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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...

I am not quite sure what the paper really says, if it is indeed consistent. I am not sure anywhere it says what you are suggesting the data showed. but Nath has specifically said that patients 'can' do things but don't.

I don't know whether it did or didn't but my point was that I don't think PEG was even mentioned. And I think it very likely that this argument is only made when it is thought that if the patient is not 'over-medicalised' by offering artificial feeding they will eventually get around to eating...

When I try to stand up from near the floor my brain tells itself that my muscle cannot contract. It just won't. But I know that if you put an electric current through it it contracts fine - I have had it done as part of electrophysiological tests. And of course the muscle works fine in other...

But wasn't that all said in the context of it being established that she had mental capacity? And my memory is that PEG was not mentioned, only TPN. For people without mental capacity you do whatever it takes to try to keep them alive. My understanding is that the objections to TPN assumed...