Extrasensory Perception ESP Introduction Although many of you reading this book, like myself, have few personal doubts that something like extrasensory perception is real, the effort to establish ESP as a scientific fact has been a continuous struggle the outcome of which still remains uncertain. Many subjects whose demonstrations had originally convinced researchers from the British Society for Psychical Research were later detected using bogus means to dupe these eminent scientists. Fascinated by their few successes, researchers continued undaunted in the midst of failures, criticism, and detected frauds. Joseph Banks Rhine in in a monograph entitled Extra-Sensory Perceptionwhich summarized results from his experiments at Duke University beginning in
Policy Aetna considers both fiberoptic endoscopy and videofluoroscopy medically necessary for evaluation of swallowing function. Fiberoptic endoscopic evaluation of swallowing FEES is the preferred test over videofluoroscopy in the evaluation of a swallowing disorder in any of the following conditions: Aetna considers portable modified barium swallow study MBSS; also known as videofluoroscopic swallowing study experimental and investigational because its clinical value has not been established.
Background Oropharyngeal dysphagia is usually either a primary abnormality related to structural aberrations of the oropharynx or a secondary manifestation of neuromuscular disease. Causes for dysfunctional swallowing are protean.
Both diagnosis and therapy of oropharyngeal dysphagia are based on functional assessment. Following the performance of a clinical examination, instrumental work-up includes evaluating specific aspects of swallowing function, judging the consequences of the swallowing dysfunction, and assessing factors that may be contributing to swallowing dysfunction.
Videofluoroscopy has long been viewed as the "gold standard" for evaluation of a swallowing disorder for the comprehensive information it provides. However, it is not very efficient and accessible in certain clinical and practical situations.
Fiberoptic endoscopic evaluation of swallowing FEES has been shown to be safe and effective for assisting in swallowing evaluation, and in therapy as a visual display to help patients learn various swallowing maneuvers.
In FEES, a flexible fiberoptic endoscope is introduced transnasally to the patient's hypopharynx where the clinician can clearly view laryngeal and pharyngeal structures.
The patient is then led through various tasks to evaluate the sensory and motor status of the pharyngeal and laryngeal mechanism. Food and liquid boluses are then given to the patient so that the integrity of the pharyngeal swallow can be determined.
Appropriate postural changes and swallowing maneuvers are attempted to detect problems and enable the examiner to make recommendations regarding optimal interventions to improve the safety and efficiency of the swallow, the advisability of oral feeding, and use of appropriate behavioral strategies that facilitate safe and efficient swallowing.
The most critical finding is aspiration, and the literature demonstrates that FEES is able to detect this finding with good sensitivity. Fiberoptic endoscopic evaluation of swallowing with sensory testing FEESST is an alternative to modified barium swallow evaluation of patients at risk for aspiration.
The procedure entails the passage of a specially equipped flexible endoscope into the oropharynx. The special equipment includes a sensory stimulator that allows quantification of stimuli, a television monitor, a video printer, and a videocassette recorder. Sensory evaluation is performed by administering pulses of air at sequentially increased pressures to elicit the laryngeal adductor reflex.
Motor evaluation is carried out by delivering various food items with different consistencies while factors such as oral transit time, inhibition of swallowing, laryngeal elevation, spillage, residue, condition of swallow, laryngeal closure, reflux, aspiration, and ability to clear residue, are monitored.
A randomized controlled clinical outcome study of FEESST by Aviv et al found no significant difference in rates of pneumonia in dysphagic patients evaluated with modified barium swallow and dysphagic patients evaluated with FEESST. The use of laryngopharyngeal sensory testing is controversial.
An evidence-based guideline on dysphagia from the Scottish Intercollegiate Guidelines Network SIGN, concluded that "[l]aryngopharyngeal testing has also been described but insufficient evidence was identified to recommend it".
Current clinical guidelines on stroke from the Royal College of Physicians recommend FEES or some other instrumental investigation to allow visualization of the pharynx in persons who have persistent dysphagia.
Bockler noted that although FEES has been established as a valid procedure in instrumental evaluation of swallowing even in young children, the significance of the endoscopic method on infants has not yet been fully clarified.
These researchers evaluated FEES in infants by focusing on its feasibility and limits. A total of 27 infants from a neuropediatric hospital presented for FEES were included in this analysis.
In 24 of the 27 infants information about swallowing pathology could be obtained. Silent aspiration of saliva Penetration Aspiration Scale PAS level 8 or silent deep penetration of test diets to the level of the glottis PAS level 5 presented in 10 children and overt deep penetration of test diets in 3 children.
In no case a sufficient insight into the subglottis or trachea could be obtained. Therefore a differentiation of silent deep penetration and aspiration of test diets was impossible.
As a consequence of the FEES results, probe and diet management was changed in 7 children. The procedure was limited in terms of providing direct evidence on aspiration in cases of deep penetrations of test diets.Studies of forage and/or grass feeding of cattle versus grain finishing have been conducted in varying regions throughout the world but generalization of these results to .
Aeromedical Factors. As a pilot, it is important to stay aware of the mental and physical standards required for the type of flying done. This page provides information on medical certification and on aeromedical factors related to flying activities. Assignment 1: "Sensory Perceptions" Can you really trust your senses and the interpretation of sensory data to give you an accurate view of the world?
Describe and discuss the accuracy and the weaknesses of the human senses as they pertain to thinking in . Factors Contributing To Accuracy Of Sensory Data.
Assignment 1: "Sensory Perceptions" Can you really trust your senses and the interpretation of sensory data to give you an accurate view of the world?Describe and discuss the accuracy and the weaknesses of the human senses as they pertain to thinking in general and to your own thinking in particular..
Write a two to three (2–3) page. The Medical Services Advisory Committee (MSAC) is an independent non-statutory committee established by the Australian Government Minister for Health in Three 3 Factors Contributing To The Accuracy Of Sensory Data.
Assignment 1: "Sensory Perceptions" Can you really trust your senses and the interpretation of sensory data to give you an accurate view of the world?Describe and discuss the accuracy and the weaknesses of the human senses as they pertain to thinking in general and to your own thinking in particular.