A bulletin board system or BBS (also called Computer Bulletin Board Service, CBBS[1]) is a computer server running software that allows users to connect to the system using a terminal program. Once logged in, the user can perform functions such as uploading and downloading software and data, reading news and bulletins, and exchanging messages with other users through public message boards and sometimes via direct chatting. In the middle to late 1980s, message aggregators and bulk store-and-forward'ers sprung up to provide services such as FidoNet, which is similar to email.
Many BBSes also offer online games in which users can compete with each other. BBSes with multiple phone lines often provide chat rooms, allowing users to interact with each other. Bulletin board systems were in many ways a precursor to the modern form of the World Wide Web, social networks, and other aspects of the Internet. Low-cost, high-performance modems drove the use of online services and BBSes through the early 1990s. Infoworld estimated that there were 60,000 BBSes serving 17 million users in the United States alone in 1994, a collective market much larger than major online services such as CompuServe.
The introduction of inexpensive dial-up internet service and the Mosaic web browser offered ease of use and global access that BBS and online systems did not provide, and led to a rapid crash in the market starting in 1994. Over the next year, many of the leading BBS software providers went bankrupt and tens of thousands of BBSes disappeared. Today, BBSing survives largely as a nostalgic hobby in most parts of the world, but it is still an extremely popular form of communication for Taiwanese youth (see PTT Bulletin Board System).[2] Most surviving BBSes are accessible over Telnet and typically offer free email accounts, FTP services, IRC and all the protocols commonly used on the Internet. Some offer access through packet switched networks or packet radio connections.[1]
History
Precursors
A precursor to the public bulletin board system was Community Memory, started in August 1973 in Berkeley, California. Useful microcomputers did not exist at that time, and modems were both expensive and slow. Community Memory therefore ran on a mainframe computer and was accessed through terminals located in several San Francisco Bay Area neighborhoods.[3] The poor quality of the original modem connecting the terminals to the mainframe prompted a user to invent the Pennywhistle modem, whose design was highly influential in the mid-1970s.
Community Memory allowed the user to type messages into a computer terminal after inserting a coin, and offered a "pure" bulletin board experience with public messages only (no email or other features). It did offer the ability to tag messages with keywords, which the user could use in searches. The system acted primarily in the form of a buy and sell system with the tags taking the place of the more traditional classifications. But users found ways to express themselves outside these bounds, and the system spontaneously created stories, poetry and other forms of communications. Unfortunately, the system was expensive to operate, and when their host machine became unavailable and a new one could not be found, the system closed in January 1975.
Similar functionality was available to most mainframe users, which might be considered a sort of ultra-local BBS when used in this fashion. Commercial systems, expressly intended to offer these features to the public, became available in the late 1970s and formed the online service market that lasted into the 1990s. One particularly influential example was PLATO, which had thousands of users by the late 1970s, many of whom used the messaging and chat room features of the system in the same way that would become common on BBSes.
The first BBSes

Early modems were generally very simple devices using acoustic couplers to handle telephone operation. The user would first pick up the phone, dial a number, then press the handset into rubber cups on the top of the modem. Disconnecting at the end of a call required the user to pick up the handset and return it to the phone. Examples of direct-connecting modems did exist, and these often allowed the host computer to send it commands to answer or hang up calls, but these were very expensive devices used by large banks and similar companies.
With the introduction of microcomputers with expansion slots, like the S-100 bus machines and Apple II, it became possible for the modem to communicate instructions and data on separate lines. A number of modems of this sort were available by the late 1970s. This made the BBS possible for the first time, as it allowed software on the computer to pick up an incoming call, communicate with the user, and then hang up the call when the user logged off.
The first public dial-up BBS was developed by Ward Christensen and Randy Suess. According to an early interview, when Chicago was snowed under during the Great Blizzard of 1978, the two began preliminary work on the Computerized Bulletin Board System, or CBBS. The system came into existence largely through a fortuitous combination of Christensen having a spare S-100 bus computer and an early Hayes internal modem, and Suess's insistence that the machine be placed at his house in Chicago where it would be a local phone call to millions of users. Christensen patterned the system after the cork board his local computer club used to post information like "need a ride". CBBS officially went online on 16 February 1978.[4] CBBS, which kept a count of callers, reportedly connected 253,301 callers before it was finally retired.
Smartmodem

A key innovation required for the popularization of the BBS was the Hayes Smartmodem. Internal modems like the ones used by CBBS and similar early systems were usable, but generally expensive due to the manufacturer having to make a different modem for every computer platform they wanted to target. They were also limited to those computers with internal expansion, and could not be used with other useful platforms like video terminals. External modems were available for these platforms but required the phone to be dialed using a conventional handset, making them unable to accept incoming calls without manual intervention. Internal modems could be software controlled to perform both outbound and inbound calls, but external modems had only the data pins to communicate with the host system.
Hayes' solution to the problem was to use a small microcontroller to implement a system that examined the data flowing into the modem from the host computer, watching for certain command strings. This allowed commands to be sent to and from the modem using the same data pins as all the rest of the data, meaning it would work on any system that could support even the most basic modems. The Smartmodem could pick up the phone, dial numbers, and hang up again, all without any operator intervention. The Smartmodem was not necessary for BBS use but made overall operation dramatically simpler. It also improved usability for the caller, as most terminal software allowed different phone numbers to be stored and dialed on command, allowing the user to easily connect to a series of systems.
The introduction of the Smartmodem led to the first real wave of BBS systems. Limited in both speed and storage capacity, these systems were normally dedicated solely to messaging, both private email and public forums. File transfers were painfully slow at these speeds, and file libraries were typically limited to text files containing lists of other BBS systems. These systems attracted a particular type of user who used the BBS as a unique type of communications medium, and when these local systems were crowded from the market in the 1990s, their loss was lamented for many years.
Higher speeds, commercialization
Speed improved with the introduction of 1200 bit/s modems in the early 1980s, giving way to 2400 bit/s fairly rapidly. The improved performance led to a substantial increase in BBS popularity. Most of the information was displayed using ordinary ASCII text or ANSI art, but a number of systems attempted character-based graphical user interfaces which began to be practical at 2400 bit/s.
There was a lengthy delay before 9600bit/s models began to appear on the market. 9600bit/s was not even established as a strong standard before V.32bis at 14.4kbit/s took over in the early 1990s. This period also saw the rapid rise in capacity and a dramatic drop in the price of hard drives. By the late 1980s, many BBS systems had significant file libraries, and this gave rise to leeching, users calling BBSes solely for their files. These users would tie up the modem for some time, leaving less time for other users, who got busy signals. The resulting upheaval eliminated many of the pioneering message-centric systems.[5]
This also gave rise to a new class of BBS systems, dedicated solely to file upload and downloads. These systems charged for access, typically a flat monthly fee, compared to the per-hour fees charged by Event Horizons BBS and most online services. A host of 3rd party services sprang up to support these systems, offering simple credit card merchant account gateways for the payment of monthly fees, and entire file libraries on compact disk that made initial setup very easy. Early 1990s editions of Boardwatch were filled with ads for single-click install solutions dedicated to these new sysops. While this gave the market a bad reputation, it also led to its greatest success. During the early 1990s, there were a number of mid-sized software companies dedicated to BBS software, and the number of BBSes in service reached its peak.
Towards the early 1990s, the BBS industry became so popular that it spawned three monthly magazines, Boardwatch, BBS Magazine, and in Asia and Australia, Chips 'n Bits Magazine which devoted extensive coverage of the software and technology innovations and people behind them, and listings to US and worldwide BBSes.[6] In addition, in the USA, a major monthly magazine, Computer Shopper, carried a list of BBSes along with a brief abstract of each of their offerings.
GUIs
Through the late 1980s and early 1990s, there was considerable experimentation with ways to improve the BBS experience from its command-line interface roots. Almost every popular system improved matters somewhat by adding ANSI-based color menus to make reading easier, and most also allowed cursor commands to offer command-line recall and similar features. Another common feature was the use of autocomplete to make menu navigation simpler, a feature that would not re-appear on the web until decades later.
A number of systems also made forays into GUI-based interfaces, either using character graphics sent from the host, or using custom GUI-based terminal systems. The latter initially appeared, unsurprisingly, on the Amiga and Macintosh platform, where TeleFinder and FirstClass became very popular. FirstClass offered a host of features that would be difficult or impossible under a terminal-based solution, including bi-directional information flow and non-blocking operation that allowed the user to exchange files in both directions while continuing to use the message system and chat, all in separate windows. Skypix featured on Amiga a complete markup language. It used a standardized set of icons to indicate mouse driven commands available online and to recognize different filetypes present on BBS storage media. It was capable to transmit data like images, audio files, and audio clips between users linked to same BBS or off-line if BBS was in the circuit of FidoNet organization.
On the PC, efforts were more oriented to extensions of the original terminal concept, with the GUI being described in the information on the host. One example was the Remote Imaging Protocol, essentially a picture description system, which remained relatively obscure. Probably the ultimate development of this style of operation was the dynamic page implementation of the University of Southern California BBS (USCBBS) by Susan Biddlecomb, which predated the implementation of the HTML Dynamic web page. A complete Dynamic web page implementation was accomplished using TBBS with a TDBS add-on presenting a complete menu system individually customized for each user.
Rise of the Internet and decline of BBS
The demand for complex ANSI and ASCII screens and larger file transfers taxed available channel capacity, which in turn propelled demand for faster modems. 14.4 kbit/s modems were standard for a number of years while various companies attempted to introduce non-standard systems with higher performance, normally about 19.2 kbit/s. Another delay followed due to a long V.34 standards process before 28.8kbit/s was released, only to be quickly replaced by 33.6kbit/s, and then 56kbit/s.
These increasing speeds had the side effect of dramatically reducing the noticeable effects of channel efficiency. When modems were slow, considerable effort was put into developing the most efficient protocols and display systems possible. Running a general-purpose protocol like TCP/IP over a 1200 bit/s modem was a painful experience. With 56 kbit/s modems, however, the overhead was so greatly reduced as to be unnoticeable. Dial-up Internet service became widely available in 1994, and a must-have option for any general-use operating system by 1995.
These developments together resulted in the sudden obsolescence of bulletin board technology in 1995 and the collapse of its supporting market. Technically, Internet service offered an enormous advantage over BBS systems, as a single connection to the user's Internet service provider allowed them to contact services around the world. In comparison, BBS systems relied on a direct point-to-point connection, so even dialing multiple local systems required multiple phone calls. Moreover, Internet protocols allowed that same single connection to be used to contact multiple services at the same time, say download files from an FTP library while checking the weather on a local news web site. In comparison, a connection to a BBS allowed access only to the information on that system.
Estimating numbers
According to the FidoNet Nodelist, BBSes reached their peak usage around 1996, which was the same period that the World Wide Web and AOL became mainstream. BBSes rapidly declined in popularity thereafter, and were replaced by systems using the Internet for connectivity. Some of the larger commercial BBSes, such as MaxMegabyte and ExecPC BBS, evolved into Internet Service Providers.
The website textfiles.com serves as an archive that documents the history of the BBS. The  on textfiles.com contains over 105,000 BBSes that have existed over a span of 20 years in North America alone. The owner of textfiles.com, Jason Scott, also produced BBS: The Documentary, a DVD film that chronicles the history of the BBS and features interviews with well-known people (mostly from the United States) from the heyday BBS era.  As of 2016 an estimated 100 to 150 are still active, mostly for nostalgia.[7]
Software and hardware

Unlike modern websites and online services that are typically hosted by third-party companies in commercial data centers, BBS computers (especially for smaller boards) were typically operated from the SysOp's home. As such, access could be unreliable, and in many cases, only one user could be on the system at a time. Only larger BBSes with multiple phone lines using specialized hardware, multitasking software, or a LAN connecting multiple computers, could host multiple simultaneous users.
The first BBSes used homebrew software,[lower-alpha 1] quite often written or customized by the SysOps themselves, running on early S-100 bus microcomputer systems such as the Altair 8800, IMSAI 8080 and Cromemco under the CP/M operating system. Soon after, BBS software was being written for all of the major home computer systems of the late 1970s era – the Apple II, Atari 8-bit family, Commodore and TRS-80 being some of the most popular.
A few years later, in 1981, IBM introduced the first DOS based IBM PC, and due to the overwhelming popularity of PCs and their clones, DOS soon became the operating system on which the majority of BBS programs were run. RBBS-PC, ported over from the CP/M world, and Fido BBS, created by Tom Jennings (who later founded FidoNet) were the first notable DOS BBS programs. Many successful commercial BBS programs were developed for DOS, such as PCBoard BBS, RemoteAccess BBS, and Wildcat! BBS. Some popular freeware BBS programs for DOS included Telegard BBS and Renegade BBS, which both had early origins from leaked WWIV BBS source code. There were several dozen other BBS programs developed over the DOS era, and many were released under the shareware concept, while some were released as freeware including iniquity.
BBS systems on other systems remained popular, especially home computers, largely because they catered to the audience of users running those machines. The ubiquitous Commodore 64 (introduced in 1982) was a common platform in the 1980s. Popular commercial BBS programs were Blue Board, Ivory BBS, Color64 and CNet 64. In the early 1990s, a small number of BBSes were also running on the Commodore Amiga. Popular BBS software for the Amiga were ABBS, Amiexpress, C-Net, StormforceBBS, Infinity and Tempest. There was also a small faction of devoted Atari BBSes that used the Atari 800, then the 800XL, and eventually the 1040ST. The earlier machines generally lacked hard drive capabilities, which limited them primarily to messaging.
MS-DOS continued to be the most popular operating system for BBS use up until the mid-1990s, and in the early years, most multi-node BBSes were running under a DOS based multitasker such as DESQview or consisted of multiple computers connected via a LAN. In the late 1980s, a handful of BBS developers implemented multitasking communications routines inside their software, allowing multiple phone lines and users to connect to the same BBS computer. These included Galacticomm's MajorBBS (later WorldGroup), eSoft The Bread Board System (TBBS), and Falken. Other popular BBS's were Maximus and Opus, with some associated applications such as BinkleyTerm being based on characters from the Berkley Breathed cartoon strip of Bloom County. Though most BBS software had been written in BASIC or Pascal (with some low-level routines written in assembly language), the C language was starting to gain popularity.
By 1995, many of the DOS-based BBSes had begun switching to modern multitasking operating systems, such as OS/2, Windows 95, and Linux. One of the first graphics based BBS applications was Excalibur BBS with a low bandwidth applications that required its own client for efficiency. This led to one of the earliest implementations of Electronic Commerce in 1996 with replication of partner stores around the globe. TCP/IP networking allowed most of the remaining BBSes to evolve and include Internet hosting capabilities. Recent BBS software, such as Synchronet, Mystic BBS, EleBBS, DOC or Wildcat! BBS, provide access using the Telnet protocol rather than dialup, or by using legacy DOS-based BBS software with a FOSSIL-to-Telnet redirector such as NetFoss.
Presentation

BBSes were generally text-based, rather than GUI-based, and early BBSes conversed using the simple ASCII character set. However, some home computer manufacturers extended the ASCII character set to take advantage of the advanced color and graphics capabilities of their systems. BBS software authors included these extended character sets in their software, and terminal program authors included the ability to display them when a compatible system was called. Atari's native character set was known as ATASCII, while most Commodore BBSes supported PETSCII. PETSCII was also supported by the nationwide online service Quantum Link.[lower-alpha 2]
The use of these custom character sets was generally incompatible between manufacturers. Unless a caller was using terminal emulation software written for, and running on, the same type of system as the BBS, the session would simply fall back to simple ASCII output. For example, a Commodore 64 user calling an Atari BBS would use ASCII rather than the machine's native character set. As time progressed, most terminal programs began using the ANSI standard, but could use their native character set if it was available.
COCONET, a BBS system made by Coconut Computing, Inc., was released in 1988 and only supported a GUI (no text interface was initially available but eventually became available around 1990), and worked in EGA/VGA graphics mode, which made it stand out from the text-based BBS systems. COCONET's bitmap and vector graphics and support for multiple type fonts were inspired by the PLATO system, and the graphics capabilities were based on what was available in the Borland BGI graphics library. A competing approach called Remote Imaging Protocol (RIP) emerged and was promoted by Telegrafix in the early to mid-1990s but it never became widespread. An industry standard technology called NAPLPS was also considered, and although it became the underlying graphics technology behind the Prodigy service, it never gained popularity in the BBS market. There were several GUI-based BBSes on the Apple Macintosh platform, including TeleFinder and FirstClass, but these remained widely used only in the Mac market.
In the UK, the BBC Micro based OBBS software, available from Pace for use with their modems, optionally allowed for color and graphics using the Teletext based graphics mode available on that platform. Other systems used the Viewdata protocols made popular in the UK by British Telecom's Prestel service, and the on-line magazine Micronet 800 whom were busy giving away modems with their subscriptions.
The most popular form of online graphics was ANSI art, which combined the IBM Extended ASCII character set's blocks and symbols with ANSI escape sequences to allow changing colors on demand, provide cursor control and screen formatting, and even basic musical tones. During the late 1980s and early 1990s, most BBSes used ANSI to make elaborate welcome screens, and colorized menus, and thus, ANSI support was a sought-after feature in terminal client programs. The development of ANSI art became so popular that it spawned an entire BBS "artscene" subculture devoted to it.

The Amiga Skyline BBS software was the first in 1987 featuring a script markup language communication protocol called Skypix which was capable of giving the user a complete graphical interface, featuring rich graphic content, changeable fonts, mouse-controlled actions, animations and sound.[8]
Today, most BBS software that is still actively supported, such as Worldgroup, Wildcat! BBS and Citadel/UX, is Web-enabled, and the traditional text interface has been replaced (or operates concurrently) with a Web-based user interface. For those more nostalgic for the true BBS experience, one can use NetSerial (Windows) or DOSBox (Windows/*nix) to redirect DOS COM port software to telnet, allowing them to connect to Telnet BBSes using 1980s and 1990s era modem terminal emulation software, like Telix, Terminate, Qmodem and Procomm Plus. Modern 32-bit terminal emulators such as mTelnet and SyncTerm include native telnet support.
Content and access
Since most early BBSes were run by computer hobbyists, they were typically technical in topic, with user communities revolving around hardware and software discussions.
As the BBS phenomenon grew, so did the popularity of special interest boards. Bulletin Board Systems could be found for almost every hobby and interest. Popular interests included politics, religion, music, dating, and alternative lifestyles. Many SysOps also adopted a theme in which they customized their entire BBS (welcome screens, prompts, menus, and so on) to reflect that theme. Common themes were based on fantasy, or were intended to give the user the illusion of being somewhere else, such as in a sanatorium, wizard's castle, or on a pirate ship.
In the early days, the file download library consisted of files that the SysOps obtained themselves from other BBSes and friends. Many BBSes inspected every file uploaded to their public file download library to ensure that the material did not violate copyright law. As time went on, shareware CD-ROMs were sold with up to thousands of files on each CD-ROM. Small BBSes copied each file individually to their hard drive. Some systems used a CD-ROM drive to make the files available. Advanced BBSes used Multiple CD-ROM disc changer units that switched 6 CD-ROM disks on demand for the caller(s). Large systems used all 26 DOS drive letters with multi-disk changers housing tens of thousands of copyright-free shareware or freeware files available to all callers. These BBSes were generally more family friendly, avoiding the seedier side of BBSes. Access to these systems varied from single to multiple modem lines with some requiring little or no confirmed registration.
Some BBSes, called elite, WaReZ or pirate boards, were exclusively used for distributing cracked software, phreaking, and other questionable or unlawful content. These BBSes often had multiple modems and phone lines, allowing several users to upload and download files at once. Most elite BBSes used some form of new user verification, where new users would have to apply for membership and attempt to prove that they were not a law enforcement officer or a lamer. The largest elite boards accepted users by invitation only. Elite boards also spawned their own subculture and gave rise to the slang known today as leetspeak.
Another common type of board was the support BBS run by a manufacturer of computer products or software. These boards were dedicated to supporting users of the company's products with question and answer forums, news and updates, and downloads. Most of them were not a free call. Today, these services have moved to the web.
Some general purpose Bulletin Board Systems had special levels of access that were given to those who paid extra money, uploaded useful files or knew the SysOp personally. These specialty and pay BBSes usually had something unique to offer their users, such as large file libraries, warez, pornography, chat rooms or Internet access.
Pay BBSes such as The WELL and Echo NYC (now Internet forums rather than dial-up), ExecPC, PsudNetwork and MindVox (which folded in 1996) were admired for their tight-knit communities and quality discussion forums. However, many free BBSes also maintained close knit communities, and some even had annual or bi-annual events where users would travel great distances to meet face-to-face with their on-line friends. These events were especially popular with BBSes that offered chat rooms.
Some of the BBSes that provided access to illegal content faced opposition. On July 12, 1985, in conjunction with a credit card fraud investigation, the Middlesex County, New Jersey Sheriff's department raided and seized The Private Sector BBS, which was the official BBS for grey hat hacker quarterly 2600 Magazine at the time.[9] The notorious Rusty n Edie's BBS, in Boardman, Ohio, was raided by the FBI in January 1993 for trading unlicensed software, and later sued by Playboy for copyright infringement in November 1997. In Flint, Michigan, a 21-year-old man was charged with distributing child pornography through his BBS in March 1996.[10]
Networks
Most early BBSes operated as individual systems. Information contained on that BBS never left the system, and users would only interact with the information and user community on that BBS alone. However, as BBSes became more widespread, there evolved a desire to connect systems together to share messages and files with distant systems and users. The largest such network was FidoNet.
As is it was prohibitively expensive for the hobbyist SysOp to have a dedicated connection to another system, FidoNet was developed as a store and forward network. Private email (Netmail), public message boards (Echomail) and eventually even file attachments on a FidoNet-capable BBS would be bundled into one or more archive files over a set time interval. These archive files were then compressed with ARC or ZIP and forwarded to (or polled by) another nearby node or hub via a dialup Xmodem session. Messages would be relayed around various FidoNet hubs until they were eventually delivered to their destination. The hierarchy of FidoNet BBS nodes, hubs, and zones was maintained in a routing table called a Nodelist. Some larger BBSes or regional FidoNet hubs would make several transfers per day, some even to multiple nodes or hubs, and as such, transfers usually occurred at night or early morning when toll rates were lowest. In Fido's heyday, sending a Netmail message to a user on a distant FidoNet node, or participating in an Echomail discussion could take days, especially if any FidoNet nodes or hubs in the message's route only made one transfer call per day.
FidoNet was platform-independent and would work with any BBS that was written to use it. BBSes that did not have integrated FidoNet capability could usually add it using an external FidoNet front-end mailer such as FrontDoor, BinkleyTerm, InterMail or D'Bridge, and a mail processor such as FastEcho or Squish. The front-end mailer would conduct the periodic FidoNet transfers, while the mail processor would usually run just before and just after the mailer ran. This program would scan for and pack up new outgoing messages, and then unpack, sort and "toss" the incoming messages into a BBS user's local email box or into the BBS's local message bases reserved for Echomail. As such, these mail processors were commonly called "scanner/tosser/packers."
Many other BBS networks followed the example of FidoNet, using the same standards and the same software. These were called FidoNet Technology Networks (FTNs). They were usually smaller and targeted at selected audiences. Some networks used QWK doors, and others such as RelayNet (RIME) and WWIVnet used non-Fido software and standards.
Before commercial Internet access became common, these networks of BBSes provided regional and international e-mail and message bases. Some even provided gateways, such as UFGATE, by which members could send/receive e-mail to/from the Internet via UUCP, and many FidoNet discussion groups were shared via gateway to Usenet. Elaborate schemes allowed users to download binary files, search gopherspace, and interact with distant programs, all using plain text e-mail.
As the volume of FidoNet Mail increased and newsgroups from the early days of the Internet became available, satellite data downstream services became viable for larger systems. The satellite service provided access to FidoNet and Usenet newsgroups in large volumes at a reasonable fee. By connecting a small dish & receiver, a constant downstream of thousands of FidoNet and Usenet newsgroups could be received. The local BBS only needed to upload new outgoing messages via the modem network back to the satellite service. This method drastically reduced phone data transfers while dramatically increasing the number of message forums.
FidoNet is still in use today, though in a much smaller form, and many Echomail groups are still shared with Usenet via FidoNet to Usenet gateways. Widespread abuse of Usenet with spam and pornography has led to many of these FidoNet gateways to cease operation completely.
Shareware and freeware

Much of the shareware movement was started via user distribution of software through BBSes. A notable example was Phil Katz's PKARC (and later PKZIP, using the same ".zip" algorithm that WinZip and other popular archivers now use); also other concepts of software distribution like freeware, postcardware like JPEGview and donationware like Red Ryder for the Macintosh first appeared on BBS sites. Doom from id Software and nearly all Apogee Software games were distributed as shareware (Apogee is, in fact, credited for adding an order form to a shareware demo). The Internet has largely erased the distinction of shareware – most users now download the software directly from the developer's website rather than receiving it from another BBS user 'sharing' it. Today shareware is commonly used to mean electronically distributed software from a small developer.
Many commercial BBS software companies that continue to support their old BBS software products switched to the shareware model or made it entirely free. Some companies were able to make the move to the Internet and provide commercial products with BBS capabilities.
Features
A classic BBS had:
A computer
One or more modems
One or more phone lines, with more allowing for increased concurrent users
A BBS software package
A sysop – system operator
A user community
The BBS software usually provides:
Menu Systems
One or more message bases
File areas
SysOp side, live viewing of all caller activity
Voting – opinion booths
Statistics on message posters, top uploaders / downloaders
Online games (usually single player or only a single active player at a given time)
A doorway to third-party online games
Usage auditing capabilities
Multi-user chat (only possible on multi-line BBSes)
Internet email (more common in later Internet-connected BBSes)
Networked message boards
Most modern BBSes allow telnet access over the Internet using a telnet server and a virtual FOSSIL driver.
A "yell for SysOp" page caller side menu item that sounded an audible alarm to the SysOp. If chosen, the SysOp could then initiate a text-to-text chat with the caller.
Primitive social networking features, such as leaving messages on a user's profile
See also

ANSI art
BBS: The Documentary
Free-net
Imageboard
Internet forum
Internet Relay Chat
KOM (BBS)
List of BBS software
List of bulletin board systems
Minitel
PODSnet
Shell account
Terminal emulator
Textboard
User-generated content
Usenet
Warez

Notes

Citations

Sources

 Cite journal requires |journal= (help)

 –

– Collection of historical BBS documents, files and history

 at Curlie

Who developed the first bulletin board system of computer server?


Allegheny Health Network (AHN), based in Pittsburgh, is a non-profit, eight-hospital academic medical system with facilities located in Western Pennsylvania and one hospital in Western New York. The second-largest provider of health care in its region and one of the largest providers in Pennsylvania, AHN was formed in 2013 when Highmark Inc., a Pennsylvania-based Blue Cross Blue Shield insurance carrier, purchased the assets of the West Penn Allegheny Health System (WPAHS) and added three more hospitals (Jefferson Hospital in Jefferson Hills, Pa., Saint Vincent Hospital in Erie, Pa., and Westfield Memorial Hospital in Westfield, N.Y.) to its new provider division.[1] Allegheny Health Network was formed to act as the parent company to the WPAHS hospitals and its affiliate hospitals,[2] while Highmark Health today serves as the ultimate parent of AHN, creating one of the nation's largest integrated health delivery and financing systems.[3]
Today, AHN consists of one quaternary-care academic hospital and transplant center (Allegheny General Hospital in Pittsburgh), four tertiary-care hospitals (Jefferson, Saint Vincent, West Penn Hospital in Pittsburgh and Forbes Hospital in Monroeville, Pa.) and three community hospitals (Westfield Memorial, Canonsburg Hospital in Canonsburg, Pa., and Allegheny Valley Hospital in Harrison Township, Pa.). Together, the hospitals comprise more than 2,200 beds. In addition to its hospitals, AHN cares for patients from western Pennsylvania and the adjacent regions of Ohio, West Virginia, New York and Maryland at more than 250 clinical locations, including four large “Health + Wellness Pavilions,” cancer clinics, surgical centers, outpatient clinics, and primary care locations.
The system also includes the AHN Research Institute, the Allegheny Clinic (a physicians’ organization), a home health and infusion company (Healthcare@Home),[4] a group-purchasing organization, LifeFlight (the first airborne medical transport service in the Northeast U.S.[5]), and the STAR Center[6] (Simulation, Training and Academic Research Center), which provides simulation training for medical, nursing, and other health care professionals. The network offers four dozen graduate medical programs, operates two nursing schools (West Penn Hospital School of Nursing[7] in Pittsburgh and the Citizens School of Nursing[8] in Natrona Heights, Pa.), and serves as a clinical campus for the medical schools of Drexel University and Temple University, which are located in Philadelphia, as well as Lake Erie College of Osteopathic Medicine, located in Erie.
As of 2018, AHN employs approximately 19,000 people, with over 2,400 employed and affiliated physicians, plus 2,000 volunteers.[9] In 2017, the hospitals and clinics of AHN together admitted nearly 90,000 patients, logged 300,000 emergency room visits and delivered more than 7,500 babies.[9] In its most recent fiscal year, AHN reported more than $3 billion in revenue and net profit of $51.1 million.[10]
Facilities

Allegheny General Hospital
Now the academic flagship of Allegheny Health Network, Allegheny General Hospital (AGH) began as a 50-bed infirmary, housed in two adjoining brick rowhomes in what was then Allegheny City, immediately north of Pittsburgh.[11] While Pittsburgh itself had already established several hospitals, including West Penn Hospital, by the 1870s, Allegheny City needed one of its own to accommodate its burgeoning population and to care for the victims of fires, floods and disease outbreaks that often swept over the Ohio River's northern bank.[11] Starting in 1881, the mayor of Allegheny City began meeting with a committee of physicians and prominent residents of Allegheny City, to discuss the construction of, and fund-raising for, a new North Side hospital. Three years later, the committee bought two adjacent properties along Stockton Avenue, near the modern-day Nova Place.
The hospital was officially chartered in 1882 and on Feb. 15, 1886, the forerunner to Allegheny General Hospital opened its doors.[11] In 1887, the hospital established a children's wing, and in 1889, an ambulance was donated to the hospital; AGH would operate its own ambulance service for the next 64 years. A hospital annex was opened in June 1892, giving AGH additional surgical space. At the turn of the century, the hospital's directors began collecting funds for a new AGH, to be built just a block away, also along Stockton Avenue. The seven-story, 400-bed facility cost $620,000, and opened in 1904.[11] The new space included more modern laboratory facilities: separate rooms for urinalysis, blood work, bacteriology, and autopsies. Within the decade, the hospital's board president, Dr. Maitland Alexander, convinced the kin of steel magnate William H. Singer to build a new, three-story research laboratory behind the hospital, which opened in 1916 and would later be known as the Singer Research Institute[12] (now called the AHN Research Institute[13]). Like many hospitals of that era, AGH distinguished itself during war time; AGH was among the first medical institutions in the country to offer its services to the U.S. Department of War during WWI, and in 1918, the AGH Red Cross Unit made its way from Pittsburgh to Bourbonne-les-Bains, France, where a complement of AGH employees manned a French military hospital.[11]

Back home, Allegheny City and Pittsburgh continued to grow, as did Pittsburgh itself, and with the Stocktown Avenue AGH hemmed in by railroad tracks, the hospital board again looked for a location to for a new hospital. They found one 2,000 feet to the north. New York architecture firm York and Sawyer was hired to draw plans for what would be one of the nation's first “skyscraper” hospitals, and by 1929, construction was underway.[14] The cornerstone was laid in 1930, and the plastering was almost finished by 1931.The Great Depression interrupted construction, but the U.S Public Works Administration loaned AGH the $2 million that it needed to complete the project, and on June 24, 1936, the third iteration of Allegheny General Hospital was formally dedicated. The 22-story, $8 million hospital had 1,300 separate rooms, including 162 private patient rooms. Built in the Lombard architectural style, the cream-brick tower was an instant landmark structure, visible for miles; the high rise is now designated a Pittsburgh History and Landmarks Foundation historic landmark. The new hospital featured multiple kitchens, a pediatric wing, maternity wards, an x-ray department and a cardiology department; pneumatic tubes, call boxes and a state-of-the-art phone system helped hospital employees communicate.
In the decades that followed World War II, the hospital continued to expand and build, adding a new East Wing, and in 1981, a new inpatient tower, the $104 million Snyder Pavilion.[15] AGH also continued to push the boundaries of medicine and research in those decades, particularly in the areas of thoracic surgery, shock trauma care, cancer treatment, orthopaedic surgery, organ transplants and, most notably, open-heart surgery. Built on the foundation laid by world renowned surgical pioneer George Magovern,[16] by 1998, AGH was performing more than 1,500 open-heart procedures annually, the largest volume of any hospital in the state, serving patients from across the country and around the world.[17] Today, Allegheny General is a 576-bed quaternary care and educational hospital, and it is AHN's highest-volume hospital, seeing 24,000 inpatient admissions, 23,000 surgeries, and nearly 56,000 emergency department visits each year.[18] Over the last five years, AGH has invested in a new orthopaedic center, a new cardiovascular intensive care unit, a new cardiac MRI center, new hybrid operating rooms, an ambulatory surgery center and some of the world's most technologically advanced surgical robots.[19]
In 2018, construction began on a new academic cancer center on the AGH campus.[20]
In the early 1980s, AGH's directors created a nonprofit holding company, called the Allegheny Health, Education and Research Foundation, to operate the hospital.[21] That foundation ultimately collapsed in one of the nation's largest nonprofit bankruptcies (see AHERF).
Allegheny Valley Hospital
Allegheny Valley Hospital (AVH) has served Natrona Heights, Pa., and the surrounding community for over 100 years.[22] AVH has 228 licensed beds and provides emergency care, surgical care, rehabilitation care and other health care services for its patients. Like many of its Western Pennsylvania counterparts, Allegheny Valley Hospital was built to serve the region's flourishing industrial towns. By the late 1800s, industrial activity had reached the town of Tarentum, about 22 miles northeast of Pittsburgh and home to lumber and saw mills, steel mills, brick kilns, and several plate glass factories.[22] Serious injuries were a daily occurrence, but without a hospital, many patients were sent by train to a hospital in Pittsburgh. In 1906 a committee of doctors and prominent area residents secured a charter for the establishment of what was then called the Allegheny Valley General Hospital. Under the leadership of Dr. George Getze, the committee leased a property along Tarentum's Second Avenue, and the hospital was open for business on Jan. 28, 1909.[22]
It was a three-story home, with only 20 rooms available for patient visits and surgeries, and in 1910, the hospital was moved to its second location, a larger house along West Seventh Avenue, just downriver from the original home. This home, too, became quickly obsolete, and soon the hospital leaders agreed to buy a piece of land near the old Tarentum Fairground for $12,000.
The new 98-bed Natrona Heights hospital was dedicated on May 24, 1919.[22] The three-story, brick and terra cotta structure remains standing today, at the center of what is now a much larger Allegheny Valley Hospital. In the century that has passed since the third AVH opened, the hospital has added to that original foundation, building a nurses wing in 1928, a north wing in 1943, a $2 million south wing in 1958, a laboratory in 1974, and a four-level, $26.5 million addition in 1983 that houses AVH's emergency department, radiology, and other units.[22]
Today, AVH sees nearly 6,000 inpatient admissions and 40,000 emergency department visits, and performs 5,000 surgeries.[18] In recent years, AVH had added new inpatient units, cardiac MRI and rehabilitation services, robotic surgery capabilities, and inpatient rehab services for patients who have sustained trauma or strokes. It primarily serves residents living in Northeastern Allegheny County, Westmoreland County, Armstrong County and Butler County.
For a decade in the early 2000s, AVH was formally known as the Alle-Kiski Medical Center.[23] In 2011, the name reverted to Allegheny Valley Hospital.[23] In 2000, AVH also affiliated with the nearby Citizens School of Nursing, which opened in 1913 and continues to educate nursing students today.[22]
AVH was an independent hospital through most of its history. In 1997, it was acquired by AHERF.[24] Following the bankruptcy of AHERF, AVH became an affiliate of West Penn Allegheny Health System.[24] After WPAHS was acquired by Highmark Inc., AVH became an affiliate of the new Allegheny Health Network in 2013.[25]
Canonsburg Hospital
Canonsburg Hospital is a community hospital located just outside Canonsburg, Pa. Canonsburg Hospital was formed 1904, when, according to the Pittsburgh Post-Gazette, “the Women's Shakespeare Club of Canonsburg solicited donations of ‘linens, supplies, a hen and brood of chickens and a generous supply of fruit’ for what turned out to be an ambitious if not unusual project for a literary club. ... [But], as history records, this Women's Shakespeare Club's project ended well and proved to be much ado about something pretty special: medical care. For what the Women's Shakespeare Club of Canonsburg started [was] Canonsburg General Hospital.”[26]
The club raised $2,000 to help buy a house on Barr Street in Canonsburg, which served as the hospital for 10 years. They also formed the Canonsburg General Hospital Association to oversee the hospital’s operations. The hospital opened at its original Barr Street location on Oct. 17, 1904, and the first patient was a woman who was “traveling with her husband in a horse and carriage from the village of Midland in Chartiers to Canonsburg when the berserk horse sent them flying.[26]”
The following year, the hospital opened a nursing school, which remained in operation until 1960. In 1913, the hospital board agreed to construct a new hospital building, also on Barr Street, which grew to 54 beds by 1930. The “new” Barr Street hospital eventually named its dining room after Perry Como, the famous singer who born in Canonsburg in 1912.
By the late 1970s, Canonsburg Hospital had outgrown its red-brick Barr Street home, and in 1979 the hospital applied to the Pennsylvania Department of Health to build a new hospital. At the time in Pennsylvania, new hospital construction had to be approved by the state through a “certificate of need.” The application for a certificate of need was initially rejected by the state on the grounds that existing hospitals in the area had enough capacity to handle projected patient volume, but Canonsburg-area residents lobbied then-Pennsylvania Gov. Dick Thornburgh with “more than 5,000 letters [and] 2,000 mail-grams demanding the department approve the project.”[26] In 1981, the Health Department issued a certificate of need, and a new hospital was built in North Strabane Township, just outside of Canonsburg borough. The new $15.8 million hospital opened May 14, 1983, on 31 acres; the former Barr Street hospital is now a personal care and retirement home.
In 2000, Canonsburg Hospital joined the former West Penn Allegheny Health System. In 2013, it became a part of Allegheny Health Network. The current 104-bed[18] inpatient facility has undergone several expansions since its 1983 opening: In 1996, a new ambulatory care center was opened; in 2003, the physical therapy department was enlarged; in 2006, the emergency department was expanded to accommodate increased patient volume; and since its affiliation with AHN in 2013, the hospital has opened a sleep lab. The hospital primarily serves residents living in Southern Allegheny and Northern Washington counties. Canonsburg annually admits over 4,000 patients and logs approximately 21,000 emergency visits, and performs nearly 3,000 surgeries.[18]
Forbes Hospital
When Monroeville's first hospital opened its doors in 1978 to accommodate communities along the fast-developing U.S. Route 22 corridor, it was known as East Suburban Health Center, joining two other hospitals in the young Forbes Health System.[27] That system was created in 1972 following the merger of Columbia Hospital in Wilkinsburg and Pittsburgh Hospital in East Liberty; both of those facilities still exist and are now privately owned rehabilitation hospitals.
Planning for a Monroeville hospital began in the 1960s, when two rival groups competed for the rights to build a new medical facility in eastern Allegheny County. East Suburban General Hospital group, aligned with West Penn Hospital, wanted to build along Mosside Boulevard. Forbes Health System wanted to build on a site next to the Parkway East. In 1973, those competing groups joined forces.[27] Construction began in 1975. The merged group decided to keep the Forbes name, because all of the hospitals in the existing Forbes Health System – Pittsburgh Hospital, Columbia Hospital and the new Monroeville hospital – were along the old Forbes Road, a historic military path built in the 1700s from Carlisle to Pittsburgh.
The East Suburban Health Center opened in spring of 1978,[27] with 257 beds, serving much of eastern Allegheny County and parts of Westmoreland and Armstrong Counties. In 1983, health system leaders changed the hospital's name to the Forbes Regional Health Center, and in 1996, the Forbes Health Care system entered into a merger with the Allegheny Health, Education and Research Foundation (AHERF), which was then the parent company of Allegheny General Hospital. Canonsburg Hospital and Allegheny Valley Hospital also became members of AHERF[24] and its Pittsburgh area hospital-management arm, Allegheny University Medical Center. Following AHERF's collapse and bankruptcy filing, in 2000, Forbes Regional joined the newly created West Penn Allegheny Health System, and in 2013 became part of Allegheny Health Network.
Today, clinicians at Forbes provide access to obstetrics care, cardiovascular surgery, cancer care, neurosurgery, diabetes care, orthopaedics surgery, and many other advanced specialties. More than 700 physicians are on staff at the hospital, and each year Forbes delivers over a thousand babies and treats more than 40,000 patients in its emergency department.[18] In recent years, Forbes has continued to invest significantly in its capabilities, adding state-of-the-art robotic surgical technology, opening an inpatient rehabilitation unit, expanding and upgrading its intensive care facilities, enhancing its labor and delivery services, and establishing has the region's first and only Level II Trauma Center.[28] In 2015, Forbes became the first hospital within AHN to go live with a new fully integrated health records system, Epic;[29] in 2017, Forbes broke ground on a perioperative center expansion,[30] and in 2018 it broke ground on a new free-standing cancer center.[31]
Jefferson Hospital
Jefferson Hospital, nine miles south of Downtown Pittsburgh, opened its doors in 1977[32] at its current Jefferson Hills campus, and can trace its roots to the early 20th Century. Jefferson, formerly known as Jefferson Regional Medical Center, was created through the merger of two older hospitals: St. Joseph's Hospital in Pittsburgh's South Side, which opened in 1904, and Homestead Hospital, which began treating patients in 1908.[33]
Both hospitals were originally built close to steel mills, and cared for the people who worked in them. Eventually, those hospitals moved to larger facilities, then merged in 1973, and together they were known as the South Hills Health System. In 1977, the new Coal Valley Road hospital opened,[34] to accommodate Pittsburgh's rapidly growing southern suburbs. Later, the health system changed its name to Jefferson Regional Medical Center, and by the mid-'80s, the hospital had added an ambulatory surgery center, a new professional medical building, and was operating one of the largest home-care nursing programs in the area.
In 2013, Jefferson Regional officially joined Allegheny Health Network. Today, Jefferson is a 341-bed hospital that serves the city's South Hills. Annually, its clinicians perform 17,000 surgeries and treat more than 50,000 patients seeking emergency care.[18] Over the last decade, Jefferson has established a leading open-heart surgery and cardiovascular disease program, added advanced neurology and neurosurgical services, and developed a new comprehensive, state-of-the-art cancer center, which includes 20 infusion chairs and two patient beds for treatments, a patient education library, and a comprehensive resource center for patients and their families to learn more about nutrition and supportive care services available to them.[35]
In 2014, Jefferson also added a new labor and delivery unit, the first new OB program and unit to be built at a Pennsylvania hospital in three decades.[36] The new OB unit also features a Level II neonatal nursery for special needs, two dedicated cesarean-section rooms, 24/7 obstetric anesthesia and newborn services, numerous patient services and amenities, and the latest in infant security technology.
In recent years, Jefferson has also added advanced robotic surgery and orthopaedic surgery, neurosurgery, and behavioral health services, and in 2018 Jefferson Hospital announced plans for a $21 million expansion of its emergency department.[37]
Saint Vincent Hospital
In the 1870s in Erie, Pa., the Sisters of St. Joseph began raising money to build what would be Erie's first medical institution.[38] On September 5, 1875, Saint Vincent Hospital opened; at a cost of $7,000, it was a three-story, 12-bed hospital staffed by one surgeon and seven Sisters, who handled “everything from nursing to laundry.” According to hospital historians, “The Sisters' ministry to the sick began with an unfortunate accident in front of the St. Joseph orphanage in 1874. After caring for an injured man, other cases were soon brought to the Sisters, until demand became so great that Mother Agnes Spencer obtained permission from Bishop Mullen to build the hospital.[38]”
As the Erie region expanded, the hospital quickly outgrew its original three-story home, and by 1900 a new “Old Main” annex was established, followed by the creation of a nursing school (1901); yet another annex (E Building in 1911); a nurses home (1925) and a new diagnostic building and 65-bed maternity ward (1939). All of the new facilities were built on Saint Vincent's original Sassafras Street campus. After World War II came another round of expansion, and in the 1950s hospital leaders revealed plans to build a new, air-conditioned four-story inpatient center with diagnostic, X-ray, physiotherapy, lab and clinical facilities, and remodeling of business quarters.[38]
It 1978, a helipad was added, allowing for air transport of critically ill or injured patients to and from the hospital. In the 1980s, Saint Vincent teamed partnered with nearby Hamot Medical Center to create a jointly operated “Tri-State Regional Trauma Center” and a “Tri-State Regional Cancer Center;” those partnerships have since been dissolved.
By the late 1980 and early 1990s, Saint Vincent was one of the busiest hospitals in the state, necessitating additional expansion; the Saint Vincent Outpatient Surgery Center opened, and a new multi-story South Building would house maternity, intensive-care units, engineering areas, a new entrance and lobby, cardio-technical services, and the laboratory. In 2008, Saint Vincent's Neonatal Intensive Care Unit (NICU) was renovated and opened in September of that year; the new 10,000-square foot facility featured 19 individual, private pods for families to bond with their babies. That year, 2,308 babies were delivered at SVH.[38]
In 2012, Saint Vincent's board voted to pursue a “strategic affiliation” with Highmark Inc.[39] The following year, Highmark officially created Allegheny Health Network, and Saint Vincent joined the new network as its northwestern Pennsylvania hub.
In 2017, Highmark and AHN announced $115 million in capital investments for Saint Vincent and the Erie region,[40] including a new emergency department, new operating suites, a new Women and Infants Center, and a new Health + Wellness Pavilion. In 2018, Saint Vincent broke ground on the new pavilion and a new free-standing cancer center.[41]
Westfield Memorial Hospital
Founded in 1942,[42] Westfield Memorial Hospital is an affiliate of Saint Vincent Hospital, which is 30 miles to the west. It is the only AHN hospital outside of the state of Pennsylvania.
Westfield is a four-bed acute care hospital that serves New York's largely rural Chautauqua County. Because the Amish communities of northwestern Chautauqua County deliver approximately 65–80 babies per year with no professional assistance, “the number of unanticipated complications at birth is greatly increased among this population.[43]” In 2007, Westfield launched a comprehensive ambulatory midwifery care program for mothers and babies, with funding from NYSHealth.
In 2016, Westfield Memorial served 23,000 patients and the emergency department reported more than 7,500 visits.[44] Westfield is one of the largest employers in northwest Chautauqua County, with about 100 full-time and part-time employees.
In 2018, Westfield Memorial unveiled its new expanded emergency department; the updated facility includes “four new treatment rooms and one large trauma room, along with the creation of a new ambulance vestibule.”[45] Also in 2018, Westfield will be connected to Saint Vincent and all AHN clinicians through the implementation of a new electronic health records system.
In 2016, Westfield was reaccredited as an acute-care hospital by the New York Commission on Health Care Facilities in the 21st Century, the culmination of a multi-year evaluation process that reviewed the services, capacities and capabilities of all of New York's hospitals.
As a result of that evaluation process, Westfield was given a five-year “limited life” operating certificate in 2011.[46] At the time, Westfield had been a 32-bed facility, and the state recommended turning Westfield into a standalone “diagnostic center” without emergency services. The Westfield community rallied about the hospital and “convinced the state of New York that this may not be the right thing to do,” according to The Observer of Dunkirk, NY. In response to the public lobbying, Westfield remained a full-service acute-care hospital, but was required to “find ways to make improvements and provide their services more effectively to the community.”[46]
Westfield, along with Saint Vincent, became a part of AHN in 2013.
Western Pennsylvania Hospital (West Penn Hospital)

When the Western Pennsylvania Hospital was chartered in 1848,[47] Pittsburgh was a growing iron town, one of the largest American cities west of the Allegheny Mountains. It was prosperous city, but it was also a dirty and dangerous one. Industrial accidents were common, and outbreaks of smallpox, scarlet fever, diphtheria and other scourges were common among Pittsburgh's 45,000 residents, thousands of whom were immigrant laborers from Europe.
To care for these sick, injured or destitute immigrants, Pittsburgh began building hospitals. The first to be built were religiously affiliated, but soon, city stewards agreed that Pittsburgh would also need a publicly charted hospital that could provide health care for all, without sectarian restrictions.[47] In 1847, Henry D. Sellers, M.D., proposed a new hospital in Pittsburgh's 12th ward, on a hillside overlooking the city's Strip District and adjacent to what is now Polish Hill (today, that plot is home to a ballfield and West Penn Park, named in honor of the hospital). On March 18, 1848, the hospital was formally incorporated, and the four-story, 120-patient hospital finally opened in spring 1853, after five years of design and construction.[47]
In its first year of operation, 172 patients were admitted, and only 24 of those admitted had the means to pay for their stay.[47] Because so many of the patients were indigent (most people who could afford medical care were treated by house-call doctors), the nurses and physicians who were recruited to work at West Penn did so voluntarily, in three-month rotations. They treated patients with the medicines of the day — mercury, opium, tobacco and calomel.[47]
Many of those who were treated at West Penn during its earliest days had mental illness, and it was soon clear that they needed more than hospital care — they need a specialized facility of their own. In 1862, West Penn opened the Dixmont Hospital (known officially as the "Department of the Insane in the Western Pennsylvania Hospital of Pittsburgh”) on a steep bluff overlooking the Ohio River, about eight miles downriver from West Penn. That hospital, the first specialized mental health facility in Western Pennsylvania, remained under West Penn's ownership until 1907, after which Dixmont was independently controlled.[47]
Eight years after the opening of West Penn Hospital, America was at war with itself. While the fighting didn’t come to Pittsburgh, wounded soldiers did, and West Penn became a primary triage center serving Union Forces.[48] Because of its size, and because it was a public hospital not bound by religious affiliations, the United States government commandeered West Penn Hospital in 1862, making alterations to it and turning it into a military hospital for the next three years. (Civilians could still be treated at West Penn in emergency situations). By the end of the Civil War in 1865, some 3,000 soldiers had been treated at West Penn. Some never recovered to full health, staying in the east wing of the hospital in what became known as the Soldiers Home.

As the science of medicine evolved, the training of physicians was evolving, too. The West Penn Medical College, founded by West Penn surgeons and doctors, opened in October 1885, with a class of 55 students. It was the region's first medical school. Similarly, by 1890, work was underway on a new nursing school and dormitory, another first for the region.
At the turn of the 20th Century, Pittsburgh was booming, and West Penn had outgrown its busy Strip District home. Smoky, noisy and buffeted by railroad yards, the hillside was referred to as the “Golgotha of the Iron City.”[47] The hospital needed electricity, more modern rooms, and a better location, and the hospital's board — populated by names like Heinz, Frick, Carnegie, Mellon and Horne — agreed to build a new hospital in Pittsburgh's Bloomfield neighborhood, about a mile to the east. The cornerstone was laid in 1909, and on New Year's Day, 1912, the new West Penn Hospital opened. The six-story, X-shaped hospital was able to accommodate up to 500 patients, and featured modern operating rooms, laboratories, and X-ray machines.
The new hospital and its staff would be tested repeatedly over the coming years — the 1918 flu epidemic saw West Penn again commandeered by the federal government, the Great Depression eroded the financial resources of West Penn and nearly every other American hospital, and World War II drained West Penn of physicians and nurses.[47]
West Penn survived those tests, and after the war, in 1950, West Penn added a new obstetrical wing, an intensive care unit came in 1958, and by the 1960s, another substantial expansion was underway. Led by board President Aiken Fisher, West Penn launched a capital campaign to build a new entrance to the hospital along Millvale Avenue, and to build a new ambulatory care center along Liberty Avenue (to be named Mellon Pavilion). Both Mellon Pavilion and the hospital's renowned Burn Care Unit opened in 1970, a heliport was added in 1971, and the East Tower, which specialized in diagnostic and critical care, opened in 1981. A nine-story patient care tower was added in 1995, topped by a copper dome visible for miles.[47]
The late 1990s and early 2000s resulted in several changes to West Penn's governance structure. Following the fall of AHERF and its historic 1998 bond default,[21] West Penn Hospital agreed to rescue AGH and its affiliates through a merger. As alternative to bankruptcy liquidation, AGH, Forbes, Allegheny Valley and Canonsburg “were transferred to the West Penn system in 1999 in exchange for a $25 million payment to the creditors,[21] who agreed to release [AGH] from liability for all claims.” That new system was known as the West Penn Allegheny Health System.
In 2010, as parent company West Penn Allegheny Health System was experiencing severe cash shortages and financial difficulties, WPAHS leadership agreed to close West Penn's emergency room as a cost-saving measure.[49] It closed on Jan. 1, 2010, and remained closed until February 2012, after WPAHS had reached an agreement in principle with Highmark Inc. regarding the acquisition of the hospital system. That agreement was announced in June 2011, and without the affiliation and capital infusion from Highmark, had “another investor not materialized, WPAHS was preparing a budget that would have included the autumn closure of West Penn Hospital,” according to the Pittsburgh Post-Gazette.[50] West Penn became a part of Allegheny Health Network in 2013.
Today, West Penn Hospital is a 317-bed academic medical center;[18] its obstetrical program delivers 4,000 babies a year, and the hospital's Level III neonatal intensive care unit, its adult and pediatric certified burn trauma center, its extended-hours oncology clinic and dozens of other services draw patients from across the state. West Penn was also the first hospital in the region to earn Magnet Recognition status from the American Nurses Credentialing Center,[51] an achievement denoting the quality of a hospital's nursing team. West Penn's marrow and stem cell transplantation program is one of the most sophisticated in the country and one of the busiest in the state.
Health + Wellness Pavilions
Allegheny Health Network is home to four Health + Wellness Pavilions, one-stop-shop medical malls that provide patients with access to a comprehensive array of retail, preventive, diagnostic and therapeutic health care services, under one roof.[52] These large-scale pavilions were designed to provide patients and physicians with a well-organized, uniquely integrated and multi-disciplinary approach to disease management, prevention and wellness. The first of these pavilions opened in 2014 in Wexford.[53] Since then, AHN has opened Health + Wellness Pavilions in Peters, Bethel Park and Erie, with construction on an additional facility in Erie[54] now underway.
Under construction
In 2017, AHN and Highmark Health announced a series of capital investments: Construction of at least five new hospitals, including one full-service hospital north of Pittsburgh[55] and four small-scale “neighborhood hospitals,” or micro-hospitals, designed by Emerus;[56] a new academic cancer center on the AGH campus and several stand-alone cancer centers throughout Western Pennsylvania,[57] as well as an expansion of AHN's ongoing oncology partnership[58] with Johns Hopkins Medicine and its Sidney Kimmel Comprehensive Cancer Center; $115 million in capital upgrades to Saint Vincent Hospital and nearby facilities; and improvements to existing hospitals. In all, the capital improvements announced in 2017 total $1 billion.[59]
Notable Institutes
Like many health systems, AHN delivers patient care at hospitals and outpatient centers, but manages and organizes that care through service-line-oriented institutes.[60] As of 2018, AHN's highest-volume and best-known institutes include its Cancer Institute, Cardiovascular Institute, Emergency Services, Esophageal & Lung Institute, Medicine Institute, Neuroscience Institute, Orthopaedic Institute, Transplant Institute, and its Women & Children's Institute.[61]
Financials
In Q1 and Q2 of 2018, AHN reported positive operating income and net income.[62][63] In Q3 of 2018, AHN reported positive operating income and flat net income.[64]
In 2017, AHN reported operating income of $31.2 million, or $58.2 million better than the network's projected net loss of -$27 million and $63.8 million better than the 2016 full-year loss of -$32.6 million.[65] AHN also reported 2017 net income of $51.1 million, or $80.1 million better than AHN's projected loss of -$29 million, and $91.1 million better than AHN's 2016 full-year net loss of -$40.0 million.[65] The results represented AHN's first full year of positive operating results and positive net income since the formation of the network in 2013. For the year, AHN reported $3.1 billion in operating revenue.[66]
In late 2017, AHN also refinanced its debt with the issuance of $1 billion in long-term bonds,[67] purchased by a bank consortium led by PNC Financial Services. The debt issuance allowed AHN to extinguish three existing loan structures, including preexisting bond issues at Saint Vincent Hospital and Jefferson Hospital. Its debt was reduced from $1.4 billion to just above $1 billion.[66] In July 2018, AHN announced that it would refinance its existing debt by issuing $1 billion in new long-term revenue bonds through the Allegheny County Hospital Development Authority; according to S&P Global Ratings, those revenue bonds have been assigned  an "'A' long-term rating" with a stable outlook.[68]
In 2016, AHN reported operating losses of $40 million.[69] In 2015, it reported an operating loss of $39 million.[70] Prior to 2015, the hospitals of the core WPAHS entity reported finances separately from the rest of AHN; in 2014, WPAHS hospitals reported a $13.3 million operating loss.[71]
Predecessor organizations
West Penn Allegheny Health System (WPAHS)
West Penn Allegheny Health System was a five-hospital, Pittsburgh-based network formed through the merger of West Penn Hospital (also known as The Western Pennsylvania Hospital) and the Pittsburgh-area assets of the Allegheny Health, Education and Research Foundation, which included Allegheny General, Forbes, Canonsburg and Allegheny Valley Hospital.[21]
The merger occurred in 1999, following the collapse of AHERF, and the health system struggled to maintain market share in Allegheny County and beyond. In the ensuing years, WPAHS lost market share to its rival UPMC, and WPAHS's relationship with Highmark Inc., the region's largest health insurer, also deteriorated: In April 2009, WPAHS filed an anti-trust suit against both Highmark and UPMC, “alleging that Highmark and UPMC illegally raised prices for local health consumers while trying to ‘destroy’ West Penn Allegheny. The suit detailed actions by the two going back to 2002 that it said were designed to assure Highmark's ongoing dominance in the local insurance market while establishing higher payment rates and eliminating West Penn Allegheny to benefit UPMC.”[72]
Two years after that lawsuit was filed, WPAHS’s finances had further deteriorated, and WPAHS’s board was contemplating a menu of options to rescue the distressed system. Eventually, WPAHS entered into negotiations[73] with Highmark Inc. regarding the full acquisition of the health system by the health insurer. Highmark agreed to the rescue, in part because a Highmark was at a contract impasse with UPMC that imperiled its customers' future access to UPMC facilities.[73]
In June of 2011, the boards that led Highmark Inc. and West Penn Allegheny Health System announced a “capital partnership” in which Highmark would invest $475 million in WPAHS, including an upfront $50 million payment that kept the doors open at West Penn Hospital.[74] In 2013, the proposed acquisition became official.[2] West Penn Allegheny Health System continues to exist as a legal entity,[18] but as of 2013 it has been fully absorbed into the larger Allegheny Health Network, which is owned by parent company Highmark Health.
Allegheny Health, Education, and Research Foundation (AHERF)
AHERF was created in 1983, as a nonprofit corporation that operated Allegheny General Hospital.[21] Under Chief Operating Officer Sherif Abdelhak,[75] AHERF and its board embarked on an ambitious growth campaign, expanding rapidly “into both Philadelphia and Pittsburgh through acquisitions encompassing several hospitals, medical schools, and primary care physicians.” [21]
In 1987, AHERF acquired the Medical College of Pennsylvania and its two affiliated hospitals in Philadelphia; in 1991 it acquired United Hospitals Inc., a system of four hospitals in Philadelphia; in 1993 it acquired Hahnemann Medical College and its affiliated hospital in Philadelphia; and in 1997, AHERF formed Allegheny University Medical Centers to operate AHERF's new Pittsburgh-area affiliates (Forbes Hospital, Allegheny Valley Hospital and Canonsburg Hospital).[21]
By the end of 1997 AHERF had transformed itself from a sole urban hospital into Pennsylvania's largest statewide integrated health and education system. But the rapid expansion came at a great cost, and soon AHERF was unable to meet debt obligations and keep up with capital improvement demands; health system leadership permitted “internal subsidies, hidden internal cash transfers and raids on hospital endowments.”[21] The rapid financial deterioration meant that by spring of 1998, AHERF was losing nearly a million dollars a day.[76] In July 1998, AHERF filed for bankruptcy, and the resulting $1.3 billion protection filing was the nation's largest health care failure to date.[21]
The subsequent collapse of AHERF and the break-up of its assets led to the creation of the West Penn Allegheny Health System.

When was the Allegheny Health Network formed?


Bronchiolitis obliterans (BO), also known as popcorn lung and constrictive bronchiolitis, is a disease that results in obstruction of the smallest airways of the lungs (bronchioles) due to inflammation.[1] Symptoms include a dry cough, shortness of breath, wheezing and feeling tired.[1] These symptoms generally get worse over weeks to months.[4] It is not related to cryptogenic organizing pneumonia, previously known as bronchiolitis obliterans organizing pneumonia.[4]

Causes include breathing in toxic fumes, respiratory infections, connective tissue disorder or complications following a bone marrow or heart-lung transplant.[1] Symptoms may not occur until two to eight weeks following toxic exposure or infection.[1] The underlying mechanism involves inflammation that results in scar tissue formation.[1] Diagnosis is by CT scan, pulmonary function tests or lung biopsy.[1] A chest X-ray is often normal.[4]

While the disease is not reversible, treatments can slow further worsening.[1] This may include the use of corticosteroids or immunosuppressive medication.[1] A lung transplant may be tried.[4] Outcomes are often poor, with most people dying in months to years.[4]

Bronchiolitis obliterans is rare in the general population.[4] It affects about 75% of people by ten years following a lung transplant and up to 10% of people who have received a bone marrow transplant from someone else.[4] The condition was first clearly described in 1981.[4] Prior descriptions occurred as early as 1956.[6]
Signs and symptoms
Bronchiolitis obliterans is a lung disease characterized by fixed airway obstruction. Inflammation and scarring occur in the airways of the lung, resulting in severe shortness of breath and dry cough. FEV1 (forced expiratory volume in 1 second) should be above 80% of predicted values to be considered normal. Bronchiolitis obliterans reduces this to between 16% and 21%. Symptoms include dry cough, shortness of breath and wheezing. The symptoms can start gradually, or severe symptoms can occur suddenly.[7][8]
Cause
Bronchiolitis obliterans has many possible causes, including collagen vascular disease, transplant rejection in organ transplant patients, viral infection (respiratory syncytial virus, adenovirus, HIV, cytomegalovirus), Stevens-Johnson syndrome, Pneumocystis pneumonia, drug reaction, aspiration and complications of prematurity (bronchopulmonary dysplasia), and exposure to toxic fumes, including diacetyl, sulfur dioxide, nitrogen dioxide, ammonia, chlorine, thionyl chloride, methyl isocyanate, hydrogen fluoride, hydrogen bromide, hydrogen chloride, hydrogen sulfide, phosgene, polyamide-amine dyes, mustard gas and ozone . It can also be present in patients with rheumatoid arthritis.[9] Certain orally administrated emergency medications, such as activated charcoal, have been known to cause it when aspirated.[10] The ingestion of large doses of papaverine in the vegetable Sauropus androgynus has caused it.[11] Additionally, the disorder may be idiopathic (without known cause).[12][13][14]
Industrial inhalants
There are many industrial inhalants that are known to cause various types of bronchiolitis, including bronchiolitis obliterans.[15]
Industrial workers who have presented with bronchiolitis:
nylon-flock workers[14]
workers who spray prints onto textiles with polyamide-amine dyes[14]
battery workers who are exposed to thionyl chloride fumes
workers at plants that use or manufacture flavourings, e.g. diacetyl butter-like flavouring [7][14][16]
Diacetyl

Bronchiolitis obliterans may be caused by inhalation of airborne diacetyl, a chemical used to produce the artificial butter flavoring[17] in many foods such as candy and microwave popcorn and occurring naturally in wines. This first came to public attention when eight former employees of the Gilster-Mary Lee popcorn plant in Jasper, Missouri, developed bronchiolitis obliterans. In 2000, the Missouri Department of Health called in the National Institute for Occupational Safety and Health to make a determination of the cause, and to recommend safety measures. After surveying the plant and each patient's medical history, NIOSH recommended respiratory protection for all workers in microwave popcorn production. Due to this event, bronchiolitis obliterans began to be referred to in the popular media as "popcorn lung" or "popcorn workers lung".[18][19][20][21] It is also referred to as "flavorings-related lung disease".[22]
Bronchiolitis obliterans caused by diacetyl inhalation begins with a cough, wheezing and dyspnea (shortness of breath), and usually progresses slowly, but severe symptoms can develop without warning. Other symptoms that appear in some workers include fever, weight loss, and night sweats. Symptoms do not change when workers are away from the workplace.[22] CT images show bronchial wall thickening and trapped air. Non-smokers may be at higher risk for this form of bronchiolitis obliterans. The Occupational Safety and Health Administration (OSHA) recommended that diacetyl manufacturing companies regularly sample air in work environments, provide air purifying respirators, and engage in medical surveillance of at-risk workers. In 2011, National Institute for Occupational Safety and Health proposed a recommended short-term exposure limit of 25 parts per billion (ppb) and a time weighted average exposure of 5 ppb.[21]
In 2007 a heavy consumer of microwaved popcorn was diagnosed by a doctor in Denver with "popcorn lung," the first known case involving a consumer.[23] On 16 January 2008, it was announced that Wayne Watson, a Denver man who developed "popcorn lung" after inhaling fumes from microwaved popcorn, was suing the Kroger grocery store chain and its affiliates. In the lawsuit, filed in U.S. District Court, Watson's attorney claimed that the companies "failed to warn that preparing microwave popcorn in a microwave oven as intended and smelling the buttery aroma could expose the consumer to an inhalation hazard and a risk of lung injury."[24] On 19 September 2012 a jury in U.S. District Court in Denver awarded $2.3 million in actual damages and $5 million in punitive damages to Watson. Defendants included Gilster-Mary Lee, the manufacturer; Kroger, and Kroger's subsidiary Dillons, owners of King Soopers & City Market, a Colorado regional supermarket chain.[25][26][27]
On 27 August 2007, Weaver Popcorn Company of Indianapolis promised to replace the diacetyl butter flavor ingredient in Pop Weaver popcorn with another flavoring.[28]
In September 2007, Dr. Cecile Rose, pulmonary specialist at Denver's National Jewish Health medical and research Center, warned federal agencies that consumers, not just flavoring or food factory workers, may be in danger of contracting bronchiolitis obliterans. David Michaels, of the George Washington University School of Public Health, first published Rose's warning letter on his blog.[29][30]
On 4 September 2007, the Flavor and Extract Manufacturers recommended reduction of diacetyl in butter-like flavorings. The next day ConAgra Foods announced that it would soon remove diacetyl from its popcorn products.[31]
Diacetyl is approved by the Food and Drug Administration as a safe flavor ingredient, but there is evidence to suggest that inhalation in large amounts is dangerous. There are currently no warnings from federal regulators about diacetyl.
Diacetyl is found in the vapor created by some electronic cigarette flavours.[32]
A NIOSH peer-reviewed publication documents that, in laboratory studies, acute inhalation exposures to acetyl propionyl (2,3-pentanedione), one of the compounds with a buttery flavor and/or smell put forward as a safer alternative to diacetyl, cause airway epithelial damage that is as harmful as diacetyl.[33]
Burn pits
A new form of constrictive bronchiolitis is starting to present in Iraq and Afghanistan veterans. It has been attributed to veterans being exposed to trash burn pits. Veterans present with shortness of breath and other asthma-like symptoms. The only way to diagnose this condition is by doing a lung biopsy as chest X-rays and CT scans come back as normal. The government still denies that there is any correlation between burn pits and health problems but the government has started an "Airborne Hazards and Open Burn Pit Registry" to begin tracking the health of veterans who were exposed to burn pits to see if there is a connection.[34][35]
Diagnosis
Bronchiolitis obliterans is often misdiagnosed as asthma, chronic bronchitis, emphysema or pneumonia.[22]
Several tests are often needed to correctly diagnose bronchiolitis obliterans, including chest X-rays, diffusing capacity of the lung tests (DLCO), spirometry, lung volume tests, high-resolution CT (HRCT), and lung biopsy. Diffusing capacity of the lung (DLCO) tests are usually normal; people with early-stage BO are more likely to have normal DLCO. Spirometry tests usually show fixed airway obstructions and sometimes restriction, where the lungs can't expand fully. Lung volume tests may show hyperinflation (excessive air in lungs caused by air trapping). HRCT can also show air trapping when the person being scanned breathes out completely; it can also show thickening in the airway and haziness in the lungs. Transthoracic lung biopsies are preferable for diagnosis of constrictive BO compared to transbronchial biopsies; regardless of the type of biopsy, a diagnosis may only be achieved by examination of multiple samples.[22]
Prevention
Flavorings-related lung disease can be prevented with the use of engineering controls (e.g. exhaust hoods or closed systems), personal protective equipment, monitoring of potentially affected workers, worker education,[36] and by not using lung-disease-causing flavorings.
Treatment
This disease is irreversible and severe cases often require a lung transplant.[22] Transplant recipients are at risk for re-developing the disease, as bronchiolitis obliterans is a common complication of chronic rejection. Evaluation of interventions to prevent bronchiolitis obliterans relies on early detection of abnormal spirometry results or unusual decreases in repeated measurements.
A multi-center study has shown the combination of inhaled fluticasone propionate, oral montelukast, and oral azithromycin may be able to stabilize the disease and slow disease progression.[37] This has only been studied in patients who previously underwent hematopoietic stem cell transplantation.
See also
Diffuse panbronchiolitis


Of all the religions in Denmark, the most prominent is Christianity in the form of the Evangelical Lutheran Church of Denmark (Dansk Folkekirke), the state religion. Hence, Denmark is not a secular state as there is a clear link between the church and the state with a  Minister for Ecclesiastical Affairs. However, pockets of other major faiths can be found among the population. In January 2018, 75.3[1] of the population of Denmark were registered members of the Church of Denmark (Den Danske Folkekirke), the officially established church, which is Protestant in classification and Lutheran in orientation.[2][notes 1] This is down 0.6% compared to the year earlier and 1.6% down compared to two years earlier. Despite the high membership figures, only 3% of the population regularly attend Sunday services[3][4] and only 19% of Danes consider religion to be an important part of their life.[5] [3]

According to the latest Eurobarometer estimates, as of 2015, 78.2% of Danish people are Christians (67.4% are Protestant, 2.0% are Orthodox and 1.3 are Catholics), 19.7% are non-religious and 2.1% are members of other religions.[6]
Religiosity
According to a Eurobarometer Poll conducted in 2010,[7] 28% of Danish citizens responded that "they believe there is a God", 47% responded that "they believe there is some sort of spirit or life force" and 24% responded that "they do not believe there is any sort of spirit, God or life force". Another poll, carried out in 2008, found that 25% of Danes believe Jesus is the son of God, and 18% believe he is the saviour of the world.[8] A gallup report in 2009 found that only 19% of Danes consider religion to be an important part of their life.[5]
Just under 20% of the Danish population identifies as atheist.[9] Phil Zuckerman, an American professor of sociology, after spending 14 months in Sweden and Denmark talking to hundreds of people about religion, reported that they were “often disinclined or hesitant to talk with [prof. Zuckerman] about religion, and even once they agreed to do so, they usually had very little to say on the matter.”[10]
Many Danish people define themselves as spiritual but not religious.[11][12]
Religious communities

Christianity

Christianity is the predominant religion of Denmark, with three quarters of the Danish population estimated as adherents of the "Folkekirken" ("People's Church"), Denmark's national Lutheran church.[14] Aside from Lutheranism, there is a small Catholic minority, as well as small Protestant denominations such as the Baptist Union of Denmark and the Reformed Synod of Denmark.
According to official statistics from January 2018, 75.3%[15][16] of the population of Denmark are members of the Evangelical Lutheran Church of Denmark (Den danske folkekirke), the country's state church since the Reformation in Denmark–Norway and Holstein, and designated "the Danish people's church" by the 1848 Constitution of Denmark.[17]
There are around 4,000 Christians who have converted from a Muslim background in the country, most of them belonging to some form of Protestantism.[18]
Judaism

A Jewish community has been present in Denmark since the seventeenth century, when the monarchs began allowing Jews to enter the country and practice their religion on an individual basis. Emancipation followed gradually and by the end of the nineteenth century most Jews were fully assimilated into Danish society. In the early decades of the twentieth century there was an influx of more secular, Yiddish speaking, Eastern European Jews. Nearly 99% of Danish Jews survived the Holocaust, in part due to the actions of the Danish resistance, and to the Swedish authorities' offer of asylum to the Danish Jews.[19]
Today there are approximately 10,000 ethnic Jews in Denmark, and three synagogues located in Copenhagen.
Islam

Muslims living in Denmark make up approximately 3% of the population and form the country's second largest religious community and largest minority religion.[3][21] As of 2009 there are nineteen recognised Muslim communities in Denmark.[21][22] Ahmadi Muslims constructed the first mosque in the capital, Copenhagen. There were approximately 600 Ahmadis all over Denmark in 2006.[23]
Other groups

According to a survey of various religions and denominations undertaken by the Danish Foreign Ministry, other religious groups comprise less than 1% of the population individually and approximately 2% when taken all together.[24]
Baha'i Faith

The Baha'i Faith arrived in Denmark in 1925, but it did not make much impact until the arrival of American pioneers in 1946. A National Spiritual Assembly was formed in 1962. In 2005, it was estimated that there were about 1,251 Baha'is in the country.[25]
Buddhism

Buddhism in Denmark was brought back from expeditions that explored the Indian subcontinent. Initial interest was mainly from intellectuals, authors, Buddhologists and Philologists. In 1921, Christian F. Melbye founded the first Buddhist Society in Denmark, but it was later dissolved in 1950 before his death in 1953.[26][27] In the 1950s, there was a revival in interest towards Buddhism, especially Tibetan Buddhism and Hannah and Ole Nydahl, founded the first Karma Kagyu Buddhist centers in Copenhagen.[26][27] The third wave of Buddhism came in the 1980s, when refugees from Vietnam, Sri Lanka and China came to Denmark.
In 2009 Aarhus University estimated that there were 20,000 practising Buddhists in Denmark.[28][29]
Hinduism
In Denmark there are about 7,500-8,000 Hindus of Tamil Origin.The Hindu Community in Denmark is Registered as reported in International Religious Freedom Report 2006, Denmark. Also reported is the Krishna devotees. However, since Krishna is part of Hinduism, it need not be mentioned separately. Out of a population of 5.3 million, the Indian community (PIOs and NRIs) is approximately 5,000. (This Percentage excludes Sri Lankan Tamil Hindus.) Indian Nationals in Denmark are mainly Computer Professionals, Doctors, Kiosk and restaurant owners and students.
Neopaganism
A neopagan religious group, Forn Siðr — Ásatrú and Vanatrú Association in Denmark, describes itself as a revival of the Norse paganism prevalent in Denmark before Christianization. It gained state recognition in November 2003.[30] There are about 500 registered heathens (0.01% of the population) adhering to the old Norse beliefs.
In 2016, the Valheim Hof was established in Korinth.[31]
Politics and government
Politicians in Denmark will not generally be found making use of any religious rhetoric or arguments in their declarations, and this is especially the case for government ministers, with the possible, occasional exception of the Minister for Ecclesiastical Affairs in the course of his or her duties. Four of Denmark's prime ministers have identified themselves as atheists.[32]
The Christian Democrats is the only major political party to regularly employ religious rhetoric and arguments, and they have not been represented in the Folketing since 2001, as they have not been able to acquire the minimum 2% of the votes needed to secure a seat.
Danish Constitution

The Constitution of Denmark contains a number of sections related to religion.
§4 establishes the Evangelical Lutheran Church of Denmark as the state church of Denmark.
§6 requires the Danish monarch to be a member of the state church.
§67 grants freedom of worship.
§68 states that no one is required to personally contribute to any form of religion other than his own. As state subsidies are not considered personal contributions[33] the Church of Denmark receives subsidies - according to §4 - beyond the church tax paid by the members of the church. The Church of Denmark is the only religious group to receive direct financial support from the state. Other religious groups can receive indirect support through tax deductions on contributions.[34]
§70 grants freedom of religion by ensuring civil and political rights can not be revoked due to race or religious beliefs. It further states race and religious beliefs can not be used to be exempt from civil duties.
§71 ensures no one can be imprisoned due to religious beliefs.
See also

Christianization of Scandinavia
Buddhism in Denmark
Bahá'í Faith in Denmark
Islam in Denmark
Jyllands-Posten Muhammad cartoons controversy
History of the Jews in Denmark
Rescue of the Danish Jews
Hinduism in Denmark
Notes