title: Chronic fatigue syndrome

text: Immunological abnormalities are frequently observed in those with CFS. Decreased NK cell activity is found more often in people with CFS and this correlates with severity of symptoms. People with CFS have an abnormal response to exercise, including increased production of complement products, increased oxidative stress combined with decreased antioxidant response, and increased Interleukin 10, and TLR4, some of which correlates with symptom severity. Increased levels of cytokines have been proposed to account for the decreased ATP production and increased lactate during exercise; however, the elevations of cytokine levels are inconsistent in specific cytokine, albeit frequently found. Similarities have been drawn between cancer and CFS with regard to abnormal intracellular immunological signaling. Abnormalities observed include hyperactivity of Ribonuclease L, a protein activated by IFN, and hyperactivity of NF-κB.


title: Chronic fatigue syndrome

text: Evidence points to abnormalities in the hypothalamic-pituitary-adrenal axis (HPA axis) in some, but not all, persons with CFS, which may include slightly low cortisol levels, a decrease in the variation of cortisol levels throughout the day, decreased responsiveness of the HPA axis, and a high serotonergic state, which can be considered to be a "HPA axis phenotype" that is also present in some other conditions, including post-traumatic stress disorder and some autoimmune conditions. It is unclear whether or not decreased cortisol levels of the HPA axis plays a primary role as a cause of CFS, or has a secondary role in the continuation or worsening of symptoms later in the illness. In most healthy adults, the cortisol awakening response shows an increase in cortisol levels averaging 50% in the first half-hour after waking. In people with CFS, this increase apparently is significantly less, but methods of measuring cortisol levels vary, so this is not certain.


title: Chronic fatigue syndrome

text: Autoimmunity has been proposed to be a factor in CFS, but there are only a few relevant findings so far.


title: Chronic fatigue syndrome

text: There are a subset of patients with increased B cell activity and autoantibodies, possibly as a result of decreased NK cell regulation or viral mimicry. In 2015, a large German study found 29% of ME/CFS patients had elevated autoantibodies to M3 and M4 muscarinic acetylcholine receptors as well as to ß2 adrenergic receptors. A 2016 Australian study found that ME/CFS patients had significantly greater numbers of single nucleotide polymorphisms associated with the gene encoding for M3 muscarinic acetylcholine receptors.


title: Chronic fatigue syndrome

text: Studies have observed mitochondrial abnormalities in cellular energy production, but recent focus has concentrated on secondary effects that may result in aberrant mitochondrial function because inherent problems with the mitochondria structure or genetics have not been replicated.


title: Chronic fatigue syndrome

text: No characteristic laboratory abnormalities are approved to diagnose CFS; while physical abnormalities can be found, no single finding is considered sufficient for diagnosis. Blood, urine, and other tests are used to rule out other conditions that could be responsible for the symptoms. The CDC states that a medical history should be taken and a mental and physical examination should be done to aid diagnosis.


title: Chronic fatigue syndrome

text: The CDC recommends considering the questionnaires and tools described in the 2015 Institute of Medicine report, which include:


title: Chronic fatigue syndrome

text: A two-day cardiopulmonary exercise test (CPET) is not necessary for diagnosis, although lower readings on the second day may be helpful in supporting a claim for social security disability. A two-day CPET cannot be used to rule out chronic fatigue syndrome.


title: Chronic fatigue syndrome

text: Clinical practice guidelines are generally based on case descriptions, with the aim of improving diagnosis, management and treatment. An example is the ME/CFS guideline for the National Health Services in England and Wales, updated in 2021. Other guidance can be found at the New York Department of Health.


title: Chronic fatigue syndrome

text: Certain medical conditions can cause chronic fatigue and must be ruled out before a diagnosis of CFS can be given. Hypothyroidism, anemia, coeliac disease (that can occur without gastrointestinal symptoms), diabetes and certain psychiatric disorders are a few of the diseases that must be ruled out if the patient presents with appropriate symptoms. Other diseases, listed by the Centers for Disease Control and Prevention, include infectious diseases (such as Epstein–Barr virus, influenza, HIV infection, tuberculosis, Lyme disease), neuroendocrine diseases (such as thyroiditis, Addison's disease, adrenal insufficiency, Cushing's disease), hematologic diseases (such as occult malignancy, lymphoma), rheumatologic diseases (such as fibromyalgia, polymyalgia rheumatica, Sjögren's syndrome, lupus, giant-cell arteritis, polymyositis, dermatomyositis), psychiatric diseases (such as bipolar disorder, schizophrenia, delusional disorders, dementia, anorexia/bulimia nervosa), neuropsychologic diseases (such as obstructive sleep apnea, parkinsonism, multiple sclerosis), and others (such as nasal obstruction from allergies, sinusitis, anatomic obstruction, autoimmune diseases, cancer, chronic hepatitis, some chronic illness, alcohol or other substance abuse, pharmacologic side effects, heavy metal exposure and toxicity, marked body weight fluctuation). Ehlers–Danlos syndromes (EDS) may also have similar symptoms. Medications can also cause side effects that mimic symptoms of CFS.


title: Chronic fatigue syndrome

text: Persons with fibromyalgia (FM, or fibromyalgia syndrome, FMS), like those with CFS, have muscle pain, severe fatigue and sleep disturbances. The presence of allodynia (abnormal pain responses to mild stimulation) and of extensive tender points in specific locations differentiates FM from CFS, although the two diseases often co-occur.


title: Chronic fatigue syndrome

text: Depressive symptoms, if seen in CFS, may be differentially diagnosed from primary depression by the absence of anhedonia, decreased motivation, and guilt; and the presence of somatic symptoms such as sore throat, swollen lymph nodes, and exercise intolerance with post exertional exacerbation of symptoms.


title: Chronic fatigue syndrome

text: There is no approved pharmacological treatment, therapy or cure for CFS, although various drugs have been or are being investigated. A 2014 report prepared by the Agency for Healthcare Research and Quality stated that there are wide variations in patient management, that many receive a multifaceted approach to treatment, and that no medications have been approved by the US Food and Drug Administration (FDA) for the treatment of ME/CFS, although several have been used off label. The report concluded that although counseling and graded exercise therapy (GET) have shown some benefits, these interventions have not been studied fully enough to recommend them for all persons affected. The report expressed concern that GET appears to be associated with worsening symptoms in some. The CDC no longer recommends these interventions, and there is some evidence of patient harm.


title: Chronic fatigue syndrome

text: The CDC guide for the management of CFS states that while there is no cure, a number of methods might improve symptoms. Treatment strategies for sleep problems; pain; depression, stress, and anxiety; dizziness and lightheadedness (orthostatic intolerance); and memory and concentration problems are enumerated. Other useful topics that patients and doctors might discuss include carefully monitoring and managing activity to avoid worsening of symptoms, counseling to cope with the impact the illness may have on quality of life, proper nutrition and nutritional supplements that may support better health, and complementary therapies that might help increase energy or decrease pain.


title: Chronic fatigue syndrome

text: The United Kingdom's National Institute for Health and Clinical Excellence (NICE) 2021 guideline directed toward healthcare professionals and patients, specifies the need for shared decision-making between patients and medical care teams and acknowledges the reality and impact of the condition and the symptoms. The NICE guideline covers diagnosis, illness management, and aspects of symptom management: diet, medications, coexisting conditions, flare-ups, and energy management. The guideline recognized symptoms of severe ME/CFS may be misunderstood as neglect or abuse and recommends assessment for safeguarding of persons suspected of having ME/CFS be evaluated by professionals with experience and understanding of the illness. The guideline states that GET is not an appropriate treatment for ME/CFS. CBT might be offered to help a person manage the difficulties of dealing with a chronic illness, not to cure the illness.


title: Chronic fatigue syndrome

text: Prior to publication of the NICE 2021 guideline, Andrew Goddard, president of the Royal College of Physicians, stated there was concern NICE did not adequately consider the experts' support and evidence of the benefits of GET and CBT, and urged they be included in the guideline. Various ME/CFS patient groups disputed the benefits of the therapies and stated that GET can make the illness more severe.


title: Chronic fatigue syndrome

text: Comorbid conditions can occur in CFS that may interact with and exacerbate the symptoms of CFS. Appropriate medical intervention for these conditions may be beneficial. The most commonly diagnosed include fibromyalgia, irritable bowel syndrome, depression, anxiety, allergies, and chemical sensitivities.


title: Chronic fatigue syndrome

text: Pacing, or activity management, is an illness management strategy based on the observation that symptoms tend to increase following mental or physical exertion, and was recommended for CFS in the 1980s. It is now commonly used as a management strategy in chronic illnesses and in chronic pain.


title: Chronic fatigue syndrome

text: Its two forms are "symptom-contingent pacing", in which the decision to stop (and rest or change an activity) is determined by self-awareness of an exacerbation of symptoms, and "time-contingent pacing", which is determined by a set schedule of activities that a patient estimates he or she is able to complete without triggering post-exertional malaise (PEM). Thus, the principle behind pacing for CFS is to avoid overexertion and an exacerbation of symptoms. It is not aimed at treating the illness as a whole. Those whose illness appears stable may gradually increase activity and exercise levels, but according to the principle of pacing, must rest or reduce their activity levels if it becomes clear that they have exceeded their limits. Use of a heart-rate monitor with pacing to monitor and manage activity levels is recommended by a number of patient groups, and the CDC considers it useful for some individuals to help avoid post-exertional malaise.


title: Chronic fatigue syndrome

text: Energy envelope theory, considered to be consistent with pacing, is a management strategy suggested in the 2011 international consensus criteria for ME, which refers to using an "energy bank budget". Energy envelope theory was devised by psychologist Leonard Jason, who previously had CFS. Energy envelope theory states that patients should stay within, and avoid pushing through, the "envelope" of energy available to them, so as to reduce the post-exertional malaise "payback" caused by overexertion. This may help them make "modest gains" in physical functioning. Several studies have found energy envelope theory to be a helpful management strategy, noting that it reduces symptoms and may increase the level of functioning in CFS. Energy envelope theory does not recommend unilaterally increasing or decreasing activity and is not intended as a therapy or cure for CFS. It has been promoted by various patient groups. Some patient groups recommend using a heart rate monitor to increase awareness of exertion and enable patients to stay within their aerobic threshold envelope. Despite a number of studies showing positive results for energy envelope theory, randomized controlled trials are lacking.


title: Chronic fatigue syndrome

text: Stretching, movement therapies, and toning exercises are recommended for pain in patients with CFS, and pain medication is also suggested. In many chronic illnesses, aerobic exercise is beneficial, but in chronic fatigue syndrome, the CDC does not recommend it. The CDC states:


title: Chronic fatigue syndrome

text: The CDC states that counseling may help patients cope with pain caused by CFS, and that talking with a professional counselor or therapist may help people to more effectively manage the symptoms that affect their quality of daily life.


title: Chronic fatigue syndrome

text: A proper diet is a significant contributor to the health of any individual. Medical consultation about diet and supplements is recommended for persons with CFS. Persons with CFS may benefit from a balanced diet and properly supervised administration of nutritional support if deficiencies are detected by medical testing. Risks of nutritional supplements include interactions with prescribed medications.


title: Chronic fatigue syndrome

text: NICE indicates CBT might be offered to help cope with the difficulty of dealing with the symptoms of ME/CFS, but should not be intended to be curative. The rationale behind the use of CBT to change beliefs about the illness is disputed. The CDC states that speaking with a therapist may help people cope with the illness.


title: Chronic fatigue syndrome

text: A 2015 National Institutes of Health report concluded that while counseling and behavior therapies could produce benefits for some people, they may not yield improvement in quality of life, and because of this limitation such therapies should not be considered as a primary treatment, but rather should be used only as one component of a broader approach. This same report stated that although counseling approaches have shown benefit in some measures of fatigue, function and overall improvement, these approaches have been inadequately studied in subgroups of the wider CFS patient population. Further concern was expressed that reporting of negative effects experienced by patients receiving counseling and behavior therapies had been poor. A report by the Institute of Medicine published in 2015 states that it is unclear whether CBT helps to improve cognitive impairments experienced by patients.


title: Chronic fatigue syndrome

text: A 2014 systematic review reported that there was only limited evidence that patients increased levels of physical activity after receiving CBT. The authors concluded that, as this finding is contrary to the cognitive behavioural model of CFS, patients receiving CBT were adapting to the illness rather than recovering from it. In a letter published online in the Lancet in 2016, Dr Charles Shepherd, medical advisor to the MEA, expressed the view that the contention between patients and researchers lay in "a flawed model of causation that takes no account of the heterogeneity of both clinical presentations and disease pathways that come under the umbrella diagnosis of ME/CFS".


title: Chronic fatigue syndrome

text: Patient organisations have rebuffed the use of CBT as a treatment for CFS to alter illness beliefs. The ME Association (MEA) recommended in 2015, based on the results of an opinion survey of 493 patients who had received CBT treatment in the UK, CBT in its current form should not be used as a primary intervention for people with CFS. In 2019, a large UK survey of people with ME/CFS reported that CBT was ineffective for more than half of respondents.


title: Chronic fatigue syndrome

text: Recommendation for treatment using graded exercise therapy (GET) was removed from NICE's updated Guidelines for Diagnosis and Management of ME/CFS in October 2021. It was removed due to low quality evidence regarding benefit, with the guidelines now stating that clinicians should not prescribe ""any programme that ... uses fixed incremental increases in physical activity or exercise, for example, graded exercise therapy.""


title: Chronic fatigue syndrome

text: Previously, the National Institutes of Health concluded that while GET could produce benefits, it may not yield improvement in quality of life, and because of this limitation GET should not be considered as a primary treatment. It was recommended to be used only as one component of a broader approach. It noted that a focus on exercise programs had discouraged patient participation in other types of physical activity due to concerns of increased symptoms. An addendum stated, if studies based on the Oxford criteria were excluded, there would be insufficient evidence of the effectiveness of GET.


title: Chronic fatigue syndrome

text: A 2019 updated Cochrane review stated that, exercise therapy probably has a positive effect on fatigue in adults, and slightly improves sleep, but the long-term effects are unknown and has limited relevance to current definitions of ME/CFS. Cochrane started re-evaluating the effects of exercise therapies in chronic fatigue syndrome in 2020.


title: Chronic fatigue syndrome

text: Patient organisations have long criticised the use of exercise therapy, most notably GET, as a treatment for CFS. Based on an opinion survey of patients who had received GET, in 2015 the ME Association concluded, GET in its current delivered form should not be recommended as a primary intervention for persons with CFS.


title: Chronic fatigue syndrome

text: APT, not to be confused with pacing, is a therapy rather than a management strategy. APT is based on the idea that CFS involves a person only having a limited amount of available energy, and using this energy wisely will mean the "limited energy will increase gradually". A large clinical trial known as the PACE trial found APT was no more effective than usual care or specialized medical care. The PACE trial generated much criticism due to the broad Oxford criteria patient selection, the standards of outcome effectiveness were lowered during the study and that re-analysis of the data did not support the magnitude of improvements initially reported.


title: Chronic fatigue syndrome

text: Unlike pacing, APT is based on the cognitive behavioral model of chronic fatigue syndrome and involves increasing activity levels, which it states may temporarily increase symptoms. In APT, the patient first establishes a baseline level of activity, which can be carried out consistently without any post-exertional malaise ("crashes"). APT states that persons should plan to increase their activity, as able. However, APT also requires patients to restrict their activity level to only 70% of what they feel able to do, while also warning against too much rest. This has been described as contradictory, and Jason states that in comparison with pacing, this 70% limit restricts the activities that patients are capable of and results in a lower level of functioning. Jason and Goudsmit, who first described pacing and the energy envelope theory for CFS, have both criticized APT for being inconsistent with the principles of pacing and highlighted significant differences. APT was promoted by Action for ME until 2019. Action for ME was the patient charity involved in the PACE trial.


title: Chronic fatigue syndrome

text: Rintatolimod is a double-stranded RNA drug developed to modulate an antiviral immune reaction through activation of toll-like receptor 3. In several clinical trials of CFS, the treatment has shown a reduction in symptoms, but improvements were not sustained after discontinuation. Evidence supporting the use of rintatolimod is deemed low to moderate. The US FDA has denied commercial approval, called a new drug application, citing several deficiencies and gaps in safety data in the trials, and concluded that the available evidence is insufficient to demonstrate its safety or efficacy in CFS. Rintatolimod has been approved for marketing and treatment for persons with CFS in Argentina, and in 2019, FDA regulatory requirements were met for exportation of rintatolimod to the country. Rintatolimod is currently in an experimental trial in the US to treat both ME/CFS and Long COVID.


title: Chronic fatigue syndrome

text: Information on the prognosis of CFS is limited, and the course of the illness is variable. According to the NICE guideliene, CFS "varies in long-term outlook from person to person." Complete recovery, partial improvement, and worsening are all possible. Symptoms generally fluctuate over days, weeks, or longer periods, and some people may experience periods of remission. Overall, "many will need to adapt to living with ME/CFS." Some people who improve need to manage their activities in order to stay improved. Children and teenagers are more likely to recover or improve than adults.


title: Chronic fatigue syndrome

text: A 2005 systematic review found that for untreated CFS, "the median full recovery rate was 5% (range 0–31%) and the median proportion of patients who improved during follow-up was 39.5% (range 8–63%)," and that 8 to 30% of patients were able to return to work. Age at onset, a longer duration of follow-up, less fatigue severity at baseline, and other factors were occasionally, but non consistently, related to outcome. Another review found that children have a better prognosis than adults, with 54–94% having recovered by follow-up, compared to less than 10% of adults returning to pre-illness levels of functioning.


title: Chronic fatigue syndrome

text: The prevalence rates for CFS/ME vary widely depending on "case definitions and diagnostic methods". Based on the 1994 CDC diagnostic criteria, the global prevalence rate for CFS is 0.89%. In comparison, the prevalence rate for the stricter criteria, such as the 1988 CDC "Holmes" criteria for CFS and the 2003 Canadian criteria for ME (both of which, for example, exclude patients with psychiatric diagnoses), produce an incidence rate of only 0.17%. For an example of how these rates impact a nation: the CDC website notes that between 836,000 and 2.5 million Americans have ME/CFS, "but most remain undiagnosed".


title: Chronic fatigue syndrome

text: Females are diagnosed about 1.5 to 2.0 times more often with CFS than males. An estimated 0.5% of children have CFS, and more adolescents are affected with the illness than younger children.


title: Chronic fatigue syndrome

text: The incidence rate according to age has two peaks, one at 10–19 and another at 30–39 years (see graph in right margin). The effect is seen both in female and in male data, but is more pronounce in females. It was suggested that this occurs because these age groups may be more vulnerable to CFS. The rate of prevalence is highest between ages 40 and 60.


title: Chronic fatigue syndrome

text: A range of both theorised and confirmed medical entities and naming conventions have appeared historically in the medical literature dealing with ME and CFS. These include:


title: Chronic fatigue syndrome

text: Many names have been proposed for the illness. Currently, the most commonly used are "chronic fatigue syndrome", "myalgic encephalomyelitis", and the umbrella term "ME/CFS". Reaching consensus on a name is challenging because the cause and pathology remain unknown.


title: Chronic fatigue syndrome

text: The term "chronic fatigue syndrome" has been criticized by some patients as being both stigmatizing and trivializing, and which in turn prevents the illness from being seen as a serious health problem that deserves appropriate research. While many patients prefer "myalgic encephalomyelitis", which they believe better reflects the medical nature of the illness, there is resistance amongst some clinicians toward the use of myalgic encephalomyelitis on the grounds that the inflammation of the central nervous system (myelitis) implied by the term has not been demonstrated.


title: Chronic fatigue syndrome

text: A 2015 report from the Institute of Medicine recommended the illness be renamed "systemic exertion intolerance disease", (SEID), and suggested new diagnostic criteria, proposing post-exertional malaise, (PEM), impaired function, and sleep problems are core symptoms of ME/CFS. Additionally, they described cognitive impairment and orthostatic intolerance as distinguishing symptoms from other fatiguing illnesses.


title: Chronic fatigue syndrome

text: Reynolds "et al." (2004) estimated that the illness caused about $20,000 per person with CFS in lost productivity, which totals to $9.1 billion per year in the United States. This is comparable to other chronic illnesses that extract some of the biggest medical and socioeconomic costs. Direct healthcare costs are estimated at between $9 and $14 billion annually in the US alone. A 2008 study calculated that the total annual cost burden of ME/CFS to society in the US was extensive, and could approach $24.0 billion. A 2017 estimate for the annual economic burden in the United Kingdom from ME/CFS was 3.3 billion pounds sterling.


title: Chronic fatigue syndrome

text: 12 May is designated as ME/CFS International Awareness Day. The day is observed so that stakeholders have an occasion to improve the knowledge of "the public, policymakers, and health-care professionals about the symptoms, diagnosis, and treatment of ME/CFS, as well as the need for a better understanding of this complex illness." It was chosen because it is the birthday of Florence Nightingale, who had an illness appearing similar to ME/CFS or fibromyalgia.


title: Chronic fatigue syndrome

text: Some in the medical community do not recognize CFS as a real condition, nor does agreement exist on its prevalence. There has been much disagreement over proposed causes, diagnosis, and treatment of the illness. This uncertainty can significantly affect doctor-patient relations. A 2006 survey of GPs in southwest England found that despite more than two-thirds of them accepting CFS/ME as a recognizable clinical entity, nearly half did not feel confident with making the diagnosis and/or treating the disease. Three other key factors that were significantly, positively associated with GPs' attitudes were knowing someone socially with CFS/ME, being male, and seeing more patients with the condition in the last year.


title: Chronic fatigue syndrome

text: From the patient perspective, one 1997 study found that 77% of individuals with CFS reported negative experiences with health-care providers. In a more recent metaanalysis of qualitative studies, a major theme identified in patient discourses was that they felt severely ill, yet were blamed and dismissed. A study of themes in patient newsgroup postings noted key themes relating to denial of social recognition of suffering and feelings of being accused of "simply faking it". Another theme that emerged strongly was that achieving diagnosis and acknowledgement requires tremendous amounts of "hard work" by patients.


title: Chronic fatigue syndrome

text: In 2010, several national blood banks adopted measures to discourage or prohibit individuals diagnosed with CFS from donating blood, based on concern following the 2009 claim of a link between CFS and a retrovirus which was subsequently shown to be unfounded. Organizations adopting these or similar measures included the Canadian Blood Services, the New Zealand Blood Service, the Australian Red Cross Blood Service and the American Association of Blood Banks, In November 2010, the UK National Blood Service introduced a permanent deferral of donation from ME/CFS patients based on the potential harm "to those patients" that may result from their giving blood. Donation policy in the UK now states, "The condition is relapsing by nature and donation may make symptoms worse, or provoke a relapse in an affected individual."


title: Chronic fatigue syndrome

text: Much contention has arisen over the cause, pathophysiology, nomenclature, and diagnostic criteria of CFS. Historically, many professionals within the medical community were unfamiliar with CFS, or did not recognize it as a real condition; nor did agreement exist on its prevalence or seriousness. Some people with CFS reject any psychological component.


title: Chronic fatigue syndrome

text: In 1970, two British psychiatrists, McEvedy and Beard, reviewed the case notes of 15 outbreaks of benign myalgic encephalomyelitis and concluded that it was caused by mass hysteria on the part of patients, or altered medical perception of the attending physicians. Their conclusions were based on previous studies that found many normal physical test results, a lack of a discernible cause, and a higher prevalence of the illness in females. Consequently, the authors recommended that the disease should be renamed "myalgia nervosa". This perspective was rejected in a series of case studies by Dr. Melvin Ramsay and other staff of the Royal Free Hospital, the center of a significant outbreak. The psychological hypothesis posed by McEvedy and Beard created great controversy, and convinced a generation of health professionals in the UK that this could be a plausible explanation for the condition, resulting in neglect by many medical specialties. The specialty that did take a major interest in the illness was psychiatry.


title: Chronic fatigue syndrome

text: Because of the controversy, sociologists hypothesized that stresses of modern living might be a cause of the illness, while some in the media used the term "Yuppie flu" and called it a disease of the middle class. People with disabilities from CFS were often not believed and were accused of being malingerers. The November 1990 issue of "Newsweek" ran a cover story on CFS, which although supportive of an organic cause of the illness, also featured the term 'yuppie flu', reflecting the stereotype that CFS mainly affected yuppies. The implication was that CFS is a form of burnout. The term 'yuppie flu' is considered offensive by both patients and clinicians.


title: Chronic fatigue syndrome

text: In 2009, the journal "Science" published a study that identified the XMRV retrovirus in a population of people with CFS. Other studies failed to reproduce this finding, and in 2011, the editor of "Science" formally retracted its XMRV paper while the "Proceedings of the National Academy of Sciences" similarly retracted a 2010 paper which had appeared to support the finding of a connection between XMRV and CFS.


title: Chronic fatigue syndrome

text: The lack of research funding and the funding bias towards biopsychosocial studies and against biomedical studies has been highlighted a number of times by patient groups and a number of UK politicians. A parliamentary inquiry by an "ad hoc" group of parliamentarians in the United Kingdom, set up and chaired by former MP, Dr Ian Gibson, called the Group on Scientific Research into CFS/ME, was addressed by a government minister claiming that few good biomedical research proposals have been submitted to the Medical Research Council (MRC) in contrast to those for psychosocial research. They were also told by other scientists of proposals that have been rejected, with claims of bias against biomedical research. The MRC confirmed to the group that from April 2003 to November 2006, it has turned down 10 biomedical applications relating to CFS/ME and funded five applications relating to CFS/ME, mostly in the psychiatric/psychosocial domain.


title: Chronic fatigue syndrome

text: In 2008, the MRC set up an expert group to consider how the MRC might encourage new high-quality research into CFS/ME and partnerships between researchers already working on CFS/ME and those in associated areas. It currently lists CFS/ME with a highlight notice, inviting researchers to develop high-quality research proposals for funding. In February 2010, the All-Party Parliamentary Group on ME (APPG on ME) produced a legacy paper, which welcomed the recent MRC initiative, but felt that far too much emphasis in the past had been on psychological research, with insufficient attention to biomedical research, and that further biomedical research must be undertaken to help discover a cause and more effective forms of management for this disease.


title: Chronic fatigue syndrome

text: Controversy surrounds psychologically oriented models of the disease and behavioral treatments conducted in the UK.


title: Chronic fatigue syndrome

text: In 1998, $13 million for CFS research was found to have been redirected or improperly accounted for by the United States CDC, and officials at the agency misled Congress about the irregularities. The agency stated that they needed the funds to respond to other public-health emergencies. The director of a US national patient advocacy group charged the CDC had a bias against studying the disease. The CDC pledged to improve their practices and to restore the $13 million to CFS research over three years.


title: Chronic fatigue syndrome

text: On 29 October 2015, the National Institutes of Health declared its intent to increase research on ME/CFS. The NIH Clinical Center was to study individuals with ME/CFS, and the National Institute of Neurological Disorders and Stroke would lead the Trans-NIH ME/CFS Research Working Group as part of a multi-institute research effort.


title: Chronic fatigue syndrome

text: In 1989, "The Golden Girls" (1985–1992) featured chronic fatigue syndrome in a two-episode arc, "Sick and Tired: Part 1" and "Part 2", in which protagonist Dorothy Zbornak, portrayed by Bea Arthur, after a lengthy battle with her doctors in an effort to find a diagnosis for her symptoms, is finally diagnosed with CFS. American author Ann Bannon had CFS. Laura Hillenbrand, author of the popular book "Seabiscuit", has struggled with CFS since age 19.


title: Chronic fatigue syndrome

text: The different case definitions used to research the illness influence the types of patients selected for studies, and research also suggests subtypes of patients may exist within a heterogeneous population. In one of the definitions, symptoms are accepted that may suggest a psychiatric disorder, while others specifically exclude primary psychiatric disorders. The lack of a single, unifying case definition was criticized in the Institute of Medicine's 2015 report for "creating an unclear picture of the symptoms and signs of the disorder" and "complicating comparisons of the results" (study results).


title: Chronic fatigue syndrome

text: More robust diagnostic methods are being investigated with the aim of identifying unique biomarkers that may be used in clinical testing. In 2019, two different papers were published proposing blood-based biomarkers for CFS. One found that blood cells of CFS patients could be distinguished from healthy controls by their response to hyperosmotic stress. Another found that the red blood cells of CFS patients were stiffer, and thus less able to deform in order to pass through capilliaries.


title: JJ Redick

text: Jonathan Clay "JJ" Redick (born June 24, 1984) is an American former professional basketball player who is a podcaster and sports analyst for ESPN. He was selected 11th overall by the Orlando Magic in the 2006 NBA draft. He played college basketball for the Duke Blue Devils.


title: JJ Redick

text: In college, Redick was known for his excellent three-point and free-throw shooting. He set ACC records during his career for most points and most career ACC tournament points at the time. Redick is the all-time leading scorer for Duke. He also set several other Duke records, including most points in a single season.


title: JJ Redick

text: After being drafted by the Magic, he played for seven seasons in Orlando, followed by a short spell with the Milwaukee Bucks, then four seasons with the Los Angeles Clippers. In 2017, he signed a one-year contract with the Philadelphia 76ers, and re-signed with them on a one-year deal the following year. In 2019, Redick signed a two-year deal with the New Orleans Pelicans. He was traded to the Dallas Mavericks in 2021. After 15 seasons in the NBA, Redick retired on September 21, 2021.


title: JJ Redick

text: Redick became the first NBA player and the second active professional athlete to take on a podcast during the regular season. It was started on 2016 at Yahoo! Sports. He moved his podcast to media company Uninterrupted, then continued his podcast episodes on The Ringer in 2017. In 2020 he left The Ringer to start his own YouTube channel, and he co-founded the media company ThreeFourTwo Productions.


title: JJ Redick

text: Redick was a McDonald's All-American at Cave Spring High School in Roanoke, Virginia, winning the 2002 McDonald's All-American Game MVP. He scored 43 points as a senior in the Virginia High School League (VHSL) Class AAA state championship game, a game in which the Knights defeated George Wythe High School of Richmond. Redick's total was a VHSL championship-game record for all classes, standing until future Texas Tech player Mac McClung scored 47 for Gate City High School in the 2018 Class 2A final. Redick played Amateur Athletic Union (AAU) basketball with the Boo Williams team, playing against Dwyane Wade in a July 1999 tournament in Orlando.


title: JJ Redick

text: Considered a five-star recruit by Scout.com, Redick was highly recruited and listed as the No. 2 shooting guard and the No. 13 player in the nation in 2002.


title: JJ Redick

text: In his first year at Duke University, Redick led his team with 30 points in their victory over NC State in the ACC Tournament championship game. He put up 26 points against Central Michigan in the second round of the NCAA tournament. However, he struggled in Duke's Sweet Sixteen loss to Kansas, hitting only two of 16 shots.


title: JJ Redick

text: Redick served as co-captain in his junior year, along with senior point guard Daniel Ewing. He also served as captain his senior year, along with fellow seniors Shelden Williams, Sean Dockery and Lee Melchionni.


title: JJ Redick

text: In the 2004–05 season, Redick led Duke in scoring with 21.8 points per game. He won the ACC Player of the Year award, and the Adolph F. Rupp Trophy for national player of the year. Redick's victory in the Rupp voting spoiled the consensus for Utah's Andrew Bogut, who won every other major player of the year award. In 2006, after facing close competition all year from Gonzaga's Adam Morrison, Redick won the major player of the year awards.


title: JJ Redick

text: Redick set a record for the most consecutive free throws made in the ACC with 54. This record began on March 20, 2003, and ended on January 15, 2004. It was broken on January 22, 2012, by Scott Wood from NC State. Redick entered his final postseason with a chance to go down as the NCAA's all-time leading free-throw shooter. The record, 91.3%, was held at the time by Gary Buchanan of Villanova. In an otherwise triumphant visit to Greensboro Coliseum for the 2006 ACC tournament and early NCAA tournament games, Redick struggled at the line, lowering his career free-throw percentage by about 0.5% and finishing his career with 91.16% (660 out of 724).


title: JJ Redick

text: On February 14, 2006, in the first half of a game against Wake Forest, Redick broke Virginia alumnus Curtis Staples's NCAA record of 413 career three-pointers made. Keydren Clark of Saint Peter's College subsequently surpassed Redick's mark in the MAAC tournament. However, Redick returned the favor by hitting 15 three-pointers in the ACC Tournament and 12 in the NCAA Tournament to finish ahead of Clark. Redick finished his career with an NCAA-record 457 three-point field goals shooting 40.4% from three-point range. His career three-pointers record was broken on February 2, 2014, by Oakland University's Travis Bader.


title: JJ Redick

text: In the game after breaking Staples' record, Redick scored 30 points on February 19, 2006, against Miami to become the all-time leading scorer at Duke, with 2,557 points scored in his career. On February 25, in a game versus Temple, Redick passed Dickie Hemric's 51-year-old ACC scoring record of 2,587 points with a pair of free throws in the waning minutes of the game. His record was topped in one of the opening round games of the 2009 NCAA tournament by North Carolina's Tyler Hansbrough. Redick finished his career with 2,769 points.


title: JJ Redick

text: On March 10, 2006, in an ACC Tournament quarterfinal against Miami, Redick scored 25 points, setting a Duke record for points in a season with 858. Redick ended the season with 964 points. Redick came up just short of the ACC record for points scored in a season, which was set by Dennis Scott with 970 points in 1990. Redick also finished his career as the leading scorer in ACC tournament history. His total of 225 points eclipsed Wake Forest's Len Chappell, who scored 220 points in the tournament from 1960 to 1962.


title: JJ Redick

text: As the marquee player of the Blue Devils, Redick was the target of abuse by fans of rival teams. Clay Travis, of CBS Sports, called him the "most hated current athlete in America." After students from rivals Maryland and North Carolina discovered his cell phone number, Redick estimated that he received 50 to 75 hate calls per day from opposing fans. He was often the target of obscenity-laced tirades from fans. Redick was so often a target from rival fans that even his family members were harassed. Opposing crowds went as far as telling him during the game that "they had sex with his little sister" and that "your little brother is gay". Comments that crowds antagonized Redick with involving his underage siblings weren't dealt with. JJ almost quit basketball his sophomore year because of how much hate he received for no specific reason from so many people.


title: JJ Redick

text: He had 36 double-figure scoring games in a single season, tied as of March 28, 2010, for 5th-most in Duke history with Jon Scheyer, Shane Battier, and Jason Williams.


title: JJ Redick

text: J.J. Redick was chosen as a cover athlete and official spokesman for College Hoops 2K7. The game was released on Xbox, Xbox 360


title: JJ Redick

text: On February 4, 2007, Redick's no. 4 jersey was retired at Cameron Indoor Stadium at a special halftime ceremony. Redick became the 13th Duke player to have his jersey retired.


title: JJ Redick

text: Redick was selected with the 11th pick in the 2006 NBA draft by the Orlando Magic. Pre-draft scouting reports praised Redick's perimeter shooting and basketball intelligence, but questioned his defensive ability and speculated that he might not be tall or athletic enough to create his own shots in the NBA. This scouting report was highlighted when Duke played LSU in the 2006 NCAA tournament. LSU's Garrett Temple, a 6'5" guard known for his athleticism and a large wingspan, chased Redick throughout the game. Taken out of his normal rhythm, Redick—the number two scorer in the nation at the time—had one of the worst shooting performances of his college career, shooting 3-for-18 from the field and scoring 11 points in a Duke loss.


title: JJ Redick

text: In a 2005 interview with the "Charlotte Observer", Redick said, "I think I'll be a role player like 80 percent of the players in the league are. I don't expect to be a star, I'll just shoot, be a team player." He moved up into the backup shooting guard position behind well-known veteran and Duke alum Grant Hill.


title: JJ Redick

text: Redick competed against Trevor Ariza and Keith Bogans for the starting shooting guard spot in 2007–08. He was pulled from playing more than once for his lack of defense during the preseason. He came into the season as a third-string player and saw limited action due to back spasms, but moved into limited rotation after Ariza was traded to the Los Angeles Lakers early in the season. In January 2008, Redick posted on his personal blog that "it's been proven that even if I play well in the limited minutes I get that not much is going to change." On January 31, 2008, the "Orlando Sentinel" reported that Redick had asked his agent, Arn Tellem, to inquire about a possible trade. "We want to see what's out there," Redick said. "I want to stay here, but it's been frustrating." Magic coach Stan Van Gundy responded: "Right now it would be very hard to fit him in. I know it's also hard to keep sitting him on the bench... Should we be playing him? Right now we're going good so we probably won't disrupt things." The Orlando Magic confirmed Van Gundy's comments by stating that Redick would not receive more minutes or a trade before the February 21, 2008 trade deadline.


title: JJ Redick

text: In the 2008–09 season, Redick averaged 17.4 minutes per game instead of the previous season's 8.1; he played in 64 games instead of the previous season's 34. He averaged six points per game. The Magic made it to the NBA Finals, but lost to the Lakers in five games. Redick started all seven games in the Eastern Conference Semi-finals in place of regular starter Courtney Lee.


title: JJ Redick

text: On March 28, 2010, Redick set career highs in rebounds (7), assists (8) and minutes played (46). Vince Carter was injured just 95 seconds into the game; backup swingman Mickael Pietrus was also injured, leaving Redick to play the entire game.


title: JJ Redick

text: On July 9, 2010, the Chicago Bulls signed Redick to a three-year, $19 million offer sheet. The Magic matched this offer on July 16, 2010, retaining the rights to Redick. On April 25, 2012, Redick achieved a career high with the Magic, scoring 31 points against the Charlotte Bobcats.


title: JJ Redick

text: On February 21, 2013, Redick was traded from the Magic to the Milwaukee Bucks along with guard Ish Smith and forward Gustavo Ayon for guard Beno Udrih, guard Doron Lamb, and forward Tobias Harris. Redick had difficulties in Milwaukee and his performance suffered.


title: JJ Redick

text: On July 10, 2013, Redick was acquired by the Los Angeles Clippers via a three-team sign-and-trade deal that also involved the Bucks and the Phoenix Suns. Redick reportedly signed a four-year, $27 million contract. Redick started 218 of the first 219 games he played for the Clippers, becoming a "full-fledged starter" in the NBA. On January 15, 2014, Redick scored a then career-high 33 points in a 129–127 win over the Dallas Mavericks.


title: JJ Redick

text: On January 18, 2016, Redick scored a career-high 40 points in a 140–132 overtime win over the Houston Rockets. He connected on his first five attempts behind the arc and finished 9-of-12 on three-pointers, tying Caron Butler's franchise record for three-pointers made in a game. He later competed in the Three-Point Contest during the 2016 NBA All-Star weekend.


title: JJ Redick

text: On November 5, 2016, Redick increased his streak of consecutive games with a made three-pointer to 62, in a 116–92 win over the San Antonio Spurs. He also completed a four-point play against the Spurs, the 26th of his career. On April 12, 2017, Redick made three 3-pointers against Sacramento in the regular-season finale to finish with 201, breaking his career high and single-season franchise record of 200. The Clippers went on to lose in the first round of the NBA playoffs in seven games to the Utah Jazz.


title: JJ Redick

text: On July 8, 2017, Redick signed a one-year, $23 million contract with the Philadelphia 76ers. On November 3, 2017, Redick scored 31 points on 11-of-19 shooting with 8-of-12 from 3-point range in a 121–110 win over the Indiana Pacers. On November 25, 2017, he hit eight 3-pointers and scored 29 points in a 130–111 win over the Orlando Magic. Redick missed seven games in January 2018 with a leg injury.


title: JJ Redick

text: On July 6, 2018, Redick re-signed with the 76ers. Redick was moved to the bench for the start of the 2018–19 season and on October 20, he had his best game since moving to the bench, scoring 31 points on 10-of-20 shooting, including eight 3-pointers, in a 116–115 win over the Magic. On December 19, in a 131–109 win over the New York Knicks, Redick scored his 10,000th career point. On February 8, he scored a season-high 34 points in a 117–110 win over the Denver Nuggets. On March 19, he was two assists shy of his first NBA triple-double in 761 career games, finishing with 27 points, 10 rebounds and eight assists in a 118–114 win over the Charlotte Hornets. In April 2019, Redick set the franchise record for most 3-pointers in a season, surpassing Kyle Korver's mark of 226 set in 2004–05.


title: JJ Redick

text: On July 15, 2019, Redick signed with the New Orleans Pelicans. After finishing the pandemic-shortened season with a record of 30–42, the Pelicans missed the playoffs, marking the first time in Redick's career that he missed the playoffs.


title: JJ Redick

text: He was reunited with his former Magic head coach Van Gundy in his second season in New Orleans. It was around this time that he had decided to leave The ringer that he's been in since 2017 and start all over with a YouTube channel in 2020, putting content out every week going forward.


title: JJ Redick

text: Redick was traded to the Dallas Mavericks on March 26, 2021. He made his debut to the Mavs on April 12.


title: JJ Redick

text: On September 21, 2021, Redick announced his retirement from basketball and stated that "All good things must come to an end. It's a cliche that's used often but rarely does it hold its true meaning. This, however, is not one of those instances."


title: JJ Redick

text: In January 2016, Redick launched a podcast on Yahoo! Sports. He was the first active NBA player and the second active professional athlete to host a podcast. Redick said that he did not get any pushback from the organizations about doing the podcast and attributed that to focusing on getting the basketball work done first.


title: JJ Redick

text: He began in 2016 at Yahoo! Sports. In July 2017, he moved his podcast to Uninterrupted, a media company. After meeting producer and writer Tommy Alter, Redick decided to continue his podcast on The Ringer in 2017. Redick hosted three seasons on the Ringer: two as a solo host, and the third with Alter as co-host.


title: JJ Redick

text: In 2020, he left The Ringer to own his content and start his own media company, co-founding ThreeFourTwo Productions with Alter, a reference to the 342 shots he would take every Sunday during the off-season. He currently hosts "The Old Man and the Three" along with Alter. The podcast premiered August 5, 2020 inside the NBA bubble in Orlando, Florida with Portland Trail Blazers guard Damian Lillard as the first guest. Redick's "The Old Man and the Three" has over 180 million views on YouTube and 4.8 stars on Apple Podcasts.


title: JJ Redick

text: Following his retirement, Redick became an on-air sports analyst for ESPN. Redick made his debut on November 3 as a studio analyst for coverage of the Brooklyn Nets-Atlanta Hawks game.


title: JJ Redick

text: Redick was a member of the 2003 USA Men's Junior World Championship Team. In 2005, he competed with the USA Basketball Under-21 Team, in Frisco, Texas, which won gold medals at the World Championships and the Global Games. In 2006, Redick was named to the USA national team 2006–2008 National Team Program. He competed for a spot with the 2008 Olympic Team, but was not placed on the final roster. A recurring back injury kept him from competing in the 2007 FIBA Americas Championship.


title: JJ Redick

text: Redick was born in Cookeville, Tennessee, the son of Jeanie and Ken Redick. His father played basketball for two seasons at Ohio Wesleyan University, and his older twin sisters, Catie and Alyssa, both played for Campbell University. His younger brother, David, was a tight end for the Marshall University's football team until he decided not to play due to injury. He then moved to Orlando with JJ before going back home and attending Virginia Tech. His youngest sister, Abigail, played basketball for Virginia Tech and Drexel University. Redick was nicknamed "JJ" as a toddler because his twin sisters repeated his original nickname of "J". His father's background as a stoneware potter led to his middle name, "Clay." Redick graduated from Duke University with a major in history and a minor in cultural anthropology.


title: JJ Redick

text: Redick is a Christian. Redick has four tattoos of Bible verses: Isaiah 40:31, Joshua 1:9, Psalm 40:1–3, and Philippians 4:13.


title: JJ Redick

text: On June 13, 2006, Redick was arrested and charged with driving under the influence of alcohol in Durham County, North Carolina. His blood-alcohol level was 0.11, while the legal limit in North Carolina is 0.08. Redick was released on a $1,000 bond shortly after being arrested. Redick pleaded guilty.


title: JJ Redick

text: On June 26, 2010, Redick married longtime girlfriend Chelsea Kilgore. They have two children together, Knox and Kai.


title: A. R. Rahman discography

text: A. R. Rahman made his debut in Indian Music Industry with the 1992 Tamil film "Roja". In his three decade long career, he has composed and produced original scores and songs for more than 145 films in various languages, namely Tamil, Hindi, Telugu, Malayalam, English, Persian and Mandarin.


title: A. R. Rahman discography

text: "Bombay Theme" is alternatively credited as "Bombay Theme Tune," "Mumbai Theme Tune" or "Bombay Theme Music" in compilations


title: A. R. Rahman discography

text: Rahman released five original ringtones in 2002 exclusive to Airtel customers. Later, he released another ringtone "Disabled Film" for the same brand. In 2010, he composed a ringtone for Lebara Mobile.


title: Bree Olson

text: Rachel Marie Oberlin (born October 7, 1986), also known by her stage name Bree Olson, is an American actress, model, and former pornographic actress. She performed in over 600 pornographic films from 2006 to 2011. Since leaving the adult film industry, she has become critical of the industry and the stigma attached to being a former porn actress.


title: Bree Olson

text: Olson was born in Houston, Texas. Olson's mother and stepfather moved with her to Fort Wayne, Indiana when she was two years old.


title: Bree Olson

text: Olson entered the pornographic film industry in November 2006, and initially worked for a variety of companies such as Digital Playground, Elegant Angel, and Red Light District Video. She was a contract performer with Adam & Eve from 2007 to 2010. She has performed in over 280 pornographic movies.


title: Bree Olson

text: Olson was named "Penthouse" Pet of the Month for March 2008. In 2010, she was named by "Maxim" as one of the 12 top female stars in porn. She appeared on the cover of the May 2011 issue of "Penthouse", on the cover of the August 2011 issue of "Playboy" magazine, and on the cover of the July 2013 issue of "Hustler" magazine. She retired from shooting pornography in 2011 at the age of 25.


title: Bree Olson

text: In 2007, Olson appeared in an episode of the first season of E! reality show "Keeping Up with the Kardashians", in which she is hired as a nanny but ostensibly gets fired on her first day at work after matriarch Kris Jenner objects to her state of dress and behavior as "inappropriate." She later appeared in the independent comedy film "Purgatory Comics" (2009).


title: Bree Olson

text: Olson co-starred in the horror film "The Human Centipede 3 (Final Sequence)" (2015) and Penn Jillette and Adam Rifkin's "Director's Cut" (2016). In 2015, she played Divatox in the short, web film "Power/Rangers".


title: Bree Olson

text: In February 2011, Olson moved in with actor Charlie Sheen as one of his two "goddesses." The relationship ended in April 2011.


title: Bree Olson

text: On March 24, 2016, writing as a guest columnist in "Daily Dot", she related her post-porn social life, stating, "porn didn't hurt me. The way society treats me for having done it does". In the same article, she said she was "broke". This article was later followed by her March 25 appearance in the YouTube documentary series "Real Women, Real Stories", in which she repeated these statements, adding that she believes society in general perceives ex-porn stars in a highly negative manner, specifically as morally akin to pedophiles. She is also critical of the pornography industry, noting "We are the only entertainment industry that doesn't offer talent royalties after they are gone," but not of the profession itself.


title: Bree Olson

text: On February 3, 2011, Olson was arrested and charged with driving under the influence in her home town of Fort Wayne, Indiana. She pleaded guilty to the DUI charge and received a year of probation and requirement to perform community service.


title: Prisoner of war

text: A prisoner of war (POW) is a person who is held captive by a belligerent power during or immediately after an armed conflict. The earliest recorded usage of the phrase "prisoner of war" dates back to 1610.


title: Prisoner of war

text: Belligerents hold prisoners of war in custody for a range of legitimate and illegitimate reasons, such as isolating them from the enemy combatants still in the field (releasing and repatriating them in an orderly manner after hostilities), demonstrating military victory, punishing them, prosecuting them for war crimes, exploiting them for their labour, recruiting or even conscripting them as their own combatants, collecting military and political intelligence from them, or indoctrinating them in new political or religious beliefs.


title: Prisoner of war

text: For most of human history, depending on the culture of the victors, enemy fighters on the losing side in a battle who had surrendered and been taken as prisoners of war could expect to be either slaughtered or enslaved. Early Roman gladiators could be prisoners of war, categorised according to their ethnic roots as Samnites, Thracians, and Gauls ("Galli"). Homer's "Iliad" describes Greek and Trojan soldiers offering rewards of wealth to opposing forces who have defeated them on the battlefield in exchange for mercy, but their offers are not always accepted; see Lycaon for example.


title: Prisoner of war

text: Typically, victors made little distinction between enemy combatants and enemy civilians, although they were more likely to spare women and children. Sometimes the purpose of a battle, if not of a war, was to capture women, a practice known as "raptio"; the Rape of the Sabines involved, according to tradition, a large mass-abduction by the founders of Rome. Typically women had no rights, and were held legally as chattels.


title: Prisoner of war

text: In the fourth century AD, Bishop Acacius of Amida, touched by the plight of Persian prisoners captured in a recent war with the Roman Empire, who were held in his town under appalling conditions and destined for a life of slavery, took the initiative in ransoming them by selling his church's precious gold and silver vessels and letting them return to their country. For this he was eventually canonized.


title: Prisoner of war

text: According to legend, during Childeric's siege and blockade of Paris in 464 the nun Geneviève (later canonised as the city's patron saint) pleaded with the Frankish king for the welfare of prisoners of war and met with a favourable response. Later, Clovis I () liberated captives after Genevieve urged him to do so.


title: Prisoner of war

text: King Henry V's English army killed many French prisoners of war after the Battle of Agincourt in 1415. This was done in retaliation for the French killing of the boys and other non-combatants handling the baggage and equipment of the army, and because the French were attacking again and Henry was afraid that they would break through and free the prisoners to fight again.


title: Prisoner of war

text: In the later Middle Ages a number of religious wars aimed to not only defeat but also to eliminate enemies. Authorities in Christian Europe often considered the extermination of heretics and heathens desirable. Examples of such wars include the 13th-century Albigensian Crusade in Languedoc and the Northern Crusades in the Baltic region. When asked by a Crusader how to distinguish between the Catholics and Cathars following the projected capture (1209) of the city of Béziers, the papal legate Arnaud Amalric allegedly replied, "Kill them all, God will know His own".


title: Prisoner of war

text: Likewise, the inhabitants of conquered cities were frequently massacred during Christians' Crusades against Muslims in the 11th and 12th centuries. Noblemen could hope to be ransomed; their families would have to send to their captors large sums of wealth commensurate with the social status of the captive.


title: Prisoner of war

text: Feudal Japan had no custom of ransoming prisoners of war, who could expect for the most part summary execution.


title: Prisoner of war

text: In the 13th century the expanding Mongol Empire famously distinguished between cities or towns that surrendered (where the population was spared but required to support the conquering Mongol army) and those that resisted (in which case the city was ransacked and destroyed, and all the population killed). In Termez, on the Oxus: "all the people, both men and women, were driven out onto the plain, and divided in accordance with their usual custom, then they were all slain".


title: Prisoner of war

text: The Aztecs warred constantly with neighbouring tribes and groups, aiming to collect live prisoners for sacrifice. For the re-consecration of Great Pyramid of Tenochtitlan in 1487, "between 10,000 and 80,400 persons" were sacrificed.


title: Prisoner of war

text: During the early Muslim conquests of 622–750, Muslims routinely captured large numbers of prisoners. Aside from those who converted, most were ransomed or enslaved. Christians captured during the Crusades were usually either killed or sold into slavery if they could not pay a ransom. During his lifetime ( – 632), Muhammad made it the responsibility of the Islamic government to provide food and clothing, on a reasonable basis, to captives, regardless of their religion; however, if the prisoners were in the custody of a person, then the responsibility was on the individual. The freeing of prisoners was highly recommended as a charitable act.


title: Prisoner of war

text: On certain occasions where Muhammad felt the enemy had broken a treaty with the Muslims he endorsed the mass execution of male prisoners who participated in battles, as in the case of the Banu Qurayza in 627. The Muslims divided up the females and children of those executed as "ghanima" (spoils of war).


title: Prisoner of war

text: In Europe, the treatment of prisoners of war became increasingly centralized, in the time period between the 16th and late 18th century. Whereas prisoners of war had previously been regarded as the private property of the captor, captured enemy soldiers became increasingly regarded as the property of the state. The European states strove to exert increasing control over all stages of captivity, from the question of who would be attributed the status of prisoner of war to their eventual release. The act of surrender was regulated so that it, ideally, should be legitimized by officers, who negotiated the surrender of their whole unit. Soldiers whose style of fighting did not conform to the battle line tactics of regular European armies, such as Cossacks and Croats, were often denied the status of prisoners of war.


title: Prisoner of war

text: In line with this development the treatment of prisoners of war became increasingly regulated in interactional treaties, particularly in the form of the so-called cartel system, which regulated how the exchange of prisoners would be carried out between warring states. Another such treaty was the 1648 Peace of Westphalia, which ended the Thirty Years' War. This treaty established the rule that prisoners of war should be released without ransom at the end of hostilities and that they should be allowed to return to their homelands.


title: Prisoner of war

text: There also evolved the right of "parole", French for "discourse", in which a captured officer surrendered his sword and gave his word as a gentleman in exchange for privileges. If he swore not to escape, he could gain better accommodations and the freedom of the prison. If he swore to cease hostilities against the nation who held him captive, he could be repatriated or exchanged but could not serve against his former captors in a military capacity.


title: Prisoner of war

text: Early historical narratives of captured European settlers, including perspectives of literate women captured by the indigenous peoples of North America, exist in some number. The writings of Mary Rowlandson, captured in the chaotic fighting of King Philip's War, are an example. Such narratives enjoyed some popularity, spawning a genre of the captivity narrative, and had lasting influence on the body of early American literature, most notably through the legacy of James Fenimore Cooper's "The Last of the Mohicans". Some Native Americans continued to capture Europeans and use them both as labourers and bargaining chips into the 19th century; see for example John R. Jewitt, a sailor who wrote a memoir about his years as a captive of the Nootka people on the Pacific Northwest coast from 1802 to 1805.


title: Prisoner of war

text: The earliest known purpose-built prisoner-of-war camp was established at Norman Cross in Huntingdonshire, England in 1797 to house the increasing number of prisoners from the French Revolutionary Wars and the Napoleonic Wars. The average prison population was about 5,500 men. The lowest number recorded was 3,300 in October 1804 and 6,272 on 10 April 1810 was the highest number of prisoners recorded in any official document. Norman Cross Prison was intended to be a model depot providing the most humane treatment of prisoners of war. The British government went to great lengths to provide food of a quality at least equal to that available to locals. The senior officer from each quadrangle was permitted to inspect the food as it was delivered to the prison to ensure it was of sufficient quality. Despite the generous supply and quality of food, some prisoners died of starvation after gambling away their rations. Most of the men held in the prison were low-ranking soldiers and sailors, including midshipmen and junior officers, with a small number of privateers. About 100 senior officers and some civilians "of good social standing", mainly passengers on captured ships and the wives of some officers, were given "parole" outside the prison, mainly in Peterborough although some further afield. They were afforded the courtesy of their rank within English society.


title: Prisoner of war

text: During the Battle of Leipzig both sides used the city's cemetery as a lazaret and prisoner camp for around 6,000 POWs who lived in the burial vaults and used the coffins for firewood. Food was scarce and prisoners resorted to eating horses, cats, dogs or even human flesh. The bad conditions inside the graveyard contributed to a city-wide epidemic after the battle.


title: Prisoner of war

text: The extensive period of conflict during the American Revolutionary War and Napoleonic Wars (1793–1815), followed by the Anglo-American War of 1812, led to the emergence of a cartel system for the exchange of prisoners, even while the belligerents were at war. A cartel was usually arranged by the respective armed service for the exchange of like-ranked personnel. The aim was to achieve a reduction in the number of prisoners held, while at the same time alleviating shortages of skilled personnel in the home country.


title: Prisoner of war

text: At the start of the American Civil War a system of paroles operated. Captives agreed not to fight until they were officially exchanged. Meanwhile, they were held in camps run by their own army where they were paid but not allowed to perform any military duties. The system of exchanges collapsed in 1863 when the Confederacy refused to exchange black prisoners. In the late summer of 1864, a year after the Dix–Hill Cartel was suspended, Confederate officials approached Union General Benjamin Butler, Union Commissioner of Exchange, about resuming the cartel and including the black prisoners. Butler contacted Grant for guidance on the issue, and Grant responded to Butler on 18 August 1864 with his now famous statement. He rejected the offer, stating in essence, that the Union could afford to leave their men in captivity, the Confederacy could not. After that about 56,000 of the 409,000 POWs died in prisons during the American Civil War, accounting for nearly 10% of the conflict's fatalities. Of the 45,000 Union prisoners of war confined in Camp Sumter, located near Andersonville, Georgia, 13,000 (28%) died. At Camp Douglas in Chicago, Illinois, 10% of its Confederate prisoners died during one cold winter month; and Elmira Prison in New York state, with a death rate of 25% (2,963), nearly equalled that of Andersonville.


title: Prisoner of war

text: During the 19th century, there were increased efforts to improve the treatment and processing of prisoners. As a result of these emerging conventions, a number of international conferences were held, starting with the Brussels Conference of 1874, with nations agreeing that it was necessary to prevent inhumane treatment of prisoners and the use of weapons causing unnecessary harm. Although no agreements were immediately ratified by the participating nations, work was continued that resulted in new conventions being adopted and becoming recognized as international law that specified that prisoners of war be treated humanely and diplomatically.


title: Prisoner of war

text: Chapter II of the Annex to the 1907 Hague Convention "IV – The Laws and Customs of War on Land" covered the treatment of prisoners of war in detail. These provisions were further expanded in the 1929 Geneva Convention on the Prisoners of War and were largely revised in the Third Geneva Convention in 1949.


title: Prisoner of war

text: Article 4 of the Third Geneva Convention protects captured military personnel, some guerrilla fighters, and certain civilians. It applies from the moment a prisoner is captured until their release or repatriation. One of the main provisions of the convention makes it illegal to torture prisoners and states that a prisoner can only be required to give their name, date of birth, rank and service number (if applicable).


title: Prisoner of war

text: The ICRC has a special role to play, with regards to international humanitarian law, in restoring and maintaining family contact in times of war, in particular concerning the right of prisoners of war and internees to send and receive letters and cards (Geneva Convention (GC) III, art.71 and GC IV, art.107).


title: Prisoner of war

text: However, nations vary in their dedication to following these laws, and historically the treatment of POWs has varied greatly. During World War II, Imperial Japan and Nazi Germany (towards Soviet POWs and Western Allied commandos) were notorious for atrocities against prisoners of war. The German military used the Soviet Union's refusal to sign the Geneva Convention as a reason for not providing the necessities of life to Soviet POWs; and the Soviets also used Axis prisoners as forced labour. The Germans also routinely executed Allied commandos captured behind German lines per the Commando Order.


title: Prisoner of war

text: To be entitled to prisoner-of-war status, captured persons must be lawful combatants entitled to combatant's privilege—which gives them immunity from punishment for crimes constituting lawful acts of war such as killing enemy combatants. To qualify under the Third Geneva Convention, a combatant must be part of a chain of command, wear a "fixed distinctive marking, visible from a distance", bear arms openly, and have conducted military operations according to the laws and customs of war. (The Convention recognizes a few other groups as well, such as "[i]nhabitants of a non-occupied territory, who on the approach of the enemy spontaneously take up arms to resist the invading forces, without having had time to form themselves into regular armed units".)


title: Prisoner of war

text: Thus, uniforms and badges are important in determining prisoner-of-war status under the Third Geneva Convention. Under Additional Protocol I, the requirement of a distinctive marking is no longer included. "Francs-tireurs", militias, insurgents, terrorists, saboteurs, mercenaries, and spies generally do not qualify because they do not fulfill the criteria of Additional Protocol 1. Therefore, they fall under the category of unlawful combatants, or more properly they are not combatants. Captured soldiers who do not get prisoner of war status are still protected like civilians under the Fourth Geneva Convention.


title: Prisoner of war

text: The criteria are applied primarily to "international" armed conflicts. The application of prisoner of war status in non-international armed conflicts like civil wars is guided by Additional Protocol II, but insurgents are often treated as traitors, terrorists or criminals by government forces and are sometimes executed on spot or tortured. However, in the American Civil War, both sides treated captured troops as POWs presumably out of reciprocity, although the Union regarded Confederate personnel as separatist rebels. However, guerrillas and other irregular combatants generally cannot expect to receive benefits from both civilian and military status simultaneously.


title: Prisoner of war

text: In addition, if wounded or sick on the battlefield, the prisoner will receive help from the International Committee of the Red Cross.


title: Prisoner of war

text: When a country is responsible for breaches of prisoner of war rights, those accountable will be punished accordingly. An example of this is the Nuremberg and Tokyo Trials. German and Japanese military commanders were prosecuted for preparing and initiating a war of aggression, murder, ill treatment, and deportation of individuals, and genocide during World War II. Most were executed or sentenced to life in prison for their crimes.


title: Prisoner of war

text: The United States Military Code of Conduct was promulgated in 1955 via under President Dwight D. Eisenhower to serve as a moral code for United States service members who have been taken prisoner. It was created primarily in response to the breakdown of leadership and organization, specifically when U.S. forces were POWs during the Korean War.


title: Prisoner of war

text: When a military member is taken prisoner, the Code of Conduct reminds them that the chain of command is still in effect (the highest ranking service member eligible for command, regardless of service branch, is in command), and requires them to support their leadership. The Code of Conduct also requires service members to resist giving information to the enemy (beyond identifying themselves, that is, "name, rank, serial number"), receiving special favours or parole, or otherwise providing their enemy captors aid and comfort.


title: Prisoner of war

text: Since the Vietnam War, the official U.S. military term for enemy POWs is EPW (Enemy Prisoner of War). This name change was introduced in order to distinguish between enemy and U.S. captives.


title: Prisoner of war

text: In 2000, the U.S. military replaced the designation "Prisoner of War" for captured American personnel with "Missing-Captured". A January 2008 directive states that the reasoning behind this is since "Prisoner of War" is the international legal recognized status for such people there is no need for any individual country to follow suit. This change remains relatively unknown even among experts in the field and "Prisoner of War" remains widely used in the Pentagon which has a "POW/Missing Personnel Office" and awards the Prisoner of War Medal.


title: Prisoner of war

text: During World War I, about eight million men surrendered and were held in POW camps until the war ended. All nations pledged to follow the Hague rules on fair treatment of prisoners of war, and in general the POWs had a much higher survival rate than their peers who were not captured. Individual surrenders were uncommon; usually a large unit surrendered all its men. At Tannenberg 92,000 Russians surrendered during the battle. When the besieged garrison of Kaunas surrendered in 1915, 20,000 Russians became prisoners. Over half the Russian losses were prisoners as a proportion of those captured, wounded or killed. About 3.3 million men became prisoners.


title: Prisoner of war

text: The German Empire held 2.5 million prisoners; Russia held 2.9 million, and Britain and France held about 720,000, mostly gained in the period just before the Armistice in 1918. The US held 48,000. The most dangerous moment for POWs was the act of surrender, when helpless soldiers were sometimes killed or mistakenly shot down. Once prisoners reached a POW camp conditions were better (and often much better than in World War II), thanks in part to the efforts of the International Red Cross and inspections by neutral nations.


title: Prisoner of war

text: There was much harsh treatment of POWs in Germany, as recorded by the American ambassador (prior to America's entry into the war), James W. Gerard, who published his findings in "My Four Years in Germany". Even worse conditions are reported in the book "Escape of a Princess Pat" by the Canadian George Pearson. It was particularly bad in Russia, where starvation was common for prisoners and civilians alike; a quarter of the over 2 million POWs held there died. Nearly 375,000 of the 500,000 Austro-Hungarian prisoners of war taken by Russians perished in Siberia from smallpox and typhus. In Germany, food was short, but only 5 per cent died.


title: Prisoner of war

text: The Ottoman Empire often treated prisoners of war poorly. Some 11,800 British soldiers, most from the British Indian Army, became prisoners after the five-month Siege of Kut, in Mesopotamia, in April 1916. Many were weak and starved when they surrendered and 4,250 died in captivity.


title: Prisoner of war

text: During the Sinai and Palestine campaign 217 Australian and unknown numbers of British, New Zealand and Indian soldiers were captured by Ottoman forces. About 50 per cent of the Australian prisoners were light horsemen including 48 missing believed captured on 1 May 1918 in the Jordan Valley. Australian Flying Corps pilots and observers were captured in the Sinai Peninsula, Palestine and the Levant. One third of all Australian prisoners were captured on Gallipoli including the crew of the submarine AE2 which made a passage through the Dardanelles in 1915. Forced marches and crowded railway journeys preceded years in camps where disease, poor diet and inadequate medical facilities prevailed. About 25 per cent of other ranks died, many from malnutrition, while only one officer died. The most curious case came in Russia where the Czechoslovak Legion of Czechoslovak prisoners (from the Austro-Hungarian army) who were released and armed to fight on the side of the Entente, who briefly served as a military and diplomatic force during the Russian Civil War.


title: Prisoner of war

text: At the end of the war in 1918 there were believed to be 140,000 British prisoners of war in Germany, including thousands of internees held in neutral Switzerland. The first British prisoners were released and reached Calais on 15 November. Plans were made for them to be sent via Dunkirk to Dover and a large reception camp was established at Dover capable of housing 40,000 men, which could later be used for demobilisation.


title: Prisoner of war

text: On 13 December 1918, the armistice was extended and the Allies reported that by 9 December 264,000 prisoners had been repatriated. A very large number of these had been released "en masse" and sent across Allied lines without any food or shelter. This created difficulties for the receiving Allies and many ex-prisoners died from exhaustion. The released POWs were met by cavalry troops and sent back through the lines in lorries to reception centres where they were refitted with boots and clothing and dispatched to the ports in trains.


title: Prisoner of war

text: Upon arrival at the receiving camp the POWs were registered and "boarded" before being dispatched to their own homes. All commissioned officers had to write a report on the circumstances of their capture and to ensure that they had done all they could to avoid capture. Each returning officer and man was given a message from King George V, written in his own hand and reproduced on a lithograph.


title: Prisoner of war

text: While the Allied prisoners were sent home at the end of the war, the same treatment was not granted to Central Powers prisoners of the Allies and Russia, many of whom had to serve as forced labour, e.g. in France, until 1920. They were released after many approaches by the ICRC to the Allied Supreme Council.


title: Prisoner of war

text: Historian Niall Ferguson, in addition to figures from Keith Lowe, tabulated the total death rate for POWs in World War II as follows:


title: Prisoner of war

text: The Empire of Japan, which had signed but never ratified the 1929 Geneva Convention on Prisoners of War, did not treat prisoners of war in accordance with international agreements, including provisions of the Hague Conventions, either during the Second Sino-Japanese War or during the Pacific War, because the Japanese viewed surrender as dishonorable. Moreover, according to a directive ratified on 5 August 1937 by Hirohito, the constraints of the Hague Conventions were explicitly removed on Chinese prisoners.


title: Prisoner of war

text: Prisoners of war from China, the United States, Australia, Britain, Canada, India, the Netherlands, New Zealand, and the Philippines held by Japanese imperial armed forces were subject to murder, beatings, summary punishment, brutal treatment, slavery, medical experiments, starvation rations, poor medical treatment and cannibalism. The most notorious use of forced labour was in the construction of the Burma–Thailand Death Railway. After 20 March 1943, the Imperial Navy was ordered to kill prisoners taken at sea. After the Armistice of Cassibile, Italian soldiers and civilians in East Asia were taken as prisoners by Japanese armed forces and subject to the same conditions as other POWs.


title: Prisoner of war

text: According to the findings of the Tokyo Tribunal, the death rate of Western prisoners was 27.1 per cent, seven times that of POWs under the Germans and Italians. The death rate of Chinese was much higher. Thus, while 37,583 prisoners from the United Kingdom, Commonwealth, and Dominions, 28,500 from the Netherlands, and 14,473 from the United States were released after the surrender of Japan, the number for the Chinese was only 56. The 27,465 United States Army and United States Army Air Forces POWs in the Pacific Theater had a 40.4 per cent death rate. The War Ministry in Tokyo issued an order at the end of the war to kill the remaining POWs.


title: Prisoner of war

text: No direct access to the POWs was provided to the International Red Cross. Escapes among Caucasian prisoners were almost impossible because of the difficulty of hiding in Asiatic societies.


title: Prisoner of war

text: Allied POW camps and ship-transports were sometimes accidental targets of Allied attacks. The number of deaths which occurred when Japanese "hell ships"—unmarked transport ships in which POWs were transported in harsh conditions—were attacked by U.S. Navy submarines was particularly high. Gavan Daws has calculated that "of all POWs who died in the Pacific War, one in three was killed on the water by friendly fire". Daws states that 10,800 of the 50,000 POWs shipped by the Japanese were killed at sea while Donald L. Miller states that "approximately 21,000 Allied POWs died at sea, about 19,000 of them killed by friendly fire."


title: Prisoner of war

text: Life in the POW camps was recorded at great risk to themselves by artists such as Jack Bridger Chalker, Philip Meninsky, Ashley George Old, and Ronald Searle. Human hair was often used for brushes, plant juices and blood for paint, toilet paper as the "canvas". Some of their works were used as evidence in the trials of Japanese war criminals.


title: Prisoner of war

text: Female prisoners (detainees) at Changi Prison in Singapore, recorded their ordeal in seemingly harmless prison quilt embroidery.


title: Prisoner of war

text: Research into the conditions of the camps has been conducted by The Liverpool School of Tropical Medicine.


title: Prisoner of war

text: After the French armies surrendered in summer 1940, Germany seized two million French prisoners of war and sent them to camps in Germany. About one third were released on various terms. Of the remainder, the officers and non-commissioned officers were kept in camps and did not work. The privates were sent out to work. About half of them worked for German agriculture, where food supplies were adequate and controls were lenient. The others worked in factories or mines, where conditions were much harsher.


title: Prisoner of war

text: Germany and Italy generally treated prisoners from the British Empire and Commonwealth, France, the U.S., and other western Allies in accordance with the Geneva Convention, which had been signed by these countries. Consequently, western Allied officers were not usually made to work and some personnel of lower rank were usually compensated, or not required to work either. The main complaints of western Allied prisoners of war in German POW camps—especially during the last two years of the war—concerned shortages of food.


title: Prisoner of war

text: Only a small proportion of western Allied POWs who were Jews—or whom the Nazis believed to be Jewish—were killed as part of the Holocaust or were subjected to other antisemitic policies. For example, Major Yitzhak Ben-Aharon, a Palestinian Jew who had enlisted in the British Army, and who was captured by the Germans in Greece in 1941, experienced four years of captivity under entirely normal conditions for POWs.


title: Prisoner of war

text: A small number of Allied personnel were sent to concentration camps, for a variety of reasons including being Jewish. As the US historian Joseph Robert White put it: "An important exception ... is the sub-camp for U.S. POWs at Berga an der Elster, officially called "Arbeitskommando 625" [also known as "Stalag IX-B"]. Berga was the deadliest work detachment for American captives in Germany. 73 men who participated, or 21 percent of the detachment, perished in two months. 80 of the 350 POWs were Jews." Another well-known example was a group of 168 Australian, British, Canadian, New Zealand and US aviators who were held for two months at Buchenwald concentration camp; two of the POWs died at Buchenwald. Two possible reasons have been suggested for this incident: German authorities wanted to make an example of "Terrorflieger" ("terrorist aviators") or these aircrews were classified as spies, because they had been disguised as civilians or enemy soldiers when they were apprehended.


title: Prisoner of war

text: Information on conditions in the stalags is contradictory depending on the source. Some American POWs claimed the Germans were victims of circumstance and did the best they could, while others accused their captors of brutalities and forced labour. In any case, the prison camps were miserable places where food rations were meager and conditions squalid. One American admitted "The only difference between the stalags and concentration camps was that we weren't gassed or shot in the former. I do not recall a single act of compassion or mercy on the part of the Germans." Typical meals consisted of a bread slice and watery potato soup which was still more substantial than what Soviet POWs or concentration camp inmates received. Another prisoner stated that "The German plan was to keep us alive, yet weakened enough that we wouldn't attempt escape."


title: Prisoner of war

text: As the Red Army approached some POW camps in early 1945, German guards forced western Allied POWs to walk long distances towards central Germany, often in extreme winter weather conditions. It is estimated that, out of 257,000 POWs, about 80,000 were subject to such marches and up to 3,500 of them died as a result.


title: Prisoner of war

text: In September 1943 after the Armistice, Italian officers and soldiers many places waiting for orders were arrested by Germans and Italian fascists and taken to internment camps in Germany or Eastern Europe, where they were held for the duration of the war. The International Red Cross could do nothing for them, as they were not regarded as POWs, but the prisoners held the status of "military internees". Treatment of the prisoners was generally poor. The author Giovannino Guareschi was among those interned and wrote about this time in his life. The book was translated and published as "My Secret Diary". He wrote about semi-starvation, the casual murder of individual prisoners by guards and how, when they were released (now from a German camp), they found a deserted German town filled with foodstuffs that they (with other released prisoners) ate.. It is estimated that of the 700,000 Italians taken prisoner by the Germans, around 40,000 died in detention and more than 13,000 lost their lives during the transportation from the Greek islands to the mainland.


title: Prisoner of war

text: Germany did not apply the same standard of treatment to non-western prisoners, especially many Polish and Soviet POWs who suffered harsh conditions and died in large numbers while in captivity.


title: Prisoner of war

text: Between 1941 and 1945 the Axis powers took about 5.7 million Soviet prisoners. About one million of them were released during the war, in that their status changed but they remained under German authority. A little over 500,000 either escaped or were liberated by the Red Army. Some 930,000 more were found alive in camps after the war. The remaining 3.3 million prisoners (57.5% of the total captured) died during their captivity. Between the launching of Operation Barbarossa in the summer of 1941 and the following spring, 2.8 million of the 3.2 million Soviet prisoners taken died while in German hands. According to Russian military historian General Grigoriy Krivosheyev, the Axis powers took 4.6 million Soviet prisoners, of whom 1.8 million were found alive in camps after the war and 318,770 were released by the Axis during the war and were then drafted into the Soviet armed forces again. By comparison, 8,348 Western Allied prisoners died in German camps during 1939–45 (3.5% of the 232,000 total).


title: Prisoner of war

text: The Germans officially justified their policy on the grounds that the Soviet Union had not signed the Geneva Convention. Legally, however, under article 82 of the Geneva Convention, signatory countries had to give POWs of all signatory and non-signatory countries the rights assigned by the convention. Shortly after the German invasion in 1941, the USSR made Berlin an offer of a reciprocal adherence to the Hague Conventions. Third Reich officials left the Soviet "note" unanswered. In contrast, Nikolai Tolstoy recounts that the German Government – as well as the International Red Cross – made several efforts to regulate reciprocal treatment of prisoners until early 1942, but received no answers from the Soviet side. Further, the Soviets took a harsh position towards captured Soviet soldiers, as they expected each soldier to fight to the death, and automatically excluded any prisoner from the "Russian community".


title: Prisoner of war

text: Some Soviet POWs and forced labourers whom the Germans had transported to Nazi Germany were, on their return to the USSR, treated as traitors and sent to gulag prison-camps.


title: Prisoner of war

text: According to some sources, the Soviets captured 3.5 million Axis servicemen (excluding Japanese), of whom more than a million died. One specific example is that of the German POWs after the Battle of Stalingrad, where the Soviets captured 91,000 German troops in total (completely exhausted, starving and sick), of whom only 5,000 survived the captivity.


title: Prisoner of war

text: German soldiers were kept as forced labour for many years after the war. The last German POWs like Erich Hartmann, the highest-scoring fighter ace in the history of aerial warfare, who had been declared guilty of war crimes but without due process, were not released by the Soviets until 1955, two years after Stalin died.


title: Prisoner of war

text: As a result of the Soviet invasion of Poland in 1939, hundreds of thousands of Polish soldiers became prisoners of war in the Soviet Union. Thousands were executed; over 20,000 Polish military personnel and civilians perished in the Katyn massacre. Out of Anders' 80,000 evacuees from the Soviet Union in the United Kingdom, only 310 volunteered to return to Poland in 1947.


title: Prisoner of war

text: After the Soviet–Japanese War, 560,000 to 760,000 Japanese prisoners of war were captured by the Soviet Union. The prisoners were captured in Manchuria, Korea, South Sakhalin and the Kuril Islands, then sent to work as forced labour in the Soviet Union and Mongolia. An estimated 60,000 to 347,000 of these Japanese prisoners of war died in captivity.


title: Prisoner of war

text: Stories that circulated during the Cold War claimed 23,000 Americans held in German POW camps had been seized by the Soviets and never been repatriated. The claims had been perpetuated after the release of people like John H. Noble. Careful scholarly studies demonstrated that this was a myth based on the misinterpretation of a telegram about Soviet prisoners held in Italy.


title: Prisoner of war

text: During the war, the armies of Western Allied nations such as Australia, Canada, the UK and the US were given orders to treat Axis prisoners strictly in accordance with the Geneva Convention. Some breaches of the Convention took place, however. According to Stephen E. Ambrose, of the roughly 1,000 US combat veterans he had interviewed, only one admitted to shooting a prisoner, saying he "felt remorse, but would do it again". However, one-third of interviewees told him they had seen fellow US troops kill German prisoners.


title: Prisoner of war

text: In Britain, German prisoners, particularly higher-ranked officers, were housed in luxurious buildings where listening devices were installed. A considerable amount of military intelligence was gained from eavesdropping on what the officers believed were private casual conversations. Much of the listening was carried out by German refugees, in many cases Jews. The work of these refugees in contributing to the Allied victory was declassified over half a century later.


title: Prisoner of war

text: In February 1944, 59.7% of POWs in America were employed. This relatively low percentage was due to problems setting wages that would not compete against those of non-prisoners, to union opposition, as well as concerns about security, sabotage, and escape. Given national manpower shortages, citizens and employers resented the idle prisoners, and efforts were made to decentralize the camps and reduce security enough that more prisoners could work. By the end of May 1944, POW employment was at 72.8%, and by late April 1945 it had risen to 91.3%. The sector that made the most use of POW workers was agriculture. There was more demand than supply of prisoners throughout the war, and 14,000 POW repatriations were delayed in 1946 so prisoners could be used in the spring farming seasons, mostly to thin and block sugar beets in the west. While some in Congress wanted to extend POW labour beyond June 1946, President Truman rejected this, leading to the end of the program.


title: Prisoner of war

text: Towards the end of the war in Europe, as large numbers of Axis soldiers surrendered, the US created the designation of Disarmed Enemy Forces (DEF) so as not to treat prisoners as POWs. A lot of these soldiers were kept in open fields in makeshift camps in the Rhine valley ("Rheinwiesenlager"). Controversy has arisen about how Eisenhower managed these prisoners. (see "Other Losses").


title: Prisoner of war

text: After the surrender of Germany in May 1945, the POW status of the German prisoners was in many cases maintained, and they were for several years used as public labourers in countries such as the UK and France. Many died when forced to clear minefields in countries such as Norway and France. "By September 1945 it was estimated by the French authorities that two thousand prisoners were being maimed and killed each month in accidents".


title: Prisoner of war

text: In 1946, the UK held over 400,000 German POWs, many having been transferred from POW camps in the US and Canada. They were employed as labourers to compensate for the lack of manpower in Britain, as a form of war reparation. A public debate ensued in the U.K. over the treatment of German prisoners of war, with many in Britain comparing the treatment to the POWs to slave labour. In 1947, the Ministry of Agriculture argued against repatriation of working German prisoners, since by then they made up 25 percent of the land workforce, and it wanted to continue having them work in the UK until 1948.


title: Prisoner of war

text: The "London Cage", an MI19 prisoner of war facility in London used during and immediately after the war to interrogate prisoners before sending them to prison camps, was subject to allegations of torture.


title: Prisoner of war

text: After the German surrender, the International Red Cross was prohibited from providing aid, such as food or prisoner visits, to POW camps in Germany. However, after making appeals to the Allies in the autumn of 1945, the Red Cross was allowed to investigate the camps in the British and French occupation zones of Germany, as well as providing relief to the prisoners held there. On 4 February 1946, the Red Cross was also permitted to visit and assist prisoners in the US occupation zone of Germany, although only with very small quantities of food. "During their visits, the delegates observed that German prisoners of war were often detained in appalling conditions. They drew the attention of the authorities to this fact, and gradually succeeded in getting some improvements made".