their author, Hill's considerations are now sometimes taught as a checklist to be implemented for assessing causality.[37] Hill himself said "None of my nine viewpoints can bring indisputable evidence for or against the cause-and-effect hypothesis and none can be required sine qua non."[36]

text:
Strength of Association: A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.[36]
Consistency of Data: Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.[36]
Specificity: Causation is likely if a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.[36]
Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).[36]
Biological gradient: Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence.[36]
Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).[36]
Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that "... lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations".[36]
Experiment: "Occasionally it is possible to appeal to experimental evidence".[36]
Analogy: The effect of similar factors may be considered.[36]

text: Legal interpretation[edit]

text: Epidemiological studies can only go to prove that an agent could have caused, but not that it did cause, an effect in any particular case:

text: "Epidemiology is concerned with the incidence of disease in populations and does not address the question of the cause of an individual's disease. This question, sometimes referred to as specific causation, is beyond the domain of the science of epidemiology. Epidemiology has its limits at the point where an inference is made that the relationship between an agent and a disease is causal (general causation) and where the magnitude of excess risk attributed to the agent has been determined; that is, epidemiology addresses whether an agent can cause a disease, not whether an agent did cause a specific plaintiff's disease."[38]

text: In United States law, epidemiology alone cannot prove that a causal association does not exist in general. Conversely, it can be (and is in some circumstances) taken by US courts, in an individual case, to justify an inference that a causal association does exist, based upon a balance of probability.

text: The subdiscipline of forensic epidemiology is directed at the investigation of specific causation of disease or injury in individuals or groups of individuals in instances in which causation is disputed or is unclear, for presentation in legal settings.

text: Population-based health management[edit]

text: Epidemiological practice and the results of epidemiological analysis make a significant contribution to emerging population-based health management frameworks.

text: Population-based health management encompasses the ability to:

text:
Assess the health states and health needs of a target population;
Implement and evaluate interventions that are designed to improve the health of that population; and
Efficiently and effectively provide care for members of that population in a way that is consistent with the community's cultural, policy and health resource values.

text: Modern population-based health management is complex, requiring a multiple set of skills (medical, political, technological, mathematical etc.) of which epidemiological practice and analysis is a core component, that is unified with management science to provide efficient and effective health care and health guidance to a population. This task requires the forward looking ability of modern risk management approaches that transform health risk factors, incidence, prevalence and mortality statistics (derived from epidemiological analysis) into management metrics that not only guide how a health system responds to current population health issues, but also how a health system can be managed to better respond to future potential population health issues.[39]

text: Examples of organizations that use population-based health management that leverage the work and results of epidemiological practice include Canadian Strategy for Cancer Control, Health Canada Tobacco Control Programs, Rick Hansen Foundation, Canadian Tobacco Control Research Initiative.[40][41][42]

text: Each of these organizations use a population-based health management framework called Life at Risk that combines epidemiological quantitative analysis with demographics, health agency operational research and economics to perform:

text:
Population Life Impacts Simulations: Measurement of the future potential impact of disease upon the population with respect to new disease cases, prevalence, premature death as well as potential years of life lost from disability and death;
Labour Force Life Impacts Simulations: Measurement of the future potential impact of disease upon the labour force with respect to new disease cases, prevalence, premature death and potential years of life lost from disability and death;
Economic Impacts of Disease Simulations: Measurement of the future potential impact of disease upon private sector disposable income impacts (wages, corporate profits, private health care costs) and public sector disposable income impacts (personal income tax, corporate income tax, consumption taxes, publicly funded health care costs).

text: Validity: precision and bias[edit]

text: Different fields in epidemiology have different levels of validity. One way to assess the validity of findings is the ratio of false-positives (claimed effects that are not correct) to false-negatives (studies which fail to support a true effect). To take the field of genetic epidemiology, candidate-gene studies produced over 100 false-positive findings for each false-negative. By contrast genome-wide association appear close to the reverse, with only one false positive for every 100 or more false-negatives.[43] This ratio has improved over time in genetic epidemiology as the field has adopted stringent criteria. By contrast other epidemiological fields have not required such rigorous reporting and are much less reliable as a result.[43]

text: Random error[edit]

text: Random error is the result of fluctuations around a true value because of sampling variability. Random error is just that: random. It can occur during data collection, coding, transfer, or analysis. Examples of random error include: poorly worded questions, a misunderstanding in interpreting an individual answer from a particular respondent, or a typographical error during coding. Random error affects measurement in a transient, inconsistent manner and it is impossible to correct for random error.

text: There is random error in all sampling procedures. This is called sampling error.

text: Precision in epidemiological variables is a measure of random error. Precision is also inversely related to random error, so that to reduce random error is to increase precision. Confidence intervals are computed to demonstrate the precision of relative risk estimates. The narrower the confidence interval, the more precise the relative risk estimate.

text: There are two basic ways to reduce random error in an epidemiological study. The first is to increase the sample size of the study. In other words, add more subjects to your study. The second is to reduce the variability in measurement in the study. This might be accomplished by using a more precise measuring device or by increasing the number of measurements.

text: Note, that if sample size or number of measurements are increased, or a more precise measuring tool is purchased, the costs of the study are usually increased. There is usually an uneasy balance between the need for adequate precision and the practical issue of study cost.

text: Systematic error[edit]

text: A systematic error or bias occurs when there is a difference between the true value (in the population) and the observed value (in the study) from any cause other than sampling variability. An example of systematic error is if, unknown to you, the pulse oximeter you are using is set incorrectly and adds two points to the true value each time a measurement is taken. The measuring device could be precise but not accurate. Because the error happens in every instance, it is systematic. Conclusions you draw based on that data will still be incorrect. But the error can be reproduced in the future (e.g., by using the same mis-set instrument).

text: A mistake in coding that affects all responses for that particular question is another example of a systematic error.

text: The validity of a study is dependent on the degree of systematic error. Validity is usually separated into two components:

text:
Internal validity is dependent on the amount of error in measurements, including exposure, disease, and the associations between these variables. Good internal validity implies a lack of error in measurement and suggests that inferences may be drawn at least as they pertain to the subjects under study.
External validity pertains to the process of generalizing the findings of the study to the population from which the sample was drawn (or even beyond that population to a more universal statement). This requires an understanding of which conditions are relevant (or irrelevant) to the generalization. Internal validity is clearly a prerequisite for external validity.

text: Selection bias[edit]

text: Selection bias occurs when study subjects are selected or become part of the study as a result of a third, unmeasured variable which is associated with both the exposure and outcome of interest.[44] For instance, it has repeatedly been noted that cigarette smokers and non smokers tend to differ in their study participation rates. (Sackett D cites the example of Seltzer et al., in which 85% of non smokers and 67% of smokers returned mailed questionnaires.)[45] It is important to note that such a difference in response will not lead to bias if it is not also associated with a systematic difference in outcome between the two response groups.

text: Information bias[edit]

text: Information bias is bias arising from systematic error in the assessment of a variable.[46] An example of this is recall bias. A typical example is again provided by Sackett in his discussion of a study examining the effect of specific exposures on fetal health: "in questioning mothers whose recent pregnancies had ended in fetal death or malformation (cases) and a matched group of mothers whose pregnancies ended normally (controls) it was found that 28% of the former, but only 20% of the latter, reported exposure to drugs which could not be substantiated either in earlier prospective interviews or in other health records".[45] In this example, recall bias probably occurred as a result of women who had had miscarriages having an apparent tendency to better recall and therefore report previous exposures.

text: Confounding[edit]

text: Confounding has traditionally been defined as bias arising from the co-occurrence or mixing of effects of extraneous factors, referred to as confounders, with the main effect(s) of interest.[46][47] A more recent definition of confounding invokes the notion of counterfactual effects.[47] According to this view, when one observes an outcome of interest, say Y=1 (as opposed to Y=0), in a given population A which is entirely exposed (i.e. exposure X = 1 for every unit of the population) the risk of this event will be RA1. The counterfactual or unobserved risk RA0 corresponds to the risk which would have been observed if these same individuals had been unexposed (i.e. X = 0 for every unit of the population). The true effect of exposure therefore is: RA1 − RA0 (if one is interested in risk differences) or RA1/RA0 (if one is interested in relative risk). Since the counterfactual risk RA0 is unobservable we approximate it using a second population B and we actually measure the following relations: RA1 − RB0 or RA1/RB0. In this situation, confounding occurs when RA0 ≠ RB0.[47] (NB: Example assumes binary outcome and exposure variables.)

text: Some epidemiologists prefer to think of confounding separately from common categorizations of bias since, unlike selection and information bias, confounding stems from real causal effects.[44]

text: The profession[edit]

text: To date, few universities offer epidemiology as a course of study at the undergraduate level. One notable undergraduate program exists at Johns Hopkins University, where students who major in public health can take graduate level courses, including epidemiology, their senior year at the Bloomberg School of Public Health.[48]

text: Many epidemiologists are physicians, or hold graduate degrees such as a Master of Public Health (MPH), Master of Science of Epidemiology (MSc.). Doctorates include the Doctor of Public Health (DrPH), Doctor of Pharmacy (PharmD), Doctor of Philosophy (PhD), Doctor of Science (ScD), Doctor of Social Work (DSW), Doctor of Clinical Practice (DClinP), Doctor of Podiatric Medicine (DPM), Doctor of Veterinary Medicine (DVM), Doctor of Nursing Practice (DNP), Doctor of Physical Therapy (DPT), or for clinically trained physicians, Doctor of Medicine (MD) or Bachelor of Medicine and Surgery (MBBS or MBChB) and Doctor of Osteopathic Medicine (DO).

text: As public health/health protection practitioners, epidemiologists work in a number of different settings. Some epidemiologists work 'in the field'; i.e., in the community, commonly in a public health/health protection service, and are often at the forefront of investigating and combating disease outbreaks. Others work for non-profit organizations, universities, hospitals and larger government entities such as state and local health departments, various Ministries of Health, Doctors without Borders, the Centers for Disease Control and Prevention (CDC), the Health Protection Agency, the World Health Organization (WHO), or the Public Health Agency of Canada. Epidemiologists can also work in for-profit organizations such as pharmaceutical and medical device companies in groups such as market research or clinical development.


document_title: List of Presidents of the United States by military service

question_text: who was the last military general to be elected president

root

text: The United States Constitution names the President of the United States the commander in chief of the U.S. armed forces. Previous service in the military is not a prerequisite for the position of president. As of the 2016 presidential election[update], no member of the U.S. Marine Corps or U.S. Coast Guard has yet been elected President. The most frequent military experience is Army/Army Reserve with 15 presidents, followed by State Militias at 9, Navy/Naval Reserve at 6 and the Continental Army with 2 presidents serving.

tag: p

text: Eight presidents served during World War II, while seven served in the military during the American Civil War.

text: The following list outlines the military service of each president before becoming the commander in chief.

text:
President
Service
Rank
Active Service

Donald J. Trump
None
None
None

Barack Obama
None
None
None

George W. Bush
Texas Air National Guard, United States Air Force
First Lieutenant
Stateside service as pilot during Vietnam War (1968–1973). Received early discharge in 1973.[1]

Bill Clinton
None
None
None. Signed agreement to join Reserve Officer Training Corps at University of Arkansas during Vietnam War.[2] Subsequently withdrew and entered draft, but received high draft number and was not drafted.[3] (See Bill Clinton: Vietnam War opposition and draft controversy.)

George H. W. Bush
United States Naval Reserve
Lieutenant (Junior Grade)
Navy pilot in World War II (1942–1945). Shot down and received the Distinguished Flying Cross.

Ronald Reagan
United States Army Reserve, United States Army Air Corps
Captain
Stateside service during World War II (1942–1945); Army Reserve (1937–1942).

Jimmy Carter
United States Navy
Lieutenant (navy)
Served during World War II as a midshipman at the United States Naval Academy. Sea duty and stateside service 1946–1953 during the Korean War.

Gerald Ford
United States Naval Reserve
Lieutenant Commander
World War II (1942–1945); combat on USS Monterey, discharged in 1946.

Richard Nixon
United States Naval Reserve
Commander
World War II (1942–1945); earned two battle stars for service in the Pacific.

Lyndon B. Johnson
United States Naval Reserve
Commander[4]
World War II received Silver Star medal after observation mission in which aircraft he was on came under Japanese attack.

John F. Kennedy
United States Naval Reserve
Lieutenant (navy)
Served in combat during World War II. Received the Navy and Marine Corps Medal and the Purple Heart.

Dwight D. Eisenhower
United States Army
General of the Army
Stateside service during World War I. Served as Supreme Allied Commander in Europe during World War II (1942–1945). Visited troops in Korea in December 1952. Entire active-duty career spanned from 1915 until 1969 (excepting his two terms as president).

Harry S. Truman[5]
Missouri Army National Guard,
United States Army,
United States Army Reserve
Colonel
Stateside National Guard service in Missouri (1905–1911); served in combat in France during World War I (1917–1918); transferred to Army Reserve and retired in 1953.

Franklin D. Roosevelt
None
None
None; Assistant Secretary of the Navy during World War I. Attempted to resign in order to enter uniformed service, but resignation not accepted. Visited France as part of Navy Department duties to observe military activities first hand.

Herbert Hoover
None
None
None; helped guide US Marines in 1900 during the Boxer Rebellion.

Calvin Coolidge
None
None
None

Warren G. Harding
None
None
None

Woodrow Wilson
None
None
None

William Howard Taft
Connecticut Home Guard
None
None; United States Secretary of War 1904–1908. Enlisted in Connecticut Home Guard for World War I.

Theodore Roosevelt
United States Army
Colonel
New York National Guard, 1882 to 1886, captain and company commander. Spanish–American War service as second in command and then commander of the 1st United States Volunteer Cavalry (Rough Riders). Only U.S. President to receive the Medal of Honor (awarded posthumously in 2001). Also a Navy Civilian, as Assistant Secretary of the Navy[6]

William McKinley
United States Army
Brevet Major
American Civil War. Served in the 23rd Ohio Infantry under future President Rutherford B. Hayes; fought in the Battle of South Mountain, The Battle of Antietam, and in the Valley Campaigns of 1864.

Benjamin Harrison
United States Army
Brigadier General
American Civil War; Commanded an Infantry Brigade at the battles of Resaca, New Hope Church, Kennesaw Mountain, Marietta, Peachtree Creek and Atlanta; also Commanded a brigade during Sherman's March to the Sea.

Grover Cleveland
None
None
Paid George Benninsky $150 to take his place after Cleveland was drafted during American Civil War under the Conscription Act of 1863.

Chester A. Arthur
New York State Militia
Brigadier General
Judge Advocate General, Second Brigade of the New York Militia. Served as Engineer-in-Chief on the Governor's staff, Quartermaster General and Inspector General of the New York Militia before and during the American Civil War. Declined appointment as commander of the 9th New York Volunteer Infantry Regiment and command of four New York City regiments organized as the Metropolitan Brigade when Governor requested he remain Quartermaster General.

James Garfield
United States Army
Major General
American Civil War (1861–1863; commanded an Ohio Infantry Brigade at the Battles of Shiloh and Corinth; served as Chief of Staff for General William Rosecrans at the Battle of Chickamauga; left the army to serve in the United States House of Representatives).

Rutherford B. Hayes
United States Army
Major General
American Civil War. Served in the 23rd Ohio Infantry and commanded future President William McKinley; wounded at the Battle of South Mountain; also served at the Battle of Antietam and in the Valley Campaigns of 1864.

Ulysses S. Grant
United States Army
General of the Army
Mexican–American War and American Civil War; served 1843–54 and 1861–68.

Andrew Johnson
United States Army
Brigadier General
Served in Tennessee Militia in 1830s. American Civil War; served as Military Governor of Tennessee in 1862.

Abraham Lincoln
Illinois State Militia
Captain
Black Hawk War (served three months in 1832); see Abraham Lincoln in the Black Hawk War.

James Buchanan
Pennsylvania State Militia
Private
War of 1812

Franklin Pierce
United States Army
Brigadier General
New Hampshire Militia, 1831–46; Mexican–American War; commanded Infantry Brigade at Battle of Contreras (where his leg was injured), Battle of Churubusco, and the Assault on Mexico City.

Millard Fillmore
New York State Militia
Major
Served in New York Militia in 1820s and 1830s; Organized Union Continentals home guard unit in Buffalo, New York during the American Civil War.

Zachary Taylor
United States Army
Major General
War of 1812, Black Hawk War, Second Seminole War, Mexican–American War; entire career spanned from 1808 until 1848.

James K. Polk
Tennessee State Militia
Colonel
Joined cavalry unit in Tennessee Militia as a Captain. Subsequently appointed a Colonel on the staff of Governor William Carroll.

John Tyler
Virginia militia
Captain
War of 1812.

William Henry Harrison
United States Army
Major General
Northwest Indian War, War of 1812.

Martin Van Buren
None
None
None. Special Judge Advocate appointed to aid in prosecuting William Hull at Hull's court-martial after surrender of Detroit during the War of 1812.

Andrew Jackson
Tennessee State Militia, Continental Army, United States Army
Major General
American Revolutionary War, War of 1812, Creek War, First Seminole War.

John Quincy Adams
None
None
None

James Monroe
Continental Army
Major
American Revolutionary War; depicted holding the American flag behind General George Washington in the famous painting Washington Crossing the Delaware; wounded at the Battle of Trenton, depicted in the painting The Capture of the Hessians at Trenton, December 26, 1776 by John Trumbull.

James Madison
Virginia militia
Colonel
American Revolutionary War, did not see action.

Thomas Jefferson
Virginia militia
Colonel
Commander of Albemarle County Militia at start of American Revolution, did not see action.

John Adams
None
None
Adams served as chairman of the Continental Congress's Board of War (1776–77), making him the simultaneous equivalent of today's Secretary of Defense and Chairman of Senate Armed Services Committee; was a semi-participant in a naval engagement between a British and US ship during the American Revolution.

George Washington
Virginia militia, Virginia Regiment, Continental Army, United States Army
General of the Armies
French and Indian War, American Revolutionary War.

tag: table


document_title: List of Arab flags

question_text: red white and black flag with arabic writing

text: List of Arab flags

text: Arab national flags[edit]

text:
Flag
Duration
Use
Description

1962 to present

Flag of Algeria
Two vertical bands of green and white and the red crescent moon encircling the red five-pointed star in the center within the dividing line.

2002 to present

Flag of Bahrain
A red field with the white serrated band with five points on the hoist-side.

2002 to present

Flag of Comoros
Four horizontal bands of yellow, white, red and blue and the green isosceles triangle is based on the hoist-side bearing the white vertical crescent moon with the convex side is facing the hoist and in the center and four small white five-pointed stars are placed vertically in the line in between the points of the crescent.

1977 to present

Flag of Djibouti
Two horizontal bands of light blue and light green and the white isosceles triangle is based on the hoist-side bearing the red five-pointed star in the center.

1984 to present

Flag of Egypt
Three horizontal bands of red, white and black and the National Coat of Arms in gold in the center of the white band.

2008 to present

Flag of Iraq
Three horizontal bands of red, white and black and the Takbir is written in the Kufic Script in green in the center of the white band. The written of the Takbir is: "ALLAHU AKBAR" (In Arabic for, "GOD IS THE GREATEST").

1928 to present

Flag of Jordan
Three horizontal bands of black, white and green and the red isosceles triangle is based on the hoist-side bearing the small white seven-pointed star in the center.

1961 to present

Flag of Kuwait
Three horizontal bands of green, white and red and the black trapezoid is based on the hoist-side.

1943 to present

Flag of Lebanon
Three horizontal bands of red, white (double-width) and red and the green Cedar Tree in the center of the white band.

2011 to present

Flag of Libya
Three horizontal stripes of red, black (double-width) and green and the white crescent and the five-pointed star in the center of the black stripe.

2017 to present

Flag of Mauritania
A green field with the golden five-pointed star and the golden horizontal crescent moon, the closed side is down, in the center in between two red horizontal bands on the top and the bottom edges of the flag.

1956 to present

Flag of Morocco
A red field with the Seal of Solomon is the green pentagram, a five-pointed linear star, in the center.

1970 to present

Flag of Oman
Three horizontal bands of white, red and green and the red vertical band is on the hoist-side bearing the National Emblem in white in the center and near the top of the red band.

1988 to Present
Flag of the State of Palestine
Three horizontal bands of black, white and green and the red equilateral triangle is based on the hoist side.

1971 to present

Flag of Qatar
A maroon field with the white serrated band with nine points on the hoist side.

1973 to present

Flag of Saudi Arabia
A green field with the Shahada is written in the Thuluth Script in white and the white horizontal saber, in which the tip was pointed to the hoist-side, in the center. The National Flag is manufactured with differing obverse and the reverse sides, so that the Shahada reads and the saber points correctly from right to left on both sides. The written of the Shahada is: ("LĀ 'ILĀHA 'ILLĀ-LLĀH, MUḤAMMADUR-RASŪLU-LLĀH" (In Arabic for, "THERE IS NO GOD BUT GOD AND MUHAMMAD IS THE MESSENGER OF GOD")).

1960 to present

Flag of Somalia
A light blue field with the large white five-pointed star in the center.

1970 to present

Flag of Sudan
Three horizontal bands of red, white and black and the green isosceles triangle is based on the hoist-side.

1980 to present

Flag of Syria
Three horizontal bands of red, white and black and two green five-pointed stars that arranged in the horizontal line in the center of the white band.

1831 to present [1]
Flag of Tunisia
A red field with the large white disk in the center bearing the red crescent moon nearly encircling the red five-pointed star.

1971 to present

Flag of the United Arab Emirates
Three horizontal bands of green, white and black and the red vertical band is on the hoist-side.

1990 to present

Flag of Yemen
Three horizontal bands of red, white and black.

text: Old Arab national flags[edit]

text:
Flag
Duration
Use
Description

1958
Flag of the Arab Federation

1917-1920
Flag of the Arab Revolt

1972–1977
Flag of the Federation of Arab Republics

1958-1972
Flag of the United Arab Republic

1972-2002
Flag of the State of Bahrain

1963-1975
Flag of the State of Comoros

1975-1978
Flag of the State of Comoros

1978-1992
Flag of the Federal and Islamic Republic of Comoros

1992-1996

1996-2001

1922-1958
Flag of the Kingdom of Egypt

1924-1959
Flag of the Kingdom of Iraq

1959-1963
Flag of the Republic of Iraq

1963-1991

1991-2004

2004-2008

1969–1972
Flag of the Libyan Arab Republic

1977-2011
Flag of the Libyan Arab Jamahiriya

1959-2017
Flag of the Mauritania

1932-1934
Flag of the Kingdom of Saudi Arabia

1934-1938

1938-1973

1956-1970
Flag of the Republic of Sudan
A horizontal tricolour of blue (representing the Nile), yellow (representing the Sahara), and green (representing farmlands).

1920
Flag of the Arab Kingdom of Syria

1932-1961
Flag of the Syrian Republic

1963-1972
Flag of the Syrian Arab Republic

1918-1923
Flag of the Mutawakkilite Kingdom of Yemen

1923-1927

1927–1962

1962–1990
Flag of the Yemen Arab Republic

1379–1967
Flag of the Kathiri Sultanate of Hadhramaut

1967–1990
Flag of the People's Democratic Republic of Yemen

1856-1896
Flag of the Sultanate of Zanzibar

1963-1964

text: Arab organizations[edit]

text:
Flag
Duration
Use
Description

Flag of the Arab League

Flag of the Organisation of the Islamic Conference

Flag of the Cooperation Council for the Arab States of the Gulf

1947 to Present
Flag of the Ba'ath Party
Three equal horizontal stripes (black, white, and green from top to bottom) overlaid by a red triangle issuing from the hoist. These are the Pan-Arab colors.

text: Other Arab territories[edit]

text:
Flag
Duration
Use
Description

1964-present
Flag of the Palestinian Liberation Organization and the Palestinian National Authority
Identical to the flag of the State of Palestine

1976–present
Flag of the Sahrawi Arab Democratic Republic

1996–present
Flag of Somaliland

Flag of Syria as claimed by the Syrian opposition

1979-present
Flag of Khuzestan separatists


document_title: Elijah Wood

question_text: who does elijah wood play in american dad

text: Elijah Wood

text: Early life[edit]

text: Wood was born on January 28, 1981, in Cedar Rapids, Iowa, the second of three children.[1] His parents, Debbie (née Krause) and Warren Wood, operated a delicatessen.[2] Wood is of Austrian, Danish, English, German, and Polish descent.[3] He was raised Roman Catholic.[4][5][6] He has an older brother, Zachariah (born 1974), who is a video game producer at Sony,[7][8] and a younger sister, Hannah (born October 7, 1983), who is an actress.[9][10] At age seven, Wood began modeling in his hometown and took piano lessons.[11][12] In elementary school, he appeared in The Sound of Music and played the title character in The Wonderful Wizard of Oz. He also served as choir boy in a Marion Creative Council production of See How They Run. In 1989, his parents sold their delicatessen and the family–without his father–moved to Los Angeles for Wood to pursue an acting career. His parents divorced when he was 15.[13]

text: Career[edit]

text: 1988–1998: Early work[edit]

text: Wood modeled and did local commercials. He got his first break in the video for Paula Abdul's "Forever Your Girl", directed by David Fincher. This was followed by a pivotal role in the TV film, Child in the Night, and a minor role in Back to the Future Part II. Nine-year-old Wood auditioned for a role in Kindergarten Cop, but was told by director Ivan Reitman that his performance was not believable, which Wood later said was "a harsh thing to say to a nine-year-old".[14] Playing Aidan Quinn's son in Avalon and Tin Men garnered professional attention for Wood; Avalon received widespread critical acclaim and was nominated for four Academy Awards. A small part in Richard Gere's Internal Affairs was followed by the role of a boy who brings estranged couple Melanie Griffith and Don Johnson back together in Paradise (1991). Wood co-starred with Mel Gibson and Jamie Lee Curtis in Forever Young (1992) and Joseph Mazzello in Radio Flyer.

text: In 1993, Wood played the title character in The Adventures of Huck Finn, and co-starred with Macaulay Culkin in The Good Son; The following year, he starred in The War. The latter film was nominated for four awards and won two. Roger Ebert's film review praised Wood highly, stating that Wood "has emerged, I believe, as the most talented actor, in his age group, in Hollywood history".[15]

text: Wood's title role in North was followed by a Super Bowl commercial for Wavy Lay's potato chips (with Dan Quayle).[16] In 1995, Wood was in the video for The Cranberries "Ridiculous Thoughts", played the lead role in Flipper, and was in Ang Lee's critically acclaimed, The Ice Storm. In 1997, Wood was Jack "The Artful Dodger" Dawkins in Tony Bill's film adaptation of Oliver Twist, and had a leading role in Deep Impact, and supporting one in The Faculty. In 1999, Wood played a suburban white teenager who affects hip-hop lingo in James Toback's Black and White, and a junior hitman in Chain of Fools.

text: 1999–2003: The Lord of the Rings[edit]

text: Wood was cast as Frodo Baggins in The Lord of the Rings: The Fellowship of the Ring, the first installment of director Peter Jackson's adaptation of J. R. R. Tolkien's multi-volume novel. This gave Wood top billing as Baggins, alongside a cast that included Ian McKellen, Liv Tyler, Orlando Bloom, Cate Blanchett, Christopher Lee, Sean Bean, Sean Astin, Billy Boyd, Dominic Monaghan, Viggo Mortensen, and John Rhys-Davies. The Lord of the Rings trilogy was filmed in New Zealand, in a process taking more than one year for principal photography alone, with pick-up shots occurring annually for the next four years. Before the cast left the country, Jackson gave Wood two gifts: one of the One Ring props used on the set and Sting, Frodo's sword. He was also given a pair of prosthetic "hobbit feet" of the type worn during filming.

text: In 2002, Wood lent his voice to the direct-to-video release of The Adventures of Tom Thumb and Thumbelina. The second part of Peter Jackson's trilogy was also released, titled The Lord of the Rings: The Two Towers. In 2003, Wood starred in the direct-to-video movie All I Want (also titled Try Seventeen). The Lord of the Rings: The Return of the King was unveiled that December, sweeping the 76th Academy Awards in early 2004.

text: Wood's first post-trilogy role was in Eternal Sunshine of the Spotless Mind, as a lab technician; he next played the serial killer Kevin in Robert Rodriguez's adaptation of Frank Miller's comic-book series, Sin City. On May 12, 2005, Wood hosted a program called MTV Presents: The Next Generation Xbox Revealed when the new Xbox 360 games console was launched.[17]

text: In 2005, Wood starred in Everything Is Illuminated, in which he plays a young Jewish-American man on a quest to find the woman who saved his grandfather during World War II. It was based on the novel of the same name by Jonathan Safran Foer. In Green Street, he played an American college student who falls in with a violent English football firm. Both had limited release but were critically acclaimed.

text: Wood shot a small part in Paris, je t'aime, which consists of 18 five-minute sections, each directed by a different director. Wood’s section, called "Quartier de la Madeleine", was directed by Vincenzo Natali. The film opened on May 18 at the 2006 Cannes Film Festival and was shown at 2006 Toronto International Film Festival. First Look Pictures acquired the North American rights, and the film opened in the US in early 2007.[18]

text: In 2006, he was part of the ensemble cast of Emilio Estevez's Bobby, in which his character marries Lindsay Lohan's character to change his draft classification.[19] The film premiered at the Venice Film Festival and was released theatrically on November 17, 2006.

text: In Happy Feet, Wood provided the voice of Mumble, a penguin who can tap dance, but not sing.[20] Happy Feet was released on November 17, 2006, and has grossed over $380 million worldwide. The movie also received a Golden Globe Award nomination and won an Academy Award and a BAFTA for Best Animated Feature. Day Zero, a drama about the draft in the United States, had its debut at the 2007 Tribeca Film Festival. Wood portrays draftee Aaron Feller.[21]

text: In 2006, Wood hosted the special Saving a Species: The Great Penguin Rescue for Discovery Kids Channel;[22] he was nominated for a Daytime Emmy in the category of acting in a children/youth/family special.[23] On January 4, 2007, Wood joined Screen Actors Guild President Alan Rosenberg to announce the nominees for the 13th Annual Screen Actors Guild Awards.[24]

text: In The Oxford Murders, a film adaptation of the novel of the same name by Guillermo Martínez, Wood plays a graduate student who investigates a series of bizarre, mathematically-based murders in Oxford.[25] It was released in Spain on January 18, 2008. Wood also voiced the lead in the animated feature film version of the short film 9.[26] A project in which Wood was set to star, a biographical film about singer Iggy Pop, putatively named The Passenger,[27] has not come to fruition after years in development.[28]

text: Wood's first starring TV role is on the FX series, Wilfred, in which he plays Ryan Newman. The pilot was shot in the summer of 2010.[29] In January 2011, it was confirmed that Wood would reprise the role of Frodo Baggins in The Hobbit: An Unexpected Journey, the first film of The Hobbit trilogy,[30] released on December 14, 2012.

text: In 2012, Wood appeared in the psychedelic and dreamlike Flying Lotus music video "Tiny Tortures," where he appears as a recent amputee coming to grips with his new situation.

text: At PAX East in April 2012, it was confirmed that Wood would give the voice to Agent Maine's AI, Sigma, in Season 10 of the machinima series Red vs. Blue. Wood also starred in the Beastie Boys' music video for "Make Some Noise", along with Seth Rogen and Danny McBride.

text: In 2013, Wood starred in Grand Piano (Director: Eugenio Mira, Writer: Damien Chazelle).

text: Since 2016, Wood has been co-starring with Samuel Barnett as Todd Brotzman in the BBC America series Dirk Gently's Holistic Detective Agency.

text: Other work[edit]

text: In 2005, Wood started his own record label called Simian Records. On September 19, 2006, Wood announced that Simian had signed The Apples in Stereo as their first band, with their new album New Magnetic Wonder released in February 2007.[31] In addition, he also directed the music video for "Energy".[32] The other band signed to Simian thus far is Heloise and the Savoir Faire.

text: In 2006, Wood was also in Season 2 Episode 6 of American Dad!. He was the voice of Ethan, a college student and Haley's crush, who listens to Professor Baxter's (Roger) advice about following your heart and doing something new. Ethan takes this the wrong way and stabs his father 38 times (not shown) and becomes very crazy. Roger admits to being a fake, and he and Hayley leave, saying that the police are coming. This suggests that Ethan gets arrested, and is out of the show. Wood does not appear again.

text: Wood has also provided voiceovers for video games, providing the voice for Spyro the Dragon in the Legend of Spyro game trilogy,[33] as well as reprising Mumble in the game version of Happy Feet.[34] He also contributed his talents to fellow Lord of the Rings star Viggo Mortensen's album Pandemoniumfromamerica, singing and playing various instruments on the album.[35]

text: On April 11, 2008, Wood was the guest host of Channel 4's Friday Night Project. On April 25, 2009, Wood was honored with the Midnight Award by the San Francisco International Film Festival as an American actor who "has made outstanding contributions to independent and Hollywood cinema, and who brings striking intelligence, exemplary talent and extraordinary depth of character to his roles".[36] Wood also starred in an episode of Yo Gabba Gabba!, entitled "Eat," where he danced and "went crazy" alongside the rest of the Yo Gabba Gabba! cast. Wood can be seen in a short film on stepthroughtheportal.com. The site is an interactive website created by Simian Records artists The Apples in Stereo, promoting their upcoming album, Travelers in Space and Time.

text: In addition to producing and acting, Wood has become a well-known DJ. Together with his friend Zach Cowie, they formed Wooden Wisdom and has toured around the world. They have spun at events such as the Bushmills Live 2012 festival at the Old Bushmills Distillery, the opening of the Brickell City Centre and at the pre-Emmy party at The London West Hollywood hotel.[37][38]

text: Despite the common misconception, Wood has confirmed that his DJ name is just his name, and not "DJ Frodo" as has been falsely spread by the internet.[39]

text: Wood has signed up to co-produce and also star in the film Black Wings Has My Angel, based on the noir novel of the same name, with Anthony Moody and Rob Malkani of Indalo Productions. Wood, alongside Tom Hiddleston and Anna Paquin, started shooting in late 2012.[40]

text: In 2010, Wood, together with Daniel Noah and Josh C. Waller, founded The Woodshed, a production company that promotes horror films. In 2013, the company was re-branded as SpectreVision.[41] In 2010, Wood starred in the web series 'Red vs Blue as the A.I. fragment Sigma.

text: In 2010, Wood also starred alongside Lemmy and Selma Blair in the short film/music video Full of Regret for Canadian rock band Danko Jones.[42]

text: Wood also stars in the TV show Wilfred and voiced Shay, one of two main characters in the adventure game Broken Age for which he won the 2014 Performance in a Comedy, Lead by National Academy of Video Game Trade Reviewers (NAVGTR).[43] In 2014, Wood provided the voice of Wirt in Over the Garden Wall, a miniseries on Cartoon Network.

text: Charity work[edit]

text: Wood's most dedicated charitable commitment is to The Art of Elysium that therapeutically helps hospitalized children deal with their ailments by concentrating on creating art. He has been involved with the organization since 2008 and received their Spirit of Elysium Award in 2012 for his continued support with the charity.

text: Wood has supported campaigns such as Keep a Child Alive, ALDO/YouthAIDS, Make a Film Foundation and TOMS Shoes among other civil, political and environmental causes. Fellow actor Liev Schreiber, who directed Wood in Everything Is Illuminated, commented that Wood has a "generosity of spirit" and a "sincere goodness as a human being".[44]

text: On April 23, 2010, in a charitable gesture, Wood visited the town of Curepto, Chile, one of the hardest hit by the 8.8 magnitude earthquake that struck Chile on February 27, 2010. He made personal visits to many of the victims and was accompanied by the First Lady of Chile, Cecilia Morel.[45][46]

text: Personal life[edit]

text: In 2013, Wood sold his $1.75 million home in Santa Monica, California,[47] and purchased a $1 million home in the Bouldin Creek neighborhood of Austin, Texas.[48]

text: Wood is a music lover, owning a collection of roughly 4,000 vinyl records and CDs. He has cited The Smashing Pumpkins as his favorite band.[49]

text: Wood has a tattoo of the number nine written in the Sindarin language, which uses the Tengwar script, and in the English language (rather than Quenya as is widely believed), below his waist on the right side. It refers to his character as one of the Fellowship of the Ring. By coincidence, he had a voice role in a film titled 9. The other actors of "The Fellowship" got the same tattoo, with the exception of John Rhys-Davies, whose stunt double got the tattoo instead.[50]

text: In May 2006, Autograph Collector Magazine published its list of 10 Best & 10 Worst Hollywood Autograph Signers; Wood was ranked #7 of Best Signers.[51]

text: In 2008, during an appearance on Jack Osbourne's show Adrenaline Junkie, he became the first person to cross Victoria Falls on ropes.[52]

text: Wood supported 2016 presidential candidate Bernie Sanders.[53]

text: Wood is a fan of the podcast My Dad Wrote a Porno and appeared on an episode of the podcast in 2016.[54]

text: In 2016, Wood spoke of his belief that organized child sexual abuse does happen in the Hollywood film industry.[55]

text: Filmography[edit]


document_title: Current Procedural Terminology

question_text: identify the cpt section in which the code 97001 is located

text: Current Procedural Terminology

text: Types of code[edit]

text: There are three types of CPT code: Category I, Category II, and Category III.

text: Category I[edit]

text: Category I CPT Code(s). There are six main sections:[7]

text: Codes for evaluation and management: 99201–99499[edit]

text:
(99201–99215) Office/other outpatient services
(99217–99220) Hospital observation services
(99221–99239) Hospital inpatient services
(99241–99255) Consultations
(99281–99288) Emergency department services
(99291–99292) Critical care services
(99304–99318) Nursing facility services
(99324–99337) Domiciliary, rest home (boarding home) or custodial care services
(99339–99340) Domiciliary, rest home (assisted living facility), or home care plan oversight services
(99341–99350) Home health services
(99354–99360) Prolonged services
(99363–99368) Case management services
(99374–99380) Care plan oversight services
(99381–99429) Preventive medicine services
(99441–99444) Non-face-to-face physician services
(99450–99456) Special evaluation and management services
(99460–99465) Newborn care services
(99466–99480) Inpatient neonatal intensive, and pediatric/neonatal critical, care services
(99487–99489) Complex chronic care coordination services
(99495–99496) Transitional care management services
(99499) Other evaluation and management services

tag: ul

text: Codes for anesthesia: 00100–01999; 99100–99150[edit]

text:
(00100–00222) head
(00300–00352) neck
(00400–00474) thorax
(00500–00580) intrathoracic
(00600–00670) spine and spinal cord
(00700–00797) upper abdomen [8]
(00800–00882) lower abdomen
(00902–00952) perineum
(01112–01190) pelvis (except hip)
(01200–01274) upper leg (except knee)
(01320–01444) knee and popliteal area
(01462–01522) lower leg (below knee)
(01610–01682) shoulder and axillary
(01710–01782) upper arm and elbow
(01810–01860) forearm, wrist and hand
(01916–01936) radiological procedures
(01951–01953) burn excisions or debridement
(01958–01969) obstetric
(01990–01999) other procedures
(99100–99140) qualifying circumstances for anesthesia
(99143–99150) moderate (conscious) sedation

text: Codes for surgery: 10000–69990[edit]

text:
(10000–10022) general
(10040–19499) integumentary system
(20000–29999) musculoskeletal system
(30000–32999) respiratory system
(33010–37799) cardiovascular system
(38100–38999) hemic and lymphatic systems
(39000–39599) mediastinum and diaphragm
(40490–49999) digestive system
(50010–53899) urinary system
(54000–55899) male genital system
(55920–55980) reproductive system and intersex
(56405–58999) female genital system
(59000–59899) maternity care and delivery
(60000–60699) endocrine system
(61000–64999) nervous system
(65091–68899) eye and ocular adnexa
(69000–69979) auditory system

text: Codes for Radiology: 70000-79999[edit]

text:
(70000-76499) diagnostic radiology
(76500–76999) diagnostic ultrasound
(77001–77032) radiologic guidance
(77051–77059) breast mammography
(77071–77084) bone/joint studies
(77261–77999) radiation oncology
(78000-79999) nuclear medicine

text: Codes for pathology and laboratory: 80000–89398[edit]

text:
(80000–80076) organ or disease-oriented panels
(80100–80103) drug testing
(80150–80299) therapeutic drug assays
(80400–80440) evocative/suppression testing
(80500–80502) consultations (clinical pathology)
(81000–81099) urinalysis
(82000–84999) chemistry
(85002–85999) hematology and coagulation
(86000–86849) immunology
(86850–86999) transfusion medicine
(87001–87999) microbiology
(88000–88099) anatomic pathology (postmortem)
(88104–88199) cytopathology
(88230–88299) cytogenetic studies
(88300–88399) surgical pathology
(88720–88741) in vivo (transcutaneous) lab procedures
(89049–89240) other procedures
(89250–89398) reproductive medicine procedures

text: Codes for medicine: 90281–99099; 99151–99199; 99500–99607[edit]

text:
(90281–90399) immune globulins, serum or recombinant prods
(90465–90474) immunization administration for vaccines/toxoids
(90476–90749) vaccines, toxoids
(90801–90899) psychiatry
(90901–90911) biofeedback
(90935–90999) dialysis
(91000–91299) gastroenterology
(92002–92499) ophthalmology
(92502–92700) special otorhinolaryngologic services
(92950–93799) cardiovascular
(93875–93990) noninvasive vascular diagnostic studies
(94002–94799) pulmonary
(95004–95199) allergy and clinical immunology
(95250–95251) endocrinology
(95803–96020) neurology and neuromuscular procedures
(96101–96125) central nervous system assessments/tests (neuro-cognitive, mental status, speech testing)
(96150–96155) health and behavior assessment/intervention
(96360–96549) hydration, therapeutic, prophylactic, diagnostic injections and infusions, and chemotherapy and other highly complex drug or highly complex biologic agent administration
(96567–96571) photodynamic therapy
(96900–96999) special dermatological procedures
(97001–97799) physical medicine and rehabilitation
(97802–97804) medical nutrition therapy
(97810–97814) acupuncture
(98925–98929) osteopathic manipulative treatment
(98940–98943) chiropractic manipulative treatment
(98960–98962) education and training for patient self-management
(98966–98969) non-face-to-face nonphysician services
(99000–99091) special services, procedures and reports
(99170–99199) other services and procedures
(99500–99602) home health procedures/services
(99605–99607) medication therapy management services

text: Category II[edit]

text: CPT II codes describe clinical components usually included in evaluation and management or clinical services and are not associated with any relative value. Category II codes are reviewed by the Performance Measures Advisory Group (PMAG), an advisory body to the CPT Editorial Panel and the CPT/HCPAC Advisory Committee. The PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA) and the Physician Consortium for Performance Improvement. The PMAG may seek additional expertise and/or input from other national health care organizations, as necessary, for the development of Category II codes. These may include national medical specialty societies, other national health care professional associations, accrediting bodies and federal regulatory agencies.

text: Category II codes make use of an alphabetical character as the 5th character in the string (i.e., 4 digits followed by the letter F). These digits are not intended to reflect the placement of the code in the regular (Category I) part of the CPT codebook. Appendix H in CPT section contains information about performance measurement exclusion of modifiers, measures, and the measures' source(s). Currently there are 11 Category II codes. They are:

text:
(0001F-0015F) Composite measures
(0500F-0575F) Patient management
(1000F-1220F) Patient history
(2000F-2050F) Physical examination
(3006F-3573F) Diagnostic/screening processes or results
(4000F-4306F) Therapeutic, preventive or other interventions
(5005F-5100F) Follow-up or other outcomes
(6005F-6045F) Patient safety
(7010F-7025F) Structural Measures

text: CPT II codes are billed in the procedure code field, just as CPT Category I codes are billed. Because CPT II codes are not associated with any relative value, they are billed with a $0.00 billable charge amount.[9]

text: Category III[edit]

text: Category III CPT Code(s) – Emerging technology (Category III codes: 0016T-0207T[10])

text: Major psychotherapy revisions[edit]

text: The CPT code revisions that affect counselors are simple and straightforward. Here is a list of psychotherapy CPT codes that will be retired, and their 2013 comparables:

text: 90801 –> \ Family therapy codes (90847 and 90846) will remain unchanged, as will codes for psychological testing.[11]

text: Criticism of copyright[edit]

text: CPT is a registered trademark of the American Medical Association. The AMA holds the copyright for the CPT coding system.[12] However, in Practice Management v. American Medical Association[13] the U.S. Court of Appeals for the Ninth Circuit held that the AMA could not enjoin a competitor on the basis that the AMA had misused its copyright.

text: Despite the copyrighted nature of the CPT code sets, the use of the code is mandated by almost all health insurance payment and information systems, including the Centers for Medicare and Medicaid Services (CMS) and HIPAA, and the data for the code sets appears in the Federal Register. As a result, it is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code.[14]

text: Limited CPT search offered by the AMA[edit]

text: The AMA offers a limited search of the CPT manual for personal, non-commercial use on its web site.[15]


document_title: Sunday Will Never Be the Same

question_text: who wrote sunday will never be the same

question_tokens: who wrote sunday will never be the same

text: Sunday Will Never Be the Same

text:
"Sunday Will Never Be the Same"

Single by Spanky and Our Gang

from the album Spanky and Our Gang

B-side
"Distance"

Released
April 1967 (1967)

Genre
Sunshine pop

Length
2:58

Label
Mercury

Songwriter(s)
Terry Cashman, Gene Pistilli

Producer(s)
Jerry Ross

Spanky and Our Gang singles chronology

"And Your Bird Can Sing"
(1966)
"Sunday Will Never Be the Same"
(1967)
"Making Every Minute Count"
(1967)

"And Your Bird Can Sing"
(1966)
"Sunday Will Never Be the Same"
(1967)
"Making Every Minute Count"
(1967)

text: "Sunday Will Never Be the Same" is a 1967 song by the American band Spanky and Our Gang from their self-titled debut album. The single peaked at #9 on the Billboard Hot 100[1] and #7 in the Canadian RPM Magazine charts (July 1, 1967). The song was written by Terry Cashman and Gene Pistilli and borrows an interlude from the French carol “Les Anges Dans Nos Campagnes”.

text: Like most of their hit singles, producer Jerry Ross used a group of session musicians to provide the instrumental backing track while the rest of the group members provided lead and background vocals. Session personnel on this record included Vinnie Bell, Al Gorgoni, Hugh McCracken, Charles Macey on guitar, Paul Griffin on piano, Artie Butler on harpsichord, Joe Macho on bass, Bobby Gregg and Al Rogers on drums, David Sackson, Irving Spice, Louis Stone, Ray Free, Matthew Raimondi, Lou Haber on violins, Artie Kaplan on flute, and Seymour Barab and Maurice Bialkin on cellos. Additional instruments were also played by Samuel Casale, Charles Naclerio, Joseph Renzetti, and James Wisner.

text: Cover versions[edit]

text: The O'Kaysions released a version of the song on their 1968 debut album, Girl Watcher.[2]