title: Jared Leto filmography

text: Jared Leto is an American entertainer with an extensive career in film, music, and television. He made his debut with minor roles in the television shows "Camp Wilder" (1992) and "Almost Home" (1993). He achieved recognition in 1994 for his role as Jordan Catalano in the teen drama television series "My So-Called Life". The show was praised for its portrayal of adolescence and gained a cult following, despite being canceled after only one season. The same year, he made his television film debut starring alongside Alicia Silverstone in "Cool and the Crazy". Leto's first film role was in the 1995 drama "How to Make an American Quilt". He later co-starred with Christina Ricci in "The Last of the High Kings" (1996) and received a supporting role in "Switchback" (1997). In 1997, Leto starred in the biopic "Prefontaine" in which he played the role of Olympic hopeful Steve Prefontaine. His portrayal received positive reviews from critics and is often considered his breakthrough role. The following year, Leto starred together with Alicia Witt in the horror "Urban Legend". He then acted alongside Sean Penn and Adrien Brody in the war film "The Thin Red Line" (1998). After supporting roles in "Black and White" and "Girl, Interrupted", Leto portrayed Angel Face in "Fight Club" (1999), which has since become a cult film.


title: Jared Leto filmography

text: In 2000, Leto played Paul Allen in the psychological thriller "American Psycho". The same year, he starred as heroin addict Harry Goldfarb in "Requiem for a Dream", directed by Darren Aronofsky. His acting in the addiction drama received praise from film critics. During this period Leto focused increasingly on his band Thirty Seconds to Mars, returning to acting in 2002 in the David Fincher-directed thriller "Panic Room", which was well-received both critically and commercially. Following the lead role in the independent film "Highway" (2002), he co-starred with Colin Farrell in the historical drama "Alexander" (2004) as Hephaestion. Leto then starred together with Nicolas Cage in the political crime thriller "Lord of War" (2005) and acted alongside Salma Hayek in the crime drama "Lonely Hearts" (2006) as Raymond Fernandez. He also began to direct music videos for Thirty Seconds to Mars, with the first being "The Kill" (2006). The following year, he portrayed Mark David Chapman in the biopic "Chapter 27". Despite divided critical opinion on the film as a whole, Leto's performance was widely praised.


title: Jared Leto filmography

text: In 2009, he starred in the science fiction drama "Mr. Nobody" directed by Jaco Van Dormael. Critics praised the film's artistry and Leto's acting. He later directed the music videos for "Kings and Queens" (2009) and "Hurricane" (2010), which were both nominated for the MTV Video Music Award for Best Direction. The latter garnered controversy upon release and was initially censored due to its elements of violence. In 2012, Leto made his directorial debut with the documentary film "Artifact". After a six-year hiatus, he returned to film acting in the 2013 drama "Dallas Buyers Club" starring together with Matthew McConaughey, for which he received the Academy Award for Best Supporting Actor, Golden Globe Award for Best Supporting Actor – Motion Picture, Screen Actors Guild Award for Outstanding Performance by a Male Actor in a Supporting Role and a variety of film critics' circle awards. Leto then premiered the web series "Into the Wild" (2014) and the documentary film "A Day in the Life of America" (2019). He also played the Joker in the superhero film "Suicide Squad" (2016), which was unfavorably reviewed by critics, though Leto's performance was better received.


title: Jared Leto filmography

text: In 2021, he played suspected serial killer Albert Sparma in John Lee Hancock's film "The Little Things", which earned Leto nominations for a Golden Globe Award and Screen Actors Guild Award—both for Best Supporting Actor. The same year, Leto portrays fashion designer and business magnate Paolo Gucci in Ridley Scott's biographical crime drama film "House of Gucci", which earned Leto nomination for a Satellite Award and Critics' Choice Movie Award—both for Best Supporting Actor. He played the Marvel Comics character Morbius the Living Vampire in the live-action film "Morbius" released in 2022, part of the Sony's Spider-Man Universe.


title: Alaskan Malamute

text: The Alaskan Malamute () is a large breed of dog that was originally bred for its strength and endurance to haul heavy freight as a sled dog and hound. It is similar to other arctic breeds such as the husky, the spitz, the Greenland Dog, Canadian Eskimo Dog, the Siberian Husky, and the Samoyed.


title: Alaskan Malamute

text: Although it is believed that the first dogs arrived in the Americas 12,000 years ago, people and their dogs did not settle in the Arctic until the Paleo-Eskimo people 4,500 years ago, followed by the Thule people 1,000 years ago, with both originating from Siberia. Malamutes were thought to be bred by the Malimiut Inupiaq people of Alaska's Norton Sound region.


title: Alaskan Malamute

text: The Malamute has been identified as a basal breed that predates the emergence of the modern breeds in the 19th century. A study in 2013 showed that the Alaskan Malamute has a similar east Asian origin to, but is not clearly related to, the Greenland Dog and the Canadian Eskimo Dog, but contains a possible admixture of the Siberian Husky.


title: Alaskan Malamute

text: In 2015, a study using several genetic markers indicated that the Malamute, the Siberian Husky, and the Alaskan husky share a close genetic relationship between each other and were related to Chukotka sled-dogs from Siberia. They were separate from the two Inuit dogs, the Canadian Eskimo Dog and the Greenland Dog. In North America, the Malamute and the Siberian Husky both had maintained their Siberian lineage and had contributed significantly to the Alaskan husky, which showed evidence of crossing with European breeds that was consistent with this breed being created in post-colonial North America. DNA extracted from a 9,500-year-old dog, Zhokhov, named after the Siberian island, was found to have shared a common ancestor with the Greenland sledge dog, the Alaskan Malamute and the Siberian Husky.


title: Alaskan Malamute

text: The American Kennel Club (AKC) breed standard describes a natural range of size, with a desired size of tall and for females, tall and for males. Heavier individuals () and dogs smaller than are commonly seen. There is often a marked size difference between males and females. Weights upwards of are also seen.


title: Alaskan Malamute

text: The coat of the Alaskan Malamute is a double coat. The undercoat has an oily and woolly texture and can be as thick as two inches. The outer guard coat is coarse and stands off the body longer at the withers but not more than one inch off the sides of the body. Ears are small in proportion to the head and stand firmly erect when at attention. The Alaskan Malamute is a heavy dog, with a more formidable nature and structure than the Siberian Husky, which is bred for speed. The Alaskan Malamute is bred for power and endurance, which is its original function and what the standard of the breed requires of Alaskan Malamute breeders.


title: Alaskan Malamute

text: The usual colors are various shades of grey and white, sable and white, black and white, seal and white, red and white, or solid white. There are a wide range of markings in the breed including face markings, blazes, a splash at the nape of the neck, and a collar or half collar. White is often the predominant color on the body, parts of the legs, feet, and part of the markings of the face. In terms of color variants, some Malamutes exhibit a dark grey to buff-colored undertone around their trimmings and white areas, presenting with a color-linked gene known as Agouti. Two agouti alleles, with the possibility of a third, appear to be found in Malamutes: aw (Agouti Pattern or Wolf/Wild Pattern), at (Tan Point Pattern or Black Pattern), and awat (Heterozygous Agouti or Dark Agouti).


title: Alaskan Malamute

text: The eyes of the Alaskan Malamute are almond-shaped and are varied shades of brown; however, the darker eye is preferred. Purebred Alaskan Malamutes will not have blue eyes. The physical build of the Malamute is compact and strong with substance, bone and snowshoe feet.


title: Alaskan Malamute

text: According to the AKC breed standard, the Malamute's tail is well furred and is carried over the back like a waving plume. Corkscrew tails are occasionally seen but are faulted in the AKC breed standard (a corkscrew tail is commonly seen in the Akita). The Malamutes well-furred tails aid in keeping them warm when they curl up in the snow. They are often seen wrapping the tail around their nose and face, which presumably helps protect them against harsh weather such as blowing snow. Their ears are generally upright, wedge-shaped, small in proportion to the head and set to the side of the skull. The muzzle is deep and broad, tapering slightly from the skull to the nose. Nose and gums are black but some Malamutes have a snow nose, which is black with a pink undertone that can get darker or lighter, depending on the season.


title: Alaskan Malamute

text: Alaskan Malamutes are still in use as sled dogs for personal travel, hauling freight, or helping move light objects; some, however, are used for the recreational pursuit of sledding, also known as mushing, as well as for skijoring, bikejoring, carting, and canicross. However, most Malamutes today are kept as family pets or as show or performance dogs in weight pulling, dog agility, or packing. Malamutes are generally slower in long-distance dog sled racing against smaller and faster breeds, so their working usefulness is limited to freighting or traveling over long distances at a far slower rate than required for racing. They can also help move heavy objects over shorter distances. An adult male Alaskan Malamute can pull around of weight, depending on build and training.


title: Alaskan Malamute

text: Malamutes, like other Northern and sled dog breeds, can have a high prey drive, due to their origins and breeding. This may mean that in some cases they will chase smaller animals, including other canines, as well as rabbits, squirrels, and cats. While Malamutes are, as a general rule, particularly amicable around people and can be taught to tolerate smaller pets, it is necessary to be mindful of them around smaller animals and small children.


title: Alaskan Malamute

text: Malamutes are very fond of people, a trait that makes them particularly sought-after family dogs, but unreliable watchdogs as they do not tend to bark. Malamutes are nimble around furniture and smaller items, making them ideal house dogs, provided they get plenty of time outdoors meeting their considerable exercise requirements. Alaskan Malamutes also often participate in animal therapy programs, like visiting patients in hospitals, due to their soft nature. If they are year-round outdoor dogs, letting them play in a baby pool filled with cold water in summer keeps them cool. In the winter, they prefer snow.


title: Alaskan Malamute

text: Malamutes are usually quiet dogs, seldom barking. When a Malamute does vocalize, it often appears to be "talking" by vocalizing a "woo woo" sound. A similar-looking Spitz dog, the Siberian Husky, is much more vocal.


title: Alaskan Malamute

text: There is only one known health survey of Alaskan Malamutes, a 2004 UK Kennel Club survey with a small sample size of 14 dogs. The median lifespan of 10.7 years measured in that survey is typical of a breed their size; however, this study had a sample size too small to be considered reliable, and much anecdotal evidence suggests they have on average one of the longest lifespans of large dogs, up to 15 years. The major cause of death was cancer (36%).


title: Alaskan Malamute

text: The most commonly reported health problems of Alaskan Malamutes, in the 2004 UK Kennel Club survey (based on a sample size of 64 dogs) were musculoskeletal (hip dysplasia), and hereditary cataracts. There are additional health issues in the breed, the origins of which are unknown, including seizure disorders, found in young puppies as well as adults, epilepsy, congenital heart problems, kidney problems and skin disorders.


title: Alaskan Malamute

text: Other health issues in Malamutes include elbow dysplasia, inherited polyneuropathy, osteochondrodysplasia, cerebellar hypoplasia, heart defects, and eye problems (particularly cataract and progressive retinal atrophy). A growing problem among arctic dog breeds, including the Alaskan Malamute, but especially their cousin, the Samoyed, is canine diabetes, with onset occurring typically in middle age (5 to 7 years).


title: Alaskan Malamute

text: Another health issue with Malamutes is zinc deficiency. This breed cannot easily absorb zinc, and infections, skin, and coat problems can arise.


title: Alaskan Malamute

text: Thyroid disorders are the most common hormonal issue in dogs, and hypothyroidism is common in Malamutes.


title: Alaskan Malamute

text: The Alaskan Malamute had a prominent role with their human companions as a utilitarian dog, working, hunting, and living alongside humans. The dogs were renowned for their excellent hunting abilities and were used to hunt large predators such as bears. They also aided their owners in finding seals by alerting them to seal blowholes. The interdependent relationship between the Mahlemut and their dogs fostered prosperity among both and enabled them to flourish in the inhospitable land above the Arctic Circle.


title: Alaskan Malamute

text: For a brief period during the Klondike Gold Rush of 1896, the Malamute and other sled dogs became extremely valuable to recently landed prospectors and settlers and were frequently crossbred with imported breeds.


title: Alaskan Malamute

text: The Malamute dog has had a distinguished history; aiding Rear Admiral Richard Byrd to the South Pole, and the miners who came to Alaska during the Gold Rush of 1896, as well as serving in World War II primarily as search and rescue dogs in Greenland, although also used as freighting and packing dogs in Europe. This dog was never destined to be a racing sled dog; it was used for heavy freighting, pulling hundreds, perhaps thousands of pounds of supplies to villages and camps in groups of at least four dogs for heavy loads.


title: Alaskan Malamute

text: In 2018, researchers at the University of Washington recorded the behavior of an Alaskan Malamute by attaching sensors to its paws, torso and tail, allowing them to capture its normal movements. The data was entered into a machine learning system with the aim of predicting the dog's behavior in various situations. The predictive ability of the software was only limited to short time frames, but it was able to identify "walkable" surfaces after observing the dog walk on, or avoid, certain surfaces.


title: Demographics of Ukraine

text: The demographics of Ukraine include statistics on population growth, population density, ethnicity, education level, health, economic status, religious affiliations, and other aspects of the population of Ukraine.


title: Demographics of Ukraine

text: The data in this article are based on the 2001 Ukrainian census which is the most recent, the "CIA World Factbook", and the State Statistics Committee of Ukraine. The next census was scheduled to take place in 2020 but was postponed to 2023.


title: Demographics of Ukraine

text: On 1 January 2022 the total population of Ukraine was estimated to be 43.4 million (without the Autonomous Republic of Crimea and Sevastopol, illegally annexed by Russia in 2014, Ukraine's population would be 41,167,336,).


title: Demographics of Ukraine

text: During the War in Donbas, in 2014, the Ukrainian Government also lost control of portions of the Donbas region, including major cities such as Luhansk, Donetsk, and Horlivka. If the population of these cities are also subtracted from Ukraine's current demographics, the total population of Ukraine falls below 40 million. Additionally due to the Russian invasion, more than 8 million Ukrainians have left the country. In January 2020, an electronic census estimated that the population of Ukraine (excluding occupied Crimea and parts of the Donbas), to be 37.3 million.


title: Demographics of Ukraine

text: The majority of the historical information is sourced from "Demoscope.ru". The territory of modern Ukraine at the times listed above varied greatly. The western regions of Ukraine, west of Zbruch river, until 1939 for most of the time were part of the Kingdom of Galicia and later the Polish Republic. The detailed information for those territories is missing, for more information see Demographics of Poland. The Crimean peninsula changed hands as well, in 1897 it was a part of the Taurida Governorate, but after the October Revolution became part of the Russian SFSR, and later was turned under the administration of the Ukrainian SSR.


title: Demographics of Ukraine

text: The territory of "Budjak" (southern Bessarabia) became a part of the Ukrainian SSR in June 1940. The censuses of 1926 through 1989 were taken in the Ukrainian SSR. The census of 1897 is taken with the correspondence to nine gubernias that included in the territory of today's Ukraine. The statistics of 1906 records are taken from www.statoids.com which provides a broad degree of historical explanation on the situation in the Imperial Russia. The census statistics of 1931 was estimated by Ukrainian professor Zenon Kuzela (1882–1952) from Berlin. His calculations are as of 1 January 1931. This ethnographer is mentioned in the encyclopedia of Ukraine as one of the sources only available due to lack of the official census.


title: Demographics of Ukraine

text: The 2001 census was the first (and so far only) official census of independent Ukraine. Its data is given as on 1 January. The 2003–2009 stats were taken from the official website of Ukrstat and represent the data as of February of each year for the real population.


title: Demographics of Ukraine

text: The famines of the 1930s, followed by the devastation of World War II, created a demographic disaster. Life expectancy at birth fell to a level as low as ten years for females and seven for males in 1933 and plateaued around 25 for females and 15 for males in the period 1941–44. According to "The Oxford companion to World War II", "Over 7 million inhabitants of Ukraine, more than one-sixth of the pre-war population, were killed during the Second World War."


title: Demographics of Ukraine

text: Significant migration took place in the first years of Ukrainian independence. More than one million people moved into Ukraine in 1991–92, mostly from the other former Soviet republics. In total, between 1991 and 2004, 2.2 million immigrated to Ukraine (among them, 2 million came from the other former Soviet Union states), and 2.5 million emigrated from Ukraine (among them, 1.9 million moved to other former Soviet Union republics). As of 2015, immigrants constituted an estimated 11.4% of the total population, or 4.8 million people. In 2006, there were an estimated 1.2 million Canadians of Ukrainian ancestry, giving Canada the world's third-largest Ukrainian population behind Ukraine itself and Russia. There are also large Ukrainian immigrant communities in the United States, Poland, Australia, Brazil, and Argentina.


title: Demographics of Ukraine

text: Since about 2015 there has been a growing number of Ukrainians working in the European Union, particularly Poland. Eurostat reported that 662,000 Ukrainians received EU residence permits in 2017, with 585,439 being to Poland. World Bank statistics show that money remittances back to Ukraine have roughly doubled from 2015 to 2018, worth about 4% of GDP. However this emigration is not represented in Ukrainian migration data, measuring registrations at the State Migration Service which is usually only done by Ukrainians obtaining foreign citizenship. It is unclear if those moving to work in the EU intend this to be temporary or permanent.


title: Demographics of Ukraine

text: According to estimations of the State Statistics Service of Ukraine, the population of Ukraine (excluding Crimea) on 1 May 2021 was 41,442,615.


title: Demographics of Ukraine

text: The country's population has been declining since the 1990s because of a high emigration rate, coupled with high death rates and low birth rates. The population has been shrinking by an average of over 300,000 annually since 1993.


title: Demographics of Ukraine

text: Ukraine suffers a high mortality rate from environmental pollution, poor diets, widespread smoking, extensive alcoholism and deteriorating medical care.


title: Demographics of Ukraine

text: During the years 2008 to 2010, more than 1.5 million children were born in Ukraine, compared to fewer than 1.2 million during 1999–2001. In 2008 Ukraine posted record-breaking birth rates since its 1991 independence. Infant mortality rates have also dropped from 10.4 deaths to 8.3 per 1,000 children under one year of age. This is lower than in 153 countries of the world.


title: Demographics of Ukraine

text: In 2019 the government ran an electronic census using multiple sources, including mobile phone and pension data, and estimated that Ukraine's population, excluding Crimea and parts of the Donbas, to be 37.3 million. About 20 million were of active working age.


title: Demographics of Ukraine

text: The current birth rate in Ukraine, , is 8.1 live births/1,000 population, and the death rate is 14.7 deaths/1,000 population.


title: Demographics of Ukraine

text: The phenomenon of lowest-low fertility, defined as total fertility below 1.3, is emerging throughout Europe and is attributed by many to postponement of the initiation of childbearing. Ukraine, where total fertility (a very low 1.1 in 2001), was one of the world's lowest, shows that there is more than one pathway to lowest-low fertility. Although Ukraine has undergone immense political and economic transformations during 1991–2004, it has maintained a young age at first birth and nearly universal childbearing. Analysis of official national statistics and the Ukrainian Reproductive Health Survey show that fertility declined to very low levels without a transition to a later pattern of childbearing. Findings from focus group interviews suggest explanations of the early fertility pattern. These findings include the persistence of traditional norms for childbearing and the roles of men and women, concerns about medical complications and infertility at a later age, and the link between early fertility and early marriage. Ukraine subsequently has one of the oldest populations in the world, with the average age of 40.8 years.


title: Demographics of Ukraine

text: To help mitigate the declining population, the government continues to increase child support payments. Thus it provides one-time payments of 12,250 hryvnias for the first child, 25,000 hryvnias for the second and 50,000 hryvnias for the third and fourth, along with monthly payments of 154 hryvnias per child. The demographic trend is showing signs of improvement, as the birth rate has been steadily growing since 2001. Net population growth over the first nine months of 2007 was registered in five provinces of the country (out of 24), and population shrinkage was showing signs of stabilising nationwide. In 2007 the highest birth rates were in the western oblasts. In 2008, Ukraine emerged from lowest-low fertility, and the upward trend has continued to 2012, while the population was still decreasing but at a pace that was slowing year to year. If early 2010s trends were continuing, the population of Ukraine could have returned to positive growth later in the same decade. Similar trends were seen in Russia and Belarus as well, which experienced population growth in the 2010s. In 2014 the strong decline in births was re-established, with 2018 having fewer than half the number of births as in 1989. (see demographic tables) In 2020 the number of births decreased to 293,000, reaching levels not seen even in the late 90s and early 2000s when the number of births started to increase.


title: Demographics of Ukraine

text: According to the 2021 interview with Ukrainian professor Iryna Kurylo from M.V. Ptukha Institute for Demography and Social Studies, Ukraine's total fertility rate is 1.20 children per woman making it the lowest in Europe.


title: Demographics of Ukraine

text: In 2001 Ukraine recorded the lowest fertility rate ever recorded in Europe for an independent country: 1.08 child/woman. During this year the number of children born was less than half of that born in 1987 and less than a quarter of that born in 1937. Lower rates were recorded only in former East Germany, which registered 0.77 child/woman in 1994, as well as Taiwan (from 2008 to 2010), South Korea in 2018 and both Hong Kong and Macau (from about 2000 to 2010). After neglect by the Kuchma administration, both the Yushchenko and the Yanukovych governments have made increasing the birth rate a priority.


title: Demographics of Ukraine

text: The figures below refer to the nine governorates of the Russian Empire (Volhynia, Katerynoslav, Kyiv, Podilia, Poltava, Tauryda, Kharkiv, Kherson and Chernihiv) with a Ukrainian majority.


title: Demographics of Ukraine

text: (b) Information is given for Ukraine's territory within its present-day boundaries, after the Soviet annexation of Eastern Galicia and Volhynia in September 1939


title: Demographics of Ukraine

text: "Note:" Starting 2014 territories of the Autonomous Republic of Crimea and the city of Sevastopol are not included in Demographics of Ukraine. These territories are included to the Demographics of Russia.


title: Demographics of Ukraine

text: Note: Recent data for Donetsk and Luhansk Oblasts has been affected by the War in Donbas, and may only include births within the government-held parts of the oblasts.


title: Demographics of Ukraine

text: Compared to 2012, amount of attrition increased by 16,278 persons, or 3.1 to 3.5 persons per 1,000 inhabitants real. Natural decrease was observed in 23 oblasts of the country, while natural increases were recorded only in the capital Kyiv, Zakarpattya, Rivne and Volyn oblast (respectively 5,302, 3,689, 2,889 and 1,034 people).


title: Demographics of Ukraine

text: Some regions registered a low natural decline, such as Chernivtsi, Ivano-Frankivsk, Sevastopol, Lviv, Ternopil, Crimea, Kherson and Odessa (respectively, −55, −642, −863, −2,124, −2,875, −2,974, −3,748 and −4,448 people). The largest declines were recorded in Donetsk, Luhansk, Dnipro, Kharkiv, Poltava and Chernihiv (respectively −28,311, −15,291, −15,007, −12,765, −10,062 and −10,057), regions which have in common a low birth rate and high mortality of a large urban population and a strong rural population aging.


title: Demographics of Ukraine

text: Although none of the oblasts in 2013 has recorded a higher fertility rate 2.10 children per woman. However, the rate has been in rural areas in the Rivne Oblast (2.50) and the Volyn Oblast (2.20). While a very close generational renewal rate was achieved in the Odessa Oblast (2.04), Zakarpattia Oblast (2.00), Mykolaiv Oblast (1.95), Chernivtsi Oblast (1.93) and Zhytomyr Oblast (1.91) weaker when they have been recorded in the Luhansk oblast (1.41), Sumy oblast (1.47) and Cherkasy Oblast (1.53).


title: Demographics of Ukraine

text: The fertility rate of the highest urban areas were recorded in the Zakarpattia Oblast (1.80), the city of Sevastopol (1.57), Volyn Oblast (1.56), Kyiv Oblast (1.56) and the Rivne Oblast (1.54). The lowest rates were recorded in the Sumy Oblast (1.23), Kharkiv Oblast (1.26), Cherkasy Oblast (1.28), Chernihiv Oblast (1.28), Chernivtsi Oblast (1.28), Luhansk oblast (1.28), Poltava oblast (1.29), Donetsk oblast (1.29) and Zaporizhzhia Oblast (1.32).


title: Demographics of Ukraine

text: Ukrainian 77.8%, Russian 17.3%, Belarusian 0.6%, Moldovan 0.5%, Crimean Tatar 0.5%, Bulgarian 0.4%, Hungarian 0.3%, Romanian 0.3%, Polish 0.3%, Jewish 0.2%, other 1.8% (2001 est.)


title: Demographics of Ukraine

text: Ukrainian (official) 67.5%, Russian (regional language) 29.6%, other (includes small Crimean Tatar-, Moldovan/Romanian-, and Hungarian-speaking minorities) 2.9% (2001 est.)


title: Demographics of Ukraine

text: Note: in February 2018, the Constitutional Court ruled that 2012 language legislation entitling a language spoken by at least 10% of an oblast's population to be given the status of "regional language" – allowing for its use in courts, schools, and other government institutions – was unconstitutional, thus making the law invalid; Ukrainian remains the country's only official nationwide


title: Demographics of Ukraine

text: Orthodox (includes Ukrainian Autocephalous Orthodox (UAOC), Ukrainian Orthodox – Kyiv Patriarchate (UOC-KP), Ukrainian Orthodox – Moscow Patriarchate (UOC-MP)), Ukrainian Greek Catholic, Roman Catholic, Protestant, Muslim, Jewish


title: Demographics of Ukraine

text: Note: Ukraine's population is overwhelmingly Christian; the vast majority – up to two-thirds – identify themselves as Orthodox, but many do not specify a particular branch; the UOC-KP and the UOC-MP each represent less than a quarter of the country's population, the Ukrainian Greek Catholic Church accounts for 8–10%, and the UAOC accounts for 1–2%; Muslim and Jewish adherents each compose less than 1% of the total population (2013 est.)


title: Demographics of Ukraine

text: In 2001, the ethnic composition was: Ukrainians 77.8%, Russian 17.3%, Romanian 1.1% (including Moldovan 0.8%), Belarusian 0.6%, Crimean Tatar 0.5%, Bulgarian 0.4%, Hungarian 0.3%, Polish 0.3%, Jewish 1.0%, Pontic Greeks 0.2% and other 1.6% (including Muslim Bulgarians, otherwise known as Torbesh and a microcosm of Swedes of Gammalsvenskby). It is also estimated that there are about 49,817 ethnic Koreans (0.12%) in Ukraine that belong to the Koryo-saram group. Their number may be as high as 100.000 as many ethnic Koreans were assimilated into the majority population.


title: Demographics of Ukraine

text: According to the latest census that took place, the following languages are common in Ukraine Ukrainian 67.5%, Russian 29.6%, Crimean Tatar, Urum (Turkic Greeks), Bulgarian, Moldovan/Romanian, Polish, Hungarian.


title: Demographics of Ukraine

text: The below table gives the total population of various ethnic groups in Ukraine and the primary language, according to the 2001 census.


title: Demographics of Ukraine

text: A 2018 survey conducted by the Razumkov Centre found that 71.7% of the population declared themselves believers in any religion, while 4.7% declared themselves non-believers, and 3.0% declared to be atheists. Of the total Ukrainian population, 87.4% declared to be Christians, comprising a 67.3% who declared to be Orthodox, 10.2% Catholic (split into 9.4% Greek Rite Catholics and 0.8% Latin Rite Catholics), 7.7% simply Christians, and 2.2% Protestants. Judaism comprises 0.4% of the population. In earlier surveys around 1% of the population stated that they adhere to Islam.


title: Demographics of Ukraine

text: According to data from 2018 among those Ukrainians who declared to believe in Orthodoxy, 28.7% declared to be members of the Ukrainian Orthodox Church of the Kyivan Patriarchate (being incorporated as of the 5 January 2019 into the Orthodox Church of Ukraine), while 12.8% declared to be members of the Ukrainian Orthodox Church of the Moscovian Patriarchate (which is an autonomous Orthodox church under the Russian Orthodox Church). A further 0.3% were members of the Ukrainian Autocephalous Orthodox Church, which, like the Kyivan Patriarchate, where incorporated in 2019 into the Orthodox Church of Ukraine. Among the remaining Orthodox Ukrainians, 23.4% declared to be "simply Orthodox", without affiliation to any patriarchate, while a further 1.9% declared that they "did not know" which patriarchate or Orthodox church they belonged to.


title: Demographics of Ukraine

text: Between the Soviet census of 1989 and the Ukrainian census of 2001, Ukraine's population declined from 51,706,600 to 48,457,020, a loss of 2,926,700 people or 5.7% of the 1989 population. However, this trend has been quite uneven and varied regionally. Two regions in western Ukraine — Rivne and Zakarpattia, saw slight population increases of 0.3% and 0.5% respectively. A third western Ukrainian region, Volyn, lost less than 0.1% of its population between 1989 and 2001. Collectively, between 1989 and 2001 the seven westernmost regions of Ukraine lost 167,500 people or 1.7% of their 1989 population. The total population of these regions in 2001 was 9,593,800.


title: Demographics of Ukraine

text: Between 1989 and 2001, the population of Kyiv City increased by 0.3% due to positive net-migration. Outside the capital, the central, southern and eastern regions experienced a severe decline in population. Between 1989 and 2001, the Donetsk region lost 491,300 people or 9.2% of its 1989 population, and neighbouring Luhansk region lost 11% of its population. Chernihiv region, in central Ukraine northeast of Kyiv, lost 170,600 people or 12% of its 1989 population, the highest percentage loss in of any region in Ukraine. In southern Ukraine, Odessa region lost 173,600 people, or 6.6% of its 1989 population. By 2001, Crimea's population declined by 29,900 people, representing only 1.4% loss of the 1989 population.


title: Demographics of Ukraine

text: However, this was due to the influx of approximately 200,000 Crimean Tatars – a number equivalent to approximately 10% of Crimea's 1989 population – who arrived in Crimea after 1989 and whose population in that region increased by a factor of 6.4 from 38,000 to 243,400 between 1989 and 2001. Collectively, the net population loss in the regions of Ukraine outside the westernmost regions was 2,759,200 people or 6.6% of the 1989 population. The total population of these regions in 2001 was 39,186,100.


title: Demographics of Ukraine

text: Thus, from 1989–2001 the pattern of population change was one of slight growth in Kyiv, slight declines in western Ukraine, large declines in eastern, central and southern Ukraine and a relatively small decline in Crimea due to a large influx of Crimean Tatars.


title: Demographics of Ukraine

text: Ukraine's total fertility rate is one of the lowest in Europe. However, significant regional differences in birth rates may account for some of the demographic differences. In the third quarter of 2007, for instance, the highest birth rate among Ukrainian regions occurred in Volyn Oblast, with a birth rate of 13.4/1,000 people, compared to the Ukrainian country-wide average of 9.6/1,000 people. Volyn's birthrate is higher than the average birth rate of any European country with the exceptions of Iceland and Albania.


title: Demographics of Ukraine

text: In 2007, for the first time since 1990, five Ukrainian regions (Zakarpattia Oblast, Rivne Oblast, Volyn Oblast, Lviv Oblast, and Kyiv Oblast) experienced more births than deaths. This demonstrates a positive trend of increasing birthrates in the last couple of years throughout Ukraine. The ratio of births to deaths in those regions in 2007 was 119%, 117%, 110%, 100.7%, and 108%, respectively.


title: Demographics of Ukraine

text: With the exception of Kyiv region, all of the regions with more births than deaths were in the less industrially developed regions of western Ukraine. According to a spokesperson for Ukraine's Ministry of Justice, the overall ratio of births to deaths in Ukraine had improved from 1 to 1.7 in 2004–2005 to 1 to 1.4 in 2008. However, the worst birth to death ratios in the country were in the eastern and central oblasts of Donetsk, Luhansk, Cherkasy and Poltava. In these regions, for every birth there were 2.1 deaths.


title: Demographics of Ukraine

text: Notably, western Ukraine never experienced the Holodomor, as Poland, Czechoslovakia, and Romania ruled it at the time, helping to explain the better demographics there, as the rural population was never devastated. Specifically, during the time of the Holodomor, Poland ruled Ivano-Frankivsk, Lviv, Rivne, Ternopil, and Volyn Oblasts, whereas Zakarpattia Oblast was under Czechoslovak rule, and Romania controlled Chernivtsi Oblast and the Budjak section of Odessa Oblast.


title: Demographics of Ukraine

text: Abortion behavior in the North, South, East and Center regions of Ukraine are relatively homogeneous while the Western region differs greatly. Overall, the abortion rate in western Ukraine is three times lower than in other regions; however this is not due to an increased use of modern contraceptive methods in the West, but simply due to the fact that pregnant women in the Western regions are more likely to keep their babies. Donetsk and Dniproptrovsk oblasts in eastern and central Ukraine have the country's highest rate of abortions.


title: Demographics of Ukraine

text: Death rates also vary widely by region; Eastern and southern Ukraine have the highest death rates in the country, and the life expectancy for children born in Chernihiv, Dnipropetrovsk, Donetsk, Kherson, Kropyvnytskyi, Luhansk, Mikolaiv, and Odessa regions is 1.5 years lower than the national average.


title: Demographics of Ukraine

text: Ukraine had a suicide rate of 16.5 per 100,000 population in 2017, a significant decrease from the suicide rate of 29.6 per 100,000 in 1998. Suicides are more frequent in the central part of the country (the highest suicide rates was in Kirovohrad Oblast; In western Ukraine, the suicide rate was lower than the national average. Lviv Oblast has the lowest suicide rate – 5.3


title: Demographics of Ukraine

text: The Southern and eastern Ukrainian regions also suffer from the highest rates of HIV and AIDS, which impacts life expectancy. In late 2000, 60% of all AIDS cases in Ukraine were concentrated in the Odessa, Dnipropetrovsk, and Donetsk regions. A major reason for this is the fact that the urbanized and industrialized regions in the East and South of Ukraine suffered most from the economic crisis in the 1990s, which in turn led to the spread of unemployment, alcoholism, and drug abuse, thus setting the conditions for wider spread of the epidemic.


title: Demographics of Ukraine

text: The western and central regions of Ukraine had lower GDP per capita than Kyiv and the industrialized eastern regions of Ukraine. In December 2019 the average monthly salary in Ukraine was 12,264 hryvnias (or 519 US dollars). Chernihiv oblast (northern Ukraine) and Kirovohrad Oblast (central Ukraine), had the lowest monthly salary of 8,851 and 9,450 hryvnias, respectively. In contrast, the monthly wage in the city of Kyiv was 18,869 hryvnias per month, and in Kyiv oblast – 13,259 per month. In 2013, outside of the capital city of Kyiv, the wealthiest region was Donetsk Oblast with annual income 31,048 hryvnias. But as of 2017, Donetsk Oblast ranks as the second poorest after Luhansk Oblast with annual incomes 25,278 hryvnias and 16,416 hryvnias respectively. Both are in the eastern Ukraine and have sustained direct losses as a consequence of military actions.


title: Demographics of Ukraine

text: Ukraine recorded one of the sharpest declines in poverty of any transition economy in 2001–2016 years. The poverty rate, measured against an absolute poverty line (below $1.25 per day in dollars, based on World Bank) fell from a high of 32 percent in 2001 to 8 percent in 2005. In terms of poverty rates, the central and northern regions have the country's highest poverty rates – 10.0%. The western and southern regions – 9.1% and 9% respectively. Kyiv City had the lowest poverty rate – 1.4%.


title: Demographics of Ukraine

text: Ukraine is the major source of migrants in many of the member states of the European Union. During the 1990s and early 2000s, Ukraine's sputtering economy and political instability contributed to rising emigration, especially to nearby Poland and Hungary, but also to other countries like Italy, Portugal, Spain, Israel and Canada. Although estimates vary, approximately two to three million Ukrainian citizens are currently working abroad, most of them illegally, in construction, service, housekeeping, and agriculture industries.


title: Demographics of Ukraine

text: Between 1991 and 2004, the government counted 2,537,400 individuals who emigrated; 1,897,500 moved to other post-Soviet states, and 639,900 moved to other, mainly Western, states.


title: Demographics of Ukraine

text: By the early 2000s, Ukrainian embassies reported that 300,000 Ukrainian citizens were working in Poland, 200,000 in Italy, approximately 200,000 in the Czech Republic, 150,000 in Portugal, 100,000 in Spain, 35,000 in Turkey, 20,000 in the United States and small significant numbers in Austria, Belgium, France, Germany, Greece, Sweden, Switzerland and the UK. The largest number of Ukrainian workers abroad, about one million, are in the Russian Federation. Since 1992, 232,072 persons born in Ukraine have emigrated to the US.


title: Demographics of Ukraine

text: From the point of view of the economic impact on natives, more appropriate than the absolute numbers is the volume of immigration as a proportion of the native population. Italy has the highest rate of Ukrainian emigrants as a proportion of the native population, while the much larger Russia has the largest absolute confirmed number of Ukrainian emigrants (leaving aside Poland, Portugal and the Czech Republic, for which there is conflicting data).


title: Demographics of Ukraine

text: Between 1991 and 2003, about 100,000 illegal immigrants were detained at the western borders. In 2005, about 5,000 illegal immigrants are detained yearly. Most of these are Asian immigrants from China, India, Pakistan and Afghanistan. At the time about 3,000 officially registered refugees resided in Ukraine, of whom most were Afghans.


title: Demographics of Ukraine

text: Ukraine accepted some 62,000 refugees from Transnistria following its war in 1992. Thousands were also accepted during decade from other post-Soviet conflicts in Abkhazia, Chechnya and Tajikistan.


title: Demographics of Ukraine

text: Results between the 1989 Soviet census and the 2001 census showed an increased number of CIS people in Ukraine from regions witnessing war. The number of Armenians in Ukraine almost doubled to 99,900 people during this period, while the number of Georgians and Azerbaijanis also had substantial increases.


title: Stanley Cup

text: The Stanley Cup () is the championship trophy awarded annually to the National Hockey League (NHL) playoff champion. It is the oldest existing trophy to be awarded to a professional sports franchise in North America, and the International Ice Hockey Federation (IIHF) considers it to be one of the "most important championships available to the sport". The trophy was commissioned in 1892 as the Dominion Hockey Challenge Cup and is named after Lord Stanley of Preston, the Governor General of Canada, who donated it as an award to Canada's top-ranking amateur ice hockey club. The entire Stanley family supported the sport, the sons and daughters all playing and promoting the game. The first Cup was awarded in 1893 to Montreal Hockey Club, and winners from 1893 to 1914 were determined by challenge games and league play. Professional teams first became eligible to challenge for the Stanley Cup in 1906. In 1915, the National Hockey Association (NHA) and the Pacific Coast Hockey Association (PCHA), the two main professional ice hockey organizations, reached a gentlemen's agreement in which their respective champions would face each other annually for the Stanley Cup. It was established as the "de facto" championship trophy of the NHL in 1926 and then the "de jure" NHL championship prize in 1947.


title: Stanley Cup

text: There are actually three Stanley Cups: the original bowl of the "Dominion Hockey Challenge Cup", the authenticated "Presentation Cup", and the spelling-corrected "Permanent Cup" on display at the Hockey Hall of Fame whenever the Presentation Cup is not available. While the NHL has maintained control over the trophy itself and its associated trademarks, the NHL does not actually own the trophy but uses it by agreement with the two Canadian trustees of the cup. The NHL has registered trademarks associated with the name and likeness of the Stanley Cup, although there has been dispute as to whether the league has the right to own trademarks associated with a trophy that it does not own.


title: Stanley Cup

text: The original bowl was made of silver and is 18.5 centimetres (7.28 inches) high and 29 centimetres (11.42 inches) wide. The current Stanley Cup is topped with a copy of the original bowl, made of a silver and nickel alloy. It has a height of 89.54 centimetres (35.25 inches) and weighs 15.5 kilograms (34.5 lb). Like the Grey Cup, and unlike the trophies awarded by the other major professional sports leagues of North America, a new Stanley Cup is not made every year. The winners originally kept it until a new champion was crowned, but winning teams currently get the Stanley Cup during the summer and a limited number of days during the season. Every year since 1924, a select portion of the winning players, coaches, management, and club staff names are engraved on its bands, which is unusual among trophies. However, there is not enough room to include all the players and non-players, so some names must be omitted. Between 1924 and 1940, a new band was added almost every year that the trophy was awarded, earning the nickname "Stovepipe Cup" due to the unnatural height of all the bands. In 1947, the cup size was reduced, but not all the large rings were the same size. In 1958, the modern one-piece Cup was designed with a five-band barrel which could contain 13 winning teams per band. Every 13 years when the bottom band of the Stanley Cup is filled with names of champions, the top band is removed and retired to be displayed in the vault of the Hockey Hall of Fame in Toronto. The four bands below it are slid up one place and a new blank band added to the bottom. The first winning team engraved on the newest band is thus, in theory "(see Engraving section below)", displayed on the trophy for the next 65 years. It has been referred to as The Cup, Lord Stanley's Cup, The Holy Grail, or facetiously as Lord Stanley's Mug. The Stanley Cup is surrounded by numerous legends and traditions, the oldest of which is the winning team drinking champagne from it.


title: Stanley Cup

text: Since the 1914–15 season, the Cup has been won a combined 103 times by 20 current NHL teams and five teams no longer in existence. It was not awarded in 1919 because of the Spanish flu epidemic and in 2005 because of the 2004–05 NHL lockout. It was held by nine different teams between 1893 and 1914. The Montreal Canadiens have won it a record 24 times and are the most recent Canadian-based team to win it, doing so in 1993; the Detroit Red Wings have won it 11 times, the most of any United States-based NHL team, most recently in 2008. The current holders of the cup are the Colorado Avalanche after their victory in 2022. More than three thousand different names, including the names of over thirteen hundred players, had been engraved on it by 2017.


title: Stanley Cup

text: After the Lord Stanley of Preston was appointed by Queen Victoria as Governor General of Canada on June 11, 1888, he and his family became highly enthusiastic about ice hockey. Stanley was first exposed to the game at Montreal's 1889 Winter Carnival, where he saw the Montreal Victorias play the Montreal Hockey Club. The "Montreal Gazette" reported that he "expressed his great delight with the game of hockey and the expertise of the players". During that time, organized ice hockey in Canada was still in its infancy and only Montreal and Ottawa had anything resembling leagues.


title: Stanley Cup

text: Stanley's entire family became active in ice hockey. Two of his sons, Arthur and Algernon, formed a new team called the "Ottawa Rideau Hall Rebels". Arthur also played a key role in the formation of what later became known as the Ontario Hockey Association (OHA), and became the founder of ice hockey in Great Britain. Arthur and Algernon persuaded their father to donate a trophy to be "an outward and visible sign of the hockey championship". Stanley sent the following message to the victory celebration held on March 18, 1892, at Ottawa's Russell House Hotel for the three-time champion Ottawa Hockey Club:


title: Stanley Cup

text: I have for some time been thinking that it would be a good thing if there were a challenge cup which should be held from year to year by the champion hockey team in the Dominion [of Canada].


title: Stanley Cup

text: There does not appear to be any such outward sign of a championship at present, and considering the general interest which matches now elicit, and the importance of having the game played fairly and under rules generally recognized, I am willing to give a cup which shall be held from year to year by the winning team.


title: Stanley Cup

text: I am not quite certain that the present regulations governing the arrangement of matches give entire satisfaction, and it would be worth considering whether they could not be arranged so that each team would play once at home and once at the place where their opponents hail from.


title: Stanley Cup

text: Soon afterwards, Stanley purchased what is frequently described as a decorative punch bowl, but which silver expert John Culme identified as a rose bowl, made in Sheffield, England, and sold by London silversmith G. R. Collis and Company (now Boodle and Dunthorne Jewellers), for ten guineas, equal to ten and a half pounds sterling, US$48.67, which is equal to $ in dollars. He had the words "Dominion Hockey Challenge Cup" engraved on one side of the outside rim, and "From Stanley of Preston" on the other side. The name "Stanley Cup" was given to it as early as May 1, 1893, when an "Ottawa Journal" article used the name as a title.


title: Stanley Cup

text: Originally, Stanley intended that the Cup should be awarded to the top amateur hockey team in Canada, to be decided by the acceptance of a challenge from another team. He made five preliminary regulations:


title: Stanley Cup

text: Stanley appointed Sheriff John Sweetland and Philip D. Ross (who went on to serve an unsurpassed 56 years) as trustees of the Cup. Sweetland and Ross first presented the trophy in 1893 to the Montreal Amateur Athletic Association on behalf of the affiliated Montreal Hockey Club, the champions of the Amateur Hockey Association of Canada (AHAC), since they "defeated all comers during the late season, including the champions of the Ontario Association" (Ottawa). Sweetland and Ross also believed that the AHAC was the top league, and as first-place finishers in the AHAC, Montreal was the best team in Canada. Naturally, the Ottawas were upset by the decision because there had been no challenge games scheduled and because the trustees failed to convey the rules on how the Cup was to be awarded prior to the start of the season.


title: Stanley Cup

text: As a result, the Cup trustees issued more specific rules on how the trophy should be defended and awarded:


title: Stanley Cup

text: Lord Stanley never saw a Stanley Cup championship game, nor did he ever present the Cup. Although his term as Governor General ended in September 1893, he was forced to return to England on July 15. In April of that year, his older brother Edward Stanley, 15th Earl of Derby died, and Stanley succeeded him as the 16th Earl of Derby.


title: Stanley Cup

text: During the challenge cup period, none of the leagues that played for the trophy had a formal playoff system to decide their respective champions; whichever team finished in first place after the regular season won the league title. However, in 1894, four teams out of the five-team AHAC tied for the championship with records of 5–3–0. The AHAC had no tie-breaking system. After extensive negotiations and Quebec's withdrawal from the championship competition, it was decided that a three-team tournament would take place in Montreal, with the Ottawa team receiving a bye to the final because they were the only road team. On March 17, in the first Stanley Cup playoff game, the Montreal Hockey Club (Montreal HC) defeated the Montreal Victorias, 3–2. Five days later, in the first Stanley Cup Finals game, Montreal HC beat the Ottawa Hockey Club 3–1.


title: Stanley Cup

text: In 1895, Queen's University was the first official challenger for the Cup, although it was controversial. The Montreal Victorias had won the league title and thus the Stanley Cup, but the challenge match was between the previous year's champion, Montreal HC, and the university squad. The trustees decided that if the Montreal HC won the challenge match, the Victorias would become the Stanley Cup champions. The Montreal HC won the match 5–1 and their cross-town rivals were crowned the champions. The first successful challenge to the Cup came the next year by the Winnipeg Victorias, the champions of the Manitoba Hockey League. On February 14, 1896, the Winnipeg squad defeated the champions 2–0 and became the first team outside the AHAC to win the Cup.


title: Stanley Cup

text: As the prestige of winning the Cup grew, so did the need to attract top players. Only nine months after winning the Cup, in March 1906, the Montreal Wanderers pushed through a resolution at the annual meeting of the Eastern Canada Amateur Hockey Association (ECAHA) to allow professional players to play alongside amateurs. The Cup trustees agreed to open the challenges to professional teams, because the ECAHA was the top hockey league in Canada at the time. The first professional competition came one month later during the Wanderers' two-game, total goals challenge series, which they won 17 goals to 5.


title: Stanley Cup

text: The smallest municipality to produce a Stanley Cup champion team is Kenora, Ontario; the town had a population of about 4,000 when the Kenora Thistles captured the Cup in January 1907. Aided by future Hall of Famers Art Ross and "Bad" Joe Hall, the Thistles defeated the Montreal Wanderers in a two-game, total goals challenge series. The Thistles successfully defended the Cup once, against a team from Brandon, Manitoba. In March 1907, the Wanderers challenged the Thistles to a rematch. Despite an improved lineup, the Thistles lost the Cup to Montreal.


title: Stanley Cup

text: In 1908, the Allan Cup was introduced as the trophy for Canada's amateurs, and the Stanley Cup started to become a symbol of professional hockey supremacy. In that same year, the first all-professional team, the Toronto Trolley Leaguers from the newly created Ontario Professional Hockey League (OPHL), competed for the Cup. One year later, the Montreal HC and the Montreal Victorias, the two remaining amateur teams, left the ECAHA, and the ECAHA dropped "Amateur" from their name to become a professional league. In 1910, the National Hockey Association (NHA) was formed. The NHA soon proved it was the best in Canada, as it kept the Cup for the next four years.


title: Stanley Cup

text: Prior to 1912, challenges could take place at any time or place, given the appropriate rink conditions, and it was common for teams to defend the Cup numerous times during the year. In 1912, Cup trustees declared that it was to be defended only at the end of the champion team's regular season.


title: Stanley Cup

text: In 1914, the Victoria Aristocrats from the Pacific Coast Hockey Association (PCHA) challenged the NHA and Cup champion Toronto Blueshirts. A controversy erupted when a letter arrived from the Stanley Cup trustees on March 17, that the trustees would not let the Stanley Cup travel west, as they did not consider Victoria a proper challenger because they had not formally notified the trustees. However, on March 18, Trustee William Foran stated that it was a misunderstanding. PCHA president Frank Patrick had not filed a challenge, because he had expected Emmett Quinn of the NHA to make all of the arrangements in his role as hockey commissioner, whereas the trustees thought they were being deliberately ignored. In any case, all arrangements had been ironed out and the Victoria challenge was accepted.


title: Stanley Cup

text: Several days later, trustee Foran wrote to NHA president Quinn that the trustees are "perfectly satisfied to allow the representatives of the three pro leagues (NHA, PCHA, and Maritime) to make all arrangements each season as to the series of matches to be played for the Cup". One year later, when the Maritime league folded, the NHA and the PCHA concluded a gentlemen's agreement in which their respective champions would face each other for the Cup, similar to baseball's World Series, which is played between the American League and National League champions. Under the new proposal, the Stanley Cup Finals series alternated between the East and the West each year, with alternating games played according to NHA and PCHA rules. The PCHA's Vancouver Millionaires won the 1915 series three games to none in a best-of-five series.


title: Stanley Cup

text: Prior to organized ice hockey expanding to any serious extent outside Canada, the concept that the Stanley Cup champion ought to be recognized as the "world champion" was already firmly established – Stanley Cup winners were claiming the title of "world champions" by no later than the turn of the century. After the Portland Rosebuds, an American-based team, joined the PCHA in 1914, the trustees promptly issued a formal statement that the Cup was no longer for the best team in Canada, but now for the best team in the world. Ice hockey in Europe was still in its infancy at this time, so it was without much controversy that winners of the Stanley Cup continued styling themselves as the "world champions" just like in baseball. Two years later, the Rosebuds became the first American-based team to play in the Stanley Cup Finals, although all its players were Canadians. In 1917, the Seattle Metropolitans became the first American-based team to win the Cup. After that season, the NHA dissolved, and the National Hockey League (NHL) took its place.


title: Stanley Cup

text: The Spanish influenza epidemic forced the Montreal Canadiens and the Seattle Metropolitans to cancel the 1919 Stanley Cup Finals after game five, marking the first time the Stanley Cup was not awarded. The series was tied at 2–2–1, but the final game was never played because Montreal Manager George Kennedy and players Joe Hall, Billy Coutu, Jack McDonald, and Newsy Lalonde were hospitalized with influenza. Hall died four days after the cancelled game, and the series was abandoned.


title: Stanley Cup

text: The format for the Stanley Cup Finals changed in 1922, with the creation of the Western Canada Hockey League (WCHL). Three leagues competed for the Cup: two league champions faced each other for the right to challenge the third champion in the final series. This lasted three seasons as the PCHA and the WCHL later merged to form the Western Hockey League (WHL) in 1925. In 1924–25 the Victoria Cougars won the Cup, the last team outside the NHL to do so.


title: Stanley Cup

text: The WHL folded in 1926 and was quickly replaced by the Prairie Hockey League. However, in the meantime, the NHL (which had entered the U.S. only two years before) bought up the contracts of most of the WHL's players and largely used them to stock the rosters of three new U.S. teams. In what would turn out to be its most significant expansion of its pre-Original Six era, the Chicago Blackhawks, Detroit Cougars (now called the Detroit Red Wings), and New York Rangers joined the NHL. With the NHL now firmly established in the largest markets of the Northeastern United States, and with the Western teams having been stripped of their best players, the PHL was deemed to be a "minor league" unworthy of challenging the NHL for hockey supremacy.


title: Stanley Cup

text: The PHL lasted only two seasons. Over the next two decades other leagues and clubs occasionally issued challenges, but none were accepted by the Cup's trustees. Since 1926, no non-NHL team has played for the Cup, leading it to become the "de facto" championship trophy of the NHL. In addition, with no major professional hockey league left to challenge it, the NHL began calling its league champions the "world champions", notwithstanding the lack of any interleague championship. In doing so, the NHL copied a policy that had been adopted by the then still-fledgling National Football League from its start in 1920 (and which the National Basketball Association also asserted upon its founding in 1946).


title: Stanley Cup

text: Finally in 1947, the NHL reached an agreement with trustee J. Cooper Smeaton to grant control of the Cup to the NHL, allowing the league to reject challenges from other leagues that may have wished to play for the Cup:


title: Stanley Cup

text: This agreement was amended on November 22, 1961, substituting the Governors of the International Hockey Hall of Fame in Kingston, Ontario with the Committee of the Hockey Hall of Fame in Toronto, Ontario as the group to name the two Canadian trustees, if need be. In the 1970s, the World Hockey Association sought to challenge for the Cup. By this time, all Cup Trustees were longtime NHL loyalists, and under the direction of NHL President Clarence Campbell the WHA's challenge for the Cup was blocked. However, notwithstanding the aforementioned legal obligation, the NHL (considering not only the WHA's presence but also the rising caliber of European ice hockey leagues) quietly stopped calling its champions the "world champions".


title: Stanley Cup

text: Nevertheless, the NHL came under pressure to allow its champion to play the WHA champion. Eventually, following the establishment of the Canada Cup as the first "best-on-best" international hockey tournament, NHL President Clarence Campbell (who was a vocal opponent of the tournament) made public overtures to establish a true world professional championship in ice hockey, "just like the World Series". Under Campbell's proposal, the NHL champion would have played the WHA champion for the right to face the European champion. In the end, Campbell's proposal went nowhere – eventually, the NHL resolved the WHA challenge by agreeing to merge with its rival, by which time the older league had quietly withdrawn its support for the idea. Neither the NHL nor any other professional hockey league makes a claim to its champions being the "world champions."


title: Stanley Cup

text: The Cup was awarded every year until 2005, when a labour dispute between the NHL's owners and the NHL Players Association (the union that represents the players) led to the cancellation of the 2004–05 season. As a result, no Cup champion was crowned for the first time since the flu pandemic in 1919. The lockout was controversial among many fans, who questioned whether the NHL had exclusive control over the Cup. A website known as freestanley.com (since closed) was launched, asking fans to write to the Cup trustees and urge them to return to the original Challenge Cup format. Adrienne Clarkson, then Governor General of Canada, alternately proposed that the Cup be presented to the top women's hockey team in lieu of the NHL season. This idea was so unpopular that the Clarkson Cup was created instead. Meanwhile, a group in Ontario, also known as the "Wednesday Nighters", filed an application with the Ontario Superior Court, claiming that the Cup trustees had overstepped their bounds in signing the 1947 agreement with the NHL, and therefore must award the trophy regardless of the lockout.


title: Stanley Cup

text: On February 7, 2006, a settlement was reached in which the trophy could be awarded to non-NHL teams should the league not operate for a season. The dispute lasted so long that, by the time it was settled, the NHL had resumed operating for the 2005–06 season, and the Stanley Cup went unclaimed for the 2004–05 season. Furthermore, when another NHL lockout commenced in 2012 the Trustees stated that the 2006 agreement did not oblige them to award the Cup in the event of a lost season, and that they were likely to reject any non-NHL challenges for the Cup in the event the 2012–13 season were cancelled, which it was not.


title: Stanley Cup

text: In 2007, the International Ice Hockey Federation (IIHF) formalized the "Triple Gold Club", the group of players and coaches who have won an Olympic Games gold medal, a World Championship gold medal, and the Stanley Cup. The term had first entered popular use following the 2002 Winter Olympics, which saw the addition of the first Canadian members.


title: Stanley Cup

text: In March 2017, to commemorate the Stanley Cup's 125th anniversary, the original Cup and the current Stanley Cup were the focus of a four-day tour of Ottawa, including a stop at Rideau Hall. The Royal Canadian Mint produced two commemorative coins to mark the anniversary. The first is a roll of Canadian quarters with an image of the Stanley Cup, the word "Stanley Cup" in English and in French with two ice hockey players and "125 years/" on the reverse and an effigy of Queen Elizabeth II on the obverse using plated steel. The second coin was designed with the Stanley Cup on the reverse and an effigy of Elizabeth II, "Stanley Cup" in English and "" in French and "50 dollars" above the effigy. It was made using 99.9% silver.


title: Stanley Cup

text: In October 2017, the Lord Stanley's Gift Monument, commemorating the donation of the Stanley Cup was erected in Ottawa at Sparks Street and Elgin Street, near the location of the dinner party announcing the Cup at the Russell House, which has since been demolished.


title: Stanley Cup

text: Like the Grey Cup, awarded to the winner of the Canadian Football League, the Stanley Cup is engraved with the names of the winning players, coaches, management, and club staff. However, this was not always the case: one of Lord Stanley's original conditions was that each team could, at their own expense, add a ring to the Cup to commemorate their victory. Initially, there was only one base ring, which was attached to the bottom of the original bowl by the Montreal Hockey Club. Clubs engraved their team names, usually in the form , on that one ring until it was full in 1902. With no more room to engrave their names (and unwilling to pay for a second band), teams left their mark on the bowl itself. The 1907 Montreal Wanderers became the first club to record their name on the bowl's interior surface, and the first champion to record the names of 20 members of their team.


title: Stanley Cup

text: In 1908, for reasons unknown, the Wanderers, despite having turned aside four challengers, did not record their names on the Cup. The next year, the Ottawa Senators added a second band onto the Cup. Despite the new room, the 1910 Wanderers and the 1911 Senators did not put their names on the Cup. The 1915 Vancouver Millionaires became the second team to engrave players' names, this time inside the bowl along its sides.


title: Stanley Cup

text: The 1918 Millionaires eventually filled the band added by the 1909 Senators. The 1915 Ottawa Senators, the 1916 Portland Rosebuds and the 1918 Vancouver Millionaires all engraved their names on the trophy even though they did not officially win it under the new PCHA-NHA system. They had won the title of only the previous champion's league and would have been crowned as Cup champions under the old challenge rules. The winners in 1918 and 1920 to 1923 did not put their winning team name on it.


title: Stanley Cup

text: No further engraving occurred until 1924, when the Canadiens added a new band to the Cup. Since then, engraving the team and its players has been an unbroken annual tradition. Originally, a new band was added each year, causing the trophy to grow in size. The "Stovepipe Cup", as it was nicknamed because of its resemblance to the exhaust pipe of a stove, became unwieldy, so it was redesigned in 1948 as a two-piece cigar-shaped trophy with a removable bowl and collar. This Cup also properly honoured those teams that did not engrave their names on the Cup. Also included was the 1918–19 no decision between the Montreal Canadiens and Seattle Metropolitans.


title: Stanley Cup

text: Since 1958, the Cup has undergone several minor alterations. The original collar and bowl were too brittle, and were replaced in 1963 and 1969, respectively. The modern one-piece Cup design was introduced in 1958, when the old barrel was replaced with a five-band barrel, each of which could contain 13 winning teams. Although the bands were originally designed to fill up during the Cup's centennial year in 1992, the names of the 1965 Montreal Canadiens were engraved over a larger area than allotted and thus there are 12 teams on that band instead of 13. When the bands were all filled in 1991, the top band of the large barrel was preserved in the Hockey Hall of Fame, and a new blank band was added to the bottom so the Stanley Cup would not grow further.


title: Stanley Cup

text: Another new band was scheduled to be added to the bottom of the cup following the 2004–05 season, but was not added because of the 2004–05 NHL lockout. After the 2005–06 champion Carolina Hurricanes were crowned and the new bottom ring was finally added (along with the retiring of the band listing the 1940–41 to 1952–53 champions), the cancelled season was acknowledged with the words "2004–05 Season Not Played".


title: Stanley Cup

text: Following the crowning of the 2017–18 champions, the Washington Capitals, the band listing the 1953–54 to 1964–65 winners was removed in September 2018, with a new band for the 2017–18 to 2029–30 champions added to the bottom of the cup. Since the introduction of the five-band cup, each engraved team is displayed on the trophy between 52 and 65 years (though in practice, this was reduced by one year as a result of the 1953–1965 band only containing 12 teams prior to its removal), depending on the order they are engraved on the relevant band.


title: Stanley Cup

text: There have only been four official Stanley Cup engravers. The fourth and current one, Montreal silversmith Louise St. Jacques, has held the position since 1988.


title: Stanley Cup

text: Currently, the Cup stands at 89.5 centimetres ( inches) tall and weighs  kilograms ( lb). By its 125th anniversary in 2017, the Stanley Cup had had 3,177 names engraved on it; of those, 1,331 belong to players.


title: Stanley Cup

text: However, since 1994 teams have been permitted to petition the NHL Commissioner, to be considered on a case-by-case basis, to engrave a player's name on the cup if the player was unavailable to play due to "extenuating circumstances". For example, the Detroit Red Wings received special permission from the NHL to inscribe the name of Vladimir Konstantinov, whose career ended after a car accident on June 13, 1997, on the Stanley Cup after Detroit defended their title in 1998.


title: Stanley Cup

text: With the Montreal Canadiens having won by far the most Cup championships of any team, the list of the players who have been engraved on the Cup the most often is dominated by Montreal players. Henri Richard of the Canadiens, with his name engraved eleven times, played on more Stanley Cup champions than any other player. He is followed by Jean Beliveau and Yvan Cournoyer of the Canadiens with ten championships, Claude Provost of the Canadiens with nine, and three players tied with eight: Red Kelly (four with the Red Wings, four with the Leafs, the most for any player who was not a member of the Canadiens) and Canadiens players Jacques Lemaire, Maurice Richard. Beliveau's name appears on the Cup more than any other individual, ten times as a player and seven times as management for a total of seventeen times.


title: Stanley Cup

text: Fifteen women have had their names engraved on the Stanley Cup. The first woman to have her name engraved on the Stanley Cup is Marguerite Norris, who won the Cup as the President of the Detroit Red Wings in 1954 and 1955. The only Canadian woman to have her name engraved on the Stanley Cup is Sonia Scurfield who won the Cup as a co-owner of the Calgary Flames in 1989.


title: Stanley Cup

text: In 2001, Charlotte Grahame, the Colorado Avalanche's Senior Director of Hockey Administration, had her name engraved on the trophy. Her son John later had his name engraved as a member of the Tampa Bay Lightning in 2004.


title: Stanley Cup

text: There are many traditions associated with the Stanley Cup. One of the oldest, started by the 1896 Winnipeg Victorias, dictates that the winning team drink champagne from the top bowl after their victory. The Cup is also traditionally presented on the ice by the NHL commissioner to the captain of the winning team after the series-winning game; each member of the victorious club carries the trophy around the rink. However, this has not always been the case; prior to the 1930s, the Cup was not awarded immediately after the victory. The first time that the Cup was awarded on the ice may have been to the 1932 Toronto Maple Leafs, but the practice did not become a tradition until the 1950s. Ted Lindsay of the 1950 Cup champion Detroit Red Wings became the first captain, upon receiving the Cup, to hoist it overhead and skate around the rink. According to Lindsay, he did so to allow the fans to have a better view of the Cup. Since then, it has been a tradition for each member of the winning team, beginning with the captain, to take a lap around the ice with the trophy hoisted above his head.


title: Stanley Cup

text: The tradition of the captain first hoisting the Cup has been "breached" a few times. In 1987 after the Edmonton Oilers defeated the Philadelphia Flyers, Wayne Gretzky handed the Cup to Steve Smith, a year after Smith made a costly gaffe that cost the Oilers the chance of making their fourth consecutive Stanley Cup Finals appearance. The second occurred in 1993 after the Montreal Canadiens defeated the Los Angeles Kings, Guy Carbonneau handed the Cup to Denis Savard, as Savard had been the player that many fans had urged the Canadiens to draft back in 1980. The third was in 2001 involving Joe Sakic and Ray Bourque when the Colorado Avalanche won the Cup in 2001, as the seventh and deciding game of the finals was the last of Bourque's 22-year NHL career, having never been on a cup-winning team until that time (until being traded to the Avalanche on March 6, 2000, Bourque had played only for the Boston Bruins). When Sakic received the trophy, he did not hoist it, but instead immediately handed it to Bourque; Sakic then became the second player on the team to hoist the trophy.


title: Stanley Cup

text: The Stanley Cup championship team is allotted 100 days during off-season to pass around the Cup. It is always accompanied by at least one representative from the Hockey Hall of Fame. Although many players have unofficially spent a day in personal possession of the Cup, in 1995 the New Jersey Devils started a tradition wherein each member of the Cup-winning team is allowed to retain the Cup for a day. After the 1994–95 season, the NHL made it mandatory that one of the official Cup handlers always be present while the Cup is passed around among players in the off-season. This may have been related to Eddie Olczyk's handling of the Cup after the New York Rangers' 1994 win - Olczyk brought the Cup to the Belmont Stakes, where Kentucky Derby winner Go for Gin ate out of it.


title: Stanley Cup

text: On August 22, 2001, Colorado Avalanche Director of Finance Mark Waggoner carried the Stanley Cup to the summit of Mount Elbert, the highest point of Colorado.


title: Stanley Cup

text: Victors of the Cup have used it to baptize their children. Three players (the New York Islanders' Clark Gillies, the Anaheim Ducks' Sean O'Donnell, and the Pittsburgh Penguins' Nick Bonino) even allowed their dogs to eat out of the Cup.


title: Stanley Cup

text: There are technically three versions of the "Stanley Cup": the original 1892 bowl or "Dominion Hockey Challenge Cup", 1963 authenticated "Presentation Cup", and the 1993 "Permanent Cup" at the Hall of Fame.


title: Stanley Cup

text: The original 1892 "Dominion Hockey Challenge Cup", purchased and donated by Lord Stanley, was physically awarded to the Champions until 1970, and is now displayed in the Vault Room at the Hockey Hall of Fame in Toronto, Ontario.


title: Stanley Cup

text: The authenticated version or "Presentation Cup" was created in 1963 by Montreal silversmith Carl Petersen. NHL president Clarence Campbell felt that the original bowl was becoming too thin and fragile, and thus requested a duplicate trophy as a replacement. The Presentation Cup is authenticated by the seal of the Hockey Hall of Fame on the bottom, which can be seen when winning players lift the Cup over their heads, and it is the one currently awarded to the champions of the playoffs and used for promotions. This version was made in secret, and first awarded in 1964.


title: Stanley Cup

text: The replica "Permanent Cup", was created in 1993 by Montreal silversmith Louise St. Jacques to be used as a stand-in at the Hockey Hall of Fame whenever the Presentation Cup is not available for display.


title: Stanley Cup

text: The Stanley Cup has served as a valuable morale booster for both American and Canadian troops, as well as their NATO allies. In 2004, the Cup was displayed at MacDill Air Force Base, located near Tampa, Florida. The visit gave both American troops and a visiting Canadian unit the thrill of seeing the trophy at close hand. The event was later touted by officials at MacDill as "a huge morale booster for our troops". In 2006, the Cup toured Marine Corps Base Camp Lejeune, North Carolina, where wounded Marines were given the opportunity to view and be photographed with the Cup.


title: Stanley Cup

text: In 2007, the Stanley Cup made its first trip into a combat zone. During the trip to Kandahar, Afghanistan from May 2 to 6, organized by the NHL, the Hockey Hall of Fame, the NHL Alumni and the Canadian Department of National Defence, the Cup was put on display for Canadian and other NATO troops. It briefly endured a rocket attack on May 3, but emerged unscathed.


title: Stanley Cup

text: The Stanley Cup did a second tour in Afghanistan as part of a "Team Canada visit" in March 2008. In the spring of 2010 the Stanley Cup made its fourth trip to Afghanistan, accompanied by ex-players.


title: Stanley Cup

text: On June 27, 2010, Chicago Blackhawks defenceman Brent Sopel paid tribute to his friend, former Toronto Maple Leafs general manager Brian Burke and Burke's late son, Brendan, by accompanying the Cup to the 2010 Chicago Gay Pride Parade.


title: Stanley Cup

text: In 2018, the Cup was used to improve the spirits of those who were affected by either of two significantly tragic events which claimed the lives of multiple individuals, the Humboldt Broncos' bus crash on April 6, and the "Capital Gazette" shooting on June 28. For the former, the Stanley Cup was brought to the hospital where the crash survivors were recuperating on April 15, and for the latter, it was presented to "Capital Gazette" employees at their temporary office on July 3. Chandler Stephenson of the 2018 Washington Capitals, also spent his day with the Stanley Cup with the Broncos that August.


title: Stanley Cup

text: The regulations set down by Lord Stanley call for two Trustees, who had the sole, joint right to govern the Cup and the conditions of its awarding until 1947, when they ceded control to the NHL. While the original regulations allow for a Trustee to resign, to date, all Cup Trustees have served until their deaths. In the event of a vacancy, the remaining trustee names the replacement for the deceased or resigned Trustee.


title: Segunda División

text: The Campeonato Nacional de Liga de Segunda División, commercially known as LaLiga SmartBank for sponsorship reasons, is the men's second professional association football division of the Spanish football league system. Administrated by the Liga Nacional de Fútbol Profesional, it is contested by 22 teams, with the top two teams plus the winner of a play-off promoted to LaLiga and replaced by the three lowest-placed teams in that division.


title: Segunda División

text: This championship was created in 1929 by the Royal Spanish Football Federation. The league has been national, single-table except for a period from 1949 to 1968 in which it was regionalized into two North and South groups. Since 1984 it has been organized by the Liga Nacional de Fútbol Profesional.


title: Segunda División

text: In 2006, the "Liga Nacional de Fútbol Profesional" agreed to a ten-year sponsorship agreement with the banking group BBVA. Segunda División was thereby rebranded as 'Liga BBVA'. Two years later, as the BBVA sponsorship was extended to the Primera División (which received the Liga BBVA commercial name), the Segunda División was then renamed as 'Liga Adelante'. Another banking group, Banco Santander, took over the sponsorship of both tiers in 2016, upon which the Segunda División was renamed 'La Liga 1|2|3', before being renamed 'LaLiga Smartbank' in time for the 2019–20 season.


title: Segunda División

text: Since the 2010–11 season, a play-off for the third and last promotion slot has been played between the teams that finished 3rd to 6th (reserve teams are not eligible for promotion).


title: Segunda División

text: The league contains 22 teams that play each other home and away for a 42-match season. Each year three teams are promoted to La Liga. The top two teams earn an automatic promotion. The third team to be promoted is the winner of a play-off between the teams that finished 3rd to 6th (reserve teams are not eligible for promotion). The play-offs comprise two-legged semi-finals followed by a two-legged final. The bottom four are relegated to Primera Federación.


title: Scoliosis

text: Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not typically cause problems, but more severe cases can affect breathing and movement. Pain is usually present in adults, and can worsen with age.


title: Scoliosis

text: The cause of most cases is unknown, but it is believed to involve a combination of genetic and environmental factors. Risk factors include other affected family members. It can also occur due to another condition such as muscle spasms, cerebral palsy, Marfan syndrome, and tumors such as neurofibromatosis. Diagnosis is confirmed with X-rays. Scoliosis is typically classified as either structural in which the curve is fixed, or functional in which the underlying spine is normal.


title: Scoliosis

text: Treatment depends on the degree of curve, location, and cause. Minor curves may simply be watched periodically. Treatments may include bracing, specific exercises, posture checking, and surgery. The brace must be fitted to the person and used daily until growing stops. Specific exercises, such as exercises that focus on the core, may be used to try to decrease the risk of worsening. They may be done alone or along with other treatments such as bracing. Evidence that chiropractic manipulation, dietary supplements, or exercises can prevent the condition from worsening is weak. However, exercise is still recommended due to its other health benefits.


title: Scoliosis

text: Scoliosis occurs in about 3% of people. It most commonly develops between the ages of ten and twenty. Females typically are more severely affected than males with a ratio of 4:1. The term is , which means "a bending".


title: Scoliosis

text: People who have reached skeletal maturity are less likely to have a worsening case. Some severe cases of scoliosis can lead to diminishing lung capacity, pressure exerted on the heart, and restricted physical activities.


title: Scoliosis

text: Recent longitudinal studies reveal that the most common form of the condition, late-onset idiopathic scoliosis, causes little physical impairment other than back pain and cosmetic concerns, even when untreated, with mortality rates similar to the general population. Older beliefs that untreated idiopathic scoliosis necessarily progresses into severe (cardiopulmonary) disability by old age have been refuted by later studies.


title: Scoliosis

text: The many causes of scoliosis include neuromuscular problems and inherited diseases or conditions caused by the environment.


title: Scoliosis

text: An estimated 65% of scoliosis cases are idiopathic, about 15% are congenital, and about 10% are secondary to a neuromuscular disease.


title: Scoliosis

text: About 38% of variance in scoliosis risk is due to genetic factors, and 62% is due to the environment. The genetics are likely complex, however, given the inconsistent inheritance and discordance among monozygotic twins. The specific genes that contribute to development of scoliosis have not been conclusively identified. At least one gene, "CHD7", has been associated with the idiopathic form of scoliosis.


title: Scoliosis

text: Several candidate gene studies have found associations between idiopathic scoliosis and genes mediating bone formation, bone metabolism, and connective tissue structure. Several genome-wide studies have identified a number of loci as significantly linked to idiopathic scoliosis. In 2006, idiopathic scoliosis was linked with three microsatellite polymorphisms in the "MATN1" gene (encoding for matrilin 1, cartilage matrix protein). Fifty-three single nucleotide polymorphism markers in the DNA that are significantly associated with adolescent idiopathic scoliosis were identified through a genome-wide association study.


title: Scoliosis

text: Adolescent idiopathic scoliosis has no clear causal agent, and is generally believed to be multifactorial; leading to "progressive functional limitations" for individuals. Research suggests that Posterior Spinal Fusion (PSF) can be used to correct the more severe deformities caused by adolescent idiopathic scoliosis. Such procedures can result in a return to physical activity in about 6 months, which is very promising, although minimal back pain is still to be expected in the most severe cases. The prevalence of scoliosis is 1% to 2% among adolescents, but the likelihood of progression among adolescents with a Cobb angle less than 20° is about 10% to 20%.


title: Scoliosis

text: Congenital scoliosis can be attributed to a malformation of the spine during weeks three to six "in utero" due to a failure of formation, a failure of segmentation, or a combination of stimuli. Incomplete and abnormal segmentation results in an abnormally shaped vertebra, at times fused to a normal vertebra or unilaterally fused vertebrae, leading to the abnormal lateral curvature of the spine.


title: Scoliosis

text: Secondary scoliosis due to neuropathic and myopathic conditions can lead to a loss of muscular support for the spinal column so that the spinal column is pulled in abnormal directions. Some conditions which may cause secondary scoliosis include muscular dystrophy, spinal muscular atrophy, poliomyelitis, cerebral palsy, spinal cord trauma, and myotonia. Scoliosis often presents itself, or worsens, during an adolescent's growth spurt and is more often diagnosed in females than males.


title: Scoliosis

text: Scoliosis associated with known syndromes is often subclassified as "syndromic scoliosis". Scoliosis can be associated with amniotic band syndrome, Arnold–Chiari malformation, Charcot–Marie–Tooth disease, cerebral palsy, congenital diaphragmatic hernia, connective tissue disorders, muscular dystrophy, familial dysautonomia, CHARGE syndrome, Ehlers–Danlos syndrome (hyperflexibility, "floppy baby" syndrome, and other variants of the condition), fragile X syndrome, Friedreich's ataxia, hemihypertrophy, Loeys–Dietz syndrome, Marfan syndrome, nail–patella syndrome, neurofibromatosis, osteogenesis imperfecta, Prader–Willi syndrome, proteus syndrome, spina bifida, spinal muscular atrophy, syringomyelia, and pectus carinatum.


title: Scoliosis

text: Another form of secondary scoliosis is degenerative scoliosis, also known as de novo scoliosis, which develops later in life secondary to degenerative (may or may not be associated with aging) changes. This is a type of deformity that starts and progresses because of the collapse of the vertebral column in an asymmetrical manner. As bones start to become weaker and the ligaments and discs located in the spine become worn as a result of age-related changes, the spine begins to curve.


title: Scoliosis

text: People who initially present with scoliosis undergo a physical examination to determine whether the deformity has an underlying cause and to exclude the possibility of the underlying condition more serious than simple scoliosis.


title: Scoliosis

text: The person's gait is assessed, with an exam for signs of other abnormalities (e.g., spina bifida as evidenced by a dimple, hairy patch, lipoma, or hemangioma). A thorough neurological examination is also performed, the skin for "café au lait" spots, indicative of neurofibromatosis, the feet for cavovarus deformity, abdominal reflexes and muscle tone for spasticity.


title: Scoliosis

text: When a person can cooperate, they are asked to bend forward as far as possible. This is known as the Adams forward bend test and is often performed on school students. If a prominence is noted, then scoliosis is a possibility and an X-ray may be done to confirm the diagnosis.


title: Scoliosis

text: When scoliosis is suspected, weight-bearing, full-spine AP/coronal (front-back view) and lateral/sagittal (side view) X-rays are usually taken to assess the scoliosis curves and the kyphosis and lordosis, as these can also be affected in individuals with scoliosis. Full-length standing spine X-rays are the standard method for evaluating the severity and progression of scoliosis, and whether it is congenital or idiopathic in nature. In growing individuals, serial radiographs are obtained at 3- to 12-month intervals to follow curve progression, and, in some instances, MRI investigation is warranted to look at the spinal cord. An average scoliosis patient has been in contact with around 50-300mGy of radiation due to these radiographs during this time period.


title: Scoliosis

text: The standard method for assessing the curvature quantitatively is measuring the Cobb angle, which is the angle between two lines, drawn perpendicular to the upper endplate of the uppermost vertebra involved and the lower endplate of the lowest vertebra involved. For people with two curves, Cobb angles are followed for both curves. In some people, lateral-bending X-rays are obtained to assess the flexibility of the curves or the primary and compensatory curves.


title: Scoliosis

text: Congenital and idiopathic scoliosis that develops before the age of 10 is referred to as early-onset scoliosis. Progressive idiopathic early-onset scoliosis can be a life-threatening condition with negative effects on pulmonary function. Scoliosis that develops after 10 is referred to as adolescent idiopathic scoliosis. Screening adolescents without symptoms for scoliosis is of unclear benefit.


title: Scoliosis

text: Scoliosis is defined as a three-dimensional deviation in the axis of a person's spine. Most instances, including The Scoliosis Research Society, define scoliosis as a Cobb angle of more than 10° to the right or left as the examiner faces the person, i.e. in the coronal plane.


title: Scoliosis

text: Scoliosis has been described as a biomechanical deformity, the progression of which depends on asymmetric forces otherwise known as the Hueter-Volkmann Law.


title: Scoliosis

text: Scoliosis curves do not straighten out on their own. Many children have slight curves that do not need treatment. In these cases, the children grow up to lead normal body posture by itself, even though their small curves never go away. If the patient has a larger curve and they are still growing, it is important to monitor the curve for change by periodic examination and standing x-rays as needed. The rise in spinal abnormalities require examination by an orthopaedic surgeon to determine if active treatment is needed.


title: Scoliosis

text: The traditional medical management of scoliosis is complex and is determined by the severity of the curvature and skeletal maturity, which together help predict the likelihood of progression.


title: Scoliosis

text: Treatment for idiopathic scoliosis also depends upon the severity of the curvature, the spine's potential for further growth, and the risk that the curvature will progress. Mild scoliosis (less than 30° deviation) and moderate scoliosis (30–45°) can typically be treated conservatively with bracing in conjunction with scoliosis-specific exercises. Severe curvatures that rapidly progress may require surgery with spinal rod placement and spinal fusion. In all cases, early intervention offers the best results.


title: Scoliosis

text: A specific type of physical therapy may be useful. Evidence to support their use however is weak. Low quality evidence suggests scoliosis-specific exercises (SSE) may be more effective than electrostimulation. Evidence for the Schroth method is insufficient to support its use. Significant improvement in function, vertebral angles and trunk asymmetries have been recorded following the implementation of Schroth method in terms of conservative management of scoliosis. Some other forms of exercises interventions have been lately used in the clinical practice for therapeutic management of scoliosis such as global postural reeducation and the Klapp method.


title: Scoliosis

text: Bracing is normally done when the person has bone growth remaining and is, in general, implemented to hold the curve and prevent it from progressing to the point where surgery is recommended. In some cases with juveniles, bracing has reduced curves significantly, going from a 40° (of the curve, mentioned in length above) out of the brace to 18°. Braces are sometimes prescribed for adults to relieve pain related to scoliosis. Bracing involves fitting the person with a device that covers the torso; in some cases, it extends to the neck (example being the Milwaukee Brace).


title: Scoliosis

text: The most commonly used brace is a TLSO, such as a Boston brace, a corset-like an appliance that fits from armpits to hips and is custom-made from fiberglass or plastic. It is typically recommended to be worn 22–23 hours a day, and applies pressure on the curves in the spine. The effectiveness of the brace depends on not only brace design and orthotist skill, but also people's compliance and amount of wear per day. An alternative form of brace is a nighttime only brace, that is worn only at night whilst the child sleeps, and which overcorrects the deformity. Whilst nighttime braces are more convenient for children and families, it is unknown if the effectiveness of the brace is as good as conventional braces. The UK government have funded a large clinical trial (called the BASIS study) to resolve this uncertainty. The BASIS study is ongoing throughout the UK in all of the leading UK children's hospitals that treat scoliosis, with families encouraged to take part.


title: Scoliosis

text: Indications for bracing: people who are still growing who present with Cobb angles less than 20° should be closely monitored. People who are still growing who present with Cobb angles of 20 to 29° should be braced according to the risk of progression by considering age, Cobb angle increase over a six-month period, Risser sign, and clinical presentation. People who are still growing who present with Cobb angles greater than 30° should be braced. However, these are guidelines and not every person will fit into this table.


title: Scoliosis

text: For example, a person who is still growing with a 17° Cobb angle and significant thoracic rotation or flatback could be considered for nighttime bracing. On the opposite end of the growth spectrum, a 29° Cobb angle and a Risser sign three or four might not need to be braced because the potential for progression is reduced. The Scoliosis Research Society's recommendations for bracing include curves progressing to larger than 25°, curves presenting between 30 and 45°, Risser sign 0, 1, or 2 (an X-ray measurement of a pelvic growth area), and less than six months from the onset of menses in girls.


title: Scoliosis

text: Scoliosis braces are usually comfortable, especially when well designed and well fitted, also after the 7- to 10-day break-in period. A well fitted and functioning scoliosis brace provides comfort when it is supporting the deformity and redirecting the body into a more corrected and normal physiological position.


title: Scoliosis

text: Evidence supports that bracing prevents worsening of disease, but whether it changes quality of life, appearance, or back pain is unclear.


title: Scoliosis

text: Surgery is usually recommended by orthopedists for curves with a high likelihood of progression (i.e., greater than 45 to 50° of magnitude), curves that would be cosmetically unacceptable as an adult, curves in people with spina bifida and cerebral palsy that interfere with sitting and care, and curves that affect physiological functions such as breathing.


title: Scoliosis

text: Surgery is indicated by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) at 45 to 50° and by the Scoliosis Research Society (SRS) at a Cobb angle of 45°. SOSORT uses the 45 to 50° threshold as a result of the well-documented, plus or minus 5° measurement error that can occur while measuring Cobb angles.


title: Scoliosis

text: Surgeons who are specialized in spine surgery perform surgery for scoliosis. To completely straighten a scoliotic spine is usually impossible, but for the most part, significant corrections are achieved.


title: Scoliosis

text: One or both of these surgical procedures may be needed. The surgery may be done in one or two stages and, on average, takes four to eight hours.