title: Government of France

text: The government is responsible to the French Parliament. In particular, the government must assume responsibility for its actions before the National Assembly, and the National Assembly can dismiss the government with a motion of censure. The government cannot function during the tenure of acting (interim) president, as that position is granted either to the President of the Senate or the Prime Minister, compromising separation of powers. If the government decides to launch an armed operation with a duration of longer than four months, it must first consult parliament and request an authorization. The Prime Minister may convene parliament for extraordinary sessions, or add additional sitting days to the legislative calendar.


title: Doctor of the Church

text: Doctor of the Church (Latin: "doctor" "teacher"), also referred to as Doctor of the Universal Church (Latin: "Doctor Ecclesiae Universalis"), is a title given by the Catholic Church to saints recognized as having made a significant contribution to theology or doctrine through their research, study, or writing.


title: Doctor of the Church

text: , the Catholic Church has named 37 Doctors of the Church. Of these, the 18 who died before the Great Schism of 1054 are also held in high esteem by the Eastern Orthodox Church, although it does not use the formal title "Doctor of the Church".


title: Doctor of the Church

text: Among the 37 recognised Doctors, 28 are from the West and nine from the East; four are women and thirty-three are men; one abbess, three nuns, one tertiary associated with a religious order; 19 bishops, twelve priests, one deacon; 27 from Europe, three from Africa, and seven from Asia. More Doctors (twelve) lived in the fourth century than any other; eminent Christian writers of the first, second, and third centuries are usually referred to as the Ante-Nicene Fathers. The shortest period between death and nomination was that of Alphonsus Liguori, who died in 1787 and was named a Doctor in 1871 – a period of 84 years; the longest was that of Irenaeus, which took more than eighteen centuries.


title: Doctor of the Church

text: In the Western church four outstanding "Fathers of the Church" attained this honour in the early Middle Ages: Gregory the Great, Ambrose, Augustine of Hippo, and Jerome. The "four Doctors" became a commonplace notion among scholastic theologians, and a decree of Boniface VIII (1298) ordering their feasts to be kept as doubles throughout the Latin Church is contained in his sixth book of Decretals (cap. "Gloriosus", de relique. et vener. sanctorum, in Sexto, III, 22).


title: Doctor of the Church

text: In the Byzantine Church, three Doctors were pre-eminent: John Chrysostom, Basil the Great, and Gregory of Nazianzus. The feasts of these three saints were made obligatory throughout the Eastern Empire by Leo VI the Wise. A common feast was later instituted in their honour on 30 January, called "the feast of the three Hierarchs". In the Menaea for that day it is related that the three Doctors appeared in a dream to John Mauropous, Bishop of Euchaita, and commanded him to institute a festival in their honour, in order to put a stop to the rivalries of their votaries and panegyrists. This was under Alexius Comnenus (1081–1118; see "Acta SS.", 14 June, under St. Basil, c. xxxviii). But sermons for the feast are attributed in manuscripts to Cosmas Vestitor, who flourished in the tenth century. The three are as common in Eastern art as the four are in Western. Durandus (i, 3) remarks that Doctors should be represented with books in their hands. In the West analogy led to the veneration of four Eastern Doctors, Athanasius of Alexandria being added to the three hierarchs.


title: Doctor of the Church

text: In the Latin Church, the four Latin Doctors "had already long been recognized" in the liturgy when the four Great Doctors of the Eastern Church, John Chrysostom, Basil the Great, Gregory of Nazianzus, and Athanasius of Alexandria were recognized in 1568 by Pope Pius V.


title: Doctor of the Church

text: To these names others have subsequently been added. The requisite conditions are enumerated as three: "eminens doctrina", "insignis vitae sanctitas", "Ecclesiae declaratio" (i.e. eminent learning, a high degree of sanctity, and proclamation by the church). Benedict XIV explains the third as a declaration by the supreme pontiff or by a general council. But though general councils have acclaimed the writings of certain Doctors, no council has actually conferred the title of Doctor of the Church. The procedure involved extending to the Catholic Church the use of the Divine Office and Mass of the saint in which the title of doctor is applied to him. The decree is issued by the Congregation for the Causes of the Saints and approved by the pope, after a careful examination, if necessary, of the saint's writings. It is not in any way an "ex cathedra" decision, nor does it even amount to a declaration that no error is to be found in the teaching of the Doctor. It is, indeed, well known that the very greatest of them are not wholly immune from error. Formally no martyrs were on the list, since the Office and the Mass had been for Confessors. Hence, as Benedict XIV pointed out during his pontificate, Ignatius of Antioch, Irenaeus of Lyons, and Cyprian of Carthage were not called Doctors of the Church. This changed in 2022 when Pope Francis declared Irenaeus of Lyons the first martyred Doctor.


title: Doctor of the Church

text: The Doctors' works vary greatly in subject and form. Augustine of Hippo was one of the most prolific writers in Christian antiquity and wrote in almost every genre. Some, such as Pope Gregory the Great and Ambrose of Milan, were prominent writers of letters. Pope Leo the Great, Pope Gregory the Great, Peter Chrysologus, Bernard of Clairvaux, Anthony of Padua and Lawrence of Brindisi left many homilies. Catherine of Siena, Teresa of Ávila, John of the Cross and Thérèse de Lisieux wrote works of mystical theology. Athanasius of Alexandria and Robert Bellarmine defended the church against heresy. Bede the Venerable wrote biblical commentaries and theological treatises. Systematic theologians include the Scholastic philosophers Anselm of Canterbury, Albert the Great, and Thomas Aquinas.


title: Doctor of the Church

text: In the 1920 encyclical "Spiritus Paraclitus", Pope Benedict XV refers to Jerome as the church's "Greatest Doctor".


title: Doctor of the Church

text: Until 1970, no woman had been named a Doctor of the Church, but since then four additions to the list have been women: Teresa of Ávila (also known as Saint Teresa of Jesus) and Catherine of Siena by Pope Paul VI; Thérèse de Lisieux (also known as Saint Therese of the Child Jesus and of the Holy Face), "the Little Flower" by Pope John Paul II; and Hildegard of Bingen by Benedict XVI. Teresa and Thérèse were both Discalced Carmelites, Catherine was a Dominican, and Hildegard was a Benedictine nun.


title: Doctor of the Church

text: Traditionally, in the Liturgy, the Office of Doctors was distinguished from that of Confessors by two changes: the Gospel reading "Vos estis sal terrae" ("You are the salt of the earth"), Matthew 5:13–19, and the eighth Respond at Matins, from Ecclesiasticus 15:5, "In medio Ecclesiae aperuit os ejus, * Et implevit eum Deus spiritu sapientiae et intellectus. * Jucunditatem et exsultationem thesaurizavit super eum." ("In the midst of the Church he opened his mouth, * And God filled him with the spirit of wisdom and understanding. * He heaped upon him a treasure of joy and gladness.") The Nicene Creed was also recited at Mass, which is normally not said except on Sundays and the highest-ranking feast days. The 1962 revisions to the Missal dropped the Creed from feasts of Doctors and abolished the title and the Common of Confessors, instituting a distinct Common of Doctors.


title: Doctor of the Church

text: On 20 August 2011, Pope Benedict XVI announced that he would soon declare John of Ávila a Doctor of the Church. Although no official announcement was given, it was reported in December 2011 that Pope Benedict intended to declare Hildegard of Bingen as a Doctor of the Church despite her not yet having been formally canonized by the papacy. Hildegard of Bingen was officially declared to be a saint of the Catholic Church by Pope Benedict XVI on 10 May 2012, clearing the way for her to be named a Doctor of the Church. Pope Benedict formally declared John of Ávila and Hildegard of Bingen to be Doctors of the Church on 7 October 2012.


title: Doctor of the Church

text: Pope Francis declared the 10th century Armenian monk Gregory of Narek to be the 36th Doctor of the Church on 21 February 2015. The decision was somewhat controversial. According to critics of Pope Francis' decision, Gregory was a monk of the Armenian Apostolic Church, which, like other Oriental Orthodox Churches, split off from the rest of Christendom over the Council of Chalcedon in 451 AD. Therefore, Gregory is seen by some as a Monophysite who was in union with neither Catholic nor Eastern Orthodox Christians at the time of his death in 1003. The Oriental Orthodox churches, among which the Armenian Apostolic Church is numbered, are Miaphysites; however, defenders of the decision have cited historical evidence that Narek Monastery, where Gregory lived and died, was a center of opposition to Monophysitism from inside the Armenian Church. It is also cited that Gregory of Narek was prior to the move by Pope Francis listed in the Roman Martyrology with a feast day of February 27 and that members of the Armenian Catholic Church have always had a strong devotion to him and his writings.


title: Doctor of the Church

text: It was not until 25 January 2021 that the Congregation for Divine Worship and the Discipline of the Sacraments decreed the insertion into the Roman Rite liturgical books of the three Doctors declared by Benedict XVI, along with Gregory of Narek, more recently declared by Pope Francis.


title: Doctor of the Church

text: In October 2019, the Polish Catholic Bishops Conference formally petitioned Pope Francis to consider making Pope John Paul II a Doctor of the Church in an official proclamation, in recognition of his contributions to theology, philosophy, and Catholic literature, as well as the formal documents (encyclicals, apostolic letters, bulls, motu proprio documents, homilies, and speeches) that he issued. Also, the Archbishop of San Salvador, El Salvador has petitioned Pope Francis to name St Oscar Romero, martyred in 1980 while he was archbishop there, who held a doctorate and was a reliably orthodox figure even as he grew to advocate for the plight of his people during the civil war there, as a Doctor of the Church. Romero and John Paul II are known to be widely respected figures today, even by many in the Eastern Catholic, Eastern Orthodox, and Protestant denominations, or who are not religious or are agnostic. If the Salvadorian bishops petition is granted St Oscar Romero would become the second Doctor of the Church who was martyred.


title: Doctor of the Church

text: In addition, parts of the Catholic Church have recognised other individuals with this title. In Spain, Fulgentius of Cartagena, Ildephonsus of Toledo and Leander of Seville have been recognized with this title. In 2007 Pope Benedict XVI, in his encyclical "Spe Salvi", called Maximus the Confessor "the great Greek Doctor of the Church", though the Congregation for the Causes of Saints considers this declaration an informal one.


title: Doctor of the Church

text: Though not named Doctors of the Church or even canonized, many of the more celebrated doctors of theology and law of the Middle Ages were given an epithet which expressed the nature of their expertise. Among these are Bl. John Duns Scotus, "Doctor subtilis" (Subtle Doctor); Bl. Ramon Llull, "Doctor illuminatus" (Illuminated Doctor); Bl. John of Ruysbroeck, "Doctor divinus ecstaticus" (Ecstatic Doctor); Alexander of Hales, "Doctor irrefragabilis" (Unanswerable Doctor); Roger Bacon, "Doctor Mirabilis" (Wondrous Doctor); Gregory of Rimini, "Doctor authenticus" (Authentic Doctor); Jean Gerson, "Doctor christianissimus" (Most Christian Doctor); Nicholas of Cusa, "Doctor christianus" (Christian Doctor); and the priest and professor Francisco Suárez, "Doctor eximius" (Exceptional Doctor). In this same line are the Latin epithets assigned to various Doctors of the Church from the Middle Ages onwards, some displaying more enthusiasm than clarity.


title: Doctor of the Church

text: The Syro-Malabar Catholic Church recognises Ambrose, Jerome, Gregory, Augustine, Athanasius, Basil, Gregory of Nazianzus and John Chrysostom, as well as Ephrem the Syrian, Isaac the Elder, Pope Leo I, John of Damascus, Cyril of Alexandria, Cyril of Jerusalem, Epiphanius of Salamis and Gregory of Nyssa.


title: Doctor of the Church

text: The Chaldean Catholic Church honours as doctor Polycarp, Eustathius of Antioch, Meletius, Alexander of Jerusalem, Athanasius, Basil, Cyril of Alexandria, Gregory Nazianzus, Gregory of Nyssa, John Chrysostom, Fravitta of Constantinople, Ephrem the Syrian, Jacob of Nisibis, Jacob of Serugh, Isaac of Armenia, Isaac of Nineveh, and Maruthas of Martyropolis.


title: Doctor of the Church

text: The Eastern Orthodox Church honors many of the pre-schism saints as well, but the term "Doctor of the Church" is not applied in the same way. One consistent use of the category is the trio of Basil the Great, Gregory of Nazianzus and John Chrysostom, recognized as universal teachers and known as the Three Holy Hierarchs. The church also recognizes three saints with the title "Theologos" (Theologian): John the Evangelist, Gregory of Nazianzus and Symeon the New Theologian.


title: Doctor of the Church

text: They also recognize their own saints Mesrob, Yeghishe, Movses Khorenatsi, David the Invincible, Gregory of Narek, Nerses III the Builder, and Nerses of Lambron as "Doctors of the Armenian Church" or the "Armenian Doctors."


title: Doctor of the Church

text: The Assyrian Church of the East recognizes Yeghishe, Diodorus of Tarsus, Theodore of Mopsuestia, and Nestorius as Doctors of the Church.


title: Doctor of the Church

text: The churches of the Anglican Communion tend not to use the term "Doctor of the Church" in their calendars of saints, preferring expressions such as "Teacher of the Faith". Those thus recognized include figures from before and after the Reformation, most of whom are chosen among those already recognized as in the Catholic Church and Eastern Orthodox Church. Those designated as Teachers of the Faith in the Church of England's calendar of saints are as follows:


title: Doctor of the Church

text: Since all of the above appear in the calendar at the level of Lesser Festival or Commemoration, their celebration is optional. Similarly, because "In the Calendar of the Saints, diocesan and other local provision may be made to supplement the national Calendar", those Doctors of the Church recognized by the Catholic Church may also be celebrated in the Church of England.


title: Doctor of the Church

text: The Lutheran calendar of saints does not use the term "Doctor of the Church." The calendar of the Lutheran Church–Missouri Synod refers to Martin Luther by the title of "Doctor" in recognition of his academic degree, Doctor of Theology from the University of Wittenberg in 1512.


title: Bucephalus

text: Bucephalus or Bucephalas (; ; – June 326 BC) was the horse of Alexander the Great, and one of the most famous horses of classical antiquity.


title: Bucephalus

text: Ancient historical accounts state that Bucephalus' breed was that of the "best Thessalian strain", and that he died in what is now Punjab, Pakistan, after the Battle of the Hydaspes in 326 BC. The horse was reportedly buried at Jalalpur Sharif, a small town situated a short distance to the southwest of Jhelum. Another account states that Bucephalus is buried in Phalia, a town located near the city of Mandi Bahauddin, which was named after him (Alexandria Bucephalous).


title: Bucephalus

text: A massive creature with a massive head, Bucephalus is described as having a black coat with a large white star on his brow. He is also supposed to have had a "wall eye" (blue eye) , and his breeding was that of the "best Thessalian strain".


title: Bucephalus

text: Plutarch says in 344 BC, at twelve or thirteen years of age, Alexander of Macedonia won the horse by making a wager with his father: A horse dealer named Philonicus the Thessalian offered Bucephalus to King Philip II for the remarkably high sum of 13 talents. Because no one could tame the animal, Philip was not interested. However, Alexander was, and he offered to pay himself should he fail.


title: Bucephalus

text: Alexander was given a chance and surprised all by subduing it. He spoke soothingly to the horse and turned it toward the sun so that it could no longer see its own shadow, which had been the cause of its distress. Dropping his fluttering cloak as well, Alexander successfully tamed the horse. Plutarch says that the incident so impressed Philip that he told the boy, "O my son, look thee out a kingdom equal to and worthy of thyself, for Macedonia is too little for thee." Philip's speech strikes the only false note in the anecdote, according to A. R. Anderson, who noted his words as the embryo of the legend fully developed in the "History of Alexander the Great" I.15, 17.


title: Bucephalus

text: The "Alexander Romance" presents a mythic variant of Bucephalus's origin. In this tale, the colt, whose heroic attributes surpassed even those of Pegasus, is bred and presented to Philip on his own estates. The mythic attributes of the animal are further reinforced in the romance by the Delphic Oracle who tells Philip that the destined king of the world will be the one who rides Bucephalus, a horse with the mark of the ox's head on his haunch.


title: Bucephalus

text: The value which Alexander placed on Bucephalus emulated his hero and supposed ancestor Achilles, who claimed that his horses were "known to excel all others—for they are immortal. Poseidon gave them to my father Peleus, who in his turn gave them to me."


title: Bucephalus

text: Arrian states, with Onesicritus as his source, that Bucephalus died at the age of thirty. Other sources, however, give as the cause of death not old age or weariness, but fatal injuries at the Battle of the Hydaspes (June 326 BC), in which Alexander's army defeated King Porus. Alexander promptly founded a city, Bucephala, in honour of his horse. It lay on the west bank of the Hydaspes river (modern-day Jhelum in Pakistan). The modern-day town of Jalalpur Sharif, outside Jhelum, is said to be where Bucephalus is buried.


title: Bucephalus

text: The legend of Bucephalus grew in association with that of Alexander, beginning with the fiction that they were born simultaneously: some of the later versions of the Alexander Romance also synchronized the hour of their death. The pair forged a sort of cult in that, after them, it was all but expected of a conqueror that he have a favourite horse. Julius Caesar had one; so too did the eccentric Roman Emperor Caligula, who made a great fuss of his horse Incitatus, holding birthday parties for him, riding him while adorned with Alexander's breastplate, and planning to make him a consul.


title: Occupational burnout

text: According to the World Health Organization (WHO), occupational burnout is a syndrome resulting from chronic work-related stress, with symptoms characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy". While burnout may influence health and can be a reason for people contacting health services, it is not itself classified by the WHO as a medical condition or mental disorder. WHO additional states that "Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."


title: Occupational burnout

text: According to Wolfgang Kaskcha, "Burnout as a phenomenon has probably existed at all times and in all cultures." He notes that the condition is described in the Book of Exodus.


title: Occupational burnout

text: Gordon Parker believes the ancient European concept of acedia refers to burnout, and not depression as many others believe.


title: Occupational burnout

text: It has been suggested that the first printed use of the term "burnout" in English was in one of Shakespeare's sonnets in 1599, referring to a woman's love burning out. The sonnet in question is one of Shakespeare's most famous.


title: Occupational burnout

text: In 1869, New York neurologist George Beard used the term "neurasthenia" to describe a very broad condition caused by the exhaustion of the nervous system, which was thought to be particularly found in "civilized, intellectual communities." The concept soon became popular, and many in the United States believed themselves to have it. Some came to call it "Americanitis". The rest cure was a commonly prescribed treatment (though there were many others). Beard yet further broadened the potential symptoms of neurasthenia over time, so that almost any symptom or behaviour could be deemed to be caused by it. Don R Lipsitt would later wonder if the term "burnout" was similarly too broadly defined to be useful.


title: Occupational burnout

text: In 1961, Graham Greene published the novel "A Burnt-Out Case", the story of an architect who became greatly fatigued by his work, and who took much time to recover.


title: Occupational burnout

text: In 1969, HB Bradley used the term "burnout" in a criminology paper to describe the fatigued staff at a centre for treating young adult offenders. This has been cited as the first known academic work to use the term for this concept.


title: Occupational burnout

text: In 1974, Herbert Freudenberger, an American psychologist, used the term in his academic paper "Staff Burn-Out." The paper was based on his qualitative observations of the volunteer staff (including himself) at a free clinic for drug addicts. He characterized burnout by a set of symptoms that includes exhaustion resulting from work's excessive demands as well as physical symptoms such as headaches and sleeplessness, "quickness to anger", and closed thinking. He observed that the burned-out worker "looks, acts, and seems depressed." After the publication of Freudenberger's paper, interest in the concept grew.


title: Occupational burnout

text: In 1976, Christina Maslach noted the term being used by California lawyers working with the poor, and began to study the concept.


title: Occupational burnout

text: In 1981, Maslach and Susan E. Jackson published an instrument for assessing burnout, the Maslach Burnout Inventory (MBI). It was the first such instrument of its kind and the most widely used burnout instrument. The two researchers described burnout in terms of emotional exhaustion, depersonalization (feeling low-empathy towards other people in an occupational setting), and reduced feelings of work-related personal accomplishment.


title: Occupational burnout

text: In 2010, the Swedish Board of Health and Welfare adopted a refined conceptualisation of severe burnout it described as "exhaustion disorder."


title: Occupational burnout

text: In 2015, The World Health Organization adopted a conceptualisation of burnout that is consistent with Maslach's. It adopted a modified version of this in 2022. However, "is not itself classified by the WHO as a medical condition or mental disorder."


title: Occupational burnout

text: The two main classification systems of psychological disorders are the Diagnostic and Statistical Manual of Mental Disorders (DSM, used in North America and elsewhere) from the American Psychiatric Association (APA), and the International Classification of Diseases (ICD, used in Europe and elsewhere) from the World Health Organisation (WHO).


title: Occupational burnout

text: Burnout is not recognized as a distinct mental disorder in the DSM-5 (published in 2013). Its definitions for Adjustment Disorders, and Unspecified Trauma- and Stressor-Related Disorder in some cases reflect the condition. 2022's update, the DSM-5-TR, did not add a definition of burnout.


title: Occupational burnout

text: As of 2017, nine European countries considered burnout as being a recognised medical disorder. These countries classify it under one or more codes of the ICD.


title: Occupational burnout

text: The ICD-10 (current 1994–2021) classified "burn-out" as a type of non-medical life-management difficulty under code Z73.0. It was considered to be one of the "factors influencing health status and contact with health services" and "should not be used" for "primary mortality coding". It was also considered one of the "problems related to life-management difficulty". The condition is further defined as being a "state of vital exhaustion," which historically had been called neurasthenia.


title: Occupational burnout

text: In 2010 the Swedish Board of Health and Welfare added “exhaustion disorder” (ED; F43.8A) to the Swedish version of the ICD-10, the ICD-10-SE, representing what is typically called "burnout" in English. (See also ). Swedish sufferers of severe burnout had earlier been treated as having neurasthenia.


title: Occupational burnout

text: According to Lindsäter et al., "The diagnosis has become almost as prevalent as major depression in Swedish health care settings, and currently accounts for more instances of long-term sick-leave reimbursement than any other single diagnosis in the country."


title: Occupational burnout

text: The Royal Dutch Medical Association defined "burnout" as a subtype of adjustment disorder as part of the ICD-10 system. In the Netherlands burnout is included in handbooks and medical staff are trained in its diagnosis and treatment. A reform of Dutch health insurance resulted in adjustment disorder treatment being removed from the compulsory basic package in 2012. Practiconers were told that more serious cases of the condition may qualify for classification as depression or anxiety disorder.


title: Occupational burnout

text: A new version of the ICD, ICD-11, was released in June 2018, for first use in January 2022. The new version has an entry coded and titled "QD85 Burn-out". The ICD-11 describes the condition this way:


title: Occupational burnout

text: This condition is classified under "Problems associated with employment or unemployment" in the section on "Factors influencing health status or contact with health services." The section is devoted to reasons other than recognized diseases or health conditions for which people contact health services. In a statement made in May 2019, the WHO said "Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition."


title: Occupational burnout

text: The ICD's browser and coding tool both attach the term "caregiver burnout" to category "QF27 Difficulty or need for assistance at home and no other household member able to render care." QF27 thus acknowledges that burnout can occur outside the work context.


title: Occupational burnout

text: The ICD-11 also has the medical condition "6B4Y Other specified disorders specifically associated with stress", which is the equivalent of the ICD-10's F43.8.


title: Occupational burnout

text: If, after treatment, a person with burnout continues to have persistent physical symptoms triggered by the condition, in Iceland they may be considered to have "somatic symptom disorder" (DSM-5) and "bodily distress disorder" (ICD-11).


title: Occupational burnout

text: Further detail about the varied ways clinicians and others use ICD and DSM classification with burnout was published by Arno Van Dam in 2021.


title: Occupational burnout

text: The US government's National Institutes of Health includes the condition as "psychological burnout" in its index of the National Library of Medicine, and provides a number of synonyms. It defines the condition as "An excessive reaction to stress caused by one's environment that may be characterized by feelings of emotional and physical exhaustion, coupled with a sense of frustration and failure."


title: Occupational burnout

text: SNOMED CT includes the term "burnout" as a synonym for its defined condition of "Physical AND emotional exhaustion state," which is a subtype of anxiety disorder. The Diseases Database defines the condition as "professional burnout."


title: Occupational burnout

text: In 1981, Maslach and Jackson developed the first widely used instrument for assessing burnout, the "Maslach Burnout Inventory" (MBI). It remains by far the most commonly used instrument to assess the condition. Consistent with Maslach's conceptualization, the MBI operationalizes burnout as a three-dimensional syndrome consisting of emotional exhaustion, depersonalization (an unfeeling and impersonal response toward recipients of one's service, care, treatment, or instruction), and reduced personal accomplishment.


title: Occupational burnout

text: The MBI originally focused on human service professionals (e.g., teachers, social workers). Since that time, the MBI has been used for a wider variety of workers (e.g., healthcare workers). The instrument or its variants are now employed with job incumbents working in many other occupations.


title: Occupational burnout

text: There are other conceptualizations of burnout that differ from that suggested by Maslach and adopted by the WHO.


title: Occupational burnout

text: In 1999, Demerouti and Bakker, with their "Oldenburg Burnout Inventory" (OLBI), conceptualized burnout in terms of exhaustion and disengagement, linking it to the job demands-resources model. This instrument is used mainly in the United States.


title: Occupational burnout

text: Also that year, Wilmar Schaufeli and Arnold Bakker released the "Utrecht Work Engagement Scale" (UWES). It uses a similar conceptualisation to the MBI. However the UWES measures vigour, dedication and absorption; positive counterparts to the values measured by the MBI. It is used mainly in Germany.


title: Occupational burnout

text: In 2005, TS Kristensen et al. released the public domain "Copenhagen Burnout Inventory" (CBI). They argued that the definition of burnout should be limited to fatigue and exhaustion. The CBI has had some use in Germany.


title: Occupational burnout

text: In 2006, Shirom and Melamed with their "Shirom-Melamed Burnout Measure" (SMBM) conceptualized burnout in terms of physical exhaustion, cognitive weariness, and emotional exhaustion. An examination of the SMBM's emotional exhaustion subscale, however, indicates that the subscale more clearly embodies Maslach's concept of depersonalization than her concept of emotional exhaustion. This measure has seen little use.


title: Occupational burnout

text: In 2010, researchers from Mayo Clinic used portions of the MBI, along with other comprehensive assessments, to develop the "Well-Being Index", a nine-item self-assessment tool designed to measure burnout and other dimensions of distress in healthcare workers specifically. It has been mainly used in the United States.


title: Occupational burnout

text: In 2014, Aniella Besèr et al. developed the "Karolinska Exhaustion Disorder Scale" (KEDS), which is used mainly in Sweden. It was designed to measure the symptoms defined by the ICD-10-SE's category for exhaustion disorder. The authors believed that those with the disorder were often initially depressed, but that this soon passed. The core symptoms of the disorder were deemed to be "exhaustion, cognitive problems, sleep disturbance". The authors also believed that the condition was clearly differentiated from both depression and anxiety.


title: Occupational burnout

text: In 2020, the "Occupational Depression Inventory" (ODI), was developed to quantify the severity of work-attributed depressive symptoms and establish provisional diagnoses of job-ascribed depression. The ODI covers nine symptoms, including exhaustion (burnout’s putative core). The instrument exhibits particularly robust psychometric properties. The ODI is the only instrument that assesses work-related suicidal thoughts, a particularly important symptom calling for immediate attention.


title: Occupational burnout

text: In 2021, the "Sydney Burnout Measure" (SBM) was released by Gordon Parker et al., which "captures domains of exhaustion, cognitive impairment, loss of empathy, withdrawal and insularity, and impaired work performance, as well as several anxiety, depression and irritability symptoms."


title: Occupational burnout

text: There are still other conceptualizations as well that are embodied in other instruments, including the "Hamburg Burnout Inventory", and "Malach-Pines's Burnout Measure."


title: Occupational burnout

text: Kristensen et al. and Malach-Pines (who also published as Pines) advanced the view that burnout can also occur in connection to life outside of work. For example, Malach-Pines developed a burnout measure keyed the role of spouse.


title: Occupational burnout

text: Maslach advanced the idea that burnout should not be viewed as a depressive condition. Recent evidence, based on factor-analytic and meta-analytic findings, calls into question this supposition. Burnout is also now often seen as involving the full array of depressive symptoms (e.g., low mood, cognitive alterations, sleep disturbance).


title: Occupational burnout

text: Marked differences among researchers' conceptualizations of what constitutes burnout have underlined the need for a consensus definition.


title: Occupational burnout

text: Farber found evidence that the most idealistic teachers who enter the profession are the most likely to suffer burnout.


title: Occupational burnout

text: A growing body of evidence suggests that burnout is etiologically, clinically, and nosologically similar to depression. In a study that directly compared depressive symptoms in burned out workers and clinically depressed patients, no diagnostically significant differences were found between the two groups; burned out workers reported as many depressive symptoms as clinically depressed patients. Moreover, a study by Bianchi, Schonfeld, and Laurent (2014) showed that about 90% of workers with very high scores on the MBI meet diagnostic criteria for depression. The view that burnout is a form of depression has found support in several recent studies. Some authors have recommended that the nosological concept of burnout be revised or even abandoned entirely given that it is not a distinct disorder and that there is no agreement on burnout's diagnostic criteria. A newer generation of studies indicates that burnout, particularly its exhaustion dimension, problematically overlaps with depression; these studies have relied on more sophisticated statistical techniques, for example, exploratory structural equation modeling (ESEM) bifactor analysis, than earlier studies of the topic. The advantage of ESEM bifactor analysis, which combines the best features of exploratory and confirmatory factor analysis, is that it provides a granular look at item-construct relationships, without falling into traps earlier burnout researchers fell into.


title: Occupational burnout

text: Liu and van Liew wrote that "the term burnout is used so frequently that it has lost much of its original meaning. As originally used, burnout meant a mild degree of stress-induced unhappiness. The solutions ranged from a vacation to a sabbatical. Ultimately, it was used to describe everything from fatigue to a major depression and now seems to have become an alternative word for depression, but with a less serious significance" (p. 434). The authors equate burnout with adjustment disorder with depressed mood.


title: Occupational burnout

text: Kakiashvili et al., however, argued that although burnout and depression have overlapping symptoms, endocrine evidence suggests that the disorders' biological bases are different. They argued that antidepressants should not be used by people with burnout because the medications can make the underlying hypothalamic–pituitary–adrenal axis dysfunction worse.


title: Occupational burnout

text: Despite its name, depression with atypical features, which is seen in the above table, is not a rare form of depression. The cortisol profile in atypical depression, in contrast to that of melancholic depression, is similar to the cortisol profile found in burnout. Commentators advanced the view that burnout differs from depression because the cortisol profile of burnout differs from that of melancholic depression; however, as the above table indicates, burnout's cortisol profile is similar to that of atypical depression.


title: Occupational burnout

text: It has previously been hypothesised that Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is caused by burnout. It is suggested that the "burning out" of the body's stress symptom (by any of a wide range of causes) can lead to chronic fatigue. However, the very nomenclature of "Chronic Fatigue Syndrome" is viewed as problematic by both patients and healthcare professionals specialising in the condition, as it fails to encompass the wide range of non-fatigue related symptoms present in ME/CFS, or to differentiate between the so-named condition and the symptom of chronic fatigue which is present in many unrelated conditions or diseases. Furthermore, more up-to-date research has shown that ME/CFS is a multi-systemic condition that is not psychological in etiology and so comparison to occupational burnout is now less prudent.


title: Occupational burnout

text: Overtraining syndrome is also known as "chronic fatigue," "burnout" and "overstress" in athletes. It has been conceptualised as adjustment disorder, a common diagnosis for those burnt out.


title: Occupational burnout

text: Recovering alcoholics often have a blunted cortisol response to stress, as do some cancer patients and survivors. This symptom is a particular feature of people suffering burnout. Altered cortisol response is experienced by up to 80% of people with depression.


title: Occupational burnout

text: Evidence suggests that the etiology of burnout is multifactorial, with personality factors playing an important, long-overlooked role. Cognitive dispositional factors implicated in depression have also been found to be implicated in burnout. One cause of burnout includes stressors that a person is unable to cope with fully.


title: Occupational burnout

text: Burnout is thought to occur when a mismatch is present between the nature of the job and the job the person is actually doing. A common indication of this mismatch is work overload, which sometimes involves a worker who survives a round of layoffs, but after the layoffs the worker finds that he or she is doing too much with too few resources. Overload may occur in the context of downsizing, which often does not narrow an organization's goals, but requires fewer employees to meet those goals. The research on downsizing, however, indicates that downsizing has more destructive effects on the health of the workers who survive the layoffs than mere burnout; these health effects include increased levels of sickness and greater risk of mortality.


title: Occupational burnout

text: The job demands-resources model has implications for burnout, as measured by the Oldenburg Burnout Inventory (OLBI). Physical and psychological job demands were concurrently associated with the exhaustion, as measured by the OLBI. Lack of job resources was associated with the disengagement component of the OLBI.


title: Occupational burnout

text: Maslach, Schaufeli and Leiter identified six risk factors for burnout in 2001: mismatch in workload, mismatch in control, lack of appropriate awards, loss of a sense of positive connection with others in the workplace, perceived lack of fairness, and conflict between values.


title: Occupational burnout

text: Although job stress has long been viewed as the main determinant of burnout, recent meta-analytic findings indicate that job stress is a weak predictor of burnout. These findings question one of the most central assumptions of burnout research.


title: Occupational burnout

text: In a systematic literature review in 2014, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) found that a number of work environment factors could affect the risk of developing exhaustion disorder or depressive symptoms:


title: Occupational burnout

text: Negative consequences of burnout on both the employee and the organization call for preventive measures in order to reduce the impact of the risk factors. Burnout prevention strategies, either addressing to the general working population (primary prevention) or the occupational groups which are more vulnerable (secondary prevention), are focused on reducing the impact of risk factors. Reviews of healthcare professionals‟ burnout focusing on identifying risk factors have been conducted previously.


title: Occupational burnout

text: Some research indicates that burnout is associated with reduced job performance, coronary heart disease, and mental health problems. Examples of emotional symptoms of occupational burnout include a lack of interest in the work being done, a decrease in work performance levels, feelings of helplessness, and trouble sleeping. With regard to mental health problems, research on dentists and physicians suggests that what is meant by burnout is a depressive syndrome. Thus reduced job performance and cardiovascular risk could be related to burnout because of burnout's tie to depression. Behavioral signs of occupational burnout are demonstrated through cynicism within workplace relationships with coworkers, clients, and the organization itself.


title: Occupational burnout

text: Other effects of burnout can manifest as lower energy and productivity levels, with workers observed to be consistently late for work and feeling a sense of dread upon arriving. They can suffer concentration problems, forgetfulness, increased frustration, and/or feelings of being overwhelmed. They may complain and feel negative, or feel apathetic and believe they have little impact on their coworkers and environment. Occupational burnout is also associated with absenteeism, other time missed from work, and thoughts of quitting.


title: Occupational burnout

text: Chronic burnout is also associated with cognitive impairments in memory and attention. (See also Effects of stress on memory.)


title: Occupational burnout

text: Research suggests that burnout can manifest differently between genders, with higher levels of depersonalisation among men and increased emotional exhaustion among women. Other research suggests that people revealing a history of occupational burnout face future hiring discrimination.


title: Occupational burnout

text: When it happens in the context of volunteering, burnout can often lead to volunteers significantly reducing their activities or stopping volunteering altogether. Likewise, academic stress, as it has been called, or academic burnout is a process originated from the inciting element, which implies the subjection to events that from the student's perspective can be considered as stressors.


title: Occupational burnout

text: Health condition treatment and prevention methods are often classified as "primary prevention" (stopping the condition occurring), "secondary prevention" (removing the condition that has occurred) and "tertiary prevention" (helping people live with the condition).


title: Occupational burnout

text: In addition to interventions that can address and improve conditions on the work side of work-life balance, the ways in which people spend their non-work time can help to prevent burnout and improve health and well-being.


title: Occupational burnout

text: Maslach believes that the only way to truly prevent burnout is through a combination of organizational change and education for the individual.


title: Occupational burnout

text: Maslach and Leiter postulated that burnout occurs when there is a disconnection between the organization and the individual with regard to what they called the six areas of worklife: workload, control, reward, community, fairness, and values. Resolving these discrepancies requires integrated action on the part of both the individual and the organization. With regard to workload, assuring that a worker has adequate resources to meet demands as well as ensuring a satisfactory work–life balance could help revitalize employees' energy. With regard to values, clearly stated ethical organizational values are important for ensuring employee commitment. Supportive leadership and relationships with colleagues are also helpful.


title: Occupational burnout

text: One approach for addressing these discrepancies focuses specifically on the fairness area. In one study employees met weekly to discuss and attempt to resolve perceived inequities in their job. The intervention was associated with decreases in exhaustion over time but not cynicism or inefficacy, suggesting that a broader approach is required.


title: Occupational burnout

text: Hätinen et al. suggest "improving job-person fit by focusing attention on the relationship between the person and the job situation, rather than either of these in isolation, seems to be the most promising way of dealing with burnout." They also note that "at the individual level, cognitive-behavioural strategies have the best potential for success."


title: Occupational burnout

text: Burnout prevention programs have traditionally focused on cognitive-behavioral therapy (CBT), cognitive restructuring, didactic stress management, and relaxation. CBT, relaxation techniques (including physical techniques and mental techniques), and schedule changes are the best-supported techniques for reducing or preventing burnout in a health-care setting. Mindfulness therapy has been shown to be an effective preventative for occupational burnout in medical practitioners. Combining both organizational and individual-level activities may be the most beneficial approach to reducing symptoms. A Cochrane review, however, reported that evidence for the efficacy of CBT in healthcare workers is of low quality, indicating that it is no better than alternative interventions.


title: Occupational burnout

text: For the purpose of preventing occupational burnout, various stress management interventions have been shown to help improve employee health and well-being in the workplace and lower stress levels. Training employees in ways to manage stress in the workplace have also been shown to be effective in preventing burnout. One study suggests that social-cognitive processes such as commitment to work, self-efficacy, learned resourcefulness, and hope may insulate individuals from experiencing occupational burnout. Increasing a worker's control over his or her job is another intervention has been shown to help counteract exhaustion and cynicism in the workplace.


title: Occupational burnout

text: Additional prevention methods include: starting the day with a relaxing ritual; yoga; adopting healthy eating, exercising, and sleeping habits; setting boundaries; taking breaks from technology; nourishing one's creative side, and learning how to manage stress.


title: Occupational burnout

text: Barry A. Farber suggests strategies like setting more achievable goals, focusing on the value of the work, and finding better ways of doing the job, can all be helpful ways of helping the stressed. People who don't mind the stress but want more reward can benefit from reassessing their work–life balance and implementing stress reduction techniques like meditation and exercise. Others with low stress, but are underwhelmed and bored with work, can benefit from seeking greater challenge.


title: Occupational burnout

text: In one trial, workers taking a high-dose Vitamin B complex "reported significantly lower personal strain and a reduction in confusion and depressed/dejected mood after 12 weeks."


title: Occupational burnout

text: In another trial, doctors undertaking a program involving "mindfulness, reflection, shared experience, and small-group learning" for 9 months had a much lessened propensity to burn out. Another trial with medical interns found a ten-week mindfulness program reduced the incidence of burnout.


title: Occupational burnout

text: Hätinen et al. list a number of common treatments, including treatment of any outstanding medical conditions, stress management, time management, depression treatment, psychotherapies, ergonomic improvement and other physiological and occupational therapy, physical exercise and relaxation. They have found that is more effective to have a greater focus on "group discussions on work related issues", and discussion about "work and private life interface" and other personal needs with psychologists and workplace representatives.


title: Occupational burnout

text: Jac JL van der Klink and Frank JH van Dijk suggest stress inoculation training, cognitive restructuring, graded activity and "time contingency" (progressing based on a timeline rather than patient's comfort) are effective methods of treatment.


title: Occupational burnout

text: Kakiashvili et al. said that "medical treatment of burnout is mostly symptomatic: it involves measures to prevent and treat the symptoms." They say the use of anxiolytics and sedatives to treat burnout related stress is effective, but does nothing to change the sources of stress. They say the poor sleep often caused by burnout (and the subsequent fatigue) is best treated with hypnotics and CBT (within which they include "sleep hygiene, education, relaxation training, stimulus control, and cognitive therapy"). They advise against the use of antidepressants as they worsen the hypothalamic–pituitary–adrenal axis dysfunction at the core of burnout. They also believe "vitamins and minerals are crucial in addressing adrenal and HPA axis dysfunction," noting the importance of specific nutrients. Omega-3 fatty acids may be helpful. DHA supplementation may also be useful for moderating norepinephrine. 11 beta-hydroxysteroid dehydrogenase (and potentially other metabolites of liquorice root extract) may help with lowered cortisol response.


title: Occupational burnout

text: Salomonsson et al. found that for workers with exhaustion disorder, CBT was better than a Return to Work Intervention (RTW-I) for reducing stress; and that people whose symptoms were primarily depression, anxiety or insomnia had reduced total time away from work after a RTW-I than for CBT.


title: Occupational burnout

text: Ybe Meesters found that light therapy (similar to that used for Seasonal Affective Disorder) may be effective.


title: Occupational burnout

text: Gordon Parker et al. found that the most useful treatment strategies appear to be talking to someone and seeking support, walking or other exercise, mindfulness and meditation, improving sleep, and leaving work completely or taking time off work.


title: Occupational burnout

text: Korczac et al. in a 2012 literature review found that "only for cognitive behavioural therapy (CBT) exists an adequate number of studies which prove its efficacy."


title: Occupational burnout

text: Ahola et al. in a 2014 literature review found that less than 1% of 4430 papers reviewed contained scientifically rigorous data, and that the 14 well-designed studies collectively "showed that such [randomised control trial] interventions did not succeed in alleviating burnout symptoms."


title: Occupational burnout

text: Lindsäter et al. in a 2022 literature review note the reported success of CBT, acceptance and commitment therapy (ACT), a multimodal rehabilitation program (MMR) program (involving group CBT, applied relaxation in a group, individual psychotherapy, physiotherapy, lectures, and medical treatment), physical exercise, cognitive training, consuming rhodiola rosea extract, and participating in an African dance program. However, overall they noted that "a multitude of interventions have been investigated for exhaustion disorder, but the evidence for any one type of intervention is limited."


title: Occupational burnout

text: Burnout also often causes a decline in the ability to update information in working memory. This is not easily treated with CBT.


title: Occupational burnout

text: One reason it is difficult to treat the three standard symptoms of burnout (exhaustion, cynicism, and inefficacy), is because they respond to the same preventive or treatment activities in different ways.


title: Occupational burnout

text: Exhaustion is more easily treated than cynicism and professional inefficacy, which tend to be more resistant to treatment. Research suggests that intervention actually may worsen the professional efficacy of a person who originally exhibited low professional efficacy.


title: Occupational burnout

text: Employee rehabilitation is a tertiary preventive intervention which means the strategies used in rehabilitation are meant to alleviate burnout symptoms in individuals who are already affected without curing them. Such rehabilitation of the working population includes multidisciplinary activities with the intent of maintaining and improving employees' working ability and ensuring a supply of skilled and capable labour in society.


title: Mallikarjuna Temple, Srisailam

text: Sri Bhramaramba Mallikarjuna Temple or Srisailam Temple is a Hindu temple dedicated to the deities Shiva and Parvati, located at Srisailam in the Indian state of Andhra Pradesh.


title: Mallikarjuna Temple, Srisailam

text: It is significant to the Hindu sects of both Shaivism and Shaktism as this temple is referred to as one of the twelve Jyotirlingas of Shiva and as one of the eighteen Shakti Peethas, centres of the Hindu Goddess. Shiva is worshiped as Mallikarjuna, and is represented by the "lingam". His consort Parvati is depicted as Bhramaramba.


title: Mallikarjuna Temple, Srisailam

text: When Shiva and Parvati decided to find suitable brides for their sons. Shiva got Buddhi (intellect), Siddhi (spiritual power), and Riddhi (prosperity) married to Ganesha. Kartikeya on his return was enraged and went away to stay alone on Mount Kraunja in the name of "Kumarabrahmachari". On seeing his father coming over to pacify him, he tried to move to another place, but on the request of the Devas, stayed close by. The place where Shiva and Parvati stayed came to be known as Shrishailam.


title: Mallikarjuna Temple, Srisailam

text: As per Hindu legend, the presiding deity in the form of Linga (an iconic form of Shiva) was worshipped with jasmine (locally called in Telugu as "Mallika"), leading to the name of presiding deity as Mallikarjuna.


title: Mallikarjuna Temple, Srisailam

text: There are inscriptional evidence from the Satavahana dynasty which place the temple to be existent from the 2nd century. Most modern additions were done during the time of king Harihara I of Vijayanagara Empire. The veerasheromandapam and paathalaganga steps was constructed during the time of Reddi Kingdom.


title: Mallikarjuna Temple, Srisailam

text: The temple complex covers 2 hectares and houses four gateway towers known as "gopurams". The temple has numerous shrines, with those of Mallikarjuna and Bhramaramba being the most prominent. The temple complex houses many halls; the most notable is the Mukha Mandapa built during the Vijayanagar period.


title: Mallikarjuna Temple, Srisailam

text: The temple is situated facing East. The center mandapam has several pillars, with a huge idol of Nadikeshwara. The temple is enclosed by tall walls measuring by and tall. There are a number of sculptures in the precinct each rising above another. The Mukamandapa, the hall leading to the sanctum, has intricately sculpted pillars. The shrine where Mallikarjuna is housed is considered the oldest in the temple, dating back to the 7th century. There is a Sahasra linga (1000 linga), believed to have been commissioned by Rama and five other lingams believed to have been commissioned by Pandavas. A mirror hall in the first precinct has images of Nataraja.


title: Mallikarjuna Temple, Srisailam

text: The nearest railway station are Markapur is 85 km, Nandyal and Kurnool are the places the distance is 180 km. The most convenient way is to take a bus or taxi from Hyderabad. Temple committee cottages and dharamshalas are available here.


title: Mallikarjuna Temple, Srisailam

text: Shiva in this temple is referred to as one of the twelve Jyotirlingas. Goddess Bramarambha's shrine is referred to as one of the fifty two Shakti peethas. This temple is classified as one of the Paadal Petra Sthalam.


title: Mallikarjuna Temple, Srisailam

text: On the way to the main temple is located Shikhareshwaram temple. It is said that by having darshan in the temple one does not get rebirth.


title: Mallikarjuna Temple, Srisailam

text: Krishna River here is called Patal Ganga. One has to go down 852 stairs to reach the river. The Shiva Linga is bathed with the water of this river.


title: Mallikarjuna Temple, Srisailam

text: As per Siva Mahapuranam, once Brahma (the Hindu God of creation) and Vishnu (the Hindu God of preservation) had an argument in terms of supremacy of creation. To test them, Shiva pierced the three worlds as a huge endless pillar of light, the "jyotirlinga". Vishnu and Brahma split their ways to downwards and upwards respectively to find the end of the light in either directions. Brahma lied that he found out the end, while Vishnu conceded his defeat. Shiva appeared as a second pillar of light and cursed Brahma that he would have no place in ceremonies while Vishnu would be worshipped till the end of eternity. The "jyotirlinga" is the supreme partless reality, out of which Shiva partly appears. The "jyotirlinga" shrines, thus are places where Shiva appeared as a fiery column of light. Originally there were believed to be 64 "jyotirlingas" while 12 of them are considered to be very auspicious and holy. Each of the twelve "jyotirlinga" sites take the name of the presiding deity – each considered different manifestation of Shiva. At all these sites, the primary image is "lingam" representing the beginningless and endless "Stambha" pillar, symbolizing the infinite nature of Shiva. The twelve "jyotirlinga" are Somnath in Gujarat, Mallikarjuna at Srisailam in Andhra Pradesh, Mahakaleswar at Ujjain in Madhya Pradesh, Omkareshwar in Madhya Pradesh, Kedarnath in Uttarakhand, Bhimashankar in Maharashtra, Viswanath at Varanasi in Uttar Pradesh, Triambakeshwar in Maharashtra, Vaidyanath at Deoghar district in Jharkhand, Nageswar at Dwarka in Gujarat, Rameshwar at Rameswaram in Tamil Nadu and Grishneshwar at Aurangabad in Maharashtra.


title: Mallikarjuna Temple, Srisailam

text: Srisailam Sri Mallikarjuna Swamy Temple is one of the 18 Maha Shakti Peetha. "The legend of Daksha Yaga and Sati's self-immolation" resulted in the emergence of Sri Parvati in the place of Sati Devi and making Shiva a householder. This mythology is the story behind the origin of Shakti Peethas. They are holy abodes of Adiparashakti formed due to the falling of Sati Devi's corpse when Shiva carried it and wandered. It is believed that Sati Devi's Upper lip has fallen here.


title: Mallikarjuna Temple, Srisailam

text: Srisailam Sri Mallikarjuna Swamy Temple is located around 180 kilometers from the Kurnool district headquarters, and 213 kilometers from Hyderabad. Pilgrims coming by train would need to alight at the railway station in either Markapur or Tarlupadu. These stations are between 2 and 2.5 hours by road. The Kacheguda-Guntur passenger passes through the Giddalur railway station that is 139 kilometers from the temple.


title: Orient (manga)

text: The story revolves around a 15-year-old boy named Musashi and takes place during Japan's Sengoku period. At the time, Japan is ruled by Oni and Bushi are considered taboo. Musashi is blending in as a miner along with others who are brainwashed into thinking the demons are their saviors and fed lies about the samurai being evil. However, Musashi knows the truth. He wants to confront the demons with his certain special power.


title: Orient (manga)

text: "Orient", written and illustrated by Shinobu Ohtaka, was serialized in Kodansha's "Weekly Shōnen Magazine" from May 30, 2018, to January 6, 2021. The manga was then transferred to Kodansha's "Bessatsu Shōnen Magazine" on February 9, 2021. Kodansha has compiled its chapters into individual "tankōbon" volumes. The first volume was published on August 17, 2018. As of November 9, 2022, seventeen volumes have been released.


title: Orient (manga)

text: In March 2020, Kodansha USA announced the acquisition of the manga for English language digital release, with the first volume being released on April 7, 2020. Kodansha USA also announced the print release of the manga starting on January 26, 2021. The manga has also been licensed in Germany by Kazé and in France by Pika.


title: Orient (manga)

text: On January 4, 2021, it was announced that the series will receive an anime television series adaptation. The series is animated by A.C.G.T and directed by Tetsuya Yanagisawa, with Mariko Kunisawa handling the scripts, Takahiro Kishida designing the characters, and Hideyuki Fukasawa composing the series' music. It aired from January 6 to March 24, 2022, on TV Tokyo and AT-X. Da-ice performed the series' opening theme song "Break Out", while Wataru Hatano performed the series' ending theme song "Naniiro." Crunchyroll licensed the series outside of Asia. Medialink licensed the series in Southeast Asia and South Asia; they released it on Ani-One Ultra YouTube channel for membership subscribers, iQIYI and Animax Asia. On January 13, 2022, Crunchyroll announced that the series will receive an English dub, which premiered on February 23.


title: Orient (manga)

text: At the end of the twelfth episode, a second cour was announced, which aired from July 12 to September 27, 2022. The opening theme song is "Break it down" by Sōta Hanamura from Da-ice and Lil' Fang from Faky, while the ending theme song is "Irochigai no Itotaba" by Gakuto Kajiwara.


title: Orient (manga)

text: Rebecca Silverman of "Anime News Network", gave the first volume 3½ out of five stars. Silverman praised the series for its iconography, adding that the demons are drawn with the same symbols and styling seen in Buddhist imagery, like bodhisattva with horns, fangs, and talons. She added that Ohtaka's art improved with the series and appreciated her departure from the "boob jokes" presented in her earlier works, making the series feel "less juvenile while still being good for middle grade readers". Silverman concluded: "in the shounen action line, this is looking like a safe bet". Faye Hopper of the same website, gave the first volume 2½ out of five stars. Hopper praised the series' art, but criticized it for its execution and pacing, adding: "New characters appear out of nowhere and are not given proper introductions, character arcs are not meaningfully advanced, and any potential tension is lost in how the characters don't face meaningful consequences for their actions. It is a mess." Hopper concluded: "a final impression is just as important as an introductory one. And sadly, at the end of the day, "Orient" just does not keep up its momentum".


title: Mastitis

text: Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs within the first few months of delivery. Complications can include abscess formation.


title: Mastitis

text: Risk factors include poor latch, cracked nipples, use of a breast pump, and weaning. The bacteria most commonly involved are "Staphylococcus" and "Streptococci". Diagnosis is typically based on symptoms. Ultrasound may be useful for detecting a potential abscess.


title: Mastitis

text: Prevention is by proper breastfeeding techniques. When infection is present, antibiotics such as cephalexin may be recommended. Breastfeeding should typically be continued, as emptying the breast is important for healing. Tentative evidence supports benefits from probiotics. About 10% of breastfeeding women are affected.


title: Mastitis

text: When it occurs in breastfeeding mothers, it is known as puerperal mastitis, lactation mastitis, or lactational mastitis. When it occurs in non breastfeeding women it is known as non-puerperal or nonlactational. Mastitis can, in rare cases, occur in men. Inflammatory breast cancer has symptoms very similar to mastitis and must be ruled out.


title: Mastitis

text: The symptoms are similar for puerperal and nonpuerperal mastitis but predisposing factors and treatment can be very different.


title: Mastitis

text: Puerperal mastitis is the inflammation of the breast in connection with pregnancy, breastfeeding or weaning. Since one of the most prominent symptoms is tension and engorgement of the breast, it is thought to be caused by blocked milk ducts or milk excess. It is relatively common; estimates range depending on methodology between 5–33%. However, only about 0.4–0.5% of breastfeeding mothers develop an abscess.


title: Mastitis

text: Some predisposing factors are known but their predictive value is minimal. It appears that proper breastfeeding technique, frequent breastfeeding and avoidance of stress are the most important factors that can be influenced.


title: Mastitis

text: Light cases of mastitis are often called breast engorgement; the distinction is overlapping and possibly arbitrary or subject to regional variations.


title: Mastitis

text: The term nonpuerperal mastitis describes inflammatory lesions of the breast occurring unrelated to pregnancy and breastfeeding. This article includes description of mastitis as well as various kinds of mammary abscesses. Skin related conditions like dermatitis and foliculitis are a separate entity.


title: Mastitis

text: Names for non-puerperal mastitis are not used very consistently and include mastitis, subareolar abscess, duct ectasia, periductal inflammation, Zuska's disease and others.


title: Mastitis

text: Periductal mastitis is a form of nonlactational mastitis, and is characterized by inflammation of the subareolar ducts. Although the cause of periductal mastitis is currently unknown, it is predicted that smoking may be related. This condition is mainly seen in young women but can also be seen in men.


title: Mastitis

text: Lactation mastitis usually affects only one breast and the symptoms can develop quickly. It develops into three stages, from the initial stage, the pus formation stage, to the restoration stage. The signs and symptoms usually appear suddenly and they include:


title: Mastitis

text: Contact should be made with a health care provider with special breastfeeding competence as soon as the patient recognizes the combination of signs and symptoms. Most of the women first experience the flu-like symptoms and just after they may notice a sore red area on the breast. Also, women should seek medical care if they notice any abnormal discharge from the nipples, if breast pain is making it difficult to function each day, or they have prolonged, unexplained breast pain.


title: Mastitis

text: A breast abscess is a collection of pus that develops in the breast with various causes. During lactation, breast abscess develops only rarely, most sources cite about 0.4–0.5% of breastfeeding women. Known risk factors are age over 30, primiparous and late delivery. No correlation was found with smoking status; however, this may be in part because far fewer smoking women choose to breastfeed. Antibiotics were not shown effective in prevention of lactation abscess but are useful to treat a secondary infection (see the section on the treatment of breast abscess in this article).


title: Mastitis

text: Keratinizing squamous metaplasia of lactiferous ducts may play a similar role in the pathogenesis of nonpuerperal subareolar abscess.


title: Mastitis

text: Since the 1980s mastitis has often been divided into non-infectious and infectious sub-groups. However, recent research suggests that it may not be feasible to make divisions in this way. It has been shown that types and amounts of potentially pathogenic bacteria in breast milk are not correlated to the severity of symptoms. Moreover, although only 15% of women with mastitis in Kvist et al.'s study were given antibiotics, all recovered and few had recurring symptoms. Many healthy breastfeeding women wishing to donate breast milk have potentially pathogenic bacteria in their milk but have no symptoms of mastitis.


title: Mastitis

text: Mastitis typically develops when the milk is not properly removed from the breast. Milk stasis can lead to the milk ducts in the breasts becoming blocked, as the breast milk is not being properly and regularly expressed. It has also been suggested that blocked milk ducts can occur as a result of pressure on the breast, such as tight-fitting clothing or an over-restrictive bra, although there is sparse evidence for this supposition.


title: Mastitis

text: Mastitis may occur when the baby is not appropriately attached to the breast while feeding, when the baby has infrequent feeds or has problems suckling the milk out of the breast.


title: Mastitis

text: The presence of cracks or sores on the nipples increases the likelihood of infection. Tight clothing or ill-fitting bras may also cause problems as they compress the breasts. There is a possibility that infants carrying infectious pathogens in their noses can infect their mothers; the clinical significance of this finding is still unknown.


title: Mastitis

text: Mastitis and breast abscesses can also be caused by direct trauma to the breast. Such injury can occur for example during sports activities or due to seat belt injury.


title: Mastitis

text: Mastitis can also develop due to contamination of a breast implant or any other foreign body, for example after nipple piercing. In such cases, the removal of the foreign body is indicated.


title: Mastitis

text: Women who are breastfeeding are at risk for developing mastitis especially if they have sore or cracked nipples or have had mastitis before while breastfeeding another baby. Also, the chances of getting mastitis increases if women use only one position to breastfeed or wear a tight-fitting bra, which may restrict milk flow Difficulties in getting a nursing infant to latch on to the breast can also increase the risk for mastitis.


title: Mastitis

text: Women with diabetes, chronic illness, AIDS, or an impaired immune system may be more susceptible to the development of mastitis.


title: Mastitis

text: Some women (approximately 15%) will require antibiotic treatment for infection which is usually caused by bacteria from the skin or the baby's mouth entering the milk ducts through skin lesions of the nipple or through the opening of the nipple. Infection is usually caused by "Staphylococcus aureus". Infectious pathogens commonly associated with mastitis are "Staphylococcus aureus", "Streptococcus" spp. and Gram-negative bacilli such as "Escherichia coli". "Salmonella spp.", mycobacteria, and fungi such as "Candida" and "Cryptococcus" have been identified in rare instances.


title: Mastitis

text: Recent research suggests that infectious pathogens play a much smaller role in the pathogenesis than was commonly assumed only a few years ago. Most detected pathogens are very common species that are natural part of the breast fauna and simple detection of their presence is not sufficient to prove a causative role. Furthermore, there are indications that treatment with antibiotics may have minimal impact, and over-all there is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for treating lactational mastitis.


title: Mastitis

text: The diagnosis of mastitis and breast abscess can usually be made based on a physical examination. The doctor will also take into account the signs and symptoms of the condition.


title: Mastitis

text: However, if the doctor is not sure whether the mass is an abscess or a tumor, a breast ultrasound may be performed. The ultrasound provides a clear image of the breast tissue and may be helpful in distinguishing between simple mastitis and abscess or in diagnosing an abscess deep in the breast. The test consists of placing an ultrasound probe over the breast.


title: Mastitis

text: In cases of infectious mastitis, cultures may be needed in order to determine what type of organism is causing the infection. Cultures are helpful in deciding the specific type of antibiotics that will be used in curing the disease. These cultures may be taken either from the breast milk or of the material aspirated from an abscess.


title: Mastitis

text: Mammograms or breast biopsies are normally performed on women who do not respond to treatment or on non-breastfeeding women. This type of tests is sometimes ordered to exclude the possibility of a rare type of breast cancer which causes symptoms similar to those of mastitis.


title: Mastitis

text: Breast cancer may coincide with or mimic symptoms of mastitis. Only full resolution of symptoms and careful examination are sufficient to exclude the diagnosis of breast cancer.


title: Mastitis

text: Lifetime risk for breast cancer is significantly reduced for women who were pregnant and breastfeeding. Mastitis episodes do not appear to influence lifetime risk of breast cancer.


title: Mastitis

text: Mastitis does however cause great difficulties in diagnosis of breast cancer and delayed diagnosis and treatment can result in worse outcome.


title: Mastitis

text: Breast cancer may coincide with mastitis or develop shortly afterwards. All suspicious symptoms that do not completely disappear within 5 weeks must be investigated.


title: Mastitis

text: Breast cancer incidence during pregnancy and lactation is assumed to be the same as in controls. Course and prognosis are also very similar to age matched controls. However diagnosis during lactation is particularly problematic, often leading to delayed diagnosis and treatment.


title: Mastitis

text: Some data suggest that noninflammatory breast cancer incidence is increased within a year following episodes of nonpuerperal mastitis and special care is required for follow-up cancer prevention screening. So far only data from short term observation is available and total risk increase can not be judged. Because of the very short time between presentation of mastitis and breast cancer in this study it is considered very unlikely that the inflammation had any substantial role in carcinogenesis, rather it would appear that some precancerous lesions may increase the risk of inflammation (hyperplasia causing duct obstruction, hypersensitivity to cytokines or hormones) or the lesions may have common predisposing factors.


title: Mastitis

text: A very serious type of breast cancer called inflammatory breast cancer presents with similar symptoms as mastitis (both puerperal and nonpuerperal). It is the most aggressive type of breast cancer with the highest mortality rate. The inflammatory phenotype of IBC is thought to be mostly caused by invasion and blocking of dermal lymphatics, however it was recently shown that NF-κB target genes activation may significantly contribute to the inflammatory phenotype. Case reports show that inflammatory breast cancer symptoms can flare up following injury or inflammation making it even more likely to be mistaken for mastitis. Symptoms are also known to partially respond to progesterone and antibiotics, reaction to other common medications can not be ruled out at this point.


title: Mastitis

text: In lactation mastitis, frequent emptying of both breasts by breastfeeding is essential. Also essential is adequate fluid supply for the mother and baby.


title: Mastitis

text: For breastfeeding women with light mastitis, massage and application of heat prior to feeding can help as this may aid unblocking the ducts. However, in more severe cases of mastitis heat or massage could make the symptoms worse and cold compresses are better suited to contain the inflammation.


title: Mastitis

text: Nonpuerperal mastitis is treated by medication and possibly aspiration or drainage (see in particular treatment of subareolar abscess and treatment of granulomatous mastitis). According to a BMJ best practice report, antibiotics are generally to be used in all nonpuerperal mastitis cases, with replacement of the antibiotics by an antifungal agent such as fluconazole in cases of deep fungal infections, and corticosteroids are to be used in case of granulomatous mastitis (with differential diagnosis to tuberculosis infection of the breast).


title: Mastitis

text: In idiopathic granulomatous mastitis, successful treatment includes invasive surgical procedures or less invasive treatment with steroid medications.


title: Mastitis

text: In lactational mastitis, antibiotics are not needed in the overwhelming majority of cases and should be used only for bacterial infections. For people with nonsevere infections, dicloxacillin or cephalexin are recommended. For people with severe infections, vancomycin is recommended. The length of antibiotic treatment ranges anywhere from 5–14 days. The effects of antibiotics has not been well studied as of 2013.


title: Mastitis

text: An abscess (or suspected abscess) in the breast may be treated by ultrasound-guided fine-needle aspiration (percutaneous aspiration) or by surgical incision and drainage; each of these approaches is performed under antibiotic coverage. In case of puerperal breast abscess, breastfeeding from the affected breast should be continued where possible.


title: Mastitis

text: For small breast abscesses, ultrasound-guided fine needle aspiration such as to completely drain the abscess is widely recognized as a preferred initial management.


title: Mastitis

text: One recommended treatment includes antibiotics, ultrasound evaluation and, if fluid is present, ultrasound-guided fine needle aspiration of the abscess with an 18 gauge needle, under saline lavage until clear. The exudate is then sent for microbiological analysis for identification of the pathogen and determination of its antibiotic sensitivity profile, which may in turn give an indication for changing the antibiotics. At follow-up, a mammography is performed if the condition has resolved; otherwise the ultrasound-guided fine-needle aspiration with lavage and microbiological analysis is repeated. If three to five aspirations still do not resolve the condition, percutaneous drainage in combination with placement of an indwelling catheter is indicated, and only if several attempts at ultrasound-guided drainage fail, surgical resection of the inflamed lactiferous ducts (preferably performed after the acute episode is over). It is noted, however, that even the excision of the affected ducts does not necessarily prevent recurrence.


title: Mastitis

text: Nonpuerperal breast abscesses have a higher rate of recurrence compared to puerperal breast abscesses. There is a high statistical correlation of nonpuerperal breast abscess with diabetes mellitus (DM). On this basis, it has recently been suggested that diabetes screening should be performed on patients with such abscess.


title: Mastitis

text: Although there are a number of recommendations regarding the treatment of breast abscesses, a 2015 review found insufficient evidence of whether needle aspiration is comparable to incision and drainage, or whether antibiotics should generally be given to women undergoing incision and drainage.


title: Mastitis

text: Temperature and severity of symptoms at presentation do not predict outcome; women with sore or damaged nipples may need special attention.


title: Mastitis

text: Mastitis is quite common among breastfeeding women. The WHO estimates that although incidences vary between 2.6% and 33%, the prevalence globally is approximately 10% of breastfeeding women. Most mothers who develop mastitis usually do so within the first few weeks after delivery. Most breast infections occur within the first or second month after delivery or at the time of weaning. However, in rare cases it affects women who are not breastfeeding.


title: Mastitis

text: Popular usage of the term "mastitis" varies by geographic region. Outside the US it is commonly used for puerperal and nonpuerperal cases, in the US the term nonpuerperal mastitis is rarely used and alternative names such as duct ectasia, subareolar abscess and plasma cell mastitis are more frequently used.


title: Mastitis

text: American usage: mastitis usually refers to puerperal (occurring to breastfeeding mothers) mastitis with symptoms of systemic infection. Lighter cases of puerperal mastitis are often called breast engorgement.


title: Mastitis

text: In this article, "mastitis" is used in the original sense of the definition as inflammation of the breast with additional qualifiers where appropriate.


title: Mastitis

text: The word "mastitis" () uses combining forms of "mast-" + "-itis". The word "mammitis" () uses combining forms of "mamm-" + "-itis". They are synonymous in modern usage, and "mastitis" is the more commonly used synonym.


title: Mastitis

text: Mastitis occurs in other animals as in humans, and is especially a concern in livestock, since milk from the affected udders of livestock may enter the food supply and pose a health risk.


title: Mastitis

text: It is a major condition in some species, like dairy cows. It is the cause of much unwanted suffering for the dairy cows. It is of tremendous economic importance for the dairy industry, and it is also of concern for public health. The same considerations apply to mastitis in sheep and goats and other milk-producing females. It is also of economic importance in the sow, but, in this species, it is not related to public health. In other domestic females (queen, mare, etc.), it is more an individual illness dealt with by veterinary practitioners.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Truth, the Ministry of Peace, the Ministry of Love, and the Ministry of Plenty are the four ministries of the government of Oceania in the 1949 dystopian novel "Nineteen Eighty-Four", by George Orwell.


title: Ministries of Nineteen Eighty-Four

text: The use of contradictory names in this manner may have been inspired by the British and American governments; during the Second World War, the British Ministry of Food oversaw rationing (the name "Ministry of Food Control" was used in World War I) and the Ministry of Information restricted and controlled information, rather than supplying it; while, in the U.S., the War Department was abolished and replaced with the "National Military Establishment" in 1947 and then became the Department of Defense in 1949, right around the time that "Nineteen Eighty-Four" was published.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Truth (Newspeak: Minitrue) is the ministry of propaganda. As with the other ministries in the novel, the name "Ministry of Truth" is a misnomer because in reality it serves the opposite: it is responsible for any necessary falsification of historical events. However, like the other ministries, the name is also apt because it decides what "truth" is in Oceania.


title: Ministries of Nineteen Eighty-Four

text: As well as administering "truth", the ministry spreads a new language amongst the populace called Newspeak, in which, for example, "truth" is understood to mean statements like when the situation warrants. In keeping with the concept of doublethink, the ministry is thus aptly named in that it creates/manufactures "truth" in the Newspeak sense of the word. The book describes the doctoring of historical records to show a government-approved version of events.


title: Ministries of Nineteen Eighty-Four

text: Winston Smith, the main character of the novel, works at the Ministry of Truth. It is an enormous pyramidal structure of glittering white concrete rising 300 metres (980 ft) into the air, containing over 3000 rooms above ground. On the outside wall are the three slogans of the Party: "WAR IS PEACE," "FREEDOM IS SLAVERY," and "IGNORANCE IS STRENGTH." There is also a large part underground, probably containing huge incinerators where documents are destroyed after they are put down memory holes. For his description, Orwell was inspired by the Senate House at the University of London.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Truth is involved with news media, entertainment, the fine arts and educational books. Its purpose is to rewrite history to change the facts to fit Party doctrine for propaganda effect. For example, if Big Brother makes a prediction that turns out to be wrong, the employees of the Ministry of Truth correct the record to make it accurate. This is the "how" of the Ministry of Truth's existence. Within the novel, Orwell elaborates that the deeper reason for its existence, the "why", is to maintain the illusion that the Party is absolute. It cannot ever seem to change its mind (if, for instance, they perform one of their constant changes regarding enemies during war) or make a mistake (firing an official or making a grossly misjudged supply prediction), for that would imply weakness and to maintain power the Party must seem eternally right and strong.


title: Ministries of Nineteen Eighty-Four

text: Minitrue plays a role as the news media by changing history, and changing the words in articles about events current and past, so that Big Brother and his government are always seen in a good light and can never do any wrong. The content is more propaganda than actual news.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Peace (Newspeak: Minipax) serves as the war ministry of Oceania's government, and is in charge of the armed forces, mostly the navy and army. The Ministry of Peace may be the most vital organ of Oceania, seeing as the nation is supposedly in an ongoing genocidal war with either Eurasia or Eastasia and requires the right amount of force not to win the war, but keep it in a state of equilibrium.


title: Ministries of Nineteen Eighty-Four

text: As explained in Emmanuel Goldstein's book, "The Theory and Practice of Oligarchical Collectivism", the Ministry of Peace revolves around the principle of perpetual war. Perpetual war uses up all surplus resources, keeping most citizens in lives of constant hardship—and thus preventing them from learning enough to comprehend the true nature of their society. Perpetual warfare also "helps preserve the special mental atmosphere that a hierarchical society needs." Since that means the balance of the country rests in the war, the Ministry of Peace is in charge of fighting the war (mostly centred around Africa and India), but making sure to never tip the scales, in case the war should become one-sided. Oceanic telescreens usually broadcast news reports about how Oceania is continually winning every battle it fights, though these reports have little to no credibility.


title: Ministries of Nineteen Eighty-Four

text: As with all the other "Nineteen Eighty-Four" ministries, the Ministry of Peace is named the exact opposite of what it does, since the Ministry of Peace is in charge of maintaining a state of war. The meaning of "peace" has been equated with the meaning of "war" in the slogan of the party, "War is Peace". Like the names of other ministries, it also has a literal application: Perpetual war is what keeps the "peace" (the status quo) in Oceania and the balance of power in the world, and since the other major powers also use warfare as a means of maintaining the status quo, the two concepts are functionally identical.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Love (Newspeak: Miniluv) serves as Oceania's interior ministry. It enforces loyalty to Big Brother through fear, buttressed through a massive apparatus of security and repression, as well as systematic brainwashing. The Ministry of Love building has no windows and is surrounded by barbed wire entanglements, steel doors, hidden machine-gun nests, and guards armed with "jointed truncheons". Referred to as "the place where there is no darkness", its interior lights are never turned off. It is arguably the most powerful ministry, controlling the will of the population. The Thought Police are a part of Miniluv.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Love, like the other ministries, is misnamed, since it is responsible for the practice and infliction of misery, fear, suffering and torture. In a sense, however, the name is apt, since its ultimate purpose is to instill "love" of Big Brother—the only form of love permitted in Oceania—in the minds of thoughtcriminals as part of the process of reverting them to orthodox thought. This is typical of the language of Newspeak, in which words and names frequently contain both an idea and its opposite; the orthodox party member is nonetheless able to resolve these contradictions through the disciplined use of doublethink.


title: Ministries of Nineteen Eighty-Four

text: Room 101, introduced in the climax of the novel, is the basement torture chamber in the Ministry of Love, in which the Party attempts to subject a prisoner to their own worst nightmare, fear or phobia, with the objective of breaking down their resistance.


title: Ministries of Nineteen Eighty-Four

text: Such is the purported omniscience of the state in the society of "Nineteen Eighty-Four" that even a citizen's nightmares are known to the Party. The nightmare, and therefore the threatened punishment, of the protagonist Winston Smith is to be attacked by rats. This is manifested in Room 101 by confronting Smith with a wire cage that contains two large rats. The front of the cage is shaped so that it can fit over a person's face. A trap-door is then opened, allowing the rats to devour the victim's face. This cage is fitted over Smith's face, but he saves himself by begging the authorities to let his lover, Julia, suffer this torture instead of him. The threatened torture, and what Winston is willing to sacrifice to escape it, breaks his last promise to himself and to Julia: never to betray her. (Even though he had confessed to their actions, he still loved her until this point.) The book suggests that Julia is likewise subjected to her own worst fear (although it is not revealed what that fear is), and when she and Winston later meet in a park, he notices a scar on her forehead. The intent of threatening Winston with the rats was to break his spirit by forcing him into betraying the only person he loved, thus eliciting his compliance.


title: Ministries of Nineteen Eighty-Four

text: Orwell named Room 101 after a conference room at Broadcasting House where he used to sit through tedious meetings.


title: Ministries of Nineteen Eighty-Four

text: The Ministry of Plenty (Newspeak: Miniplenty) is in control of Oceania's command economy. It oversees rationing of food, supplies, and goods. As told in Goldstein's book, the economy of Oceania is very important, and it is necessary to have the public continually create useless and synthetic supplies or weapons for use in the war, while they have no access to the means of production. This is the central theme of Oceania's idea that a poor, ignorant populace is easier to rule over than a wealthy, well-informed one. Telescreens often make reports on how Big Brother has been able to increase economic production, even when production has actually gone down (see ).


title: Ministries of Nineteen Eighty-Four

text: The Ministry hands out statistics which are "nonsense". When Winston is adjusting some Ministry of Plenty's figures, he explains this:


title: Ministries of Nineteen Eighty-Four

text: Like the other ministries, the Ministry of Plenty seems to be entirely misnamed, since it is, in fact, responsible for maintaining a state of perpetual poverty, scarcity and financial shortages. However, the name is also apt, because, along with the Ministry of Truth, the Ministry of Plenty's other purpose is to convince the populace that they are living in a state of perpetual prosperity. Orwell made a similar reference to the Ministry of Plenty in his allegorical work "Animal Farm" when, in the midst of a blight upon the farm, Napoleon the pig orders the silo to be filled with sand, then to place a thin sprinkling of grain on top, which fools human visitors into being dazzled about Napoleon's boasting of the farm's superior economy.


title: Ministries of Nineteen Eighty-Four

text: A department of the Ministry of Plenty is charged with organizing state lotteries. These are very popular among the proles, who buy tickets and hope to win the big prizes—a completely vain hope as the big prizes are in fact not awarded at all, the Ministry of Truth participating in the scam and publishing every week the names of non-existent big winners.


title: Ministries of Nineteen Eighty-Four

text: In the Michael Radford film adaptation, the ministry is renamed the Ministry of Production, or MiniProd.


title: Ministries of Nineteen Eighty-Four

text: The novel's popularity has resulted in the term "Room 101" being used to represent a place where unpleasant things are done.


title: Ministries of Nineteen Eighty-Four

text: In "The Ricky Gervais Show", Ricky Gervais and Stephen Merchant play a game called "Room 102", based on the concept of "Room 101", in which Karl Pilkington has to decide what things he dislikes enough to put in Room 102. This would result, according to their game, in these things being erased from existence.


title: Ministries of Nineteen Eighty-Four

text: In Terry Gilliam’s 1985 film, "Brazil", the alternate dystopian world in which the film is set bears immense similarities to that of "Nineteen Eighty-Four", including following an anxious bureaucrat who works at a governmental establishment called the Ministry of Information.


title: Ministries of Nineteen Eighty-Four

text: In 1992 cartoon "", the episode "What Is Reality?" had Batman solving one of the Riddler's riddles as taking place in "Room 101" of the police headquarters. There, Batman finds Commissioner Gordon tortured in a virtual reality simulator, and must solve riddles to free him.


title: Ministries of Nineteen Eighty-Four

text: In the 2011 "Doctor Who" episode "The God Complex", the Doctor and his companions find themselves in a hotel full of their own personal Room 101s, each with their greatest fear in it. The Doctor's own room is number 11, which serves as a double entendre, alluding both to the real Room 101, and to the fact that the then-incumbent, Matt Smith, was the eleventh actor to fulfill a starring role as the Doctor.


title: Phoenix Force (comics)

text: The Phoenix Force is a fictional entity appearing in American comic books published by Marvel Comics. Created by Chris Claremont and Dave Cockrum, the Phoenix Force is famous for its central role in "The Dark Phoenix Saga" storyline, and is frequently linked to Jean Grey.


title: Phoenix Force (comics)

text: The Phoenix first appeared in "The Uncanny X-Men" #101 (October 1976) in the guise of Jean Grey, and was created by Chris Claremont and Dave Cockrum.


title: Phoenix Force (comics)

text: The Phoenix Force is an immortal and immutable manifestation of the universal force of life and passion. The Phoenix Force is a creation of the universe that was born of the void between states of being. It is the nexus of all psionic energy of the past, present, and future in all realities of the multiverse, the Guardian of Creation and of the dangerously powerful M'Kraan Crystal.


title: Phoenix Force (comics)

text: The Phoenix Force is among the most feared beings in all of existence—it can cut, re-grow, or destroy any part of the universe. It has been described as being "the embodiment of the very passion of Creation—the spark that gave life to the Universe, the flame that will ultimately consume it."


title: Phoenix Force (comics)

text: During its time as a sentient and formless mass of energy, it traveled the cosmos and was worshiped by several alien races, including the Shi'ar, who named the entity Phal'kon, the "sister" of their other gods K'ythri and Sharra.


title: Phoenix Force (comics)

text: According to the alien peace-keeping robot Unit, a billion years ago the alien Demon Lords of Stasis cast a spell on their planet to stop the Evolution. However, five powerful beings led by a female with pyrokinetic powers wage a rebellion against the Lords of Stasis. The rebellion drew the Phoenix to the planet. Although the Demon Lords fight to prevent it, the Phoenix communes with the female and with the loyalty of her disciples that helps her to control the infinite power of the Phoenix, she breaks the spell and the Demons are swept away.


title: Phoenix Force (comics)

text: The Phoenix is later drawn to Earth when Firehair, a young primitive female red-haired mutant overwhelmed with despair by her friends' deaths, contemplates turning her psychic abilities on herself to commit suicide at the "Burnt Place". Attracted to Firehair's untapped raw psychic power, the Phoenix prevents the suicide, bonds with her, and seeks to use her to fulfill its intended purpose of razing planets to ashes. Consumed by vengeful rage, Firehair nearly gives in to the firebird's bloodlust to become a Dark Phoenix, but is pacified by her wolf guardian and decides to use her powers to protect those weaker than herself. Using the alias Lady Phoenix, she joins that time period's incarnation of the Avengers. Her only known fight is with an out-of-control Celestial called the Fallen. During this time she and Odin share a romantic relationship that Odin considers the one time in his life when he truly felt alive. It was later claimed that from their love, Thor was born, but in truth, Phoenix left Odin due to his callousness, until millennia later, she arranged for Odin and Gaea to conceived a child. When Thor was born, his birth was felt by King Laufey who immediately killed him. The Phoenix resurrected him, leaving him permanently imbued with some of her power.