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The local hospital says “We have been working with a specialist NHS centre that has this expertise, as a national leader in their field, to arrange a course of treatment that we believe can improve Karen’s condition." Has anyone any idea what this involves and where. I will check back to see if...

Hm. My sense is that it needs a tidy out.

I am not sure that works. When lying flat both tissue fluid and venous blood will find it easiest to return to the central venous blood. If you have a couple of cups of tea for breakfast you are unlikely to be significantly dehydrate (kidneys tend to shut down urine production at night). Muscle...

I always thought it was fairly implausible that salt intake would make much difference to BP. The article seems to confirm that. It may of course be based - the last bit on ATP is pseudoscience so there is clearly an agenda behind it. It tends to confirm my suspicion that salt intake really...

Yes, except it looks as if we now have a situation with too many guidelines from which people can pick and choose. I don't buy the argument that there are no resources for dealing with people with severe ME/CFS. In Exeter a physician with knowledge of ME/CFS was there. The facilities and...

Very nicely written. I now wince every time with the McE and B red herring but apart from that all very powerful and clear.

I wouldn't worry too much. I doubt there are any of importance. The things you are li'ble to read in the bible, they ain't necessarily so.

The problematic guidance is not hospital policy, no does it come from BPS psychiatrists. It comes specifically from gastroenterologists who are physicians (RCP members) and also members of the British Society for Gastroenterology. They have written articles and guidance protocols that propose...

Thanks, yes. I think with the revisiting of the original information from X it is clear that the diagnosis pf ME/CFS has effectively been used to deny options that otherwise might have been provided. Other things would have been done if the diagnosis was not 'functional'. Clearly other factors...

I don't quite follow that example. All diagnoses are concepts. In a sense the paper is trying to point out that if ME or CFS are taken as 'diagnoses' without realising that they inevitably. entail concepts (to mean anything) and that the concepts vary widely between users, then we end up with...

The problem is that there is no formal guidance. It is all a matter of interpretation, even if the implication is there. I may have got this quite wrong. The real reasons for things going wrong may be something else, which is why I am keen to try to check and re-check. We probably need a formal...

Genetic markers would be very helpful, or any other biological measure that we could interpret as part of a process. The two age peaks for women might pan out as different. Any clues that we can make sense of in process terms.

Well meckfuss might be a bit more genteel than SNT's word and it could be Spoonerised.

Yes, I often wonder whether this is more the picture for many people with ME/CFS. Maybe the relation to exertion is not the cardinal thing that makes it look as if this is a unified process. That makes sense to me. My attempt to grasp a central feature ends up with something like: Disablingly...

You can call it a diagnostic concept but most people's idea of diagnoses is that they constitute mutually exclusive 'diseases' and that is a very unhelpful view because different cross-cutting categories with different prognostic and treatment0response implications are more useful. And a...

The problem is that this was post hoc rationalisation in the full knowledge that this was a patient assumed to have capacity. The reasons are all BS but I want to get as close as I can to the sequence of reasonings that went on in 2021. That doesn't come out of any data we have as far as I can...

Your text seems to be acquiring some intriguing âccénts, @Trish. You are not transforming into une grenouille I hope?

My thought is that it would do much better to stay here because the other thread may be accessed by people who do not want to read this. I don't think they necessarily do because the relative risks change. Moreover, the issue is what would actually have been policy and doctors are notoriously...

isn't that so for all words and acronyms attached to concepts. I don't follow Davison's suggestion that you need language to have concepts. Words are just a set of indices. But by convention they are what we use when we refer to concepts. It would seem a bit silly to make the title 'The Concept...

I don't see that we ever past a concept stage. After fifty years I have a clearer concept of rheumatoid arthritis but I still have a concept. And I think we are very much at a concept stage in the sense that a syndrome concept is actually more than just a group of people with similar clinical...