Chronic fatigue syndrome is a common chronic health condition, especially for women, occurring across ethnic groups. Earlier findings suggesting that CFS is a syndrome primarily affecting white, middle-class patients were not supported by our findings.

Background: Chronic fatigue syndrome (CFS) is defined by symptoms and disability, has no confirmatory physical signs or characteristic laboratory abnormalities, and the etiology and pathophysiology remain unknown. Difficulties with accurate case ascertainment contribute to this ignorance.

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The COVID-19 pandemic, resulting from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has severely impacted the population worldwide with a great mortality rate. The current article reviews the literature on short-and long-term health consequences of prior epidemics and infections to assess potential health complications that may be associated with post-COVID-19 recovery. Past research on post-epidemic and postinfection recovery has suggested that such complications include the development of severe fatigue. Certain factors, such as the severity of infection, in addition to the 'cytokine storm' experienced by many COVID-19 patients, may contribute to the development of later health problems. We suggest that the patterns observed in past epidemics and infections may re-occur in the current COVID-19 pandemic.

Oxford Houses are democratic, mutual help-oriented recovery homes for individuals with substance abuse histories. There are more than 1200 of these houses in the United States, and each home is operated independently by its residents, without help from professional staff. In a recent experiment, 150 individuals in Illinois were randomly assigned to either an Oxford House or usual-care condition (i.e., outpatient treatment or self-help groups) after substance abuse treatment discharge. At the 24-month follow-up, those in the Oxford House condition compared with the usual-care condition had significantly lower substance use, significantly higher monthly income, and significantly lower incarceration rates.

Problem statement: Several investigators have indicated that case definitions for Chronic Fatigue Syndrome (CFS) are characterized by vaguely worded criteria that lack operational definitions and guidelines. The most widely used CFS case definition is the Fukuda et al. criteria, which uses polythetic criteria (i.e., patients are only required to have four out of a possible eight symptoms). Yet two of these eight symptoms (post-exertional malaise and memory/concentration problems) are an essential feature of this illness and the Fukuda et al. criteria do not require that these symptoms be present among all patients. Significant methodological problems could occur if investigators in different settings recruit samples with different percentages of these core symptoms. In contrast, the Canadian clinical case definition does require specific ME/CFS symptoms such as post-exertional malaise and memory/concentration problems. The provision of operationally explicit, objective criteria on specific key symptoms might reduce criterion variance as a source of unreliability. In addition, the use of structured interview schedules will ensure that symptoms are assessed in a consistent way across settings. Conclusion/Recommendations: In this article, we specified explicit rules for determining whether critical symptoms meet ME/CFS criteria using a revised Canadian case definition and a questionnaire has been developed to assess core symptoms. It is hoped that these developments will lead to increased reliability of this revised Canadian case definition as well as more frequent use of these criteria by investigators.