prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: What is the purpose of an ICD?

Read the following text and answer briefly.

Context 1: Do you know the difference between V T  and T V?
Like any exclusive club, heart disease has its own jargon, understandable only by other members of the club, particularly by cardiac care providers  For example, I remember lying in my CCU bed (that’s the Coronary Intensive Care Unit), trying to memorize the letters LAD (that’s the Left Anterior Descending, the large coronary artery whose 99% blockage had caused my MI (myocardial infarction – in my case, the so-called ‘widowmaker’ heart attack) 
To help others needing simultaneous translation of this new lingo in your research or in your own medical records, here’s a helpful list of some of the most common acronyms/terms you’ll likely find around the cardiac ward 
NOTE from CAROLYN: This entire patient-friendly, jargon-free glossary (all 8,000 words!) is also part of my book “A Woman’s Guide to Living with Heart Disease“ (Johns Hopkins University Press, November 2017) 
AA – Anti-arrhythmic: Drugs used to treat patients who have irregular heart rhythms 
Ablation – See Cardiac Ablation 
ACE Inhibitor – Angiotension Converting Enzyme inhibitor: A drug that lowers blood pressure by interfering with the breakdown of a protein-like substance involved in regulating blood pressure 
ACS – Acute Coronary Syndrome: An emergency condition brought on by sudden reduced blood flow to the heart  The first sign of acute coronary syndrome can be sudden stopping of your heart (cardiac arrest) 
AED – Automatic External Defibrillator: A portable defibrillator for use during a cardiac emergency; it can be used on patients experiencing sudden cardiac arrest by applying a brief electroshock to the heart through electrodes placed on the chest 
AF or Afib – Atrial Fibrillation: An irregular and often rapid heart rate that can cause poor blood flow to the body  Afib symptoms include heart palpitations, shortness of breath, weakness or fainting  Episodes of atrial fibrillation can come and go, or you may have chronic atrial fibrillation 
AFL – Atrial Flutter: A type of arrhythmia where the upper chambers of the heart (the atria) beat very fast, causing the walls of the lower chambers (the ventricles) to beat inefficiently as well 
A-HCM – Apical Hypertrophic Cardiomyopathy: Also called Yamaguchi Syndrome or Yamaguchi Hypertrophy, a non-obstructive form of cardiomyopathy (a disease of the heart muscle that leads to generalized deterioration of the muscle and its pumping ability) in which a portion of the heart muscle is hypertrophied (thickened) without any obvious cause although there may be a genetic link  It was first described in individuals of Japanese descent 
AI – Aortic Insufficiency: A heart valve disease in which the aortic valve does not close tightly, leading to the backward flow of blood from the aorta (the largest blood vessel) into the left ventricle (a chamber of the heart) 
AIVR – Accelerated Idioventricular Rhythm: Ventricular rhythm whose rate is greater than 49 beats/min but less than 100 beats/min, usually benign  (Ventricles are the two main chambers of the heart, left and right) 
Angina (stable) – A condition marked by distressing symptoms typically between neck and navel that come on with exertion and go away with rest, caused by an inadequate blood supply to the heart muscle typically because of narrowed coronary arteries feeding the heart muscle  Also known as Angina Pectoris  Unstable angina (UA) occurs when fatty deposits (plaques) in a blood vessel rupture or a blood clot forms, blocking or reducing flow through a narrowed artery, suddenly and severely decreasing blood flow to the heart muscle  Unstable angina is not relieved by rest; it’s dangerous and requires emergency medical attention 
Antiplatelet drugs – Medications that block the formation of blood clots by preventing the clumping of platelets (examples: Plavix, Effient, Brillinta, Ticlid, etc)  Heart patients, especially those with implanted stents after PCI, are often prescribed dual antiplatelet therapy (DAPT) which includes one of these prescribed meds along with daily low-dose aspirin 
Aorta – The main artery of the body, carrying blood from the left side of the heart to the arteries of all limbs and organs except the lungs 
Aortic Stenosis: A disease of the heart valves in which the opening of the aortic valve is narrowed  Also called AS 
Aortic valve – One of four valves in the heart, this valve allows blood from the left ventricle to be pumped up (ejected) into the aorta, but prevents blood from returning to the heart once it’s in the aorta 
AP – Apical Pulse: A central pulse located at the apex (pointy bottom) of the heart 
Apex – the lowest (pointy) tip of the heart that points downward at the base, forming what almost looks like a rounded point 
Apical Hypertrophic Cardiomyopathy (A-HCM): Also called Yamaguchi Syndrome or Yamaguchi Hypertrophy, a non-obstructive form of cardiomyopathy (a disease of the heart muscle that leads to generalized deterioration of the muscle and its pumping ability) in which a portion of the heart muscle is hypertrophied (thickened) without any obvious cause  There may be a genetic link  It was first described in people of Japanese descent 
Arrhythmia – A condition in which the heart beats with an irregular or abnormal rhythm 
AS – Aortic Stenosis: A disease of the heart valves in which the opening of the aortic valve is narrowed 
ASD – Atrial Septal Defect: See Septal Defect 
Atrial Flutter – A heart rhythm problem (arrhythmia) originating from the right atrium, most often involving a large circuit that travels around the area of the tricuspid valve (between the right atrium and the right ventricle (this is called typical atrial flutter)  Less commonly, atrial flutter can also result from circuits in other areas of the right or left atrium that cause the heart to beat fast (called atypical atrial flutter) 
Atrial Septum, the membrane that separates the left and the right upper chambers of the heart (the atria) 
Atrium – A chamber of the heart that receives blood from the veins and forces it into a ventricle or ventricles  Plural: atria 
AV – Atrioventricular: A group of cells in the heart located between the upper two chambers (the atria) and the lower two chambers (the ventricles) that regulate the electrical current that passes through it to the ventricles  Also Atrioventricular Block: An interruption or disturbance of the electrical signal between the heart’s upper two chambers (the atria) and lower two chambers (the ventricles)  Also Aortic valve: The valve that regulates blood flow from the heart into the aorta 
AVNRT – Atrioventricular Nodal Re-entry Tachycardia: a heart rhythm problem that happens when there’s an electrical short circuit in the centre of the heart, one of the most common types of SVT, most often seen in people in their twenties and thirties, and more common in women than in men 
BAV – Bicuspid Aortic Valve: The most common malformation of the heart valves in which the aortic valve has only two cusps instead of three 
BB – Beta Blocker: A blood pressure-lowering drug that limits the activity of epinephrine, a hormone that increases blood pressure 
BBB – Bundle Branch Block: – A condition in which parts of the heart’s conduction system are defective and unable to normally conduct the electrical signal, causing an irregular heart rhythm (arrhythmia) 
BMI – Body mass index: A number that doctors use to determine if you’re overweight  BMI is calculated using a formula of weight in kilograms divided by height in meters squared (BMI =W [kg]/H [m2])  Better yet, just click here to figure out your own BMI 
BNP blood test – BNP (B-type Natriuretic Peptide) is a substance secreted from the ventricles or lower chambers of the heart in response to changes in pressure that happen when heart failure develops and/or worsens  The level of BNP in the blood increases when heart failure symptoms worsen, and decreases when the heart failure condition is stable 
BP – Blood Pressure: The force or pressure exerted by the heart in pumping blood; the pressure of blood in the arteries  See also hypertension 
BrS – Brugada Syndrome: Brugada syndrome is a genetic heart disease that is characterized by distinctively abnormal electrocardiogram (EKG/ECG) findings and an increased risk of sudden cardiac arrest 
CAA – Coronary artery anomaly: A congenital defect in one or more of the coronary arteries of the heart 
CABG – Coronary Artery Bypass Graft: A surgical procedure that reroutes blood flow around a diseased or blocked blood vessel that supplies blood to the heart by grafting either a piece of vein harvested from the leg or the artery from under the breastbone 
CA – Coronary Artery: The arteries arising from the aorta that arch down over the top of the heart and divide into branches  They provide blood to the heart muscle 
CAD – Coronary Artery Disease: A narrowing of the arteries that supply blood to the heart  The condition results from a plaque rupture/blood clot or spasm and greatly increases the risk of a heart attack 
Cardiac Ablation – A procedure performed by an Electrophysiologist (EP) – a cardiologist with specialized training in treating heart rhythm problems – that typically uses catheters — long, flexible tubes inserted through a vein in the groin and threaded to the heart — to correct structural problems in the heart that cause an arrhythmia  Cardiac ablation works by scarring or destroying the tissue in your heart that triggers an abnormal heart rhythm 
Cardiac Arrest – Also known as Sudden Cardiac Arrest: The stopping of the heartbeat, usually because of interference with the electrical signal that regulates each heartbeat (often associated with coronary heart disease)  Can lead to Sudden Cardiac Death 
Cardiac Catheterization – An invasive procedure in which a catheter is inserted through a blood vessel in the wrist/arm or groin with x-ray guidance  This procedure can help provide information about blood supply through the coronary arteries, blood pressure, blood flow throughout the chambers of the heart, collection of blood samples, and x-rays of the heart’s ventricles or arteries  It’s typically performed in the cath lab during angiography 
Cardiac Resynchronization Therapy (CRT) also called bi-ventricular pacemaker: an electronic pacing device that’s surgically implanted in the chest to treat the delay in heart ventricle contractions that occur in some people with heart failure 
Cardiac Tamponade – Pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium)  Also called Tamponade 
Cardiomyopathy – a chronic disease of the heart muscle (myocardium), in which the muscle is abnormally enlarged, thickened, and/or stiffened 
Cardioversion – A medical procedure in which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia like atrial fibrillation is converted to a normal rhythm using electricity or drugs  Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle  Chemical cardioversion uses medications to convert to normal rhythm 
Cath lab – the room in the hospital/medical clinic where cardiac catheterization procedures take place (for example, when a stent is implanted into a blocked coronary artery) 
CCB – Calcium Channel Blocker: A drug that lowers blood pressure by regulating calcium-related electrical activity in the heart 
CDS – Cardiac Depression Scale: A scale that can help assess the effects of depression occurring as a result of a heart disease diagnosis 
CHF – Heart Failure (also called Congestive Heart Failure): A condition in which the heart cannot pump all the blood returning to it, leading to a backup of blood in the vessels and an accumulation of fluid in the body’s tissues, including the lungs 
CM – Cardiomyopathy: A disease of the heart muscle that leads to generalized deterioration of the muscle and its pumping ability 
CO – Cardiac Output: The amount of blood the heart pumps through the circulatory system in one minute 
Collateral arteries – These extra coronary blood vessels are sometimes able to bypass a blockage in an artery in order to supply enough oxygenated blood to enable the heart muscle to survive when in danger of being damaged because of blockage(s) 
Collateral arteries – Blood vessels that provide an alternative arterial supply of blood to an area of the heart that’s in danger of being deprived of oxygenated blood because of one or more blocked arteries 
Congenital heart defect – one of about 35 different types of heart conditions that happen when the heart or the blood vessels near the heart don’t develop normally before a baby is born (in about 1% of live births)  Because of medical advances that treat babies born with heart defects, there are now for the first time more adults with congenital heart disease than children 
Congestive heart failure (CHF) – a chronic progressive condition that affects the pumping power of your heart muscle  Often referred to simply as heart failure, CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently 
COPD – Chronic Obstructive Pulmonary Disease: A lung disease defined by persistently poor airflow as a result of breakdown of lung tissue (known as emphysema) and dysfunction of the small airways Often associated with smoking, it typically worsens over time 
Coronary Microvascular Disease – A heart condition that causes impaired blood flow to the heart muscle through the small vessels of the heart  Also called Microvascular Disease or Small Vessel Disease 
Coronary Reactivity Test – An angiography procedure specifically designed to examine the blood vessels in the heart and how they respond to different medications  Physicians use these images to distinguish different types of blood vessel reactivity dysfunction (such as Coronary Microvascular Disease) 
Costochondritis– the cause of severe chest pain, but NOT heart-related; it’s an inflammation of the cartilage that connects a rib to the breastbone 
Coumadin – A drug taken to prevent the blood from clotting and to treat blood clots  Coumadin is believed to reduce the risk of blood clots causing strokes or heart attacks  See also Warfarin 
Cox Maze procedure – A complex “cut-and-sew” surgical procedure done to treat atrial fibrillation through a complicated set of incisions made in a maze-like pattern on the left and right atria (the upper chambers of the heart) to permanently interrupt the abnormal electrical signals that are causing the irregular heartbeats of Afib  See also: Mini-Maze 
CP – Chest Pain (may also be felt as squeezing, pressure, fullness, pressure, heaviness, burning or tightness in the chest) 
CPR – Cardiopulmonary Resuscitation: An emergency procedure in which the heart and lungs are made to work by manually compressing the chest overlying the heart and forcing air into the lungs, used to maintain circulation when the heart stops pumping during Cardiac Arrest  Current guidelines suggest hands-only CPR  See also AED 
CQ10 – Co-enzyme Q10: A dietary supplement sometimes recommended for heart patients taking statin drugs 
CRP – C-reactive protein: A byproduct of inflammation, produce by the liver, found in the blood in some cases of acute inflammation 
CRT – Cardiac Resynchronization Therapy also called bi-ventricular pacemaker: an electronic pacing device that’s surgically implanted in the chest to treat the delay in heart ventricle contractions that occur in some people with heart failure 
CT – Computed tomography (CT or CAT scan): An x-ray technique that uses a computer to create cross-sectional images of the body 
CTA – Computerized Tomographic Angiogram: An imaging test to look at the arteries that supply the heart muscle with blood  Unlike a traditional coronary angiogram, CT angiograms don’t use a catheter threaded through your blood vessels to your heart but instead rely on a powerful X-ray machine to produce images of your heart and heart vessels 
CV – Coronary Vein: One of the veins of the heart that drain blood from the heart’s muscular tissue and empty into the right atrium 
CV – Cardiovascular: Pertaining to the heart and blood vessels that make up the circulatory system 
DBP – Diastolic blood pressure: The lowest blood pressure measured in the arteries  It occurs when the heart muscle is relaxed between beats 
DCM – Dilated Cardiomyopathy: A disease of the heart muscle, primarily affecting the heart’s main pumping chamber (left ventricle)  The left ventricle becomes enlarged (dilated) and can’t pump blood to your body with as much force as a healthy heart can 
DDI – Drug-drug interaction: A situation in which a medication affects the activity of another medication when both are administered together 
DIL – Diltiazem: A calcium channel blocker drug that acts as a vasodilator; used in the treatment of angina pectoris, hypertension, and supraventricular tachycardia 
Diuretic – A class of drugs used to lower blood pressure  Also known as “water pills” 
Dobutamine stress echocardiography: This is a form of a stress echocardiogram diagnostic test  But instead of exercising on a treadmill or exercise bike to stress the heart, the stress is obtained by giving a drug that stimulates the heart and makes it “think” it’s exercising  The test is used to evaluate your heart and valve function if you are unable to exercise  It is also used to determine how well your heart tolerates activity, and your likelihood of having coronary artery disease (blocked arteries), and it can evaluate the effectiveness of your cardiac treatment plan  See also TTE and Stress Echocardiogram 
Dressler’s syndrome – Happens to a small number of people three to four weeks after a heart attack  The heart muscle that died during the attack sets the immune system in motion, calling on lymphocytes, one of the white blood cells, to infiltrate the coverings of the heart (pericardium) and the lungs (pleura)  It also starts generating antibodies, which attack those two coverings  Chest pain (CP) is the predominant symptom; treated with anti-inflammatory drugs 
Dual Antiplatelet Therapy – Medications that block the formation of blood clots by preventing the clumping of platelets (examples Plavix, Effient, Brillinta, Ticlid, etc ) are often prescribed along with aspirin as part of what’s known as dual antiplatelet therapy, especially to patients who have undergone PCI and stent implantation 
DVT – Deep Vein Thrombosis: A blood clot in a deep vein in the calf 
ECG / EKG – Electrocardiogram: A test in which several electronic sensors are placed on the body to monitor electrical activity associated with the heartbeat 
Ectopic beats – small changes in an otherwise normal heartbeat that lead to extra or skipped heartbeats, often occurring without a clear cause, most often harmless 
EF – Ejection Fraction: A measurement of blood that is pumped out of a filled ventricle  The normal rate is 50-60% 
EKG/ECG – Electrocardiogram: A test in which several electronic sensors are placed on the body to monitor electrical activity associated with the heartbeat 
Endothelium: A single-cell layer of flat endothelial cells lining the closed internal spaces of the body such as the inside of blood vessels  Endothelial dysfunction affects the ability of these cells to help dilate blood vessels, control inflammation or prevent blood clots  The endothelium is associated with most forms of cardiovascular disease, such as hypertension, coronary artery disease, chronic heart failure, peripheral vascular disease, diabetes, chronic kidney failure, and severe viral infections 
Enhanced External Counterpulsation – EECP is an FDA-approved non-invasive, non-drug treatment for angina  It works by promoting the development of collateral coronary arteries  The therapy is widely used in prominent heart clinics such as the Cleveland Clinic, Mayo Clinic and Johns Hopkins – especially for patients who are not good candidates for invasive procedures such as bypass surgery, angioplasty or stenting 
EP – Electrophysiologist: A cardiologist who has additional training in diagnosing/treating heart rhythm disorders 
EPS – Electrophysiology Study: A test that uses cardiac catheterization to study patients who have arrhythmias (abnormal hear rhythm)  An electrical current stimulates the heart in an effort to provoke an arrhythmia, which is immediately treated with medications  EPS is used primarily to identify the origin of the arrhythmia and to test the effectiveness of medications used to treat abnormal heart rhythms 
EVH – Endoscopic Vessel Harvesting: To create the bypass graft during CABG open heart surgery, a surgeon will remove or “harvest” healthy blood vessels from another part of the body, often from the patient’s leg or arm  This vessel becomes a graft, with one end attaching to a blood source above and the other end below the blocked area  See CABG 
Exercise stress test – An exercise test (walking/running on a treadmill or pedalling a stationary bike) to make your heart work harder and beat faster  An EKG is recorded while you exercise to monitor any abnormal changes in your heart under stress, with or without the aid of drugs to enhance this assessment  See also: MIBI, Echocardiogram, Nuclear Stress Test 
Familial hypercholesterolemia (FH) – A genetic predisposition to dangerously high cholesterol levels  FH is an inherited disorder that can lead to aggressive and premature cardiovascular disease, including problems like heart attacks, strokes, or narrowing of the heart valves 
Femoral Artery: a major artery in your groin/upper thigh area, through which a thin catheter is inserted, eventually making its way into the heart during angioplasty to implant a stent; currently the most widely used angioplasty approach in the United States, but many other countries now prefer the Radial Artery access in the wrist 
FFR – Fractional Flow Reserve: A test used during coronary catheterization (angiogram) to measure pressure differences across a coronary artery stenosis (narrowing or blockage) defined as as the pressure behind a blockage relative to the pressure before the blockage 
HC – High Cholesterol: When fatty deposits build up in your coronary arteries 
HCTZ – Hydrochlorothiazide: A drug used to lower blood pressure; it acts by inhibiting the kidneys’ ability to retain water  Used to be called “water pills” 
Heart Failure – a chronic progressive condition that affects the pumping power of your heart muscle  Sometimes called Congestive Heart Failure (CHF) 
Holter Monitor – A portable monitoring device that patients wear for recording heartbeats over a period of 24 hours or more 
HTN – Hypertension: High blood pressure, the force of blood pushing against the walls of arteries as it flows through them 
Hypokinesia – Decreased heart wall motion during each heartbeat, associated with cardiomyopathy, heart failure, or heart attack  Hypokinesia can involve small areas of the heart (segmental) or entire sections of heart muscle (global)  Also called hypokinesis 
ICD – Implantable Cardioverter Defibrillator: A surgically implanted electronic device to treat life-threatening heartbeat irregularities 
IHD – Ischemic Heart Disease: heart problems caused by narrowing of the coronary arteries, causing a decreased blood supply to the heart muscle  Also called coronary artery disease and coronary heart disease 
INR – International Normalized Ratio: A laboratory test measure of blood coagulation, often used as a standard for monitoring the effects of the anti-coagulant drug, warfarin (coumadin) 
IST – Inappropriate sinus tachycardia: A heart condition seen most often in young women, in which a person’s resting heart rate is abnormally high (greater than 100 bpm), their heart rate increases rapidly with minimal exertion, and this rapid heart rate is accompanied by symptoms of palpitations, fatigue, and/or exercise intolerance 
Interventional cardiologist – A cardiologist who is trained to perform invasive heart procedures like angiography, angioplasty, percutaneous coronary intervention (PCI), implanting stents, etc 
IVS – Interventricular Septum: The stout wall that separates the lower chambers (the ventricles) of the heart from one another 
IVUS – Intravascular Ultrasound: A form of echocardiography performed during cardiac catheterization in which a transducer (a device that can act as a transmitter (sender) and receiver of ultrasound information) is threaded into the heart blood vessels via a catheter; it’s used to provide detailed information about the blockage inside the blood vessels 
LAD – Left Anterior Descending coronary artery: One of the heart’s coronary artery branches from the left main coronary artery which supplies blood to the left ventricle 
LAFB – Left Anterior Fascicular Block: A cardiac condition,distinguished from Left Bundle Branch Block because only the anterior half of the left bundle branch is defective and more common than left posterior fascicular block 
LAHB – Left Anterior Hemiblock: The Left Bundle Branch divides into two major branches – the anterior and the posterior fascicles  Occasionally, a block can occur in one of these fascicles 
Left Circumflex Artery – The artery carries oxygenated blood from the heart to the body; it’s a branch of the Left Main Coronary Artery after the latter runs its course in between the aorta and the Main Pulmonary Artery 
Left Main Coronary Artery – The artery that branches from the aorta to supply oxygenated blood to the heart via the Left Anterior Descending Artery (LAD) and the Left Circumflex Artery 
Lipids – fat-like substances found in your blood and body tissues; a lipid panel is a blood test that measures the level of specific lipids in blood to help assess your risk of cardiovascular disease, measuring four types of lipids: total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides 
Lipoprotein-a or Lp(a) – molecules made of proteins and fat, carrying cholesterol and similar substances through the blood  A high level of Lp(a) is considered a risk factor for heart disease; detectable via a blood test 
Long QT syndrome (LQTS): A heart rhythm disorder that can potentially cause fast, chaotic heartbeats that may trigger a sudden fainting spell or seizure  In some cases, the heart may beat erratically for so long that it can cause sudden death 
LV – Left Ventricle – One of four chambers (two atria and two ventricles) in the human heart, it receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta via the aortic valve 
LVAD – Left ventricular assist device: A mechanical device that can be placed outside the body or implanted inside the body  An LVAD does not replace the heart – it “assists” or “helps” it pump oxygen-rich blood from the left ventricle to the rest of the body, usually as a bridge to heart transplant 
LVH – Left Ventricular Hypertrophy: A thickening of the myocardium (muscle) of the Left Ventricle (LV) of the heart  
Lumen – The hollow area within a tube, such as a blood vessel 
Main Pulmonary Artery – Carries oxygen-depleted blood from the heart to the lungs 
MIBI – Nuclear Stress Test/Cardiac Perfusion Scan/Sestamibi: tests that are used to assess the blood flow to the heart muscle (myocardium) when it is stressed by exercise or medication, and to find out what areas of the myocardium have decreased blood flow due to coronary artery disease  This is done by injecting a tiny amount of radionuclide like thallium or technetium (chemicals which release a type of radioactivity called gamma rays) into a vein in the arm or hand 
Microvascular disease – a heart condition that causes impaired blood flow to the heart muscle through the small blood vessels of the heart  Symptoms mimic those of a heart attack  Also called Coronary Microvascular Disease or Small Vessel Disease  I live with this diagnosis and have written more about it here, here and here 
Mini-Maze – a surgical procedure to treat atrial fibrillation, less invasive than what’s called the Cox Maze III procedure (a “cut-and-sew” procedure), and performed on a beating heart without opening the chest 
Mitral Valve: One of four valves in the heart, the structure that controls blood flow between the heart’s left atrium (upper chamber) and left ventricle (lower chamber)  The mitral valve has two flaps (cusps)  See also MV and/or Valves 
Mitral valve prolapse: a condition in which the two valve flaps of the mitral valve don’t close smoothly or evenly, but instead bulge (prolapse) upward into the left atrium; also known as click-murmur syndrome, Barlow’s syndrome or floppy valve syndrome 
MR – Mitral regurgitation: (also mitral insufficiency or mitral incompetence) a heart condition in which the mitral valve does not close properly when the heart pumps out blood  It’s the abnormal leaking of blood from the left ventricle, through the mitral valve and into the left atrium when the left ventricle contracts 
MRI – Magnetic Resonance Imaging: A technique that produces images of the heart and other body structures by measuring the response of certain elements (such as hydrogen) in the body to a magnetic field  An MRI can produce detailed pictures of the heart and its various structures without the need to inject a dye 
MS – Mitral Stenosis: A narrowing of the mitral valve, which controls blood flow from the heart’s upper left chamber (the left atrium) to its lower left chamber (the left ventricle)  May result from an inherited (congenital) problem or from rheumatic fever 
MUGA – Multiple-Gated Acquisition Scanning: A non-invasive nuclear test that uses a radioactive isotope called technetium to evaluate the functioning of the heart’s ventricles 
Murmur – Noises superimposed on normal heart sounds  They are caused by congenital defects or damaged heart valves that do not close properly and allow blood to leak back into the originating chamber 
MV – Mitral Valve: The structure that controls blood flow between the heart’s left atrium (upper chamber) and left ventricle (lower chamber) 
Myocardial Infarction (MI, heart attack) – The damage or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to the area  The affected tissue dies, injuring the heart 
Myocardium – The muscular tissue of the heart 
New Wall-Motion Abnormalities – Results seen on an echocardiogram test report (see NWMA, below) 
Nitroglycerin – A medicine that helps relax and dilate arteries; often used to treat cardiac chest pain (angina)  Also called NTG or GTN 
NSR – Normal Sinus Rhythm: The characteristic rhythm of the healthy human heart  NSR is considered to be present if the heart rate is in the normal range, the P waves are normal on the EKG/ECG, and the rate does not vary significantly 
NSTEMI – Non-ST-segment-elevation myocardial infarction: The milder form of the two main types of heart attack  An NSTEMI heart attack does not produce an ST-segment elevation seen on an electrocardiogram test (EKG)  See also STEMI 
Nuclear Stress Test – A diagnostic test that usually involves two exercise stress tests, one while you’re exercising on a treadmill/stationary bike or with medication that stresses your heart, and another set while you’re at rest  A nuclear stress test is used to gather information about how well your heart works during physical activity and at rest  See also: Exercise stress test, Nuclear perfusion test, MIBI 
Open heart surgery – Any surgery in which the chest is opened and surgery is done on the heart muscle, valves, coronary arteries, or other parts of the heart (such as the aorta)  See also CABG 
Pacemaker – A surgically implanted electronic device that helps regulate the heartbeat 
PAD – Peripheral Artery Disease: A common circulatory problem in which narrowed arteries reduce blood flow to the limbs, usually to the legs  Symptoms include leg pain when walking (called intermittent claudication) 
PAF – Paroxysmal Atrial Fibrillation: Atrial fibrillation that lasts from a few seconds to days, then stops on its own  See also Atrial Fibrillation 
Palpitations – A noticeably rapid, strong, or irregular heartbeat due to agitation, exertion or illness 
Paroxysmal Atrial Fibrillation – An unusual heart arrhythmia of unknown origin, at one time believed to be associated with an unusual sensitivity to alcohol consumption 
PDA – patent ductus arteriosus: A persistent opening between two major blood vessels leading from the heart  The opening is called ductus arteriosus and is a normal part of a baby’s circulatory system before birth that usually closes shortly after birth  But when it remains open, it’s called a patent ductus arteriosus  If it’s small, it may never need treatment, but a large PDA left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure or other complications 
Pericardium: two thin layers of a sac-like tissue that surround the heart, hold it in place and help it work 
PET – Positron Emission Tomography: A non-invasive scanning technique that uses small amounts of radioactive positrons (positively charged particles) to visualize body function and metabolism  In cardiology, PET scans are used to evaluate heart muscle function in patients with coronary artery disease or cardiomyopathy 
PFO – Patent Forman Ovale: An opening between the left and right atria (the upper chambers) of the heart  Everyone has a PFO before birth, but in 1 out of every 3 or 4 people, the opening does not close naturally as it should after birth 
Plaque – A deposit of fatty (and other) substances in the inner lining of the artery wall; it is characteristic of atherosclerosis 
POTS – Postural Orthostatic Tachycardia Syndrome: A disorder that causes an increased heart rate when a person stands upright 
PPCM – Post-partum cardiomyopathy: A form of cardiomyopathy that causes heart failure toward the end of pregnancy or in the months after delivery, in the absence of any other cause of heart failure 
Preeclampsia – a late-pregnancy complication identified by spikes in blood pressure, protein in the urine, possible vision problems  Women who experience pregnancy complications like preeclampsia are at significantly higher risk for heart disease 
Prinzmetal’s Variant Angina – Chest pain caused by a spasm in a coronary artery that supplies blood to the heart muscle 
PSVT – Paroxysmal Supraventricular Tachycardia: – An occasional rapid heart rate (150-250 beats per minute) that is caused by events triggered in areas above the heart’s lower chambers (the ventricles)  “Paroxysmal” means from time to time  See also supraventricular tachycardia (SVT) 
Pulmonary Valve: One of the four valves in the heart, located between the pulmonary artery and the right ventricle of the heart, moves blood toward the lungs and keeps it from sloshing back into the heart 
PV – Pulmonary Vein: A vein carrying oxygenated blood from the lungs to the left atrium of the heart 
PVC – Premature Ventricular Contraction: An early or extra heartbeat that happens when the heart’s lower chambers (the ventricles) contract too soon, out of sequence with the normal heartbeat  In the absence of any underlying heart disease, PVCs do not generally indicate a problem with electrical stability, and are usually benign 
RA – Right Atrium: The right upper chamber of the heart  The right atrium receives de-oxygenated blood from the body through the vena cava and pumps it into the right ventricle which then sends it to the lungs to be oxygenated 
Radial Artery: the artery in the wrist where a thin catheter is inserted through the body’s network of arteries in the arm and eventually into the heart during a procedure to implant a stent  Doctors may also call this transradial access, the transradial approach, or transradial angioplasty  Because it’s associated with fewer complications, this is increasingly considered the default access approach in most countries, except in the U S  where the traditional Femoral Artery (groin) approach is still the most popular access 
RBBB – Right Bundle Branch Block: A delay or obstruction along the pathway that electrical impulses travel to make your heart beat  The delay or blockage occurs on the pathway that sends electrical impulses to the right side of your heart  See also Left Bundle Branch Block 
RCA – Right Coronary Artery: An artery that supplies blood to the right side of the heart 
Restenosis – The re-closing or re-narrowing of an artery after an interventional procedure such as angioplasty or stent placement  Sometimes called “stent failure” 
RHD – Rheumatic Heart Disease: Permanent damage to the valves of the heart caused especially by repeated attacks of rheumatic fever 
RM – Right Main coronary artery: A blood vessel that supplies oxygenated blood to the walls of the heart’s ventricles and the right atrium 
RV – Right Ventricle: The lower right chamber of the heart that receives de-oxygenated blood from the right atrium and pumps it under low pressure into the lungs via the pulmonary artery 
SA – Sinus node: The “natural” pacemaker of the heart  The node is a group of specialized cells in the top of the right atrium which produces the electrical impulses that travel down to eventually reach the ventricular muscle, causing the heart to contract 
SB – Sinus Bradycardia: Abnormally slow heartbeat 
SBP – Systolic Blood Pressure: The highest blood pressure measured in the arteries  It occurs when the heart contracts with each heartbeat  Example: the first number in 120/80 
SCAD – Spontaneous Coronary Artery Dissection: A rare emergency condition that occurs when a tear forms in one of the blood vessels in the heart, causing a heart attack, abnormalities in heart rhythm and/or sudden death  SCAD tends to strike young healthy women with few if any cardiac risk factors 
SD – Septal defect: A hole in the wall of the heart separating the atria (two upper chambers of the heart) or in the wall of the heart separating the ventricles (two lower chambers) 
Sestamibi stress test – See MIBI 
Short QT intervals (SQT): An abnormal heart rhythm where the heart muscle takes a shorter time to recharge between beats  It can cause a variety of complications from fainting and dizziness to sudden cardiac arrest 
Sick Sinus Syndrome (also known as sinus node dysfunction) is caused by an electrical problem in the heart; a group of related heart conditions that can affect how the heart beats, most commonly in older adults, although it can be diagnosed in people of any age  “Sick sinus” refers to the sinoatrial node (see below)  In people with sick sinus syndrome, the SA node does not function normally 
Sinoatrial node (SA): also commonly called the sinus node; it’s a small bundle of neurons situated in the upper part of the wall of the right atrium (the right upper chamber of the heart)  The heart’s electrical impulses are generated there  It’s the normal natural pacemaker of the heart and is responsible for the initiation of each heartbeat 
Spontaneous Coronary Artery Dissection (SCAD) – A rare emergency condition that occurs when a tear forms in one of the blood vessels in the heart, causing a heart attack, abnormalities in heart rhythm and/or sudden death  SCAD tends to strike young healthy women with few if any cardiac risk factors 
SSS – Sick Sinus Syndrome: The failure of the sinus node to regulate the heart’s rhythm 
ST – Sinus Tachycardia: A heart rhythm with elevated rate of impulses originating from the sinoatrial node, defined as greater than 100 beats per minute (bpm) in an average adult  The normal heart rate in the average adult ranges from 60–100 bpm  Also called sinus tach or sinus tachy 
Statins – Any of a class of drugs that lower the levels of low-density lipoproteins (LDL) – the ‘bad’ cholesterol in the blood – by inhibiting the activity of an enzyme involved in the production of cholesterol in the liver  Examples of brand name statins: Lipitor, Crestor, Zocor, Mevacor, Levachol, Lescol, etc  Also available as a cheaper generic form of the drug 
STEMI – ST-elevation heart attack (myocardial infarction)  The more severe form of the two main types of heart attack  A STEMI produces a characteristic elevation in the ST segment on an electrocardiogram (EKG)  The elevated ST segment is how this type of heart attack got its name  See also NSTEMI 
Stent – An implantable device made of expandable, metal mesh (looks a bit like a tiny chicken wire tube) that is placed (by using a balloon catheter) at the site of a narrowing coronary artery during an angioplasty procedure  The stent is then expanded when the balloon fills, the balloon is removed, and the stent is left in place to help keep the artery open  TRIVIA ALERT: the coronary stent was named after Charles Stent (1807-1885), an English dentist who invented a compound to produce dentures and other things like skin grafts and hollow tubes (essentially what a metal coronary stent is)  His real claim to fame occurred when he suggested using his material to coat underwater trans-Atlantic cable, which had broken several times as a result of corrosion by seawater  You’re welcome 
Stint – a common spelling mistake when what you really mean is the word “stent” (see above) 
Stress Echocardiography – A standard echocardiogram test that’s performed while the person exercises on a treadmill or stationary bicycle  This test can be used to visualize the motion of the heart’s walls and pumping action when the heart is stressed, possibly revealing a lack of blood flow that isn’t always apparent on other heart tests  The echocardiogram is performed just before and just after the exercise part of the procedure  See also TTE 
Sudden Cardiac Arrest – The stopping of the heartbeat, usually because of interference with the electrical signal (often associated with coronary heart disease)  Can lead to Sudden Cardiac Death 
Takotsubo Cardiomyopathy – A heart condition that can mimic a heart attack  Sometimes called Broken Heart Syndrome, it is not a heart attack, but it feels just like one, with common symptoms like severe chest pain and shortness of breath  It sometimes follows a severe emotional stress  Over 90% of reported cases are in women ages 58 to 75  Also referred to as Broken Heart Syndrome, stress cardiomyopathy, stress-induced cardiomyopathy or apical ballooning syndrome 
TAVR – Transcatheter aortic valve replacement: A minimally invasive procedure to repair a damaged or diseased aortic valve  A catheter is inserted into an artery in the groin and threaded to the heart  A balloon at the end of the catheter, with a replacement valve folded around it, delivers the new valve to take the place of the old  Also called TAVI (Transcatheter aortic valve implantation) 
Tetralogy of Fallot – A rare condition caused by a combination of four heart defects that are present at birth, affecting the structure of the heart and causing oxygen-poor blood to flow out of the heart and into the rest of the body  Infants and children with Tetralogy of Fallot usually have blue-tinged skin because their blood doesn’t carry enough oxygen  Often diagnosed in infancy, but sometimes not until later in life depending on severity 
Tg – Triglycerides: The most common fatty substance found in the blood; normally stored as an energy source in fat tissue  High triglyceride levels may thicken the blood and make a person more susceptible to clot formation  High triglyceride levels tend to accompany high cholesterol levels and other risk factors for heart disease, such as obesity 
TIA – Transient Ischemic Attack: A stroke-like event that lasts only for a short time and is caused by a temporarily blocked blood vessel 
TEE – Transesophageal echocardiogram: This test involves an ultrasound transducer inserted down the throat into the esophagus in order to take clear images of the heart structures without the interference of the lungs and chest 
Treadmill Stress Test – See Exercise Stress Test 
troponin – a type of cardiac enzyme found in heart muscle, and released into the blood when there is damage to the heart (for example, during a heart attack)  A positive blood test that shows elevated troponin is the preferred test for a suspected heart attack because it is more specific for heart injury than other blood tests, especially the newer high sensitivity troponin tests (hs-cTnT) 
TTE – Transthoracic Echocardiogram: This is the standard echocardiogram, a painless test similar to X-ray, but without the radiation, using a hand-held device called a transducer placed on the chest to transmit high frequency sound waves (ultrasound)  These sound waves bounce off the heart structures, producing images and sounds that can be used by the doctor to detect heart damage and disease 
TV – Tricuspid Valve: One of four one-way valves in the heart, a structure that controls blood flow from the heart’s upper right chamber (the right atrium) into the lower right chamber (the right ventricle) 
UA or USA – Unstable Angina: Chest pain that occurs when diseased blood vessels restrict blood flow to the heart; symptoms are not relieved by rest; considered a dangerous and emergency crisis requiring immediate medical help 
Valves: Your heart has four one-way valves that keep blood flowing in the right direction  Blood enters the heart first through the tricuspid valve, and next goes through the pulmonary valve (sometimes called the pulmonic valve) on its way to the lungs  Then the blood returning from the lungs passes through the mitral (bicuspid) valve and leaves the heart through the aortic valve 
Vasodilator: A drug that causes dilation (widening) of blood vessels 
Vasospasm: A blood vessel spasm that causes sudden constriction, reducing its diameter and blood flow to the heart muscle  See also Prinzmetal’s Variant Angina 
VB – Ventricular Bigeminy: A heart rhythm condition in which the heart experiences two beats of the pulse in rapid succession 
Vena Cava – a large vein that carryies de-oxygenated blood into the heart  There are two in humans, the inferior vena cava (carrying blood from the lower body) and the superior vena cava (carrying blood from the head, arms, and upper body) 
Ventricle – each of the two main chambers of the heart, left and right 
VF – Ventricular Fibrillation: A condition in which the ventricles (two lower chambers of the heart) contract in a rapid, unsynchronized fashion  When fibrillation occurs, the ventricles cannot pump blood throughout the body  Most sudden cardiac deaths are caused by VF or ventricular tachycardia (VT) 
VLDL – Very Low Density Lipoprotein: Molecules made up of mostly triglycerides, cholesterol and proteins  VLDL, also known as the “very bad” cholesterol, carries cholesterol from the liver to organs and tissues in the body  It may lead to low density lipoproteins (LDL), associated with higher heart disease risks  VLDL levels are tricky to measure routinely, and are usually estimated as a percentage of your triglyceride levels  By reducing triglycerides, you are usually also reducing your VLDL levels 
Warfarin – A drug taken to prevent the blood from clotting and to treat blood clots  Warfarin is believed to reduce the risk of blood clots causing strokes or heart attacks  Also known as Coumadin 
Widowmaker heart attack – The type of heart attack I survived, since you asked  A nickname doctors use to describe a severely blocked left main coronary artery or proximal left anterior descending coronary artery of the heart  This term is used because if the artery gets abruptly and completely blocked, it can cause a massive heart attack that will likely lead to sudden cardiac death  Please note the gender imbalance here: despite the number of women like me who do experience this type of cardiac event, doctors are not calling this the widowermaker, after all 
WPW – Wolff-Parkinson-White Syndrome: A condition in which an extra electrical pathway connects the atria (two upper chambers) and the ventricles (two lower chambers)  It may cause a rapid heartbeat 
NOTE FROM CAROLYN: I was very happy when we were able to include this entire glossary in my book, “A Woman’s Guide to Living with Heart Disease“ (Johns Hopkins University Press, 2017) 
Are we missing any important heart acronyms/terms from this list? Let me know!
Please can someone explain something for me  I am a 53 yr old woman and generally fit and healthy  Had 2 ECG’s due to a one off dizzy spell during a stressful time dealing with my fathers terminal diagnosis  The 2nd ECG request did give me concern as i did not know why i had to have one  On 24/01/19 at my doctors appointment she explained that on 3 the leads it showed inverted T waves  And she explained that it may suggest angina  I was so shocked  Wasn’t expecting that  She gave me a GNT (nitroglycerin) spray in case I do get pain and take 75Mg of aspirin  I’m now waiting for a Cardiology referral 
I am so stressed and consumed by what might be wrong  My maternal grandmother had angina and valve issues  Her 3 brothers all had double bypasses  Could I have inherited this? I am not overweight at 63kg and 5 ft 9  I walk 20-25 miles a week at work and general walking here and there  I started HRT (patches evorol 25 -50) in July as menopause pain was making me feel like I was 90 and was getting me down 
I am worried so much now and analysing every ache/ twinge I get  I feel like a hypochondriac at the moment  I’m worried what will happen at the cardiologist and what the test will entail and tell me  I am waiting on cholesterol test which I had on 25/01/19  Can I have inverted T waves and be fine  Please help I am so scared and crying far too much 
Hello Colleen – the first thing is: please take a big deep breath before you read another word here! I’m not a physician so of course cannot comment on your specific case, but I can tell you generally that the definition of “angina” (as this glossary lists above) is “distressing symptoms”, typically chest pain that gets worse with exertion, and goes away with rest  That’s classic stable angina… typically caused by something that’s reducing blood flow to the heart muscle (causing the chest pain of angina) 
A family history that might make a difference for you personally is only in what’s called your ‘first degree’ relatives: for example, if your mother or sister were diagnosed with heart disease before age 65, or if your Dad or brother were diagnosed before age 55, then doctors would consider that you have a family history as a risk factor for heart disease  There’s little if any scientific evidence that a grandparent or uncle’s heart disease history has any effect on your own risk 
It is a very good thing that you’re having further tests and a referral to a cardiologist, if only to ease your mind  There are many reasons for inverted T-waves, ranging from cardiac issues to completely benign conditions  One way of looking at this is choosing to believe that seeing a cardiologist will ease your mind one way or the other – so this is something to look forward to, not dread  If the cardiologist spots something suspicious, a treatment plan will be created  If not, you can wave goodbye and go back to happily living your life 
Try thinking of this cardiology appointment just as you would if your car were making some frightening noises and you were bringing it to your mechanic for a check up  You could work yourself into a complete state worrying ahead of time if the car trouble is going to be serious, or you could look at this appointment as the solution – at last! – to figuring out what’s wrong so the mechanic can recommend the next step 
Thank you for this list of so many definitions provided in plain English  what a valuable resource this is  THANK YOU, I have been looking for translations FOR PATIENTS not med school graduates– like this for three years 
My family doctor had me wear a 24 hr EKG  After reading the results, she has scheduled a scope to look inside my heart by a specialist  Completely forgoing a stress test  Said I have major changes in the EKG, what type of changes could they be looking at? Had LAD STENT INSERTED 7 YRS AGO – WHAT COULD THEY BE LOOKING FOR?
This is a great wealth of information, Carolyn! I looked and did not see my diagnosis, which is aortic stenosis  I looked under aortic as well as stenosis  Did I just miss it somehow?
I learned some new information, I am a bit familiar now, but not when I had my MI, it was like learning a new language  But, my favorite part was seeing SCAD on this list! Thank you 
Thanks and welcome! I was thinking of editing that SCAD definition actually: I suspect that that it isn’t so much that SCAD is “rare”, but it’s more that it’s “rarely correctly diagnosed” 
I totally agree that SCAD is not as rare as I believed for many years  Once awareness is spread to all medical staff, I believe many lives will be saved  Hoping for a brighter future for all SCAD patients 
I hope so too, Cathy  Perhaps when more SCAD studies (like Mayo Clinic’s) are published and read by more and more MDs, it will no longer be “rarely correctly diagnosed” 
It’s great to see IST on here  I was diagnosed with it 9 years ago and the lack of awareness is frustrating 
What a great resource for heart patients and their families!
Thanks so much, Ashley  I recently updated my original 2011 list after the world-famous Cleveland Clinic tweeted their glossary recently and I noticed that their list had a few glaring omissions (like SCAD and Brugada Syndrome) so this made me wonder what my list might be missing, too  Let me know if there’s anything else you think should be included, okay?
How is your health these days? How are you feeling?
New for me too  I have just been diagnosed with A-HCM: Apical Hypertrophic Cardiomyopathy 
I’ll add that one to my list, Kathleen – thanks!
Just saw this, Carolyn, and you’ve compiled a great resource  One note on A-HCM: Present thinking is that it’s due to a genetic modification  Runs in families though sometimes occurs spontaneously  I have not as yet done genetic testing, though it’s been offered 
Thanks Kathleen – like many cardiac diagnoses, it sounds like a moving target… Good luck to you!
This list is great  I’ve just been diagnosed and am utterly overwhelmed  Even in the WomenHeart online support community, I often have no clue most days what others are talking about with all these initials about their heart tests and specific disease  This is VERY helpful, thank you SO MUCH  Love your website which has been a godsend since my diagnosis 



ground_truth: Implantable Cardioverter Defibrillator (ICD) is a surgically implanted electronic device to treat life-threatening heartbeat irregularities.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: When did Simon English become the leader of the National Party?

Read the following text and answer briefly.

Context 2: Sir Simon William English  (born 30 December 1961) is a New Zealand former National Party politician who served as the 39th prime minister of New Zealand from 2016 to 2017  He had previously served as the 17th deputy prime minister of New Zealand and minister of finance from 2008 to 2016 under John Key and the Fifth National Government 

A farmer and public servant before entering politics, English was elected to the New Zealand Parliament in  as the National Party's candidate in the Wallace electorate  He was elevated to Cabinet in 1996 and in 1999 was made minister of finance, although he served for less than a year due to his party's loss at the 1999 general election  In October 2001, English replaced Jenny Shipley as the leader of the National Party (and consequently as Leader of the Opposition)  He led the party to its worst defeat at the 2002 general election, and as a consequence, in October 2003 he was replaced as leader by Don Brash 

In November 2006, after Brash's resignation, English became deputy leader under John Key  After National's victory at the 2008 general election, he became deputy prime minister and was also made minister of finance for the second time  Under English's direction New Zealand's economy maintained steady growth during National's three terms of government  He became a list-only MP after stepping down as an electorate MP at the 2014 general election 

John Key resigned as leader of the National Party and prime minister in December 2016  English won the resulting leadership election unopposed and was sworn in as prime minister on 12 December 2016  His tenure was only ten months, and included a three-month election campaign  In the 2017 general election, National won the largest number of seats but fell short of a majority  The parties holding the balance of power declined to support the existing government, and English was subsequently replaced as prime minister by Jacinda Ardern, leader of the Labour Party  English initially continued on as Leader of the Opposition, but resigned as leader of the National Party on 27 February 2018 and left parliament two weeks later 

Early life
English was born on 30 December 1961 at Lumsden Maternity Centre in Lumsden  He is the eleventh of twelve children of Mervyn English and Norah (née O'Brien) English  His parents purchased Rosedale, a mixed sheep and cropping farm in Dipton, Southland from Mervyn's uncle, Vincent English, a bachelor, in 1944  English was born in the maternity unit at Lumsden 

English attended St Thomas's School in Winton, then boarded at St  Patrick's College in Upper Hutt, where he became head boy  He played in the first XV of the school's rugby team  English went on to study commerce at the University of Otago, where he was a resident at Selwyn College, and then completed an honours degree in English literature at Victoria University of Wellington 

After finishing his studies, English returned to Dipton and farmed for a few years  From 1987 to 1989, he worked in Wellington as a policy analyst for the New Zealand Treasury, at a time when the free market policies favoured by Labour's finance minister Roger Douglas (known collectively as "Rogernomics") were being implemented 

English joined the National Party in 1980, while at Victoria University  He served for a period as chairman of the Southland branch of the Young Nationals, and became a member of the Wallace electorate committee  After moving to Wellington, he served for periods on the Island Bay and Miramar electorate committees, respectively 

Fourth National Government (1990–1999)

At the 1990 general election, English stood as the National candidate in Wallace, replacing the retiring Derek Angus, and was elected with a large majority  He would hold this seat, renamed Clutha-Southland in 1996, until 2014  He and three other newly elected National MPs (Tony Ryall, Nick Smith, and Roger Sowry) were soon identified as rising stars in New Zealand politics, and at various points were dubbed the "brat pack", the "gang of four", and the "young Turks"  In his first term in parliament, English chaired a select committee into social services  He was made a parliamentary under-secretary in 1993, serving under the Minister of Health 

First period in cabinet (1996–1999)
In early 1996, English was elevated to cabinet by Prime Minister Jim Bolger, becoming the Minister for Crown Health Enterprises and Associate Minister of Education (to Wyatt Creech)  He was 34 at the time, becoming the cabinet's youngest member  After the 1996 general election, the National Party was forced into a coalition with New Zealand First to retain government  In the resulting cabinet reshuffle, English emerged as Minister of Health  However, as a condition of the coalition agreement, NZ First's Neil Kirton (a first-term MP) was made Associate Minister of Health, effectively becoming English's deputy  This arrangement was described in the press as a "shotgun marriage", and there were frequent differences of opinion between the two ministers  After their relationship became unworkable, Kirton was sacked from the role in August 1997, with the agreement of NZ First leader Winston Peters 

As Minister of Health, English was responsible for continuing the reforms to the public health system that National had begun after the 1990 general election  The reforms were unpopular, and health was perceived as one of the government's weaknesses, with the health portfolio consequently being viewed as a challenge  English believed that the unpopularity of the reforms was in part due to a failure in messaging, and encouraged his National colleagues to avoid bureaucratic and money-focused language (such as references to "balance sheets" and "user charges") and instead talk about the improvements to services the government's reforms would bring  He also rejected the idea that public hospitals could be run as commercial enterprises, a view which some of his colleagues had previously promoted 

By early 1997, as dissatisfaction with Bolger's leadership began to grow, English was being touted as a potential successor, along with Jenny Shipley and Doug Graham  His age (35) was viewed as the main impediment to a successful leadership run  National's leadership troubles were resolved in December 1997, when Bolger resigned and Shipley was elected to the leadership unopposed  English had been a supporter of Bolger as leader, but Shipley reappointed him Minister of Health in her new cabinet 

English was promoted to Minister of Finance in a reshuffle in January 1999, a position which was at the time subordinate to the Treasurer, Bill Birch  After a few months, the pair switched positions as part of Birch's transition to retirement, with English assuming the senior portfolio  In early interviews, he emphasised his wish to be seen as a pragmatist rather than an ideologue, and said that the initiatives of some of his predecessors (Roger Douglas's "Rogernomics" and Ruth Richardson's "Ruthanasia") had focused on "fruitless, theoretical debates" when "people just want to see problems solved" 

Opposition (1999–2008)

After the National Party lost the 1999 election to Helen Clark's Labour Party, English continued on in the shadow cabinet as National's spokesperson for finance  He was elected deputy leader of the party in February 2001, following the resignation of Wyatt Creech, with Gerry Brownlee being his unsuccessful opponent 

Leader of the Opposition
In October 2001, after months of speculation, Jenny Shipley resigned as leader of the National Party after being told she no longer had the support of the party caucus  English was elected as her replacement unopposed (with Roger Sowry as his deputy), and consequently became Leader of the Opposition  However, he did not openly organise against Shipley, and according to The Southland Times "there was almost an element of 'aw, shucks, I'll do it then' about Mr English's ascension" 

Aged 39 when he was elected, English became the second-youngest leader in the National Party's history, after Jim McLay (who was 38 when elected in 1984)  He also became only the third Southlander to lead a major New Zealand political party, after Joseph Ward and Adam Hamilton  However, English failed to improve the party's performance  In the 2002 election, National suffered its worst electoral defeat ever, gaining barely more than twenty percent of the vote  English described it as "the worst day of my political life"  Both party insiders and the general public were split as to how much to blame him for the loss, but most of the party believed that English would be able to rebuild National's support 

By late 2003, however, National's performance in opinion polls remained poor  The party had briefly increased its popularity in the year following the election, but by October its support had fallen to levels only slightly better than what it achieved in the last ballot  English also appeared in a boxing match for a charity against entertainer Ted Clarke  This did not boost his polling or that of the National party either, with suggestions that it devalued his image as a serious politician  Don Brash, former governor of the Reserve Bank and a relative newcomer to politics, began to build up support to replace English  On 28 October, Brash gained sufficient backing in Caucus to defeat English in a leadership contest 

Shadow cabinet roles and deputy leader
On 2 November 2003, when Brash changed responsibilities for certain MPs, English became National's spokesman for education, ranked at fifth place in the party's parliamentary hierarchy  He remained in parliament after the 2005 election  In his new shadow education portfolio, English performed strongly, and remained a party favourite despite his election defeat as leader in 2002, eventually being returned to the finance portfolio in August 2004 as deputy spokesman (while still retaining responsibility for education) 

In November 2006, Brash resigned as leader  English was considered as a potential replacement leader (running against John Key) or deputy leader (against incumbent Gerry Brownlee) in the ensuing leadership election  However, a contest was avoided when the MPs agreed a Key/English ticket would run unopposed in a display of party unity  English took over the deputy leadership and the finance portfolio in the Key shadow cabinet 

Fifth National Government (2008–2017)

Deputy Prime Minister and Minister of Finance (2008–2016)

At the 2008 election, English was re-elected by his electorate, winning by a margin of about 15,500 votes  He became Deputy Prime Minister of New Zealand and Minister of Finance in the fifth National Government, being sworn into office on 19 November 2008 and continued to serve in those roles until becoming Prime Minister on 12 December 2014  He was also made Minister of Infrastructure in National's first term of government and Minister responsible for Housing New Zealand Corporation and minister responsible for the New Zealand flag consideration process in its third 

He was comfortably re-elected in Clutha-Southland in the 2011 election but opted to run as a party-list candidate in 2014  

The pairing of John Key as leader of the National Party and English as his deputy has been compared to that of Bob Hawke and Paul Keating (in Australia) and Tony Blair and Gordon Brown (in the UK) 

English acceded to the role of Finance Minister in the continuing wake of the financial crisis  In response to New Zealand's rising debt, English made budget deficit-reduction his main priority  His first budget outlined three focuses in New Zealand's financial recovery: "improving the business environment and removing roadblocks to growth; investment in productive infrastructure; and improving the way government works"  One of his first acts was creating the National Infrastructure Unit, charged with formulating a plan for infrastructure projects and investments  He commissioned a government-wide spending review, with an aim to reducing government expenditure—with the exceptions of a two-year stimulus package and long-term increases on infrastructure spending 

In April 2011, the Opposition criticised English for suggesting that New Zealand businesses could use New Zealand's low wages to help it compete with Australia  The National Government campaigned for re-election in 2011 on its economic record  The Government boasted growth for five consecutive quarters up to mid-2010, totalling 1 6% of real GDP 

Strong growth resulted in a surplus of $473 million for the 2015/16 financial year, projected to rise to $8 5 billion by 2020/21  In his 2016 Economic and Fiscal Update address, English stated that reducing debt and tackling the costs of the 2016 Kaikōura earthquake were higher priorities than reducing rates of tax 

Allowances issue
In 2009, the media, including TVNZ and TV3 revealed that English was receiving about NZ$900 a week as part of a living allowance for ministers, to live in his own NZ$1 2 million Wellington home  At the time, English also received $276,200 in his annual salary as Deputy Prime Minister  It was also revealed other ministers with homes in the capital city were also claiming accommodation allowances  On 3 August 2009, Prime Minister John Key started a review of the housing allowances claimed by cabinet ministers  English subsequently paid back $12,000 and only claimed about $24,000 a year in living allowances  The Auditor-General's office said in September 2009 that they were making "preliminary enquiries" into parliamentary housing expenses in response to a letter of complaint from Progressive party leader Jim Anderton  Two days later English stated that he would no longer take up any housing allowance and had paid back all the allowance he had received since the November 2008 election 

Prime Minister (2016–2017)

John Key resigned on 12 December, and endorsed English as his successor in the resulting leadership election  Following the drop-out of both Judith Collins and Jonathan Coleman from the leadership election, English was sworn in as the 39th Prime Minister of New Zealand on 12 December 2016 

English appointed his first cabinet on 18 December  In a reshuffle, he appointed Steven Joyce to succeed him as Finance Minister, while most ministerial portfolios remained the same 

In February 2017, English did not attend Waitangi Day commemorations at the historic treaty grounds, reportedly in response to the Ngāpuhi iwi's decision to stop the Prime Minister from speaking at the marae  Ngāpuhi have protested the Government's negotiation of the Trans Pacific Partnership Agreement (TPPA), which the iwi believe infringes upon Māori sovereignty, and thus does not adhere to the Treaty of Waitangi  English had been invited to attend in an official capacity; his non-attendance was criticised by a Ngāpuhi elder and Opposition leader Andrew Little 

In his first overseas trip as Prime Minister, English travelled to Europe to discuss trade ties, including a prospective New Zealand–European Union free trade agreement  He first travelled to London on 13 January 2017 to meet British Prime Minister Theresa May  Discussing trade relations, English said the two nations were "natural partners" and would "continue to forge ties" after the UK's withdrawal from the EU  He also arranged to meet with London Mayor Sadiq Khan, Belgian Prime Minister Charles Michel and German Chancellor Angela Merkel   In a meeting with Merkel, English received crucial backing from Germany for a trade deal with the EU  On 16 January, English stated that his government would continue to promote TPPA, despite the United States' decision to withdraw from the agreement  He explained that Southeast Asian countries would now be treated as a priority in negotiations—he also asserted that the United States was ceding influence to China by its rejection of the trade pact 

At a press conference at the Beehive on 1 February 2017, English announced that the 2017 general election would be held on 23 September  The Prime Minister later confirmed that his party would approach ACT, United Future and the Māori Party if confidence and supply agreements were required to form a government following the election  In his second cabinet reshuffle on 24 April, English appointed Gerry Brownlee as his new Foreign Affairs Minister; he also promoted Nikki Kaye to the portfolio of Education Minister, and moved Mark Mitchell into the cabinet to become Defence Minister  The reshuffle was perceived as an election preparation 

On 13 February 2017, English welcomed Australian Prime Minister Malcolm Turnbull to Wellington  The two leaders reaffirmed their shared trade agenda, and discussed changes to the Australian citizenship pathway which will affect permanent residents originating from New Zealand 

On 19 June, it was reported that Todd Barclay, who succeeded English as MP for Clutha-Southland, had clandestinely recorded one of his employee's conversations the previous year, and that John Key's leaders' budget was used to pay a confidential settlement after the employee resigned  English admitted that he had been aware of the illegal recording and the settlement, and thus implicated in the scandal 

During the 2017 National campaign launch, English introduced a $379 million social investment package including digital learning academies for high school students, more resources for mathematics, and boosting support for teaching second languages in schools, and maintaining National Standards in the school curriculum  Prime Minister English also sought to defend National's financial management and economic track record and claimed that the opposition Labour Party would raise taxes  Early opinion polling had forecast a poor showing in the election for the Labour Party, but in early August 37-year-old Jacinda Ardern took over as Labour leader and seemingly energised younger voters 

At the 2017 general election, National won the largest share of the party vote (44 4%) and the largest number of seats (56) in the House Representatives  However, National lacked enough seats to govern alone due to two of the party's support partners, the Māori Party and United Future, losing their parliamentary seats  In response, English stated that the party would be entering into talks to form a coalition with New Zealand First  Following talks with the two largest parties, New Zealand First entered a coalition arrangement with the Labour Party  English was succeeded as prime minister by Jacinda Ardern on 26 October 

Opposition (2017–2018)

Leader of the Opposition
English was re-elected as National Party leader on 24 October 2017  At the time of his re-election, English announced his intention to stay on as leader until the next general election  On 13 February 2018, however, he stood down as National Party leader due to personal reasons, and instructed the party to put into motion the processes to elect a new leader  He also retired from Parliament  English's resignation followed weeks of speculation that he would step aside for a new leader  On 27 February, he was succeeded as party leader by Simon Bridges as the result of the leadership election held that day 

Post-premiership 
In 2018, English joined the board of Australian conglomerate, Wesfarmers  English serves in Chairmanships of Mount Cook Alpine Salmon, Impact Lab Ltd and Manawanui Support Ltd  He is also a director of The Instillery, Centre for Independent Studies and The Todd Corporation Limited, and is a member of the Impact Advisory Group of Macquarie Infrastructure and Real Assets 

Political and social views

English is regarded as more socially conservative than his predecessor, John Key  He has stated his opposition to voluntary euthanasia and physician-assisted suicide, same-sex civil unions, and the decriminalisation of prostitution  As Prime Minister he opposed any "liberalisation" of abortion law 

In 2004, English voted against a bill to establish civil unions for both same-sex and opposite-sex couples  In 2005, he voted for the Marriage (Gender Clarification) Amendment Bill, which would have amended the Marriage Act to define marriage as only between a man and a woman  English voted against the Marriage (Definition of Marriage) Amendment Bill, a bill that legalised same-sex marriage in New Zealand  However, in December 2016 he stated, "I'd probably vote differently now on the gay marriage issue  I don't think that gay marriage is a threat to anyone else's marriage" 

In 2009, English voted against the Misuse of Drugs (Medicinal Cannabis) Amendment Bill, a bill aimed at amending the Misuse of Drugs Act so that cannabis could be used for medical purposes 

Personal life 
English met his future wife, Mary Scanlon, at university  She was studying medicine at the time, and became a general practitioner  Both her parents were immigrants, her father being Samoan and her mother Italian, born on the island of Stromboli  They have six children: a daughter and five sons 

English is a practising Roman Catholic, but has stated that he considers his religious beliefs personal and thus separate from politics 

In June 2002, English took part in TV3's Fight For Life, a celebrity boxing fundraiser to raise money for the Yellow Ribbon anti-youth-suicide campaign, influenced by the death of a teenage nephew in 1997  He lost a split decision to former university colleague Ted Clarke 

Honours
In the 2018 Queen's Birthday Honours, English was appointed a Knight Companion of the New Zealand Order of Merit, for services of over 27 years to the State 

See also

List of New Zealand governments
Politics of New Zealand

References

External links

Profile at National Party 
Profile on Parliament nz
Releases and speeches at Beehive govt nz

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1961 births
21st-century New Zealand politicians
Candidates in the 2017 New Zealand general election
Deputy Prime Ministers of New Zealand
Leaders of the Opposition (New Zealand)
Living people
Members of the Cabinet of New Zealand
Members of the New Zealand House of Representatives
New Zealand farmers
New Zealand finance ministers
New Zealand list MPs
New Zealand MPs for South Island electorates
New Zealand National Party MPs
New Zealand National Party leaders
New Zealand Roman Catholics
New Zealand people of Irish descent
People educated at St  Patrick's College, Silverstream
People from Dipton, New Zealand
People from Lumsden, New Zealand
Prime Ministers of New Zealand
University of Otago alumni
Victoria University of Wellington alumni
Knights Companion of the New Zealand Order of Merit

Context 3: Bare Acts Live
Himachal Pradesh Town and Country Planning Act, 1977
Himachal Pradesh Town And Country Planning Rules, 1978
3  Form of Notice 
4  Manner of publication of notice 
5  Manner of publication of Regional Plan 
6  Notice of Modifications in Regional Plan 
7  Manner of publication of existing land-use map 
8  Manner of publication of approved Interim Development Plan 
9  Manner of publication of draft development plan 
10  Manner of publication of approved development plan 
11  Intention of development undertaken on behalf of Union or State Government 
12  Form of application for permission for development of land by others 
13  Form of permission 
14  Manner of communication of order under sub-section (4) of Section 31 
16  Notice by owner to purchase interest in land 
17  Manner of communication of revocation and modification permission to development 
20  Preparation of town development scheme 
21  Acquisition of land 
22  Mode of levy 
23  Power to borrow money 
24  Terms and conditions subject to which loans may be raised by the Special area Development Authority 
1  Short title, extent, commencement and application 
3  Director and other officers 
4  Establishment of regions 
5  Director to prepare regional plan 
6  Survey 
7  Contents of regional plan 
8  Preparation of regional plan 
9  Finalisation of regional plan 
10  Restriction on use of land or development thereof 
11  Exclusion from claims of amount in certain cases 
12  Review of regional plan 
13  Planning area 
14  Director to prepare development plans 
15  Existing land use maps 
16  Freezing of land use 
17  Interim development plans 
18  Development plan 
19  Publication of draft development plan 
20  Sanction of development plans 
21  Director to prepare sectoral plan 
22  Contents of sectoral plan 
23  Provisions of sections 19 and 20 to apply to sectoral plan 
24  Review of development plan and sectoral plan 
25  Director to control land use 
26  Conformity with development plan 
27  Prohibition of development without permission 
28  Development undertaken on behalf of Union or State Government 
29  Development by local authority or by any authority constituted under this Act 
30  Application for permission for development by others 
30A  Exemption from development permission in rural areas falling within Planning or Special Area 
30B  Exemption in respect of development of certain lands or buildings 
31  Grant or refusal of permission 
34  Lapse of permission 
35  Obligation to acquire land 
36  Deletion of reservation of designated land from draft or final development plan 
37  Power of revocation and modification or permission to development 
38  Penalty for unauthorised development or for use otherwise than in conformity with development plan 
39  Power to require removal of unauthorised development 
40  Establishment of Town and Country Development Authority 
41  Incorporation of Town and Country Development Authority 
42  Constitution of Town and Country Development Authority 
42A  Constitution of Town and Country Development Authority for the Capital Town of Himachal Pradesh 
43  Term of office of Chairman and other members 
44  Resignation of members and filling of casual vacancy 
45  Remuneration of Chairman 
46  Leave of absence and appointment etc  of acting Chairman 
47  Meeting of Town and Country Development Authority 
48  Chief Executive Officer 
49  Other officers and servants 
50  Conditions of service of Chief Executive Officer and other officers and servants 
51  Town development schemes 
53  Power to revise the development schemes 
54  Power of State Government to give Directions 
55  Restriction on land use and development 
56  Lapse of scheme 
57  Town development scheme public purpose 
58  Acquisition of land for Town and Country Development Authority 
59  Developments 
60  Disposal of land, buildings and other development works 
61  Development charges 
63  Fund of Town and Country Development Authority 
64  Annual budget 
66  Constitution of special areas 
67  Special area Development Authority 
68  Incorporation of Special Area Development Authority 
70  Functions 
71  Powers 
72  Fund of Special Area Development Authority 
73  Annual estimates 
74  Power of State Government of supervision and control 
76  Power of Government to review plans etc  for ensuring conformity 
78  Dissolution of authorities 
79  Right of entry 
80  Jurisdiction of Court 
82  Member and officers to be public servants 
83  Suit and other proceedings 
84  Vacancy not to invalidate proceedings 
85  Member to continue till successor enters upon office 
86  Interpretation of regional plan etc 
87  Powers to moke rules 
89  Power to lay the rules and regulations 
The Himachal Pradesh Town and Country Planning Act, 1977
(as amended by Amendment Act No  22 of 1983)
Amended by Act No  8 of 2009
Act published in the Rajpatra, Extraordinary, dated the 30th September, 1977 vide Law Department Notification No  LLR-D(6)5/77, dated the 22nd September, 1977 
An Act to make provision for planning and development and use of land; to make better provision for the preparation of development plans and sectoral plans with a view to ensuring that town planning schemes are made in a proper manner and their execution is made effective; to constitute the Town and Country and Development Authority for proper implementation of town and country development plan; to provide for the development and administration of special areas through the Special Area Development Authority; to make provision for the compulsory acquisition of land required for the purpose of the development plans and for purposes connected with the matters aforesaid 
Be it enacted by the Himachal Pradesh Legislative Assembly in the Twenty-eighth Year of the Republic of India as follows:-
1  Short title, extent, commencement and application  - (1) This Act may be called the Himachal Pradesh Town and Country Planning Act, 1977 
(3) It shall come into force on such date as the State Government may, by notification, appoint and different dates may be appointed for different areas and for different provisions of this Act 
(4) Nothing in this Act shall apply to-
(a) lands comprised within a cantonment under the Cantonments Act, 1924; (2 of 1924) 
(b) lands owned, hired or requisitioned by the Central Government for the purpose of naval, military and air force works;
(c) lands under the control of railway administration for the purpose of construction and maintenance of works under Chapter III of the Indian Railways Act, 1890; (9 of 1890) and
(d) lands owned by any department of the Central Government where operational constructions are going on 
(a) "agriculture" includes horticulture, farming, raising of annual or periodical crops, fruits, vegetables, flowers, grass, fodder, trees or any kind of cultivation of soil, the reserving of land for fodder, grazing or thatching areas, breeding and keeping of livestock including cattle, horses, donkeys, mules, pigs, breeding of fish and keeping of bees, and the use of land ancillary to the farming of land, but does not include-
(i) keeping of cattle purely for the purpose of milking and selling the milk and milk products,
(ii) a garden which is an appendage of buildings, and the expression "agricultural" shall be construed accordingly;
(b) "amenity" includes roads and streets, water and electric supply, open spaces, parks, recreational area, natural feature, playgrounds, street lighting, drainage, sewerage and other utilities, services and conveniences;
(c) "building" includes any structure or erection, or part of a structure or erection, which is intended to be used for residential, industrial, commercial or other purposes, whether in actual use or not;
(d) "building operation" includes-
(i) erection or re-erection of a building or any part thereof,
(ii) roofing or re-roofing of any part of building or an open space,
(iii) any material alteration or enlargement of a building,
(iv) any such alteration of a building as is likely to alter its drainage or sanitary arrangements, or materially affect its security,
(v) the construction of a door opening on any street or land not belonging to the owner;
(e) "commercial use" means the use of any land or building or part thereof for the purpose of carrying on any trade, business or profession, or sale or exchange of goods of any type whatsoever and includes running of with a view to make profit hospitals, nursing homes, infirmaries, educational institutions, hostels, restaurants and boarding houses not being attached to any educational institutions, sarais and also includes the use of any land or building for storage of goods or as buildings for storage of goods or as an office whether attached to an industry or otherwise;
(f) "court" means the principal civil court of original jurisdiction in the district;
(g) "development" with its grammatical variations means the carrying out of a building, engineering, mining or other operations in, on, over or under land, or the making of any material change in any building or land or in the use of either, and includes sub-division of any land;
(h) "development plan" means interim development plan or development plan prepared under this Act;
(i) "director" means the Director of Town and Country Planning appointed under this Act;
(j) "existing land use map� means a map indicating the use to which lands in any specified area are put at the time of preparing the map, and includes the register prepared, with the map giving details of land-use;
(k) "land" includes benefits to arise out of land and things attached to the earth or permanently fastened to anything attached to the earth;
(l) "member" means a member of a Town and Country Development Authority or a Special Area Development Authority, as the case may be, and includes a Chairman thereof;
(m) "occupier" includes-
(i) a tenant,
(ii) an owner in occupation of or otherwise using his land,
(iii) a rent free tenant,
(iv) a licensee, and
(v) any person liable to pay to the owner, damages for the use and occupation of the land;
(n) "owner" includes a mortgagee in possession, a person who for the time being is receiving or is entitled to receive, or has received, the rent or premium for any land whether on his own account or on behalf of or for the further benefit of any other person or as an agent, trustee, guardian or receiver for any other person or for religious or charitable institutions or who would receive the rent or be entitled to receive the rent or premium if the land were to be let and includes a head of a Government department, General Manager of a Railway and the Chief Executive Officer, by whatever name designated, or a local authority, statutory authority, company, corporation or undertaking in respect of properties under their control;
(o) "planning area" means any area declared to be planning area under this Act;
(p) "region" means any area established to be a region under this Act;
(q) "regional plan" means a plan for the region prepared under this Act and approved by the State Government;
(r) "sector" means any sector of a planning area for which, under the development plan, a detailed sectoral plan is prepared;
(s) "slum area" means any predominantly residential area, where the dwellings which by reason of dilapidation, over-crowding, faulty arrangement of design, lack of ventilation, light or sanitary facilities or any combination of these factors are detrimental to safety, health or moral and which is defined by a development plan as a slum area;
(t) "special area" means a special area designated as such under section 66;
(u) "Special Area Development Authority� means an authority constituted under section 67;
(v) "Town Development Scheme" means a scheme prepared for the implementation of the provisions of a development plan by the Town and Country Development Authority; and
(w) "Town and Country Development Authority" means an authority established under section 40 
Director of Town and Country Planning
3  Director and other officers  - (1) After the commencement of this Act the State Government shall, by notification in the Official Gazette, appoint an officer for the purpose of carrying out functions assigned to him under this Act, as the Director of Town and Country Planning for the State and may appoint such other categories of officers as it may deem fit 
(2) The Director shall exercise such powers and perform such duties as are conferred or imposed upon him by or under this Act and the officers appointed to assist the Director shall, within such area as the State Government may specify, exercise such powers and perform such duties conferred and imposed on the Director by or under this Act as the State Government may, by special or general order, direct 
(3) The officers appointed to assist the Director shall be subordinate to him and shall work under his guidance, supervision and control 
4  Establishment of regions  - (1) The State Government may, by notification,-
(a) declare any area in the State to be a region for the purposes of this Act;
(b) define the limits of such area; and
(c) specify the name by which such region shall be known 
(2) The State Government may, by notification, alter the name of any such region and on such alteration, any reference in any law or instrument or other document to the region shall be deemed to be a reference to the region as re-named unless expressly otherwise provided or the context so requires 
(3) The State Government may, by notification,-
(a) alter the limits of a region so as to include therein or exclude therefrom Such area as may be specified in the notification;
(b) amalgamate two or more regions so as to form one region;
(c) divide any region into two or more region; or
(d) declare that the whole or part of the area comprising a region shall cease to be a region or part thereof 
5  Director to prepare regional plan  - Subject to the provisions of this Act and the rules made thereunder, it shall be the duty of the Director-
(i) to carry out a survey of the regions;
(ii) to prepare an existing land use map; and
(iii) to prepare a regional plan 
6  Survey  - (1) The Director shall, with a view to prepare the existing land use map, and other maps as are necessary for the purpose of regional plan,-
(a) carry out such surveys as may be necessary;
(b) obtain from any department of Government and any local authority such maps, survey reports and land records as may be necessary for the purpose 
(2) It shall be the duty of every Government department and local authority to furnish, as soon as may be possible, maps, reports and record, as may be required by the Director 
7  Contents of regional plan  - The regional plan shall indicate the manner in which land in the region should be used, the phasing of development, the net work of communications and transport, the proposals for conservation and development of natural resources, and in particular-
(a) allocation of land to such purposes as residential, industrial; agricultural or as forests or for mineral exploitation;
(b) reservation of open spaces for recreational purposes, gardens, tree belts, and animal sanctuaries;
(c) access or development of transport and communication facilities such as roads, railways, water ways, and the allocation and development of airports;
(d) requirements and suggestions for development of public utilities such as water supply, drainage and electricity;
(e) allocation of areas to be developed as "Special Areas� wherein new towns, townships, large industrial estates or any other type of large development projects may be established;
(f) landscaping and the preservation of areas in their natural state,
(g) measures relating to the prevention of erosion, including rejuvenation of forest areas;
(h) proposals relating to irrigation, water supply or flood control works 
8  Preparation of regional plan  - (1) After preparation of the existing land use map, the Director shall cause to be prepared a draft regional plan and publish it by making a copy thereof available for inspection and publishing a notice in such form and manner as may be prescribed inviting objections and suggestions from any person with respect to the draft plan before such date as may be specified in the notice, such date not being earlier than sixty days from the publication of the notice  Such notice shall specify in regard to the draft plan the following particulars, namely-
(a) the existing land use map and the narrative report thereon;
(b) a narrative report supported by necessary map and charts explaining the provisions of the draft plan;
(c) a note indicating the priorities assigned to works included in the draft plan and the phasing of the programme of development as such;
(d) a notice on the role being assigned to different departments of Government, the Town and Country Development Authorities; the Special Area Development Authorities, and the Local Authorities in the enforcement and implementation of draft plan 
(2) The Director shall consider all the objections and suggestions received by him within the period specified in the notice under sub-section (1) and shall, after giving a reasonable opportunity to all persons affected thereby of being heard, prepare the regional plan containing such modifications, if any, as he considers necessary and submit it to the State Government for approval together with all connected documents, plans, maps and charts 
9  Finalisation of regional plan  - (1) The State Government may approve the draft regional plan submitted under section 8 with or without modification or reject or return the same to the Director for reconsideration 
(2) Immediately after the draft regional plan is approved under sub-section (1) the State Government shall publish in such manner, as may be prescribed, a notice stating that the regional plan has been approved and mentioning a place where a copy of the plan may be inspected at all reasonable hours and shall specify therein a date on which the regional plan shall come into operation:
Provided that where the State Government approves the draft regional plan with modifications, it shall not be published, unless the State Government having published such modifications in the Official Gazette along with a notice inviting objections and suggestions thereon, within a period of not less than thirty days from the date of publication of such notice have considered the objections and suggestions after giving a reasonable opportunity of being heard to persons affected thereby 
10  Restriction on use of land or development thereof  - (1) Notwithstanding anything contained in any other law for the time being in force, on or after the date of publication of the draft regional plan, no person, authority, department of Government or any other person shall change the use of land for any purpose other than agriculture, or carry out any development in respect of any land contrary to the provisions of the draft plan, without the prior approval of the Director or any officer next to him authorised by the Director, in this behalf 
(2) Notwithstanding anything contained in any law for the time being in force, the permission referred to in sub-section (1) shall not be granted otherwise than in conformity with the provision of the draft or final plan and no permission, if granted, shall be construed to confer any legal right whatsoever on the person seeking the permission 
(3) If any work is carried out in contravention of the provisions of this section, the Municipal Corporation or Municipal Committee within its local area, and the Collector in area outside such local areas, may cause such work to be removed or demolished at the cost of the defaulter, which shall be recovered from him in the same manner as an arrear of land revenue:
Provided that no action shall be taken under this sub-section unless the person concerned is given a reasonable opportunity of being heard and a notice calling upon him to remove or demolish the work within a time specified therein 
(4) Any person aggrieved by the order of the Municipal Corporation, Municipal Committee or Collector, as the case may be, calling upon to remove or demolish the work may prefer an appeal to the Director within fifteen days of the receipt of the notice under sub-section (3) and the order of the Director in such appeal shall be final 
11  Exclusion from claims of amount in certain cases  - Where the regional plan assigns a particular land use to a certain areas and any land situate therein is already put to such use, subject to substantially similar restrictions in force under any other law which was in force on the date on which restrictions were imposed by or under this Act and if amount in respect of such restrictions have already been paid under any such other law which was in force for the time being in respect of the property or any right or interest therein to the claimant, or any predecessor in interest of the claimant, the owner shall not be entitled to any further amount on account of injury or damage caused to his rights by reasons of the restrictions placed on the use of the land under the provisions of this Act 
12  Review of regional plan  - (1) The Director may, on his own motion or if so required by the State Government, at any time after a regional plan has come into operation, undertake the review and evaluation of the regional plan and make such modification in it as may be justified by the circumstances 
(2) The foregoing provisions of this Chapter shall, so far as they can be made applicable, apply to the modifications under sub-section (1) as these provisions apply in relation to the preparation, publication and approval of a regional plan 
Planning Area and Development Plans
13  Planning area  - (1) The State Government may, by notification, constitute planning areas for the purposes of this Act and define the limits thereof 
(2) The State Government may, by notification -
(a) alter the limits of a planning area so as to include therein or excluse therefrom such area as may be specified in the notification;
(b) amalgamate two or more planning areas so as to constitute one planning area;
(c) divide any planning area into two or more planning areas;
(d) declare that the whole or part of the area constituting the planning area shall cease to be a planning area or part thereof 
14  Director to prepare development plans  - Subject to the provisions of this Act and the rules made thereunder, the Director shall-
(a) prepare an existing land use map;
(b) prepare an interim development plan;
(c) prepare a development plan;
(d) prepare a sectoral plan;
(e) carry such surveys and inspections and obtain such pertinent reports from government departments, local authorities and public institutions as may be necessary for the preparation of the plans;
(f) perform such duties and functions as are supplemental, incidental, and consequential to any of the foregoing functions or as may be assigned by the State Government for the purpose of carrying out the provisions of this Act 
15  Existing land use maps  - (1 )The Director shall carryout the survey and prepare an existing land use map and, forthwith publish the same in such manner as may be prescribed together with public notice of the preparation of the map and of the place or places where the copies may be inspected, inviting objections and suggestions in writing from any person with respect thereto within thirty days from the date of publication of such notice 
(2) After the expiry of the period specified in the notice published under sub-section (1), the Director may, after allowing a reasonable opportunity of being heard to all such persons who have filed the objections or suggestions, make such modifications therein as may be considered desirable 
(3) As soon as may be after the map is adopted with or without modifications the Director shall publish a public notice of the adoption of the map and the place or places where the copies of the same may be inspected 
(4) A copy of the notice shall also be published in the Official Gazette and it shall be conclusive evidence of the fact that the map has been duly prepared and adopted 
16  Freezing of land use  - On the publication of the existing land use map under section 15-
(a) no person shall institute or change the use of any land or carry out any development of land for any purpose other than that indicated in the existing land use map without the permission in writing of the Director;
Provided that the Director shall not refuse permission if the change is for the purpose of agriculture;
(b) no local authority or any officer or other authority shall, not withstanding anything contained in any other law for the time being in force, grant permission for the change in use of land otherwise than as indicated in the existing land use map without the permission in writing of the Director;
[(c) no Registrar or the Sub-Registrar, appointed under the Indian Registration Act, 1908, shall, in any planning area constituted under section 13, register any deed or document of transfer of any sub-division of land by way of sale, gift, exchange, lease or mortgage with possession, unless the sub-division of land is duly approved by the Director, subject to such rules as may be framed in this behalf by the State Government:]
Provided that the Registrar or the Sub-Registrar may register any transfer,-
(i) where the land is owned by a person and the transfer is made without involving any further divisions;
(ii) where the partition/sub-division of land is made in a Joint Hindu Family;
(iii) where the lease is made in relation to a part or whole of a building;
(iv) where the mortgage is made for procuring the loans for construction or improvements over the land either from the Government or from any other financial institution constituted or established under any law for the time being in force or recognised by the State Government 
17  Interim development plans  - As soon as may be, after the declaration of a planning area, the Director shall, within such time as may be necessary, prepare, after consultation with local authorities concerned, if any, and submit to the State Government an interim development plan for the planning area or any of its parts and such other area or areas contiguous or adjacent to the planning areas as the State Government may direct to be included in the interim development plan 
(2) The interim development plan shall-
(a) indicate broadly the land use proposed in the planning area;
(b) allocate broadly areas or sector of land for-
(i) residential, industrial, commercial or agricultural purposes,
(ii) open spaces, parks and gardens, green belts, zoological gardens and play-grounds,
(iii) public institutions and offices,
(iv) such special purposes as the Director may deem fit;
(c) lay down the pattern of National and State Highways connecting the planning area with the rest of the region, ring roads, arterial roads and the major roads within the planning areas;
(d) provide for the location of airports, railway stations, bus termini and indicate the proposed extension and development of railways and canals;
(e) make proposals for general land scaping and preservation of natural areas;
(f) project the requirement of the planning area of such amenities and utilities as water, drainage, electricity and suggest their fulfilment;
(g) propose broad based regulations for sectoral development, by way of guide-lines, within each sector of the location, height, size of buildings and structures, open spaces, court-yards and the use to which such buildings and structures and land may be put;
(h) lay down the board-based traffic circulation patterns in a city;
(i) suggest architectural control features, elevation and frontage of buildings and structures;
(j) indicate measures for flood control, prevention of air and water pollution, disposal of garbage and general environmental control 
(3) Subject to provisions of the rules made under this Act for regulating the form and contents of the interim development plan any such plan shall include such maps and such descriptive matter as may be necessary to explain and illustrate the proposals in the interim development plan 
(4) As soon as may be, after the submission of the interim development plan, under sub-section (1) the State Government may either approve the interim development plan or may approve it with such modification as it may consider necessary 
(5) The State Government shall publish the interim development plan as approved under sub-section (4) in the Official Gazette  The interim development plan shall come into operation from the date of its publication in the Official Gazette and shall be binding on all local authorities functioning within the planning areas 
18  Development plan  - A development plan shall -
(a) indicate broadly the land use proposed in the planning areas;
(b) allocate broadly areas or sector of land for,-
(c) lay down the pattern of National and State Highways connecting the planning area with the rest of the region, ring roads, arterial roads, and the major roads within the planning area;
(d) provide for the location of airports, railway stations, bus termini and indicate the proposed extension and development of railways;
(g) propose broad-based regulations for sectoral development, by way of guide-line, within each sector of the location, height, size of buildings and structures, open spaces, court-yards and the use to which such buildings and structures and land may be put;
(h) lay down the broad-based traffic circulation patterns in a city;
19  Publication of draft development plan  - (1) The Director shall forthwith publish the draft development plan prepared under section 18 in such manner as may be prescribed together with a notice of the preparation of the draft development plan and the place or places where the copies may be inspected, inviting objections and suggestions in writing from any person with respect thereto, within thirty days from the date of publication of such notice Such notice shall specify in regard to the draff development plan the following particulars, namely:-
(i) the existing land use maps;
(ii) a narrative report, supported by maps and charts, explaining the provisions of the draft development plan;
(iii) the phasing of implementation of the draft development plan as suggested by the Director,
(iv) the provisions for enforcing the draft development plan and stating the manner in which permission to development may be obtained;
(v) an approximate estimate of the cost of land acquisition for public purposes and the cost of works involved in the implementation of the plan 
(2) The Director shall, not later than ninety days after the date of expiry of the notice period under sub-section (1), consider all the objections and suggestions as may be received within the period specified in the notice under sub-section (1)and shall, after giving reasonable opportunity to all persons affected thereby of being heard, make such modifications in the draft development plans as he may consider necessary, and submit, not later than six months after the publication of the draft development plan, the plan so modified, to the State Government for approval together with all connected documents, plans, maps and charts 
20  Sanction of development plans  - (1) As soon as may be after the submission of the development plan under section 19 the State Government may either approve the development plan or may approve it with such modifications as it may consider necessary or may return it to the Director to modify the same or to prepare a fresh plan in accordance with such directions as it may issue in this behalf 
(2) Where the State Government approves the development plan with modifications, the State Government shall, by a notice, published in the Official Gazette, invite objections and suggestions in respect of such modifications within a period of not less than thirty days from the date of publication of the notice in the Official Gazette 
(3) After considering objections and suggestions and after giving a hearing to the persons desirous of being heard the State Government may confirm the modification in the development plan 
(4) The State Government shall publish the development plan as approved, under the foregoing provisions in the Official Gazette and shall along with the plan publish a public notice, in such manner as may be prescribed, of the approval of the development plan and the place or places where the copies of the approved development plan may be inspected 
(5) The development plan shall come into operation from the date of publication thereof in the Official Gazette and as from such date shall be binding on all Development Authorities constituted under this Act and all local authorities functioning within the planning area 
(6) After the coming into operation of the development plan, the interim development plan shall stand modified or altered to the extent the proposals in the development plan are at variance with the interim development plan 
Sectoral Plan
21  Director to prepare sectoral plan  - The Director may, on his own motion, at any time after the publication of the development plan, or thereafter if so required by the State Government shall, within six months of such requisition, prepare a sectoral plan 
22  Contents of sectoral plan  - (1) The sectoral plan shall enlarge the details of land use as indicated in the development plan and shall -
(a) indicate the land liable to acquisition for public purpose or the purposes of the Union Government, the State Government, the Town and Country Development Authority, the Special Area Development Authority, the local authority or any other authority established by or under any enactment for the time being in force 
Provided that no land shall be so designated unless the acquisition proceedings are likely to be completed within ten years of the preparation of the plan;
(b) define in detail and provide for areas reserved for agriculture, public and semi-public open spaces, parks, playgrounds, gardens, recreational areas, green belts and natural reserves;
(c) allocate in detail areas or sectors for residential, commercial, industrial, agricultural and other purposes;
(d) define and provide for the complete road and street pattern for the present and in the future and indicate the traffic circulation;
(e) lay down in detail the projected road and street improvement;
(f) indicate and provide for areas reserved for public buildings, institutions and civic developments;
(g) assess, make projections for and provide for the future requirements of amenities, services and utilities such as municipal, transport, electricity, water and drainage;
(h) prescribe in detail the sectoral regulations for each sector, with a view to facilitating on individual layout and regulating the location, height, number of storeys and the size of buildings and other structures, the size of the court-yards, courts and other open spaces and the use of the buildings, structures and land;
(i) define areas which have been badly laid out or areas which have developed so as to form slums, and provide for their proper development and/or relocation;
(j) designate areas for future development and expansion;
(k) indicate the phasing of the programme of development 
(2) The sectoral plan may and if possible shall, indicate -
(a) control over architectural features; elevation and frontage of buildings and structures; and
(b) the details of development of specific areas for housing, shopping centres, industrial areas, educational and cultural institutions and civic centres 
23  Provisions of sections 19 and 20 to apply to sectoral plan  - The provisions of sections 19 and 20 shall apply for the preparation, publication, approval and operation of sectoral plan as they apply in respect of the development plan 
24  Review of development plan and sectoral plan  - The Director may on his own motion or if so required by the State Government shall, at any time after the sectoral plan has come into operation, undertake a review and evaluation of the development plan and sectoral plan 
(2) The foregoing provisions of sections 19, 20 and 23 shall, so far as may be apply to the modification under sub-section (1) as those provisions apply in relation to the preparation, publication and approval of a development plan or a sectoral plan 
Control of Development And Use of Land
25  Director to control land use  - The overall control of development and the use of land in the planning area shall, as from the date of publication in the Official Gazette of a notification by the State Government, vest in the Director 
26  Conformity with development plan  - (1) After coming into force of the development plan, the use and development of land shall conform to the provisions of the development plan:
Provided that the Director may, at his discretion, permit the continued use of land for the purpose for which it was being used at the time of the coming into Operation of the development plan 
Provided further that such permission shall not be granted for a period exceeding seven years from the date of coming into operation of the development plan 
27  Prohibition of development without permission  - After coming into operation of the development plan, no person shall change the use of any land or carry out any development of land without the permission in writing of the Director 
Provided that no such permission shall be necessary -
(a) for carrying out works for the maintenance, repair or alteration of any building which does not materially alter the external appearance of the building;
(b) for carrying out work for the improvement or maintenance of a highway, road or public street by the Union or State Government or an authority established under this Act or by a local authority having jurisdiction, provided that such maintenance or improvement does not change the road alignment contrary to the provisions of the development plan;
(c) for the purpose of inspecting, repairing or renewing any drain, sewers, mains, pipes, cables, telephone or other apparatus including the breaking open of any street or other land for that purpose;
(d) for the excavation or soil shaping in the interest of agriculture;
(e) for restoration of land to its normal use where land has been used temporarily for any other purposes 
(f) for use for any purpose incidental to the use of building for human habitation, or any other building or land attached to such buildings;
(g) for the construction of a road intended to give access to land solely for agricultural purposes
28  Development undertaken on behalf of Union or State Government  - (1) When the Union Government or the State Government intends to carry out development of any land for the purpose of its departments or offices or authorities, the officer-in-charge thereof shall inform in writing to the Director the intention of the Government to do so, giving full particulars thereof, accompanied by such documents and plans as may be prescribed at least thirty days before undertaking such development 
(2) Where the Director raises any objection to the proposed development on the ground that the development is not in conformity with the provisions of the development plan, the officer shall,-
(i) make necessary modification in the proposals for development to meet the objections raised by the Director, or
(ii) submit the proposal for development together with the objections raised by the Director to the State Government for decision:
Provided that where no modification is proposed by the Director within thirty days of the receipt of the proposed plan by the Government, the plan will be presumed to have been approved 
(3) The State Government, on receipt of the proposals for development together with the objections of the Director shall, approve the proposals with or without modifications or direct the officer to make such modifications in the proposals as it considers necessary in the circumstances 
(4) The decision of the State Government under sub-section (3) shall be final and binding 
29  Development by local authority or by any authority constituted under this Act  - Where a local authority or any authority specially constituted under this Act intends to carry out development on any land for the purpose of that authority, the procedure applicable to the Union or State Government, under section 28 shall, mutatis' mutandis, apply in respect of such authority 
30  Application for permission for development by others  - (1) Any person, not being the Union Government, State Government, a local authority or a special authority constituted under this Act intending to carry out any development on any land, shall make an application in writing to the Director for permission, in such form and containing such particulars and accompanied by such documents as may be prescribed 
(2) Such application shall also be accompanied by such fee as may be prescribed 
[30A  Exemption from development permission in rural areas falling within Planning or Special Area  - (1) Any person who owns land in rural areas, falling within Planning or Special Areas wherein neither Interim Development Plan nor Development Plan has been notified, shall be exempted from permission under this Act for the following development activities up to the limits as may be prescribed: -
(i) Residential activities such as farm-houses and residential houses up to three storeys, cattle shed, toilet, septic tank, kitchen, store, parking shed or garage and rain shelter;
(ii) Commercial activities such as basic commercial activities like shops of general merchandise, cobbler, barber, tailoring, fruit, vegetable, tea or sweet, eating places and dhabas, chemist and farm produce sale depot;
(iii) Service Industries such as cottage or house-hold, service industries like carpentry, knitting, weaving, blacksmith, goldsmith, atta-chakki with capacity up to five horse-power, water mill, agriculture equipments or machinery repair, electrical, electronic and house-hold appliances;
(iv) Public amenities such as public amenities like panchayat offices, schools, mahila mandals, yuvak mandals, community halls, post offices, dispensaries and clinics (including health, veterinary and Indian System of Medicines) information technology kiosks, patwar khanas, guard huts, anganwaries, electricity and telephone installations and connections, roads and paths, ropeways, water tanks, rain harvesting tanks, overhead or underground water tan 



ground_truth: October 2001.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: Who is responsible for carrying out the functions assigned under the act?

Read the following text and answer briefly.

Context 4:  When he skipped class he would usually sleep in his car 
Taylor's life consists of working (where to the best of our knowledge) he does well, he is reliable and his employer likes him  When he comes home from work he either sleeps or plays video games or other games - such as kakuro  He spendes most of his time in the basement where his bedroom is and this is where he games  Taylor owns his own car, bought his own laptop and very rarely spends money  He pays us $200 /month to still live at home, unloads the dishwasher on a regular basis and does the weekly garbage  However, his room is a mess and he only cleans his bathroom when I tell him he needs to clean it 
Taylor used to read quite a bit and loved to learn  It has just been in his adult years that he has not read as much - I think because of his gaming addiction  Taylor goes to church on a regular basis but sleeps through the main meeting  In Sunday class room settings he stays awake - I think because he is able to particpate in discussions 
Taylor has only had 2 real friends since entering Junior High school  And as of now he only keeps in contact with one of them who still lives in Georgia  We have lived in Utah since the summer of 2007 and he has never had a friend to do things with since we have lived here  He has two younger siblings, a brother 22 and a sister 20  They love Taylor and spend time with him when they are home  They are both at college and doing well 
Throughout Taylor's school years he has seen a counsleor on a fairly regular basis  One summer during junior high he attended a weekly class where he interacted with other kids with Aspergers  We did see a lot of change in him from this group  After he returned from his mission he went to see a counselor for a short period - this counselor tried to help him with some social skills  His dad and I went with him the first 3 or 4 times but we found out that after we quit going with him he only went a few more times and then scheduled appointments but did not show a couple of the times  We only found this out when a bill came for a "no show" appointment 
I don't know if this is too much information but were are in dire need of help for him  In the information that we purchased from you you mentioned that you do coaching for Aspergers adults  I don't know if you can help us but I thought I would check with you just in case 
Alas I think I have found your information too late to save my marriage but I am hoping to save myself 
I am currently going through a very very painful separation after a 27 year relationship with my husband whom I am convinced has aspergers syndrome  It is a long and painful story and I am desperately trying to process it all alongside dealing with a very conflictual separation  My partner is angry non communicative and totally dismissive of me and our long shared history 
He walked out last year after I discovered he had been visiting massage parlours and developed a relationship with an illegal Chinese escourt whom he subsequently moved in with  He had been seeing this woman behind my back for over 18 months  The pain of all this indescribable and his dismissal of my pain and very existence beyond belief 
Leading up to this I had been battling anxiety and depression which my husband found very hard to cope with 
Over the years of our relationship I knew something was off but I just could not put my finger on it  I often felt a complete lack of validation and empathy  Communication was also difficult as my husband was defensive and unwilling to look at issues in our marriage 
Please Mark could you help me validate some of this pain and try and make dense of 27 years of my life without drowning in fear guilt and despair about my future 
Thank you for listening and your site 
I have had problems with drunkenness, being late for school, not handing in school work, buying pot from a dealer etc  I chose to focus on the drinking and did the grounding then (grounding happened 3 times)  I also stopped sleep overs at friends 100%  I have stopped handing out money for no reason or even buying treats like chocolate 
I did lose it one evening (and didn't do the poker face) when I was trying to unplug the internet at midnight on a school night (she’s always late for school so I am trying to get her to sleep at a reasonable hour)  I was physically stopped and pushed around so I slapped my daughter (it was not hard)  This ended up with her saying she didn’t want to come home (the next day after school)  By this stage, I also had enough and didn’t go get her  I thought I am not begging  You will run out of money soon  It was quite a relief to have some peace  Daughter’s Dad was in town (from another country) and called a family meeting with the counsellor  To cut a long story short, daughter and her counsellor put it on the table that daughter wants to go live somewhere else (with her friends family) because of the stress at home with me (we live on our own) (i e  stricter rules and her bucking up against it) 
I didn’t really want this but made a compromise that daughter would go there Tues morning – Friday afternoon as the friend is an A student whereas my daughter is failing  They do the same subjects  I made the decision at the end of the day based on what is good for me – some time away from the daughter  I also thought of your book when the child went to live with the grandparents – daughter will dig her own hole over at the friend’s house  They have a week day no going out policy which made me think it is OK  I went and discussed with them the problems experienced (drinking, pot, late nights, not handing in work)
I am also trying to follow the let go of school thing per your book  I find it really difficult to remain calm when I can see daughter on her phone and watching series (when I have her on the weekends) when I know there are projects due  I hired her a private tutor once a week for help with a subject  The tutor has just fired my daughter for not handing in work and being not committed  It’s not the first time private tutoring has not been appreciated  The school give me a report back on a Friday as to whether everything is handed in  The deal is – if the work is not handed in – no pocket money and no Friday night out)  Her school is a "progressive" school and there are no repercussions for her being late or not handing in work  I would change schools if I could but there are only 8 months left of school (she turns 18 in August) 
We have just completed the first week and beginning week two of your material  We are agreeing with your take and see our son and ourselves in most of what you are saying  Prior to finding your material and starting your program we had been having extreme out of control behaviors and had to call the police because he was breaking things in our house and pushed my husband  This happened three weeks ago  After that incident we took away privileges ie  PS4, phone (which had already been taken for a few days), and friends  So, last week while doing your program he already didn’t have privileges and has continued with poor behavior – name calling, throwing things, slamming doors  We are not sure when to give privileges back  He has been given the privilege of playing with friends on occasion  His 13th birthday is tomorrow  This past weekend, for his birthday my husband and he went boar hunting  Of course we debated about it but decided to go ahead since it was his bday  We are cooking some of the meet on the grill tomorrow night for his bday and inviting a couple of his friends over for a cookout  No more gifts other than cards and balloons  We are wondering if we should go ahead and give him his privileges back and not sure how to do it  Last Friday morning we attempted to talk giving him a date to return privileges and that conversation ended with him getting angry but he gathered from our conversation that he is getting his stuff back on his bday  We are starting week 2 assignments today but not sure how to handle what was already in place  Of course, we aren’t seeing the respect and responsibility we are looking for but realize it has been a long time  We were wanting him to pay for his phone and thought it might be a good time to introduce that idea  Allowing him to earn his phone  We expect that he will be angry with this idea and not sure how to implement 
My son and myself are interested in a inpatient Aspergers program  We line in Calif which is preferable  My son is very high functioning and was diagnosed dry late  He was eight years old  He has never been in or attended a full day of class  Partially due to depression,anxiety, and trouble with his ADHD also his aversion and being bullied and of course his Aspergers  He will not attend his freshmen year due to surgery on both Achilles' tendons from walking on his toes  With physical therapy he should be ready by his sophomore year! We all feel he needs in patient therapy to give him the tools on how to work with his issues in a structured setting and a place that will give him tools for the rest of his life 
In my utter desperation to find a way to get some help for my daughter's increasingly challenging behaviour I trawled the internet to see if I could find some strategies that would provide specific methods on dealing with teenagers with Asperger's syndrome  When I came across your website, I couldn't believe that every statement you made was exactly what I have been going through with my daughter  She has just turned 14 last week, and was diagnosed with Asperger's/ Autism Spectrum Disorder 15 months ago  I have already been seeing a child psychologist for the past five months, however the methods she has been advising have not been very effective 
Our main difficulty with our daughter is her overwhelming obsession to use her cell phone (and to a lesser extent her laptop) constantly  Without any restriction, she will be on it every minute of the day, and will be awake until the early hours every day  We have tried to incorporate her input around rules as to when she has to give in her phone, but she is unwilling to compromise on a time that she should give it to us, believing that she should have unlimited use  I believe she is unable to do any adequate study or homework, as she is constantly having to look at the phone  We have tried to put rules in place that she has to give in her phone and laptop on school nights at 22:15  If she is able to do this then she is given rewards, and if she doesn't then she knows that there will be consequences  The consequence has been restricted use the following day  However, this is usually where we fail, because taking her phone away from her results in tantrums, screaming, and even threatening to harm herself  This behaviour is relentless to the point where the whole family becomes deeply distressed, and inevitably results in her getting the phone back 
This obsession is affecting her schoolwork, and more severely her eyesight  She has become very shortsighted, and her eyesight continues to deteriorate as a result of holding the phone or laptop very close, and mostly in the dark without any lights on  My husband and I have a constant battle on our hands daily, in all areas of discipline with our daughter, but our main concern is that we have been unable to find a way to minimise this obsessive behaviour centred around her phone and laptop  Please can you provide some strategies that can help us specifically with this problem 
First of all, I thank you for developing this program and I am only at the first stage of assignment 1  I have loads of books I have bought, attended psychiatrists for my son and myself, family therapy, occupational therapy, begged and prayed for change but have been dealing with behavioural issues for so long I am definitely exhausted and resentful 
I am a mum to a 15 yr old boy with ASD, dyslexia, OCD and ODD  Sorry to focus on the labels but just to give you an idea of what I am dealing with  I also have a 13 yr old son whom finds his brother’s behaviours difficult, embarassing and challenging  My husband whom is not in great health ( he had a cerebral aneurysm clamped two years ago and has two further aneurysms that are inoperable so endures fatigue, headaches and stress)  We have however a pet cat that is very social and a calming influence in the home! I was fortunate enough to have loving parents but I lost both my mum and dad in 2008 and 2015  My inlaws are elderly and quite directly say they are too old to help us so it feels we are alone in dealing with the issues we have 
I am desperate for change as the household is one of stress and anger and I feel all the control lies in my son Patrick’s hands  I am hopeful your programme can make life better for all of us but I wonder if it is too early to ask you two questions?
The first lies with what to do when Patrick goes into my other son Brendan’s room and will either turn on a light when he is sleeping, yell when he is on his phone or create some disturbance  He will not leave the room when asked to do so and the situation always escalates into yelling and Brendan attempting to physically remove him  This happens regularly and always ends badly with doors slamming, my husband being woken and myself in tears feeling the lack of control and also I admit I seem to think “Why me?” which rationally I know is of no help 
The second problem is leaving the house for school  Patrick refuses personal hygiene (either morning or night) and any request to even brush his teeth is fraught with swearing and abuse  If I can get him to shower, he will watch the water roll down the drain and turn up the water really high temp (mu husband has had to turn down the thermostat on the hot water service) without so much as getting wet  My husband leaves for work at 6am but I leave at 745 to work as a nurse in a busy outpatients department in the Alfred Hospital (Melbourne)  My work is my sanity as it is a paid break from home but most days I am late which is causing considerable stress and anxiety not to mention my responsibility to do my job  Patrick simply refuses to leave the house and as much as I am tempted to just walk out and leave I know the house would be left unlocked and wonder if Patrick would even attend school  The time I need to leave is not negotiable but Patrick uses this to his advantage and seems to delight in stressing me out and subsequently speeding to work in a frazzled mess 
The interesting and frustrating element in all of this is that although he is socially isolated at school (he has no friends) and academically challenged his behaviour at school is not a problem  He is quiet and his teachers report he does his best and is compliant and well mannered  It is like a Jekyll and Hyde situation where another side of him at home is so angry and abusive yet at school this behaviour does not happen 
I’m Jackie, I now work primarily as a freelance tech writer, after starting my career in software development and moving on to teach IT to young adults at a variety of colleges and schools 
My freelance work is pretty varied and looks at many aspects of the computer industry as a whole, and I’ve just recently completed a piece which gives help and advice to anyone wanting to become a game designer, which you can read here: http://www gamedesigning org/become-a-game-designer/  It highlights the hard work and effort it takes to get into such a role, and also how you can further your career and continue to learn and improve as you go  I hope you’ll agree it shows that starting work in the industry takes dedication and skill and that becoming a game designer isn’t just a fly-by-night job!
If you’d be interested in sharing a quick mention of my work on your blog that would be really wonderful and I’d appreciate the chance to get my work out there to a wider audience  Alternatively, I’d be happy to write a short blurb or paragraph or two (or a longer piece - just let me know) highlighting the key points because I think some of your readers might get a lot of value from it 
My son just turned 15 and is a freshman in high school  Although this is his first year in a general ed environment, he is struggling with behaviors in school  He has meltdowns and does not express why he would have them until much later  Once we all know what caused it, the school will accommodate him and try to "change up" things so as not to cause his meltdown  Once that is resolved, another issue comes up and causes him to melt down  He is a high functioning and academically does well, when he wants to do the work  We battle at home over homework  He does not care how it is done, as long as he hands it in  He thinks failing a test is ok, at least he took the test  Homework is never on his mind when he gets home from school  If I never prompt him, he would never open is backpack  He can be aggressive but is never intentionally trying to hurt anyone  He may push over a chair in school, but it is not directed at anyone  We know how that in itself could hurt someone who gets hit by it though  He is defiant in that he only wants to do what interests him  He does not go out by himself (still immature), or abuse alcohol or drugs and never curses  He is a very funny kid and very talented  His main problems are task avoidance and seeking attention  He can be disrespectful to adults in that he is "cheeky" with them, trying to be funny or cute  And he has no "filters" 
I’ve just finished reading your Living with an Aspergers Partner ebook  I found it so informative, thank you 
You offered some personal advise, and i wanted to run a situation past you and seek your input as to a strategy for what to do next 
I’ve been seeing a guy for about 7 months now who I believe has Aspergers  I came to this conclusion months ago and I don’t think he realizes, (or acknowledges) although he is aware he has some traits 
He’s highly intelligent and successful, a pattern seeker, has a tendency to focus on the project to hand to the total exclusion of all else for as long sit takes (work or home) socially awkward (has learned coping strategies), sensitive to loud noise, high anxiety with control strategies, black and white thinking etc  He’s currently not working and I’ve seen a slow withdrawal over the last 6 weeks, including the need to ‘escape’ and leave a situation at least once 
He also has a bipolar ex overseas who has primary custody one daughter where there has been ongoing patterns of drama which has recently increased 
Over the past couple of months (since stopping work and drama increase) I’ve gone from being ‘wonderful’ in his eyes to him now being sorry and not having the ‘urge’ to spend close/intimate time with me and offering friendship  Since he shared that with me in a message he’s stonewalled and has retreated to the safety of minimal messages and talks about not knowing what best to say and not being able to find the right words somehow 
He’s a good kind man who I feel is struggling  I’m concerned about his anxiety and possibly the risk of depression  I’m fairly resilient and whilst i’m disappointed he doesn’t want to pursue a relationship with me, i’m concerned for him and his well being  One of his very few close friends is also just leaving the country to live overseas 
The strategy I’ve used so far is simply to back off and give him space  I’ve asked to take him up on an original offer he made to talk but haven’t pushed it  I also haven’t been aggressive or accusatory in the few messages i’ve sent 
Any advise you could give would be greatly appreciated,
Carli who is 10 years old and has had behavioral issues her whole life  The other night she came home very upset after having a conflict with a friend  She was at her friend's house and her and her friend wanted to get on the computer and the older sister was using it  Carli made up a story that someone was at the door to get the older sister off the computer  Her friend didn't understand that she was making up a story to get the sister off the computer  She got excited that someone was at the door and ran downstairs to answer the door  In the process of getting the door, she fell and yelled at Carli  Carli became extremely upset  She was able to control her feelings at her friend's house, but when she came home, she proceeded to cry extremely loudly for over an hour  Her dad spent most of that time with her, talking to her and trying to calm her down  After an hour, I asked him if he could please tell her to be more quiet because the other members of the household were trying to go to sleep 
My question is    how do I as the girlfriend, handle this? He did not like that I asked her to be quiet  We have a rule that if she is having bad behavior, and can't calm down in 5 minutes, he takes her out of the house because her yelling doesn't stop for a long time and is very upsetting to everyone in the household  I would like to ask him to do this with this kind of situation as well  Is this a reasonable request? His thought was that she shouldn't be made to calm down, because everyone handles being upset in a different way  But, she was literally sobbing and wailing very loudly 
My other question is should she have been told that if she wouldn't have lied, this wouldn't have happened? She has a history of lying and of not accepting responsibility for her actions  My boyfriend became very upset with me when I brought this up  He was being very sympathetic and understanding to her  I feel like he was giving her negative attention, and being an over indulgent parent by not putting his foot gown and saying, "you can't carry on like this, even though you are upset"  Please let me know how we can handle these situations better 
I am contacting you for help with adult AS  I am taking initiative to pre screen potential therapists to help my current boyfriend get therapy and help with Adult AS 
He has seen many therapists, but it seems like they aren’t really helping him with his problems  They don’t seem to understand how his (undiagnosed) AS would affect therapy approaches  For example, he may not share enough in therapy session and I’m assuming an AS therapist would recognize that is part of the AS and employ strategies to get information from him that helps with treatment  Sometime he tunes out when he is processing something heavy or that he doesn’t want to hear necessarily, or he gets distracted and I’m hoping an As therapist would recognize that and get that he may need repeated something for example, if this is happening 
He is currently suffering from depression that appears clinical in nature as well as reoccurring negative thoughts about something specific that has been worrying him about our relationship  Today he told me these reoccurring thoughts happen during all waking hours unless he watches TV, he never gets a break from them and they make him feel like he is going crazy  As his girlfriend, I am extremely concerned that he cannot get relief from these thoughts and that the therapists he is seeing are unable to help him with his problems  Therefore, I am taking initiative to try and help him find better therapy options, because I want to see him someone who can better help him get to the bottom of things and help him with the challenges he is facing  He really needs an advocate that will help him go deep to figure things out and not just assume therapies are working well, without seeing changes or getting supporting feedback from him in that regard 
Here are some questions I am trying to ask in advance to find the right people to help us with this  As you may know, insurance for these therapies are not often available  We don’t have a lot of money to go from therapist to therapist to find the right person and are hoping prescreening will help 
I recently downloaded your e-book and listened to your talks and your information is by far the most helpful I have been able to find to date  It's very accurately describes my situation as an NT wife married to a very probable AS husband  I think you for taking the time to write this and sharing your insights as well as the experiences of many of your clients  It has really helped me understand the last 32 years of our marriage and get a grasp on how to move forward 
One area that is of primary concern to me, that I did not see addressed, is stimming  I believe that is the behavior my husband is showing through constant vocal singing, repetition of words, shouting out, as well as slapping himself in the chest and general nervous activity  It is very loud and disruptive to our household and it is often a relief when he is not at home  I think there may be a level of Tourette's syndrome as well 
I did some searches on the Internet and could not find anything that really describes his behavior  Most of what I found was flapping or children's behavior  I understand that it is a release of nervous tension but I am really trying to find some strategies to help him stop this behavior as it is extremely frustrating and builds my resentment in dealing with it daily  A lot of it is embarrassing as well and sounds childish to me 
He usually does this when close family members are around and will reign himself in if he is around other people besides us  When we are home it is constant  He also has a lot of anger, mostly at himself, and blows up at unimportant things, it is as if he has a ton of negative energy inside him that need to get out and stimming is one outlet 
I will try to build my acceptance of it, but I also would just like him to stop especially the loudest and most annoying portions  Would you have any resources you could point me to?



ground_truth: The Director of Town and Country Planning is responsible for carrying out the functions assigned under the act.