GRID

and therefore will ignore the warning sign of critical pathology and imminent growing harm and fail to apply the services of the necessary QUALIFIED provider

MANDATORY conducted by a licensed Clinical Family/Child Psychologist. A caseworker or other inadequately licensed "mental health professional" has ZERO business making such an assessment.

this gives you a hint, that if any provider is attempting to give an opinion without having assessed all persons involved and relevant data and records, then they are not qualified

UNIVERSAL RISK FACTOR .....translation: you see child-parent contact problem, 1)you have a serious issue that demands qualified attention, 2) you, nor anyone in the D&N system, nor any sub license below Clinical Child/Family Psychologist is qualified to provide that qualified attention

Boom. .... pay careful attention. This is parent experiencing personal grief, it is not that parent abusing or neglecting the child.

Meaning 19% acted in a non-normative way, however, were not abused or neglected.

This would be an example of needing to know the differentials. This is an example of why we make doctors get licensed and they go through years of study and clinical experience before they can have that license and provide service to the public. This is about protecting the public.

Do you know what a type D attachment relationship? Can you tell me the diagnostic determining criteria, the differentials, the risk factors, the treatment modalities, the contraindicated modalities, the complications of severe concern, the indicators or resolution or areas of special concern to monitor? ..... exactly, tap out, you are lawfully obligated to, and you should want to. Serve the child, serve the family, serve the court/agency/legal-offices, serve your overburdened caseload, get the doctor.

Does ORPC, the court, FCS, GAL/CFY, county attorney's office, the ORPC's own LCSW's, ore smattering of other involved non- Licensed Clinical Psychologist Family/Child Psychologists have even this portion of clinical training and specialty expertise? Remember, this is research that all Colorado D&N representing offices are endorsing, not to mention it iw one of the most cited papers throughout US government, child welfare, and all related legal orginizations.

So then....why is ANY JUDGE, LAWYER, OR WELFARE REP attempting to argue the appropriateness and "best interests of child" when anything related to visitation is in dispute. This is an immediate halt of all discussion on the matter and a call to the QUALIFIED doctor's office. Full stop.You are not doctors and you are not allowed to write prescriptions.

Noted author as necessary fundamental training for a qualified provider and assessment being performed.by certified Clinical Psychologist

Don't know what it is about humans that constantly default to depression being a cause and not an effect. ....**depression is virtually never a cause of anything other than resulting choices

COVID is an excellent ACE2 inhibitor. Do people with CoVID display asthmatic condition? They do??

So at the very least it does that prostaglandin production still remains the cause of asthma when taking aspirin should this event occur

What did I just say above!

Boom. What's getting activated in COVID...mast cells and endotheliial cells

Thinking this is treatment for anti Alzheimer's, anti neurodegenerative disease, anti fibrosis,anti CVD/AS/LUNG FIBROSIS

So, it goes SCN to pv zone to dorsalmedial nucleus. DMN then has a GABA circuit to the vlpo to trigger sleep and a glutamate circuit to lateral hypothalamus to trigger wake

Which could likely be equivalent to serotonin knockout which also produced staunch insomnia

Boom. Accumulating adenosine and serotonin are causing sleep pressure drive.

Remember thought that caffeine blocks adenosine.

Does it mean anything that I've always said the sleep sensation is like it's a growing pressure behind my eyes, and this is right behind my eyes and called the "preoptic"

Prostaglandin showing up again. As in when I think prostaglandin, I think inflammation and also asthma, mast cell activation, broncho and vasoconstriction. I think about aspirin being a prostaglandin inhibitor

Weird. I thought prostaglandin d2 is known root cause involved in asthma including broncho and vasoconstriction f allergic reaction and is spewed out by mast cells and others?

Like ion gates are stuck open. Either because of a constant flooded signal, which might fit with the observed glutamate build up, which fits the increased metabolic rate, and this might fit how total signaling slows down because the nerve can't control its firing timing and just starts popping off and is slow to recover. Or maybe (and I like this better) seen a similar way, nerve cells start fatiguing and momentarily shutting down or at least in a fully useable on demand kind of way. I.e. O2 and fuel delivery and waste and damage removal/containment can't keep up. So then maybe the stars to cause backup of and flooding of neurotransmitters (glutamate) as it tries to keep duty cycling to get the message through. It would also seem likely that circuits have redundancy so even though one circuit goes down the other circuits get the signal through. And maybe as the day goes on they all just start to be spending a lot of time in swa like low pulse mode increasing message duty cycle to push the message through increasingly erroring circuits. Then, maybe the SWA pulse mode is a signal recognized downstream as the "fatigue signal" and it is received by a control center that assists in sending an increasing strong signal to shut down and sleep, maybe even a signal that starts telling cells to enter SWA. Maybe it's not even a control center. Maybe it's a paracrine signal, and maybe metabolic stress causes it's expression but The receiving of it doesn't cause a repeater effect. And maybe a function of serotonin is to be the "go to SWA mode" signal and why it builds through our the day just like SWA regions do, and why knockout zebra fish never sleep, and why ssri's may be causing me to be extra sleepy because I'm inflammed and serotonin is widely upregulated, and maybe in part why ssri s have variable to unobservable or delayed effects because 1) if you're not hyper upregulated, then you wouldn't get sleepy, and 2) the delayed positive effects are actually the result of ssri triggering better and more restorative sleep resulting in better brain function/growth/repair during sleep. And this could explain why it's been somewhat helpful for long COVID because it's making sleep better and more reparative and immunosuppresive. And maybe then the time to take an ssri is actually betfore bed. ... And MAYBE this is why a lot of people aren't getting any benefit because they are no doubt being told to take it in the morning which is when it would have the least effect and be metabolized by nighttime when you need it! Shit, hmmm, that's a lot of data linking up to fit that model. ....oh, and could explain why NREM is a en mass, yet activity load dependent SWA synchronous event because the more upstream the neurons are, the more downstrram nerve cells start to follow the command of the upstream swa pulse.

And MAYBE this explains why it's so hard to sleep when you haven't mentally done anything all day. AND MAYBE, this means that a 5HT antagonist IS ACTUALLY A BIG TREATMENT ANSWER FOR WAKEFULNESS and at the root of most cases of idiopathic hypersomnia! (I think there weren't much options for antagonists). Oh but shut, and consider this platelets,AS A RESPONSE TO INFLAMMATION because of activation, secrete serotonin! It's not a stretch to think that the brain would have a conserved use for the already in use inflammatory/injury/"SICKNESS BEHAVIOR" inducing signal molecule. Hunkering down and being able to sleep and making that sleep more reparative effective would arguably have a strong fitness advantage.

And one more idea, is rem, which they say had the same firing readings as being awake, actually the same but I'm reverse as the other study saw reverse firing? Is this resetting proteins back up the circuit or refurbishing protein/channel/mbrane structures or aberrant charges? Hell, is induction or some other extraneous charge field building up and playing a part in the days worth of accumulating resistance and part of what's happening during sleep or also during swa a reversal or purge/discharge of that opposing electric or magnetic forces? It's it interesting that blood is highly composed of iron, an extremely magnetic and inducible magnetic element? Is the health and thickness of myelin sheaths a part of the healthy function protection against this issue?

This ominous realization did not occur and come together for me until just now:

Kate's influence did not start with Kate directly. It would have started with her son Liam. I've not recognized until now the likely significant role he plays in this. He is her son. He would have already been fully traumatized by Kate or by the situation with his dad, depending on if it existed, but if it did or didn't, the fear/abandonment/insecure attachment disorder would be entrenched in both Kate and Liam and they would be reinforcing it in each other. Rhyanna working with Liam at Subway would have been the first contact in which casual conversation would begin the subtle campaign by Liam via trauma reenactment (and also fueled by being a teenage boy meets girl savior/peacocking mentality) that at first innocuously and then overtly was showing (manipulating into false belief) that she is victimized. Liam then notifies Mom of "the recruit", probably a genuine felt statement like "Mom, there's this girl at work and it sounds like she's going through what we went through and we could help her". Then Mom [Kate], which we know this happened, took the initiative to contact her (or told Liam to bring her over to the house to hangout so she could then introduce herself and have 'a talk' with her). Phone numbers were shared, instructions to not let Dad know where they lived were given, taking out to dinners were done, sharing of "stories about my husband we don't tell other people so please don't share this" were given about "my dangerous psychotic husband that Liam and I had to flee from and go on the run because the system couldn't save us so we had to act outside it". This matches the dynamic and origination story of every cult/radical "church"/scientology/NXIVM story I know and it is the same dynamic whether it's the pathogenic parent or pathogenic adult influence which in this way has an extra component of evolution. Ie, the pathogenic adult has created/obtained a pathogenic "victimized" subordinate follower. The follower then acts as a relatable/ice-breaking recruiter that has the effect on the target of " they're my peer, they're like me, I can therefore trust the accuracy of what they're saying more and am more willing to listen". Then when the follower eventually introduces the pathogenic adult, the critical judgement defence of the target is suppressed/ignored because the target has made the naive judgment error that since I believe and feel trusting in this peer, I can put that trust into someone he is introducing me too. And because that person is "the adult in the room" this person instantly gets, erroneously, the elevated security clearance in the target's mind that this person is a "trusted"+"adult"+"who understands me"+"has my best interest"+"and knows what I need". Additionally, when speaking with this adult, should the target's defense mechanisms of critical judgement start turning on, the target then looks to a reference point to "reality test", and the follower, Liam, is immediately on hand and present almost daily to act as that reference point nodding reassuringly when the target glances over [literally or metaphorically]. ..... Combine this with a parent who is getting sicker and sicker, who's observably by the child who knows her father well can tell his fear, anxiety (particularly regarding his ability to provide for them both), and sadness because of his non-improving sickness from a mysterious unknown deadly pandemic disease, a parent who is the SOLE parent and there is no second parent to reality test against and get reassuring grounded perspective (ie you are not victimized, dad isn't going to kill himself, yes this is a tough situation but we and you are not a victim and this is not a Hallmark/teen drama, and tough situations like this have long been and are a prolific part of human life and we can more than handle this situation and frankly will serve to accelerate your empowered growth and deeper understanding, meaning, passion, joy of life and further shedding of vulnerability to irrational and mismanagement of uncontrollable fear as a general skill set in your personal quiver. This all is the loss of the second, of which there may only be 2, fundamental defense mechanisms to safeguard a child's sound critical analytical/judgement skills. It is easy to empathize with a child's daily living experience, especially an adolescent, how these are the 2 mechanisms which are functioning by which they are consuming and assembling all new knowledge and understanding. #1 They first use their incumbent developed analytical/judgement skills to self analyze a concept or problem or question. #2 They verify that determination with their trusted source of truth and protection, ie their parents (a reality test). Perhaps this at the root of the common report "teenagers think they know everything". It's probably the first time the first mechanism is developed strongly enough to feel like it can safely be used in its own. And in being the first time, many errors will be made and in many of those errors the use of verification of mechanism 2 will not be used. An ill unimproving parent will exacerbate the error to not use mechanism 2. Fear and anxiety will exacerbate errors in mechanism number 1. Severity of those insults would proportionally affect the rate of error. Malfunctions in both mechanisms would have a multiplicative effect on damaging erroneous conclusions the child arrives at and the damage further choices on those erroneous conclusions causes. Then when the "virus" of the narcissistic/BLP cross generational shared persecutory delusion boundary violation gains entry into this now much increased "analytically vulnerable" child, it has the critically added effect of disabling mechanism 2 since the patent now becomes "all bad [splitting]". ..... Then ..... add to this child a history that she is a survivor, albeit exceptionally so, of incurring the pain and largely successful battle for separation from a very narcissistic mother and the family that produced that narcissism in her mother. The entire repercussions of that I am not sure, but relevant here is I think that means my child's developmental reality has a biased understanding and emotional sensitivity to the fear that a parent "I thought was normal, changed into a monster" and second "I fully believed a truth about the 1 of 2 people I trusted and depend on the most, and I was wrong. How can I trust my own conclusions now if I can't trust my own analytical and emotional judgement abilities?". No doubt also a fear and anxiety upregulating mechanism in and if itself, as well as providing a data point which can add confusion to a child frantically looking for understanding and/or can be leveraged to falsely rationalize the false narrative is correct especially when the pain of the truth is building and she is looking for any tool to suppress confronting that pain.

Then, as Rhyanna further looks for, or rather it is imposed onto her, the naive drama thirsty peer group, whom many know Liam and Kate, and whom with very good intention but naivety of teenagers who in Boulder Colorado are conditioned to both be very helpful and that money and wealth (like them) combined with middle aged Caucasian combined with a "Boulderite" personality with an air of non-confrontational superiority and cancel-culture tendencies is the equivalent of "insightful, wise, holder of truth, and generally the definition of what is good, righteous, and hold the authority to declare whom is bad and further that it is expected that they will declare whom is good and bad and that action further validates that they are and have such authorities" in these teenagers minds reenforces this false truth as accurate.. Then the school, then CIRT team "mental health professionals", then the mental health hospital centennial peaks, then Boulder county child welfare via multiple staff, then the court and the judge personally all buy in and propagate this false truth and reinforce it overtly or indirectly overtly, and some propagate it by simply ignoring and not speaking out against or in questioning validity, all reinforcing this false truth. ..... And given all this, given all these goddamn ignorant spineless children of men in their lack of knowledge or past traumas, and under the weight of their ignorance and cowardice and laziness, and then under the unreal weight and fear and confusion of her and her dad, her one parent who's been her warrior defender of knowledge, self discovery, safety, character, food, and shelter, and whom no other family support exists is now very possibly dying and cannot speak for himself or to her (because her confusion and outside influence is not allowing it) to tell her the truth and reassurance of the situation ....... her heart and mind refuse to yield. The pain from her heart refusing to give way to the lie, they are trying to make her believe had caused her to want to kill herself. My daughter s unyielding heart and character brought tears to a police officer who'd not had the fortune of experiencing someone like my daughter. And still, after a year and a half, my daughter, MY daughter, still holds fast and is unwilling to tell the COURT that her resistance is because of me and is instead because of her. Yeah, that's who my daughter is. That is the caliber here. She is her father's daughter.

I see you kid. You hold fast. I'm comin' for you.

PS - Attention needs to be given to Liam. With consideration towards his possible and to what degree of trauma, and the validity of the story regarding his father.. It is now a real question, is his father above and well, normative, searching for his son and or fallen into decline, suicidality, doom? Is Liam about to lose a father and be irreversibly severely damaged because of the complete irreversible devastation, which will also include the self blame he incurs and will not be able to reconcile.

PSS - likely it is both important and the is the time to revisit with focus Rhyannas feelings and understanding of her mom. She possibly stands to gain 1, a self confidence and esteem and complete obliteration of any feeling/false rationalization that she is somehow "less", that she is at fault, or that she is somehow "less capable" of a person now and going forward, 2) stamp out reactions of hate, tolerance, splitting, and walls she might form that would prevent problem solving, truth finding, and understanding so crucial to both abilities and finding of joy, particularly in relationships of love and family, 3) she stands to gain a mother and an entire side of a family and which is attained by a fulfilling relationship of her own architecture and which she is fully empowered to control and manage and nurture at her pleasure.

This is like an OD diagnostic code telling you where the problem is. Got an XYZ receptor AA? something is fucking up your XYZ receptors

"microvascular" (i.e. capillaries, arterioles, sub 500um diameter). Destroyed RBCs are called schistocytes, if any recognizable structure remains

Blending beneath skin > petechiae and or purpura

aka petechiae

Wtf?? Something is critically different about post COVID plasma beyond just spike clothing that makes these clots super sticky. And to naked plastic. What are these tubes made of? Is it polyethylene?? See polyalanine tact fibrin amyloid pathology studies

So this is saying....PPP of never infected people showed clotting when spike S1 was added, but it was worse in PPP (i.e. clear and clean of clots or masses) of prior COVID infected people?? So meaning, not only is spike bad, but COVID adds/changes/induces introduction of something to or into the plasma (eg protein, antibody, altered protein, viral accessory protein, ions, molecules, etc)?

This is bad logic

Jesus fucking Christ

Does this mean we're getting a shit load of antibodies and consequent agglutination coagulation but no Antibody mediated clean up and this the vascular (and elsewhere) garbage pile grows?

Table of Laws Held Unconstitutional in Whole or in Part by the Supreme Court

Goldberg v. Kelly, 397 U.S. 254 (1970) The New York City Department of Social Services promulgated Procedure No. 68-18, which halted aid immediately after the reviewing official affirmed the determination of ineligibility. The applicant was then notified of their ineligibility for welfare via a letter and not provided the opportunity to be heard prior to the termination of aid.

In steps the thought of using ivermectin,a drug that treats parasitic disease, ie malaria

Lyseine groups are the big active sites for plasmin, fibrin, pai, tPA, spike. Lyseine is I think crucial to spike induced amyloid folding

So, if we consider this all true, what's the takeaway for treatment?:

Given all the pathomechanisms summarized below, what's the 1 mechanism that causes the rest, and the rest, if treated, do not only not stop other mechanisms but themselves continue because the treatment is immediately trumped by the driving of a more underlying mechanism. .... THE EXISTING CLOTS AND CONTINUAL CLOTTING. 1ST DEGREE - clotting> antiplatelet + anticoagulant (+anti NET if exists), clots> TPA (+UPA), natto & sera, fibrin mab, other> plasminogen, pai/antiplasmin inhibitors 2nd - inflammation/Endothelium/glycocalyx/ROS/Vasoconstriction (AAB,ACE&R,Renin, NO&pathway up&downstream, Ca,) 3rd - Neuro/antifibrotics (microbiological scar tissue removal)/tissue repair (capillary density, nerve density, brain repair, connective tissue repair)

Pathogenesis: It's an excellent hitch knot, the harder you pull the rope, the more secure the knot clamps on. (If you don't pick the knot apart, the rope will exist perpetually in a knot snapping one day prematurely from it's own knot fatigue then accelerated after existing in a life being unusable and left to the elements to beat it to death, or will snap soon as it can't take the excessive load increasingly unable to loose the harder it tries to pull free.) The body's own immune and homeostasis mechanisms have formed each bend in the knot. Of all the bends to pick apart, only one will allow the other bends to be picked free. And if the knot has been heavily loaded or loaded for a long time, the only way to remove the 1 essential bend is by also picking at the other bends at the same time to finally get the 1 essential bend to let free releasing the tension in the entire knot allowing the easy yet careful (as allowing any of the bends to retighten will systematically cause the retightening of all the other bends and reforming the knot) undoing of all the bends.

• Pathological Blood components: Investigations on the causes of Long-COVID and PCS have identified pathological blood components - microclots and malformed blood cells [including large amounts of schistocytes], mainly too large so that they hinder blood flow. Lymphocytes had a significantly decreased stiffness, monocytes and neutrophils were increased in cell size, erythrocytes were less deformable and a reduced natural killer cell function. The observations of pathological blood components include microclots, large cells, less deformable erythrocytes, decreased lymphocyte stiffness, increased monocyte cell size, large, deformable, activated neutrophils, activated monocytes and activated platelets. Immune cells such as neutrophils, are excessively activated, persistently degranulate. Leads to the formation of fibrin amyloid microclots (scaffolded of platelets, fibrin, NETs, RBCs).

• Thrombosis <> Inflammation (thrombo-inflammation); capillary stasis, thrombotic Endothelium...TISSUE HYPOXIA/BLOCKED PERFUSION: detrimental interaction of pathological blood components with prothrombotic, inflammatory capillary wall changes: Stagnation or slow flow of blood cells enhances the interaction and time for interaction with the prothrombotic wall changes, mainly expressed adhesive molecules, further slowing blood flow velocity. activated neutrophils, activated monocytes and platelets. These activated cells may convert the normally antithrombotic surface of the vascular endothelium to a prothrombotic state to upregulate coagulation, stimulation of inflammatory reactions (thrombo-inflammation) [5,9,37]. the microvessels the vascular system including capillaries could be directly damaged by SARS-CoV2 virus or affected by cytokines generating an inflammatory and prothrombotic vascular wall [9,10]. Due to the long-term inflammatory environment in Long-COVID (PCS), immune cells such as neutrophils, are excessively activated, and persistently degranulate maintaining inflammatory responses. This leads to the formation of fibrin amyloid microclots, which promote tissue hypoxia and impaired oxygen exchange and may additionally block the capillaries [9,10,38-40]. It has been described that chronic inflammation can trigger coagulation proteases to bind to protease-activated receptors on the activated endothelium to induce the synthesis and expression of cell adhesion molecules, which further promotes microcirculatory disorders [9]. Several endothelial cell-related biomarkers have been observed to be strongly correlated with COVID-19 and PCS, such as VWF and Factor VIII, as well as ET-1 and angiopoietin-2 [9]. A recent study identified a disturbed retinal microcirculation to be strongly associated with PCS and ME/CFS, which may serve as a potential marker for microcirculatory disorders [10,41]. Notably, the thrombo-inflammatory status persists months after the patient has been recovered and the virus has cleared [5,39,42]. Therefore, malformed blood cells, microclots and thrombo-inflammation can potentially impede capillary perfusion and promote a microcirculatory disorder and thus, impair the organ blood supply by capillary obstruction [9].

• Capillary rareification, with shunting and blood misdistribution...MORE TISSUE HYPOXIA: and blood resistance tests give false negatives or not strung enough positives

• Interaction of the precapillary cardiovascular disturbances (PCD) with the capillary stasis – a highly unfavorable synergistic interaction in ME/CFS and PCS: Capillary stasis is strongly aggravated by the precapillary cardiovascular disturbance. Endothelial dysfunction found in ME/CFS and PCS certainly worsens the function of capillaries as well of precapillary vessels e.g., by raising vasoconstrictor tone of resistance vessels [17],[50,51].

• Cerebral blood flow: measured over a large cerebral artery was found decreased in ME/CFS and PCS [49]. The extent of flow reduction measured over a large brain artery does not reflect the true extent of the disturbance as it does not consider the microcirculatory disturbance, the maldistribution of blood flow in the capillary system (capillaries with no flow versus hyperperfused capillaries). The severity of the resulting cerebral blood flow disturbance may explain cognitive impairment, mental fatigue and at least partially brain fog.

• Ischemia leads to reperfusion injury

• Mitochondrial energy loss & exercise intolerance from IRI and bAR receptor dysfunction and SFN: IRI leads to Mitochondrial dysfunction/damage via mediated by Ca Na loading and loss of NaK-ATPase. Also, exercise demands 10-20x NaK-ATPase now stay at least amounts even at rest. Deficiency of the only two mediators - ß2AdR and CGRP (due to SFN) - that activate Na+/K+-ATPase during exercise, can be considered a major cause of exercise intolerance in conjunction with perfusion disturbances and mitochondrial dysfunction whereby all these three disturbances are interrelated in vicious cycles. ß2AdR dysfunction is assumed to be present in ME/CFS due to autoantibodies and/or desensitization to chronic stress in ME/CFS (high sympathetic tone) as the ß2AdR is the most sensitive adrenergic receptor to desensitization. The importance of CGRP and its release from sensory nerves for the activation of the Na+/K+-ATPase and for diminishing muscle fatigue has been experimentally demonstrated under conditions of stimulation and inhibition [74,75]. After degeneration of these fibers, by which CGRP is produced, there should be a deficiency in CGRP that adds to the stimulatory deficit of the Na+/K+-ATPase during exercise already caused by ß2AdR dysfunction to aggravate and fix the disturbance. These neuropeptides released from the sensory nerves like Substance P and CGRP are also vasodilatory so that their deficit as a result of SFN may contribute to muscular malperfusion

• ROS/MD; MD resulting from ROS result of MD: ROS generated as a consequence of mitochondrial dysfunction inhibit while reduced ATP levels may further weaken its activity [65,67]. Increased ROS production with evidence for inhibition of the Na+/K+ATPase activity were indeed found in patients with ME/CF [77].

• Vasoconstriction from bAR dysfunction: ß2AdR dysfunction is assumed to be present in ME/CFS due to autoantibodies and/or desensitization to chronic stress in ME/CFS (high sympathetic tone) as the ß2AdR is the most sensitive adrenergic receptor to desensitization.

• Vasoconstriction from ROS

-"Finally, we explain how mitochondrial dysfunction affects perfusion to close another vicious cycle of mutual triggering.": Mitochondrial dysfunction produces ROS to cause endothelial dysfunction and to promote endothelial cell inflammatory, activation of coagulation, and adhesivity [81]. The latter enhances vasoconstrictor influences and favors microcirculatory flow disturbances to further impair perfusion. Finally, via low ATP levels and the generation of ROS that inhibit Na+/K+ATPase [82] and, via an anaerobic metabolism that produces more protons to raise intracellular sodium by the NHE1, mitochondrial dysfunction favors itself [14,83-85]. The energetic disturbance is not severe enough to cause organ damage but limits a rise in physical and mental performance (exercise intolerance). Even worse, at a certain level of exercise, the individual post-exertional malaise threshold (PEM) threshold, intracellular sodium in skeletal muscle rises to reach the reverse mode threshold of the NCX. This causes calcium overload to trigger and renew mitochondrial damage. Thus, during exercise the functional damage reproduces itself, keeping the patients captured in a vicious cycle from which they can hardly escape.

• Mediators resulting from MD (and precursor Ischemia) energy deficit result in systemic pain and blood volume loss and microvascular leakage (causes more tissue perfusion failure and swelling): Mediators like bradykinin, prostaglandins, prostacyclin, and adenosine raising blood flow are physiologically meant to act locally only by their very short half-lives. Due to their excessive production following the poor metabolic situation in the large body muscle mass, however, spillover into the systemic circulation occurs. Any organ can be reached by them to produce the confusing myriad of symptoms including pain, spasms and edema as a result of their physiological actions. These mediators also cause renal hyperexcretion and induce microvascular leakage causing hypovolemia (see section 2) (Figure 2) [14]. Their particular physiological renal actions prevent a compensatory rise in renin for repletion of the vascular system, thereby explaining the paradox that renin does not rise with hypovolemia [79]. This leads to low stroke volume as explained above and causes orthostatic stress

Microvascular Capillary and Precapillary Cardiovascular Disturbances Strongly Interact to Severely Affect Tissue Perfusion and Mitochondrial Function inME/CFS Evolving from the Post COVID-19 Syndrome

Klaus Josef Wirth and Matthias Löhn *Posted Date: 13 December 2023 doi: 10.20944/preprints202312.0791.v1

Summary of Annotations Page 40 #1 Highlight Securing Basic Needs, Social Connections, and Appropriate Services • Housing, clothing, food, and transportation are frequently needed and critical to the client being successful in the treatment plan. For example, social workers and parents advocates helping the client access and secure these—from shopping with the client at Goodwill to filling out housing applications to getting on

2 Highlight

Checking in with the client regularly on what is working and what is not, and then advocating for adjustments to the treatment plan. F

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Treating the client as the expert on their own lives and asking them what they need to be successful. #4 Highlight Mitigating structural barriers to treatment engagement Page 41 #1 Highlight Conduct Legal and Social Science Research • Making sure attorneys are working with recent and relevant research when developing strategy (e.g., attachment theory and visitation strategy

2 Highlight

Reviewing Volume 7 and identifying areas applicable to the case #3 Highlight identifying areas of inaccuracy between case proceedings and Volume 7. #4 Highlight Making sure the treatment plan is using evidence-based practices matched to client need (e.g., a mental health service targeted at family functioning versus generic therapy#5 Highlight Reviewing services and strategies to ensure they are accessible (e.g., disability accommodations, language translation), culturally responsive (e.g., honors family customs), and trauma-informed (e.g., in a safe environment) and advocating for adjustments

6 Highlight

Attend family engagement meetings and appearance reviews to support the client, strategize in real time with other actors, and promote communication from other actors to the client in a way the client understands. • Daily communication with other actors that is necessary to move through the D&N process and enact strategy.

7 Highlight

Social workers and parent advocates lead out on promoting a meaningful treatment plan, providing specialized and focused contributions to support client needs, which then make legal advocacy and family strengthening more successful. In

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each member shares in the responsibility of moving the case forward by using available tools with different case actors, with

9 Highlight

attorneys leading this work as “team lead” Page 42

1 Highlight

Median Percentage of Time Contributed by Contractors to Supporting a Client in Addressing their Needs

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Attorneys are keenly aware of critical junctures when a case can stall out, irrevocable decisions are being made, or clients are being set up for failure

3 Highlight

are poised to activate and advance the team in ramping up communication, research, treatment support, and resource connections to disrupt pitfalls at these critical junctures. They are also most adept at navigating legal language and court actors.

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Social Workers have experience with D&N treatment plans and know how to navigate the resources and services named. Th#5 Highlight enables treatment plan advocacy and engagement to be more successful with a variety of child welfare and treatment actor Page 44

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Advocating for the client is the third major activity undertaken by the team—and work

2 Highlight

where high-quality legal representation shines.

3 Highlight

Advocating for the client happens both in and out of court, and this activity is als

4 Highlight

where the team most utilizes experts and investigators

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WHAT Does It Mean to Advocate for the Client

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Hold State Actors Accountable:

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accountable to their burden, responsibilities, and obligations by leveraging available mechanisms

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Ensure Appropriate Fact Finding:

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Ensuring due process by

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identifying and obtaining experts,

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investigators, or witnesse#12 Highlight obtaining and reviewing records, plans, reports, or other pertinent documents; observing visitations, related cases, or other meetings to obtain information

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to inform strategy development

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Preparing for litigated hearings, including preparing the client themselves, and representing the client in court.

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Hearing representation and fact finding are largely led by the attorney, in collaboration with experts and investigators.

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Social workers and parent advocates provide vital support to attorneys in accomplishing these tasks, as

17 Highlight

It is holding the Department accountable outside of a court issue [e.g., service referral

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and it is also holding the court accountable to keeping the Department honest and doing their reasonable efforts a

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making sure that they are actually connecting parents with the services that are needed

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You are the gatekeepers Page 45

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HOW Does the Team Accomplish This in Practice? HOLD STATE ACTORS ACCOUNTABLE

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following up with the Division of Child Welfare to ensure timely delivery of services an#3 Highlight Ensuring the treatment plan is done i

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collaboration with the parent

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tailored to need

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dynamics of the child-parent relationship (e.g., age, bonding issues

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Calling in when court reports are biased towards the negative and not elevating what the parenting is doing well (i.

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advocating for k

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placements

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Confronting systemic racism through simply being present

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elevating concerns to the team for strategy development

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“I find myself fighting that [visitation] fight a lot fo Page 46

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HOW Does the Team Accomplish This in Practice? ENSURE APPROPRIATE FACT FINDING

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Investigators, Experts#3 Highlight To secure evaluations, assessments, and diagnoses that can be used in strategy

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testify to appropriate services and supports for redressing allegations

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ensure a full, multi-angle account of client allegations and needs.

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Attending/observing family engagement meetings, visitations, and related cases to bear witness to what actually happens

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and be a source of information to the team and

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the courts.

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Checking in with the client regularly and knowing what is happening in their lives as a form of “working intelligence” for attorneys.

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Reviewing extensive medical records

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legal reports

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documents that inform root causes of systems involvement and identifying strategies positioned to help redress.

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Obtaining and reviewing discovery

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Trails records, investigation reports#15 Highlight Family Safety and Risk Assessme

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hold “same-page” information as the Department

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Attorney drafting of discovery requests

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motions.

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Preparing the Client for Court

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ensuring they know strategy for

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this court session

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what is appropriate for this hearing versus another space) Page 47

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calling in when court reports are biased and not uplifting client strengths they observed

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Fact finding is led by the attorney, with the support of social workers who commonly take on documentation review and provide working intelligence to the team.

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Reminder Holding state actors accountable was a prime theme in qualitative narratives Page 48#1 Highlight How Frequently Does the Team Use Experts and Investigators? Importantly, use of experts and investigators is a strategy under ensuring appropriate fact finding,

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Parent Advocates

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find out what is really going on—

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barriers

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strengths—and

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knowledge and time necessary to review documentation

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accompany the client to meetings, creating deep sources of information for accountability, hearing preparation, and fact finding. Page 49

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I’ve had things like intellectual disability come to light and then I work with the attorney to adopt new things in the treatment plan and advocate for that i

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Just making sure we’re not missing something that is impeding our client’s ability.” Page 50

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comprehensively understand a client’s needs,

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to inform case strategy and amplify client voice.#3 Highlight Advocacy Support: Calling in systemic bias of the courts and of child welfare and

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advance

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socially responsive strategies

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ORPC model of interdisciplinary representation is

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model for systems change of child welfare proceedings. Page 56

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Office of the Respondent Parents’ Counsel (ORPC): Interdiscplinary Teams for Successful Client-Centered Representation Page 58

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complex case needs

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histories can require additional advocacy

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specialized support to

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trau

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case higher risk for family separation a Page 59#1 Highlight have disabilities, and/or who face extensive resourcing challenges related to housing, food, and economic security. In addition, social workers bring experience in navigating the child welfare system and intimate knowledge of Volume 7 that supports attorneys

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Department obligations

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options for tailored client support.

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Mental Health

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Disability:

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Trauma,

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Clients facing housing, food, and economic insecurity need additional support and resource connections to break cycles of systems involvement and poverty.

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Volume 7 Accountability:

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Cases where the Department is not fulfilling obligations

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require extensive monitoring

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diligence;

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especially true when inexperienced caseworkers are assigned#13 Highlight show what is possible in #14 Highlight build client confidence #15 Highlight ensuring that family voice leads in every step of the case. #16 Highlight Social and Structural Inequities: Page 60 #1 Highlight team model is best suited for complex cases #2 Highlight where social and structural inequities are rampant, #3 Highlight model can act as a “leveling up” factor #4 Highlight outcomes are more equitably achieved

Summary of Annotations Page 15 #1 Highlight shall limit the scope of their practice to those clients for whom they have the knowledge, skill, and resources to serve

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When additional knowledge and skills are required to address clients’ needs, the clinical social worker shall seek appropriate training, supervision, or consultation, or refer the client to a professional with the appropriate expertise.

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shall be accountable for all aspects of their professional judgment, behavior, and decision Page 16 #1 Highlight The clinical social worker shall maintain collaborative contacts with social work or other related professionals and make appropriate referrals#2 Highlight shall be knowledgeable about community services and make appropriate referrals Page 18 #1 Highlight shall use consultation on an as-needed #2 Highlight Clinical social workers shall maintain access to professional supervision and/or consultation.

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shall adhere to state and federal statutes and regulations regarding supervision and consultation in their states of practice

Yeah. Because Mom is dead. And by these fucks who won't even look them in the eye, beg forgiveness or apologize, let alone offer damages or repayment of fees, and then have audacity to combat them afterwards in court.

Absolutely illegal. No court order existed. No case even existed. And no consent in any way could possibly be argued to have been given.

Jesus Christ, THESE ARE DOCTORS AT JOHNS HOPKINS

So now no longer are they acting at the discretion of the state. They are the actors.

The first credentialed qualified assessment of diagnosed by an evaluator qualified to determine existence of such diagnoses

Lord of the flies. ....High school, in the Valley....in a soap opera ....in a world that exists as strip club hip hop music videos.

..................

I agree, starting with the staffers who are paid to actually do the job

Such as? ....but what you're doing is not punitive?

Did one abuser in your career ever say "I'm a horrible person"? So why are you saying this.

I could be no more convinced you are pathological and likely from the trauma of the job or otherwise and lost or never had capacity to perform the job. You are focused on the trauma, use it to disregard and justify not doing the job if you even know what the job is and the way you do it and why it is to be done that way and what the purpose and principles of it are.

Fucking scary the level of sickness

She almost succeeded in stealing and destroying a child and family and is unable to see how misplaced it is to request invitation to allow her access to the family and child.

Lack of grip and understanding of all the situations and importances at play. She does not "perhaps" be more thorough on protecting against the abusive parent scenario, in fact she will act outside the law to protect that. But she will "perhaps" try harder not to be that abuser herself.

Another sign of pathology. Lack of understanding of the situation, the what why and how of it, that her response is about her and not about them, it's her defending herself and justifing why she did what she did and will continue to do it.

Evidence of the pathology and cause in the agency and court

And where she has become the abuser of both children and parents

Or.....that there was.

Why do we have investigation and legal protocol? What's it's purpose? Why do we bother with it? Why don't we have tree limb justice, or have habeas corpus, or Bill of Rights which the people refused to enact the United States without?

"in fact"

Savior complex

Again, ARE WE SEEING THE PROBLEM YET??

ARE WE SEEING THE PROBLEM YET?

I MEAN JESUS CHRIST, WHO IS PLAYING MANAGER AND OVERSIGHT ROLE? IN EVERY COUNTY OF EVERY STATE

And no criminal charges made, no criminal case or investigation protocol

Unqualified dipshit social worker. Not a cop. Not a detective.

"from what I've heard" HALEY. FUCKING HALEY.

FUCKING FCS AND STATE ATTORNEY.

CHILD ABUSE....SEXUAL ABUSE!

Take off your clothes or we'll keep you locked up and we'll keep you from your parents

And the judge (and court appointed Respondent attorney) just listened and said ok? No review of absence to procedure and review of all probative facts and claims?

So they're siding with Kirkpatrick AND Hanna??

JUDGE - SERIOUS ISSUE

McLean - âre you saying "child doesn't want to talk to Dad" is GROUNDS?? Is that your argument?

Oh do you wish to claim something else as grounds? Homeless? Abuse? Ok, what's your evidence and what's respondents response?

A definition which state has no training on or qualifications

Removing children from suspected risk to a known risk

To look for, vs investigation of the facts.

Criminal rights vs civil rights

Notify the unqualified investigators who are also then given the authority and mandate to make accusations and provide the "expert" report

Frame, lie, and practice confirmation bias

And the root of the problem and chief abusers are revealed.

As well, a primary cause of Smith's and others pathology.

Frame

Do you, Cliff Calvin? Do you also know karate and know what bitches want?

Again, admission that there is no abuse or neglect and jurisdiction does not exist

Therefore, no abuse. Immediate red alarm to pack up shop, return the child, beg forgiveness, remove yourself, and close case. Within less than 24hrs.

Because you expertly know that any use of legs in crps means the diagnosis is negated?

Just like the omissions by FCS. No doubt in the GRID, the very first act of every case and every new Respondent attorney would be an immediate client interview and motion updating the facts of the petition

At the very least, the doctor just put all culpability on him. And also clearly destructed the possibility of Munchausen

Smith's brain: I've made up my mind and created a story before even beginning the investigating, so now as I'm listening and asking, can I use what she just said, how bout that, to prove the tale I've created, no can't use that or that or that, that contradicts that my story is true. ..... CONFIRMATION BIAS. Don't need a medical credential to be suspect of this.

Based on?.....no sound logical evidence based argument provided. Therefore, had decided prior to hearing or considering any evidence.

And what, even among the whitest affluent graceful, parent would not have "that problem". Is it not more of a "problem" the parents who do not have this "problem"

At a minimum, this correlation based evidence was on record

And this.

While we're all developing theories, this is a major suspect for the apparent discriminatory treatment

Any MD should therefore know they are unqualified to evaluate relative to a specialist.

They should also know then that it is real and the basics of how it presents, and therefore reasonably matched the child's behavior and parent's description.

And did they then order or otherwise with matching vigor, in their role as the legal authority expert and holder of accountability and director of behavior, compel the state to quickly and diligently complete there investigation and provide a duely competent report, recommendation, and evidence backed justification?.... Did the court publicly remind the state of the extreme invasion they have chosen to make and the seriousness and respect owed in seeing this through?

Not because of incompetent compliance to protocol and cherry picking and embellishment to report a false story

This is mass criminal abuse and kidnapping and deserves the full application of the law as such

What does that mean? ...meaning, draw conclusions with out necessary evidence? Would you ever say of someone, who opened 1000s of cases, but was known to have always diligently in estimated and supported those decisions with competent judicious investigation, consideration, and justification of all facts..."aggressive"?

So your argument is: if you're a parent, than 80% chance your a child abuser. ....it does not require even signing up for a first year statistics course to know the complete false logic of the application of statistics. Did you know that 100% of accidents occur when drivers are behind the wheel? Did you know that in 100% of Child abuse cases, a child is suspected of being abused?

Lying and egregious coercion. ....if you do that thing, I'll lock you up and consider stealing your child.

This seemed more likely, based on a shed of evidence and no qualified training to make such a determination, than 30yrs of records and a regular crps specialist care will you've never spoken to to get clarification

Suspecting a theory is fine. Refusing to incorporate evidence, or sources of evidence that could refute your hypothesis is critical malpractice

Precisely

And still you feel you know better this child, what's right, and refuse to consult with child's regular providers?

What?? So 1 or more crps unqualified, or even MD qualified, just 'felt'like the kids was full of shit and all an act. .... And why had not one single professional, whom both MDs as well as the investigating SS rep are expected to do, not made one call to the child's regular doctor and specialist if they are questioning his treatment?

Based on who's psychiatric QUALIFIED "beliefs".

So you read the records in a focused environment

Based on what? Your extensive crps training and experience, especially relative to a specialists orders. How is this different from Cliff Calvin believing he is the expert in all things

BY A SPECIALIST

Meaning what? Do you have necessary psych credentials and defending medical evidence based justification? Was she also wearing a blue shirt, a sad color, indicating abuse?

No mention of the fact this had been used historically and ordered by a specialist?

Double bind. ....such insanely poor logic argument and yet almost always used as justification it should be unlawful to use

She WAS heeding a medical professional's advice... THE SPECIALIST.... It was the unqualified medical "professional" "not heeding the medical professionals suggestions"

which she provided medical records and specialist supporting the fact

"Strange" based on what? Hansen's extensive training and practice experience in medicine and crps? Hansen's conclusion (distorted arrogance) that since SHE hadn't seen it before it must be "strange"

Constant with crps and parents story and provision of medical records

As determined by a licensed M.D. specialist for that disease

I say... and then what is "autonomy", it is the feeling and belief that one one can independently satisfactorily function, meaning>... sufficiently safely and able to otherwise "take" the damage of "hits" that may come and recover and "get back up"; empowered and able to control and manifest one's own life as they see fit, has the full capability regardless of it's nascent stage of development to seek out and also find, continually, their deepest truest wants, and as further wants are uncovered/found and can recruit and depend and provide on others understanding dependence is different than thoughtful chosen acceptance or recruitment of help; and is able to not allow fear/anxiety of chance of potential negative possibilities regularly intrusively irrationally control thoughts and well being, ...is able to understand fear of the negative unknown is not a monster, if anything a supportive arrow in the quiver, and will not be given continued knee jerk defensiveness but instead be harnessed for the values it supplies --but one of factors to consider in overall decision making with only the appropriate reasonable likelihood it possesses and an informant as to others minds you may have to contend with-, and, very importantly, an empowered understanding that one is not immune to anxiety but are unwaveringly capable of recognizing it soon enough, that you will give it no credence as you see it for malfunction it is, that you will not try to control it by "forcing" it to stop because 1) it cannot be forced to stop, no such strength exists, and any such attempt will magnify it 2) you understand such action is by consequence an attempt to make the fear true because you are not logically evaluating and understanding it for the distortion and cognitive bio malfunction it is, 3) you will not turn and shy away from it in fear, but gave it head on, interrogate it, and see what it has to say, and 4)understand that the antidote is to then walk away from it and let it do whatever it wants to do as you have no ability to influence it any further, if it wants to stay with you for now or forever or leave or whatever, then it will, or whatever, it's not your concern, you will return to focusing on your life and journey and wants, and if the topic of the anxiety is currently in the same subject matter area and path you are on for your own wants and journey, then you will continue the path seeking knowledge and facts and truth, not fearful fear directed speculation and/or sleep/health to repair/improve your "tools"

I say, synonymous with restricting of freedoms. ... Fits why perhaps the top reason or close to for people willing to die, go to war, become irate and combative, and are so injured and or enraged at the thought of rape or bullying/oppression by force